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AGENCY CUSTOMER ID: 100129 <br />LOC 4: Morristown <br />Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />MARSH USA, INC, <br />SIEMENS INDUSTRY, INC, <br />BUILDING TECHNOLOGIES <br />1000 DEERFIELD PARKWAY <br />POLICY NUMBER <br />BLIPFAILO GROVE, L 60089 <br />CARRIER <br />EFFECTIVE DATE: <br />c <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability _12S qr?nce <br />RE: AEVA-320J51.I CITY OF SANTA ANA DOWNTOWN SAFETY PROGRAM ANC DETENTION CENTER <br />SANTA ANA POLtOE DEDARTMENT, CITY OFSANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AMC VOLUNTEERS ARE INCLUDED AS ADDJ ONAL INSURED UNDER <br />THE ABOVE Rf_I`r9rN0FQ OFNERAL LIABILITY AND ALTONIOBILE LIABILITY INSURANCE POLICIES ANC THE COVERAGE AFFORDED THE ADDIT OVAL I[INSURED <br />UNDER THESE PCLJCIFS SHALL BE PRIMARY AND NON-CONTRIBUTORY INSURANCE TO THE EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS <br />INDUSTRY, INC, OR ITS SUSCCNTRACTCRSfflTH RESPECT TO AL?.QPERAT=S OF THE INSURED BUT ONLY WITd RESPECT TO, ALL WORK PERFORMED BY ANC <br />ON BEHALF OF THE NAMED INSURED, SIEMENS INDUSTRY, INC, FOR CERTIFICATE HQLCER UNDER CONTRACT <br />THE OWNER AND CONTRACTOR WAIVE ALL RIGHTS AGAINST EACH OTHER AND ANY OTHER CONTRACTOR, SUBCONTRACTORS, SUB- SUBCONTRACTORS, <br />AGENTS, AND EMPLOYEES, FOR DAMAGES OR INJURIES CAUSED BY PERILS TO THE EXTENT COVERED BY:NSURANCE , EXCEPT SUCH RIGHTS AS THEY MAY <br />HAVE TO PROCEEDS OF SUCH INSURANCE HELD BYTHF O",NER AS FIDUCIARY. <br />COVPLETED OPERATIONS COVERAGE IS INCLUDED IN -HE GENERAL LIABILITY POLICY, <br />IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PRrmmi, r* INSURER WILL DELIVER NOTICE OF CANCELLATION TO <br />THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER 2 LESS <br />m;,vrxu I u I t'duvolv 1) 9 2008 ACORD CORPORATION, All rights reserved,. <br />The ACORD name and logo are! registered marks of ACORD <br />