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'�� & CERTIFICATE OF LIABILITY INSURANCE <br />DATETYYY) <br />1L72J22019 <br />019 <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: R the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATOON 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 lieu of such endorsements). <br />PRODUCER <br />MARSH USA, INC. <br />CONTACT <br />"NAME. <br />__. <br />445 SWTH STREET <br />FAX....._— <br />PHONELWLAo�AU: Nol: <br />MORRISTONN: NJ 07960.6454 <br />_ ____ -I,% <br />.... <br />EMAIL <br />1JPRESS ..... ..... ......__ <br />INSURE13)AFFORDING COVEMGE NMC0 <br />1001MRSS-19QO 610 OCKO NOC60 <br />INSURER A: HDI Global lnwrance Company 141343 <br />INSURED <br />SIEMENS INDUSTRY, INC- <br />IusuRa,Tra_vN_ers Properq Cawalty Co aiAmerxa 25674 <br />1000 DEERFEID PARKWAY <br />INSURER c-_The Trravelem indem_P!ly_ 1+a9Y 25656___, <br />BUFFALO GAiNE, IL 6DO894513 <br />INSURER O 1 <br />INSURER E <br />INSURERF <br />IN q :i II 12 tat_\ If :6 2 H M 1.1 :1:T I <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 <br />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 <br />TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TYPEOFINSDRANGE ACJDL,;SUSTij—_ __._— - — <br />POLICYNUMSER <br />POLICY EFF <br />M/OD <br />POLICYF.%P <br />LIMITS <br />A _% COMMERCOLGENERALIAASILITY GLD1110111 10101,2019 10A12020 <br />_ _, <br />EACHOCCURRENCE I S <br />1.000'000 <br />_ CLAIT ADE X ' OCCUR <br />-OAMAOEY6'RFNTEU-_._.._ <br />PREMISES jEe oraurencel $ <br />__._ — <br />1,B00,WB <br />____ I i <br />ME; DE%F (AnY,w,e Parson) _$ <br />100.000 <br />..._..1 <br />PERSONALaADVINJURY S <br />_—� <br />1,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE $ <br />10,000.000 <br />POLICY _ PRO- <br />JECT I_ JI LOC <br />�1 PROOUCrS_ COMPRIP ABC i $ <br />INGL <br />OTHER 1 - <br />h AUTOMOBILEUAa1LDY ITC2J-GAP-7449L34A-19 1B.U'1.'2Q19 1HL11'4)211 <br />COMBINEDSINGL LIMIT ,IS <br />2,6B6,98D <br />X <br />,1Ea acgdanlJ__., <br />ANY AUTO _ <br />'., <br />BODILY INJURY (Per Person) S <br />N/A <br />____ <br />F OWNED SCHEDULED <br />AUTOS ONLY __� AUTOS - <br />BODILY INJURY aodonl j $ <br />1. <br />NIA <br />y HIRED % NON SWNED <br />,AUTOS ONLY _ AUTOS ONLY <br />LY <br />i I <br />PROPERTY DAMAGE S <br />rLPa ecpdentL_ ____ _. <br />NIA <br />UMBRELLALAB - _ OCCUR li <br />EACH OCCURRENCE <br />EXCESS LAS CLAIMS -MADE ) <br />AGGREGATE S <br />DED '1 RETENTIONS <br />S <br />cOMPERSATiON ( J-U 9X50B-1 ADS) <br />10i0i <br />% SATUTE_ eat* <br />ANDEMPLOYERVLASILITY <br />AWPROPRIETOkPARTNENEXECUTIVE YIN TRK-UB-8049XS1A-t9(A2. MA, OR, WII <br />110,01,2020 <br />'- <br />-- _ ---- <br />�10X11,'2019 <br />B OFFICERiVEMBEREXCLUDED9 N NIA <br />❑ <br />- <br />E.I. EACH ACCIDENT $ <br />1,000,0D0 <br />yMarkatorym TWXJ-U&7440W38a19 (OHBWA) <br />101012019 10,101r2020 <br />EL DISEASE EA EMPLOYEE <br />1.000.000 <br />d ead=N uurler...._. <br />yy $500K LIMIT €SSWK SIR""""' <br />IDESCRIPTIDN GF OPERAnIONS W. <br />_. ..._ ..__ <br />ELDISEASE -POLICY LIMIT I. $ <br />_ <br />i•000,9B0 <br />DESCRIPTION OF OPERATIONS I LOCATIONS; VEHICLES (ACCRO 101, Additional Remarks Sc .dule, may As attachad it more apace is required) <br />RE: SIEMENS JOB# X00077971. 51011CITY OF SANTA ANA SERVICE AGREEMENT <br />SEE ATTACHED <br />CERTIFICATE HOLDER CANCELLATION <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />RISK MANAGEMENT DIVISION <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA, 4TH FLOOR <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA CA 92701 <br />REV; <br />ED & APPROVED <br />Y Ill$ <br />ANAgEMENT DIVISION <br />AUTHORIZED REPRESENTATIVE <br />1 <br />of Marsh USA inc. <br />18 019 <br />Manashi Mukhedee _3yllluno �- yd..+suve,�.0 <br />V Vwl ©1988-2016 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016183) SAMA •RO logo are registered marks of ACORD <br />