2017-353-E AMS - Siemens Industry, Inc. for HVAC service

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DocuSign Envelope ID:37AF196F-70A9-40BD-BDEO-4E0A39EC4A40 DATE(MWOD/YYYY) AC RD CERTIFICATE OF LIABILITY INSURANCE E 09/1912016 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). CONTACT i PRODUCER NAME: ---" MARSH USA,INC. PHONE I FAX 445 SOUTH STREET _OVC- Ext) (A/C,No)_" MORRISTOWN,NJ 07960-6454 E-MAIL INSURER(SAFFORDING COVERAGE NAIC k 100129-SBT-16117 Recites- NOC60 INSURER A:HDI Global Insurance Company 41343 228 - - — ---- -- INSURED INSURER e:The Travelers Indemnity Company 25658 INDUSTRY,INC. BUILDING TECHNOLOGIES INSURER c:Travelers Property Casualty Co.of America 25674 1000 DEERFIELD PARKWAY INSURER off_ — — BUFFALO GROVE,IL 60089 INSURER£ INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-007192659-06 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. L7R-------- IADDL SUER --�--- POLICY EFF POLICY EXP I LIMITS TYPE OF INSURANCE fINs WyD POLICY NUMBER ,JMMwaD)YYYY) (MMIOD/YYYY1 A X COMMERCIAL GENERAL LIABILITY r GLD1110108 10101/2016 10/01/2017 EACH OCCURRENCE $ 1,000,000 I DAMAGE TO RENTED 1000000 CLAIMS-MADE pi OCCUR PREMISES(Ea occurrence) $ — MED EXP(Any one person) $ 100,000 PERSONAL&ADV INJURY $ 1,000,000 —• -- ---— GENERAL AGGREGATE $ 10,000,000 GE 'L AGGREGATE LIMIT APPLIES PER. — X POLICY I jE7 LOC INCL PRODUCTS-COMP/OP AGG $ _� $ C AUTOMOBILE LIABILITY TC2JCAP7440 OTHER 10(0112016 1010112017 COMBINED SINGLE OMIT $ 2,000,000 L34A16 �>;a accident') _MIT $ ---- X ANY AUTO BODILY INJURY(Per person) $ N/A x __ —..—._..___........___. ALL OWNED _ SCHEDULED BODILY INJURY(Per accident) 3 NIA AUTOS _ AUTOS PROFERTY DAMAGE X X NON-OWNED PROP accident) _ .—. $ N/A —HIRED AUTOS AUTOS ; UMBRELLA LIAB __ OCCUR EACH OCCURRENCE i$ EXCESS LIAB CLAIMS-MADE AGGREGATE I DED I RETENTION$ TC2JU87440L27116(AOS) 10/01/2016 10/01/2017 X PER II II orH- $ C WORKERS COMPENSATION STATUTE L_1 FR___AND EMPLOYERS'LIABILITY Y/N TRKUB7440L28316(AZ,MA,OR 8 WI) 10/01/2016 10101/2017 F,L EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE I N I N/A C OFFICER/MEMBER EXCLUDED? TWXJUB7440L33816(OH 8 WA) 10/0112016 10/01/2017 E L DISEASE-EA EMPLOYEE $ ,0007)00 If yes,d Mandatory in NH) 1,000,000 II yes desera N under '—$500K LIMIT i$500K SIR"'" E L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mare space Is required) RE.106 NO NIA SEE ATTACHED 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 66 N ACCORDANCE WITH THE POLICY PROVISIONS. HILLSBOROUGH,NC 27278 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Maneshi Mukherjee -S't,-a,■.A..an ,A -k-- 4- ( 1 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD