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ACC—PRQY CERTIFICATE OF LIABILITY INSURANCE <br />t*_� <br />DATE(MM/DD/YYl'Y) <br />1 9/6/2023 <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 <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR 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. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Meadowbrook Insurance Agency of Saginaw <br />5311 Hampton Place <br />9• <br />Saginaw MI 48604 <br />License#: PC779010 <br />CONTACT <br />Lisa Stoner <br />PHONE Fes( <br />989-921-5308 A/c No: 989-60N145O8 <br />E-MAIL <br />ADDRESS, Istoner@meadowbrook.com <br />INSURERS AFFORDING COVERAGE <br />INSURER A; Nautilus Insurance Com an <br />INSURED DORE&AS•02 <br />Dore &Associates Inc. <br />P.O.Box 338 <br />Bay City, Mi 48707 <br />INSURERB: MichI an Millers Mutual Insurance Com an <br />INSURERC: Travelers Indemnity Company <br />25658 <br />INSURER D : Continental Insurance Company <br />35289 <br />INSURER E : <br />INSURER F : <br />GUVERAGES CERTIFICATE NUMBER:724509528 REVISION NUMBER' <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, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLIO EFF <br />MMlDDYlYYXYPI' <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />F-17 <br />CLAIMS-MADE OCCUR <br />ECP2035829 <br />9/16/2023 <br />9/16/2024 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMAGE TO RENTEU— <br />PREMISES lEa occurrence) <br />S 100,000 <br />X <br />MED EXP (Any one person) <br />S 5,000 <br />10,000 <br />PERSONAL & ADV INJURY <br />_ <br />$ 2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY D PRO- <br />JECT LOC <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$ 2.000,000 <br />$ <br />OTHER: <br />I <br />B <br />AUTOMOBILE <br />LIABILITY <br />V0513225 <br />1217/2022 <br />12/7/2023 <br />Ee aBINEDISINGLE LIMIT <br />$1,000,000 <br />ANY AUTO <br />BODILY INJURY (Per person) <br />S <br />JX <br />OWNED SCHEDULED <br />AUTOSONLY AUTOS <br />BODILY INJURY Per accident <br />( )HIRED <br />$ <br />X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />Per accident <br />$ <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />FFX2035830 <br />9/1612023 <br />9/16/2024 <br />EACH OCCURRENCE <br />$ 5.000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />$ 5,000,000 <br />DED F7RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANYPROPRIETOR/PARTNERIEXECUTIVE <br />OFFICERIMEMBEREXCLUDED7 a <br />N/A <br />6KUBAN93460-1-23 <br />5/13/2023 <br />5/13/2024 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />D <br />Leased & Rented Equip <br />C7039508524 <br />5/26/2023 <br />5/26/2024 <br />$380,000 Limit <br />$1,000 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached It more space Is required) <br />I ­_1n <br />BIDDING PURPOSE ONLY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />U 1958-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />