2019-924-E Planning - Harris Bros electrical outlet repair

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DocuSign Envelope ID:8A5F8010-951 D-410A-B360-CA37BA1 E9CA4 '`� 17 CERTIFICATE OF LIABILITY INSURANCEFDATE12/12/019 Y1 12/12/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE:P.O.BOX 328 IA CNNo Ex!:888-333-4949 Fw c xo:507-446-4664 OWATONNA,MN 55060 E-MAIL ADDRESS:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 252-856-0 INSURER B:FEDERATED SERVICE INSURANCE COMPANY 28304 HARRIS BROTHERS ELECTRIC AND CONTROLS,INC. INSURER C: 2712 HILLSBOROUGH RD DURHAM,NC 27705-4044 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:216 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY EXP TYPE OF INSURANCE ADDL SUBR POLICY NUMBER LIMITS LTR INSR WVD MMIDD/VVVV MM/DDIYYYV X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 RENTED CLAIMS-MADE OCCUR PREMISESOE.occurrence) $100,000 ME EXP(Any one person) $5,000 A Y N 6048918 07/14/2019 07/14/2020 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 XFZ7 POLICY El JEST ❑LOC PRODUCTS-COMP/OP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident) X ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED A AUTOS N N 6048918 07/14/2019 07/14/2020 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per denia X UMBRELLA LABX OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS-MADE Y N 6048919 07/14/2019 07/14/2020 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION X PERSTATUTE OTH- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETORIPARTNEWEXECUTIVE E.L.EACH ACCIDENT $1,000,000 B OFFICERIMEMBER EXCLUDED' N I A N 6048920 07/14/2019 07/14/2020 (Mandatory in NHI E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe untler DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. CERTIFICATE HOLDER CANCELLATION 252-856-0 2160 ORANGE COUNTY PLANNING&INSPECTIONS DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HILLSBOROUGH,NC 27278-8181 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD