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AC" V CERTIFICATE OF LIABILITY INSURANCE
<br />Amm2osD�)
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder In Ilou of such dndorsement s .
<br />PRODUCER
<br />MARSH USA, INC.
<br />445 SOUTH STREET
<br />MORRISTOWN, NJ 079606454
<br />CONTACT Marsh USA, Inc,
<br />NAME
<br />PHONE(973)401.8000 A/C No:
<br />EMAIL
<br />INSURERS AFFORDING COVERAGE NAIC If
<br />INSURER A: HDI Global Insurance Company 41343
<br />100129-SBT-48/19 610 Kapual N0060
<br />INSURED
<br />SIEMENS INDUSTRY, INC.
<br />INSURER B TfaVSIafS Pf0 ri Caeuall C0.0(AmeriCa 25674
<br />INSURER c: The Travelers Indeninly Company 25658
<br />BUILDING TECHNOLOGIES
<br />1000 DEERFIELD PARKWAY
<br />BUFFALO GROVE, IL 60089
<br />INSURER D
<br />INSURER E
<br />AGGREGATE LIMIT APPLIES PER:
<br />JECOT LOC
<br />INSURER F:
<br />PRODUCTGG $ INCLOTHER:
<br />COVERAGES CERTIFICATE NUMBER: NYC -009188797-16 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />IIN,TR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBRI
<br />"D
<br />POLICY NUMBER
<br />pOUCY EFF
<br />MMIODII'1'YV
<br />POLICY EXP
<br />MI DNYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />GLD11101-10
<br />10/01/2018
<br />1010112019
<br />_
<br />EACH OCCURRENCE $ 1,000,000
<br />PREM Ea occurrence $ 1,000,000
<br />GEN'L
<br />MED EXP (Any one person) $ 100,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />JECOT LOC
<br />GENERAL=$10,000,000$ 10,000,000POLICY
<br />PRODUCTGG $ INCLOTHER:
<br />$B
<br />NX
<br />OMOBILE LIABILITY
<br />ANY AUTO
<br />SCHEDULED
<br />ONLY AUTOS
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />TC2JCAP-74 OL 4A-18
<br />10101/2016
<br />10/01/2018
<br />OMBINET"`� $ 2000 WOE c
<br />BODILY INon) $ N/AOWNED
<br />BODILY INltlart $ N/qAUTOS
<br />PROPERT MMAGE $ NIA
<br />Per accident)
<br />8
<br />X
<br />UMBRELLALIAS L X
<br />[..CESS UAB I
<br />OCCUR
<br />I CLAIMS -MADE
<br />CUD1110210
<br />10101/2018
<br />10/01/2019
<br />EACHOCCURRENCE $ 1,000,000
<br />AGGREGATE $ 1,000,000
<br />DED RETENTION $
<br />$
<br />B
<br />C
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' ARTNUABLN YIN
<br />ANYPftOPRIETOR;PARTNEPoE%ECUTIVE
<br />OFFICEMMEMBEREXCLUOED? N
<br />(Mandatory
<br />ddescrin NH)
<br />P describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />TC2J4U6-8049X5 B- (AOS]
<br />TRK.UB-8040X51A.18 AZ,MA,OPWI
<br />( )
<br />TWX) -UB -7440L398-18 (OH
<br />( )
<br />""""$500K LIMIT /$SOOK SIR
<br />1 1
<br />10101/2018
<br />10/0112018
<br />lO l 019
<br />10i0A2019
<br />10!01!2019
<br />X STAT TE �RH
<br />_
<br />'
<br />E, L EACH ACCIDENT $ 1,000,000
<br />_.......... 1,655,000
<br />E.L. DISEASE -EA EMPLOYEE $
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space la required)
<br />RE 51192600070990 PO&32001015 PROJECT? 91007058 PROJECT NAME: BCA6SES-CITY OF SANTA ANA POLICE DEPT -
<br />SEEATTACHED
<br />CITY OF SANTA ANA, M-93 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 CIVIC CENTER PLAZA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />SANTA ANA, CA 92702 1 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Mari Mukherlee _tsL,,%Ao0w I)OfUs�MIe'¢aL
<br />2@ 1988-2016 ACORD CORPORATION. All rights rese
<br />(�A�CORD 25 (2016/03) a AG D name and logo are registered marks of ACORD
<br />j��lA j
<br />
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