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2023-166-E-AMS-Siemens Industry-Southern Human Services Administrative Correct to Change Order 01
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2023-166-E-AMS-Siemens Industry-Southern Human Services Administrative Correct to Change Order 01
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Last modified
4/20/2023 3:45:19 PM
Creation date
4/20/2023 3:45:13 PM
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Contract
Date
4/18/2023
Contract Starting Date
4/18/2023
Contract Ending Date
4/20/2023
Contract Document Type
Contract
Amount
-$2,000.00
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ACORD 101 (2008/01) <br />The ACORD name and logo are registered marks of ACORD <br />© 2008 ACORD CORPORATION. All rights reserved. <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER:FORM TITLE: <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY <br />CARRIER NAIC CODE <br />POLICY NUMBER <br />NAMED INSURED <br />EFFECTIVE DATE: <br />MARSH USA, INC. <br />2 2 <br />SIEMENS INDUSTRY, INC.1000 DEERFIELD PARKWAYBUFFALO GROVE,IL 60089-4513 <br />25 Certificate of Liability Insurance <br />CN102147003 <br />Morristown <br />RE: JOB NO. N/A <br />COUNTY OF ORANGE; ASSET MANAGEMENT SERVICES IS INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL LIABILITY AND AUTOMOBILE LIABILITY INSURANCE <br />POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NON-CONTRIBUTORY INSURANCE TO THE EXTENT THAT A CLAIM <br />ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE INSURED BUT ONLY WITH RESPECT TO ALL WORK <br />PERFORMED BY AND ON BEHALF OF THE NAMED INSURED, SIEMENS INDUSTRY, INC. FOR CERTIFICATE HOLDER UNDER CONTRACT. <br /> IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP <br />TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. <br />DocuSign Envelope ID: 0E0D62F3-875B-49B3-9518-B1702B962423
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