2015-519-E AMS - Siemens Industry, Inc. for annual HVAC Agreement

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DocuSign Envelope ID: C9BD830D-9399-4949-A8DC-52FA23465CE6 DocuSign Envelope ID:3CB53A1D-C04F-4B51-913A-A5ED432F87BC AC40® CERTIFICATE OF LIABILITY INSURANCE DATE 02600fDD/YYYY} 09/2612414 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 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 endorsement(s). PRODUCER CONTACT MARSH USA,INC. NAME: 445 SOUTH STREET` PHONE FAX Not: MORRISTOWN,NJ 07960-6454 EMAIL ADORE 3: INSURERS AFFORDING COVERAGE NAIC k 100120-6-7BA-SBTi-14115 228 Rentas NOC60 _ INSURER A,HDI•Gerling America Insurance Company 41343 INSURED SIEMENS INDUSTRY,INC.INCLUDING INSURER 8:The Travelers Indemnity Company 25658 - BUILDING TECHNOLOGIES DIVISION INSURER C:The Charter Oak Fire Insurance Company 25615 1000 DEERFIELD PARKWAY INSURER D:Ta elers Property Casualty CO.of America 25674 BUFFALO GROVE,IL 60089-4513 — — ----- — — INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: NYC•006752385-02 REVISION NUMBER: 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. ILTR TYPE OF INSURANCE ADD SUER D POLICY NUMBER MMIDIDNEYY POLICY M YY LIMITS A GENERAL LIABILITY GLDI 1 10106 1010112014 1010112015 EACH OCCURRENCE $ 1,000,060 X DAMAGE TO RE TED 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ _ CLAIMS-MADE EX I OCCUR MED EXP(Any one person) $ 100,000 PERSONAL&ADV INJURY $ 1,000,006 _GENER_L_A AGGREG_A_TE__ S 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/Op AGO $ INCL X POLICY PRO- LOC $ D AUTOMOBILE LIABILITY TC2JCAP7440L34A14 1010112014 1010112013 COEa acMB ci der t INED SINGLE LIMIT 2,000,000 X ANY AUTO BODILY INJURY(Per person) S NIA X ALL UTOS ED SCHEDULED AUTOS BODILY INJURY(Per accident) $ NIA X HIRED AUTOS x AUTOS PeO e accident) $ �N/A UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR Id CLAIMS-MADE AGGREGATE $ DEO 1 1 RETENTION$ $ C WORKERS COMPENSATION TG20UB744OL27114(AOS) 1010112014 1010112015 rrC$TATU- OTH- AND EMPLOYERS'LIABILITY TORY B ANY PROPRIETORIPARTNERIEXECUTWE Y i N TRKU87440L28314(AZ,fr1A,OR&WI) 10/0112014 1010112015 1,066,000 E.L.EACH ACCIDENT $ D OFFICERIIAEMBER EXCLUDED? N NIA TWXJUB744OL3381A OH 8 WA 10101/2014 10/0112015 1,000,000 (Mandatory in NH) ( ) E,L.DISEASE•EA EMPLOYE $ It yes,describe under ""$500K LIMIT 1$500K SIR""' 1,000,006 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ L_ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more apace is required) RE JOB N0.NIA a SEE ATTACKED CERTIFICATE HOLDER CANCELLATION COUNTY OF ORANGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ASSET MANAGEMENT SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 600 NC HIGHWAY 86 N ACCORDANCE WITH THE POLICY PROVISIONS. HILLSBOROUGH,NC 27278 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee 3 ,a ur oeoh: .+a t�.uw Ire O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD