Orange County NC Website
DocuSign Envelope ID:51666290-2665-4AD9-BDE1-8BEDF029CE66 <br /> '`� O CERTIFICATE OF LIABILITY INSURANCEFDATE07112/019 Y1 <br /> 07/12/2019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS <br /> CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR <br /> PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If <br /> SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br /> certificate does not confer rights to the certificate holder in lieu of such endorsements. <br /> PRODUCER CONTACT <br /> CLIENT CONTACT CENTER <br /> FEDERATED MUTUAL INSURANCE COMPANY <br /> HOME OFFICE:P.O.BOX 328 IA CNNo Ex!:888-333-4949 Fw c xo:507-446-4664 <br /> OWATONNA,MN 55060 E-MAIL <br /> ADDRESS:CLIENTCONTACTCENTER FEDINS.COM <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 <br /> INSURED 252-856-0 INSURER B:FEDERATED SERVICE INSURANCE COMPANY 28304 <br /> HARRIS BROTHERS ELECTRIC AND CONTROLS,INC. INSURER C: <br /> 2712 HILLSBOROUGH RD <br /> DURHAM,NC 27705-4044 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:203 REVISION NUMBER:0 <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS <br /> AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR POLICY EFF POLICY EXP <br /> TYPE OF INSURANCE ADDL SUBR POLICY NUMBER LIMITS <br /> LTR INSR WVD MMIDD/VVVV MM/DDIYYYV <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> RENTED <br /> CLAIMS-MADE ❑X OCCUR PREMISESOE.occurrence $100,000 <br /> ME EXP(Any one person) $5,000 <br /> A N N 6048918 07/14/2019 07/14/2020 PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> XFZ7 POLICY El JEST ❑LOC PRODUCTS-COMP/OP AGO $2,000,000 <br /> OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br /> Ea accident) <br /> X ANY AUTO BODILY INJURY(Per person) <br /> OWNED AUTOS ONLY SCHEDULED <br /> A AUTOS N N 6048918 07/14/2019 07/14/2020 BODILY INJURY(Per accident) <br /> HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY Per denia <br /> X UMBRELLA LABX OCCUR EACH OCCURRENCE $5,000,000 <br /> A EXCESS LIAB CLAIMS-MADE N N 6048919 07/14/2019 07/14/2020 AGGREGATE $5,000,000 <br /> DED I I RETENTION <br /> WORKERS COMPENSATION X PER STATUTE OTH- <br /> AND EMPLOYERS'LIABILITY Y/N ER <br /> ANY PROPRIETORIPARTNEWEXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> B OFFICERIMEMBER EXCLUDED' N I A N 6048920 07/14/2019 07/14/2020 <br /> (Mandatory in NHI E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe untler <br /> DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> 252-856-0 2030 <br /> ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH,NC 27278-8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> © 1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />