2019-391-E AMS - Siemens Cedar Grove Panel (2)

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DocuSign Envelope ID: DAFC7BCO-27FF-4433-AC79-DA33894C5C89 HATE(MMIDDIYYYY) AcvRD� CERTIFICATE OF LIABILITY INSURANCE fl911912018 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 rights to the certificate holder in lieu of such endorsement{s). PRODUCER CONTACT MARSH USA,INC. NAME: PRONE 445SOUTH STREET FAX o MORRISTOWN,NJ 07960-6454 EMAIL ADDRESS: _ INSURE%S AFFORDING COVERAGE NAIC 4 100129-SBT--18119 228 Rentas NOC60 INSURER A:HDI Globai Insurance Company 41343 INSURED INSURER R:Travelers Pr Casualty Co.of America 25674 SIEMENS INDUSTRY,INC. BUILDING TECHNOLOGIES INSURERS:The Travelers Indemnity Co an 25658 1000 DEERFIELD PARKWAY INSURER D BUFFALO GROVE,IL 60089 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-009196547-11 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. TYPE OF INSURANCE ADDL SUPOLICY EFF POLICY EXP LTR D POLICY NUMBER MMIDDIYYYY1 (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY GLD11101-i0 1010112018 1010112019 EACH OCCURRENCE S 1,000,000 DA GE TO RENTER CLAIMS-MAOE I X J OCCUR PREMISES Ea9c% enoe $ 1,000,000 -- - MED E]P[AM— ersan $ 100,000 PERSONAL s ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY❑IE° LOC PRODUCTS-COMPIOPAGG $ INCL OTHER: $ B AUTOMOBILE LIABILITY TC2J-CAP-7440L34A-18 10/0112018 10/01/2019 CEe accOMBINED SINGLE LIMITidenl $ 2,000,000 _ X ANY AUTO BODILY INJURY(Per person) $ NIA X OWNED SCHEDULED BODILY INJURY(Per accident) $ ITA AUTOS ONLY AUTOS _ X HIRED x NON-OWNED PROPERTY DAMAGE $ --NIA AUTOS ONLY AUTOS ONLY sccidenl UMBRELLA LIAR OCCUR I EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEp I I RETENTION S $ B WORRERSCOMPENSATION TC2J-UB-8049X508.18(ADS) 1010112018 I0112019 X STA U E ERH _ C AND EMPLOYERS'LIABILITY YIN TRK-UB-8049X51A-18{AZ,MA,OR,WI} 101OW018 10MI2019 -- - ANYPROPRIETORIPARTNERIEXECUTIVE E-L-EACH ACCIDENT $ 1,000,000 B OFFICE ERE](CLUDED7 NIA TWXJ-UB-744OL338.18 OH&WA 118 10101/2019 (Mandalury wy in in NH) � � 0101I20 E.L-DISEASE-EA EMPLOYEE $ 1,000,000 II yes,describe under "'°"'$540K LIMIT I$500K SIR—,, 1,000,000 DESCRIPTION OF OPERATIONS below E-L-DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,AddillataI Remarks Schedule,in ay be attached I more space Is requl red I RE:JOB 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 M NO HIGHWAY 86 N ACCORDANCE WITH THE POLICY PROVISIONS. HILLSBOROUGH,NO 27278 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee --NNko,%A-o at C 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(21316103) The ACORD name and logo are registered marks of ACORD