2020-208-E AMS - Siemens Library compressor replacement

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DocuSign Envelope ID: 15050DBC-5185-4A7C-BF51-67322707D03F A��® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 09/19/2019 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: __-- 445 SOUTH STREET PHONE fFAIC.Nol: MORMSTOWN,NJ 07960-6464 EMAIL ADDRESS: INSURE MS)AFFORDING COVERAGE NAIC# 100129-SB7-19120 228 Realas ROC60 INSURER A.HDI Glohal Insurance Compan 44343 INSURED SIEMENS INDUSTRY,INC. INSURER Ia.Tra elem Property Casualty Co.of America 25674 1000 DEERFIELD PARKWAY INSURER C;The Travelers Indemnity Company Gompany 2565B BUFFALO GROVE,IL 60089-4513 INSURER D; INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-009196547-15 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. IN SR TYPE OF INSURANCE DD UBR POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MMIDDfYYYY MMIDDIYYYY A X COMMERCIALGENERALLIABILITY GLD1110111 1010112019 10101/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ! ::.__f OCCUR DAMAGE TO RE14TED 11000,000 PREMISES Eao=rrence $ MED EXP(Any one person) $ 100,000 PERSONAL 8 ADV INJURY $ 1'0w'()00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY1:1 PROJEC7 LOC PRODUCTS-COMPIOPAGG $ INCL OTHER: $ H AUTOMOBILELlABILITY TC2J•CAP-7440L34A-19 10101/2019 IOMI12020 COaBINEDDISINGLE LIMIT $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ NIA X U SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Par accident] $ NIA AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ WA AUTOS ONLY AUTOS ONLY Per accident S UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS4AADE AGGREGATE $ DE❑ RETENTION$ $ B WORF(ERSCOMPENSAT[ON TC2J UB 8049X508 19{AQS} 1 X PER OTH- C AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE IRK UB 8049X51A 19{AZ,MA,Oft,WI} i0N0112019 10/0112020 1,000,000 B OFFICERIMEMBEREXCLUDED? NIA E L.EACH ACCIDENT $ IMandatory In NH} TWXJ-UB-744OL338.19(OH&WA) t010112019 10/01/2020 E.L.DISEASE-EA EMPLOYEE $ 1,090,coo If yes,describe under """$500K LIMIT 1$500K SIR""' 1,,009,00D DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS VEHICLES(ACORD 101,AddIfflarrat.42amuNwfickoft own d If moro space Is requlred) RE:JOB NO,NIA L.. SEE ATTACHED OCT 0 2 2319 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 _�+k auaea► 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD