2022-287-E-AMS-Harris Bros. Electric & Controls-Add outlets for office 1 _2 and hallway

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DocuSign Envelope ID: 196188C7-COEC-4F9B-94C4-37A4628FFD13 A a CERTIFICATE OF LIABILITY INSURANCEFDATE06/08/D/YIYY) 6/08/2022 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 ri hts to the certificate holder in lieu of such endorsements. PRODUCER CONTACT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY NAMEPHONE FAX HOME OFFICE: P.O.BOX 328 AIc No Est:888-333-4949 AiC No:507446-4664 OWATONNA,MN 55060 ADDRIESS,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:267 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 TYPE OF INSURANCE DDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTD CLAIMS-MADE LFX'7�j OCCUR PREMISES Ea oc uE ence $100,000 MED EXP(Any one person) $5,000 A Y N 6048918 07/14/2022 07/14/2023 PERSONAL&ADVINJURV $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY El ❑LOC PRODUCTS-COMP/OP AGG $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 07/14/2022 07/14/2023 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per a«itlent X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LAB CLAIMS-MADE N N 6048919 07/14/2022 07/14/2023 AGGREGATE $5,000,000 DED RETENTION WORKERS COMPENSATION X PER STATUTE OTH- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOWPARTNEWEXECUTIVE E.L.EACH ACCIDENT $1,000,000 B OFFICERWEMBEREXCLUDED? NIA N 6048920 07/14/2022 07/14/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E. DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) PROJECT # 22-5850CA PROJECT NAME AND ADDRESS: 131 W MARGARET LANE 131 W MARGARET LN HILLSBOROUGH , NC 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. CERTIFICATE HOLDER CANCELLATION 252-856-0 267 0 ORANGE COUNTY 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(2016/03) The ACORD name and logo are registered marks of ACORD