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A -U v3 493 1 ® A6 o CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDNYYY) 9912912014 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 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 MARSH USA, INC. 445 SOUTH STREET MORRISTOWN, NJ 07960 -6454 CONT T AC NAME: PHONE FAX AIC No Find ac No: E-MAIL ADORES INSURER 5 AFFORDING COVERAGE NAIL N INSURER A;HDI- Geding Amanda Insurance Company 41343 109129- 6 -7BA- $871.14/15 610 Watson NOC60 INSURED SIEMENS INDUSTRY, INC. INCLUDING BUILDING TECHNOLOGIES DIVISION 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089 -4513 INSURER B, The Travelers Indemnity Company 25658 INSURER G: The Charter Oak Fire Insurance Company 25615 INSURER D: Travelers Property Casualty Co. of America 25674 INSURER E INSURER F GENERAL AGGREGATE $ 10,000,000 COVERAGES CERTIFICATE NUMBER: NYC - 006326833 -10 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. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDOY/Yyyy MM /ODY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I-XI OCCUR 1 GLD1110106 1010112014 1010112015 1 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EKE (Any one parson) S 100'000 PERSONAL &ADV INJURY S 1,000.000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X I POLICY F7 PRO LOD 'PRODUCTS - COMPIOP AGG $ NCL $ D AUTOMOBILE LIABILITY X ANY AUTO X ALL OWNED SCHEDULED X AUTOS X NON -OWNED i HIRED AUTOS AUTOS TC2JCAP7440L34A14 '.. 10101014 10/01/2015 COMBINED SINGLE LIMIT Ea accident 2,000000 BODILY INJURY (Per person) $ NIA BODILY INJURY (Per accident) $ NIA PROPERTY DAMAGE Per acc,denl $ NIA $ A X UMBRELLA LIAB EXCESS LIAR X (OCCUR CLAIMS -MADE CUDIII0206 1010112014 10/0112015 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 pED RETENTION $ $ C B D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE� OFFICERMIEMBER EXCLUDED? (Mandatory in NH) dyes, descdhe under DESCRIPTION OF OPERATIONS below NIA T020UB744OL27114(ADS) TRKUB7440L28314 (AZ, MA, OR & WI) TWXJUB7440L33814 (OH ( ) " "'$500K LIMIT I $500K SIR " "' 10/0112014 1010112014 1010112014 1010112015 1010112015 1010112015 X WC STATU- oTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1.000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD tot, Additional Remarks Schedule, if more apace is required) RE: JOB NO. NIA FORM, SEE ATTACHED PROVED AS TO FORM„ Laura A. Rossini CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: PURCHASING DEPT. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA. CA 92701 -4010 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ©1988.2010 ACORD CORPORATION. ION. All rights reservea. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD