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<br /> A�Q� � DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 0813012017
<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 certiFcate 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 condltions 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 CONTACT
<br /> MBfSh U$A I(iC. NAME:
<br /> 100 Norih Tryon Street,Suile 3600 A/CNNo ext: ac No:
<br /> Charlotte,NC 28202 E-MAIL _
<br /> ADDRESS:
<br /> INSURER S)AFFORDING COVERAGE NAIC#
<br /> 22830-PXSWG9/1-17-18 GAWX iNsuReR a:Libert Mutual Fire Insurance Com an 23035
<br /> INSURED INSURER B:N/A N�A
<br /> Duke Energy Corpora6on
<br /> Incl.Piedmont Natural Gas Company INSURER C:
<br />, 550 S.Tryon SVeet
<br />' DEC4O-C INSURERD:
<br /> Charlotte,NC 2B2O2 INSURER E:
<br /> INSURER F:
<br />' COVERAGES CERTIFICATE NUMBER: ATL-004586677-06 REVISION NUMBER: 4
<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. NOTIMTHSTANDING 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 7ypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR POLICYNUMBER MM/DD MM/DD/YYYY
<br /> COMMERCIAL GENERAL LIABILITY 'Self Insured-See Below' EACH OCCURRENCE S
<br /> CLAIMS-MADE �OCCUR DA AG TO NTED
<br /> PREMISES Ea occurrence S
<br /> X Self Insured MED EXP(Any one person) $
<br /> PERSONAL&ADV INJURY $
<br /> GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $
<br /> POLICY❑PR� �LOC PRODUCTS-COMP/OP AGG $
<br /> JECT
<br /> OTHER: $
<br /> A AUTOMOBILELIABILITY AS2-641-443955-037(AOS) O9/Ol/2017 0910112018 COMBINEDSINGLELIMIT $ 'I,OOO,OOO
<br /> Ea accident
<br /> ANY AUTO 'Self Insured(NC,SC, BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED OH,KY,IN,FL,TN)' BODILY INJURY(Per accident) 5
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-0V4NED 'See Below' PROPERN DAMAGE §
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> X SPECIFIED g
<br /> UMBRELLA LIAB OCCUR 'Self Insured-See Below� EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ S
<br /> A WORKERSCOMPENSATION WC2-641-443955-027(AOS) 09/O1I2018 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE Y�N 'Self insured(NC,SC,IN,KY, 2,000,000
<br /> OFFICER/MEMBEREXCLUDED? � N/A E.L.EACH ACCIDENT $
<br /> (Mandatory in NH) OH,FL,TN)-See Below' E.L.DISEASE-EA EMPLOYEE 5 2,000,000
<br /> If yes,describe under 2,000,000
<br /> DESCRIPTION OF OPERATIONS beiow E.L.DISEASE-POLICY LIMIT 5
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedute,may be attached if more space is required)
<br /> Evidence of insurance.
<br /> General Liability: The insured is self insured for$1,000,000 each occurrencel$1,000,000 Personal&AdverUsing Injuryl$2,000,000 general aggregatel$2,000,000 Products Completed Operations. Automobile
<br /> Liability:The insured is self-insured for$1,000,000 each occurrence!$1,000,000 aggregate in ihe states listed above. Workers CompensationlEmployers Liability:The insured is Self Insured in the states shown
<br /> above with EL limit of$1,000,000 Each Accident,$1,000,000 Disease-each employee,$1,000,000 Disease-policy limit. Excess Liability: The insured is self insured for$1,000,000 each occurrencel$1,000,000
<br /> aggregate.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Duke Energy Corporation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> including Piedmont Natural Gas THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 550 South Tryon Street,DEC40-C ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Charlotte,NC 28202
<br /> AUTHORIZED REPRESENTATNE
<br /> of Marsh USA Inc.
<br /> Karen A.Burke �p.�j� ¢c.. �
<br /> OO 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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