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CERTIFICATE OF LIABILITY INSURANCE
<br />OATE 09129//2014 2014 YVY)
<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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER
<br />MARSH USA, INC,
<br />445 SOUTH
<br />CONTACT
<br />NAME:
<br />PHONE Ext u A/C No :
<br />EMAIL
<br />ADDRESS:
<br />MORRISTOWN, NJ 079606454
<br />INSURERS AFFORDING COVERAGE
<br />NAIL k
<br />GLD1110106
<br />INSURER A:HDI- Gerling America Insurance Company
<br />41343
<br />100129- 6- 7BA -SBT1 -14/15 610 Watson NOC60
<br />INSURED
<br />SIEMENS INDUSTRY, INC. INCLUDING
<br />BUILDING TECHNOLOGIES DIVISION
<br />INSURER B : The Travelers Indemnity Company
<br />25658
<br />INSURER C: The Charter Oak Fire Insurance Company
<br />25615
<br />INSURER D: Travelers Property Casualty CD, of America
<br />25674
<br />1000 DEERFIELD PARKWAY
<br />BUFFALO GROVE, IL 60089 -4513
<br />DAMAGE TO RENTED
<br />PREMISES Be occurrence
<br />$ 1,000,000
<br />BED ENE (Any one person)
<br />INSURER E:
<br />PERSONAL &ADV INJURY
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: NYC - 006326033 -10 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 />INSR
<br />LTR
<br />rypE OF
<br />ADDLSUSR
<br />POLICY NUMBER
<br />POLICY SEE
<br />MMIDOIVYVV
<br />POLICY EXP
<br />(Ni
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />GLD1110106
<br />10/01/2014
<br />10/01/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [fl OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Be occurrence
<br />$ 1,000,000
<br />BED ENE (Any one person)
<br />$ 100,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 10,000,000
<br />GENL AGGREGATE
<br />LIMIT APPLIES PER
<br />PRODUCTS - COMP /OP AGO
<br />$ INCL
<br />$
<br />X POLICY
<br />PRO LOC
<br />D
<br />AUTOMOBILE
<br />LIABILITY
<br />TC2JCAP7440L34A14
<br />10/01/2014
<br />10101/2015
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 2,000,000
<br />BODILY INJURY (Per person)
<br />$ N/A
<br />X
<br />ANY AUTO
<br />X
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$ N/A
<br />X
<br />HIRED AUTOS NON-OWNED
<br />AUTOS
<br />PROPERTY
<br />Prr accident)
<br />$ N/A
<br />$
<br />A
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />CUD11102D6
<br />10/01/2014
<br />10/01/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$
<br />C
<br />B
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR /PARTNER /EXECUTIVE YIN
<br />(Mandatory in N
<br />(Mentlatory in NH)
<br />NIA
<br />TG20UB7440L27114 (ADS)
<br />TRKUB7440L28314 (AZ, MA, QR &Wp
<br />TWXJUB7440L33814&WA
<br />(OH I
<br />10/01/2014
<br />13/61/2314
<br />10/01/2014
<br />115
<br />ON1I20
<br />10/31/2315
<br />10/01/2015
<br />X WC STATU - OTH-
<br />E.L. EACH ACCIDENT
<br />1,330,630
<br />$
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DE SCRIPTION OF OPERATIONS below
<br />" "'$500K LIMIT / $500K SIR " "'
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />RE, JOB NO. N/A
<br />SEE ATTACHED
<br />CERTIFICATE HOLDER CANCELLATION
<br />CITY OF SANTA ANA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />ATTN: PURCHASING DEPT.
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLAZA
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTA ANA, CA 92701 -4010
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Manashi Mukherjee cch,c+. -ea-
<br />© 1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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