HomeMy WebLinkAboutSIEMENS MASTER SERVICES (2)INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
10/l�l /ZoZo
CLERK OF COUNCIL __—
DATE:
Exhibit I
0' {l�In ��& yaaz4/eL Q THIRD AMENDMENT TO MASTER SERVICES AGREEMENT
A-2020-051
THIS THIRD AMENDMENT to the above -referenced agreement is entered into on March 17, 2020,
o by and between Siemens Industry, Inc., a California corporation ("Consultant"), and the City of Santa
N Ana, a charter city and municipal corporation organized and existing under the Constitution and laws
r.
of the State of California ("City").
J
RECITALS
a-
A. Whereas, Consultant has provided continuing services to the City since 2010 related to
Consultant's unique institutional knowledge, proprietary equipment and technology required to
handle the installation and maintenance of this integrated solution that involves several sub-
systems they designed, engineered, built, and maintained including work done as set forth in
Agreement #A-2015-277; and
Whereas, the parties entered into Agreement NA-2017-289 ("Agreement") on October 17, 2017, to
enhance the video security enhancement program ("Program"), to provide video monitoring
services security/surveillance to protect and monitor critical City facilities, infrastructure and
provide expanded services to implement, design, install and maintain additional hardware and
software for the Program to include new sites, locations and departments as required by the City,
and the Agreement is current and in effect; and
C. Whereas, the parties entered into a First Amendment to the Agreement (A-2017-289-02) on
January 31, 2019, to clarify the scope of work to the Agreement and compensate Consultant for
prior necessary services performed for the benefit of the City's security and surveillance systems
that did not affect the not to exceed amount of the Agreement; and
D. Whereas, the parties entered into a Second Amendment to the Agreement (A-2019-035) on March
5, 2019, to increase the scopes of work related to the Year 2 maintenance for the Program and
install camera sub -systems to four (4) additional City parks. The parties also amended the
Agreement to include additional funds in the amount of $295,574 to cover the increased services
provided by Consultant and allowed for additional time to be added to the Agreement solely to
allow Consultant to work with the City to close out projects; and
E. Whereas, the parties wish to further amend the Agreement to add the scope of services for the Year
3 maintenance for the Program and increase the compensation amount to cover costs for said
services.
The Parties therefore agree:
Section I, Scope of Services, is amended to include the attached Exhibit A-7 detailing the
additional statement of work for the Year 3 maintenance costs.
2. Section 2.a., Compensation, is amended to read:
2.a. The total amount to be expended for services during the term of this Agreement is increased
by $261,000 and shall not exceed $1,777,824.
#29133v1PaoeIof2
3. Except as modified by this Third Amendment, all other terms and conditions of the Agreement and
any prior amendments, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement
on the date and year first written above.
ATTEST:
oun
APPROVED AS TO FORM:
SONIA R. CARVALHO
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
D ent�v
Chief of Police
CITY OF SANTA ANA
ristine Ridge
City Manager
SIEMENS INDUSTRY, INC.:
A-1�2 lu
By: &1rn $t � t
Title: rjGla$ p-jt is r
�ifCGt�✓ � fi
#29133v1Page 2 of 2
Exhibit A-7 to Third Amendment
to Agreement ✓tA-2017-289
SIEMENS
October, 22 2019
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, California 92702-1988
Michael Dietsch
client Executive
Southern California
City of Santa Ana Security and Surveillance Maintenance Services Ag nt
(August 1, 2019 through July 31, 2020) av
1, Siemens shall provide the extension of its Maintenan Ma Repair and Support
Services (Siemens Service Program), at the City o ante a, e s scope of services
document
2. Term shall commence on August 1, 2019 and expir pn 31, 2020 and include systems at
the following locations (but not limited to):
a. Santa Ana City Hall, 20 Civic Center PI to Building, 605 Santa Ana Blvd
b. Ronald Reagan Federal Courthouse j. ederal Building, 34 Civic Center Plaza
Building, 411 West 41h Street City of Santa Ana Jail, 62 Civic Center Plaza
c, Santa Ana Police Department, 60 I. Downtown, Parks, Civic Center,
Center Plaza Communications and Camera Systems
d. Santa Ana Library, 26 Civi e Pla (Code Blue/ Cameras)
e. Santa Ana Civic Center a, 1 di m. Roosevelt Community Center
street lights (7) n. Garfield Community Center
f. Orange County h e =1 W. Santa o. Madison Park
Ana Boule r p. Chepas Park
g. RtibertTho B 10 Civic Center Plaza q. Santa Anita Park
h. Everest g 0 Santa Ana Blvd r, Windsor Park
c s, Memorial Park
3. ervi s r e`ment shall provide Software Maintenance Agreements (SMA) for the
fo wm pplications:
a. ilestone XProtect Software Upgrade Program (SUP)
b. Sureview Immx Software Annual Support and Maintenance (ASM)
c. Hiperwall Software Maintenance Agreement (SMA)
d. Health Monitoring SaaS Maintenance Agreement (SMA)
e. Lexray User Licenses (subscription)
4. Services agreement shall provide extended warranty "repair and replacement' coverage for
the following systems and components:
Unrestricted SOW Page I 1
SIEMENS
Michael Dietsch
Client Executive
Southern California
a. Milestone XProtect system
i. Servers (7)
b. Hiperwall Video Wall
i. Servers
ii. Workstations (5)
iii. Network switches (2)
iv. Monitors (10)
c. Sureview Immx
i. Server
d. All Siemens installed and connected cameras (304) to City Mileston pro tem
e. Power Supplies
f. Encoders
g. Siemens supplied network switches
i. Cisco &
r...
ii. HP
h. Communication Radios
i. Ubiquiti
ii. Bridgewave
iii. Siklu
1. All connections and misc cabling o : ded ens.
5. Services agreement shall provide prey ve tenance services on a quarterly basis for
the following systems:
a. Test and Inspection
i. Cameras (206
ii. Encoders
iii. Radios
iv. Anteams
vi.
eras(206)
Power supplies
iil. Antennas
Preventative Maintenance (Test and Inspect): Siemens shall provide quarterly inspections and
testing on all covered equipment. Based on any abnormal findings, Siemens technicians will be
authorized to replace parts or alter settings and programming to optimize the systems. All
findings shall be provided in a quarterly report to the client. Siemens shall maintain quarterly
reports, as part of client services program portfolio. Siemens will provide all system software
updates, as part of annual preventative maintenance visits. All software updates are provided at
Unrestricted SOW Page 12
SIEMENS
Michael Dietsch
Client Executive
Southern California
no additional cost, with the valid software maintenance programs (included in this program). All
items included in this service shall be clearly delineated in the scope of work document. Siemens
excludes the test, inspection and cleaning of SA Jail cameras.
Extended Warranty (Repair and Replace): Siemens shall provide added warranty coverage for the
identified components of the clients system. Repair and replacement of worn, failed and
malfunctioned equipment will be provided during normal business hours, wit next day service
response coverage times. Should the component be of critical or of an em cy nature,
Siemens shall provide 4 hour response in diagnosing of issue and beginning re ess.
Siemens may provide temporary replacement from back -stock, if avaIII bl S ens es not
include back -stock equipment as part of this service. All afterhou n wee ervices are
covered under this agreement, when required.
Systems Integrity/ Compliance Monitoring and Dii
realtime 24/7 monitoring of system components
edge network components). Health monitoring of
State mandated archiving requirements. Siemens u�
ability, uptime, optimized configurations of bardwan
ing that reduces life cycle costs to the system
Video Archiving Warranty: Siemens to
California Government Code 34090.
by project basis. Diagnostic Rep in
on quarterly basis and will be,. se tg
ro 'h 'iemens to provide
and ge, core network and
is critical to the maintenance of
k8rk monitoring to maintain reli-
ftware, and for diagnostic report -
quit storage for maintaining compliance with
orage will be managed by Siemens on project
e data reports in support of storage calculations
system manager.
■ Siemens pric ass ecution of preventative maintenance and cleaning services to
be perfor d ormal business hours.
■ Ste x a equipment not supplied and installed by Siemens, unless explicitly
t thi pe of work. Such items may include (but not limited to) Cisco Network
s ided by others, Promise storage arrays, servers and workstations not included
in cove ge material list. Siemens has extended warranty on Siemens supplied equipment.
• Siem Integrity/ Compliance Monitoring and Diagnostic Reporting service is provided
utilizing Siemens' cloud -based services. All software and hardware is maintained by
Siemens.
• Siemens excludes all foliage control, as may be required for radio communication.
• All permits and submittals to city, or local AHJ, are by others and excluded from this scope
of work.
Unrestricted SOW Page 13
Michael Dletsch
Client Executive
Southern California
• SA Jail test, inspection and cleaning is excluded from base services. All equipment Is
covered by repair and replace services.
• Siemens maintains HP OEM Partner status, Milestone Platinum Partner status and Cisco
Gold Certified status. Service and maintenance is executed by appropriately trained service
engineers.
• Siemens requires signed agreement or acceptable client Purchase Order, prior to allwork
commencement, including parts acquisition or project mobilization.
■ Services is limited to equipment and licensing provided by Siemens, per site ton. All
equipment supplied, installed or programmed by 3rd party is excluded fro r
described.
1 1 1 of
City of Santa Ana Security and Surveillance Mainten ce Se A ement
(August 1, 2019 through July 31, 2020).................... ........ $ 261,000.00
Santa Ana PD Systems Backbone (Storage, SMA, and nic Ws);
$ 156,000.00
Santa Ana Civic Center Systems;
$ 25400.00
Santa Ana Main Library:
$ 6,000.00
Santa Arta Downtown District:
_ � $ 37,500.00
Santa Ana Jail:
$ 17 500.00
Community Center:
$ 611000
_Garfield
Roosevelt Walker Community Center
0 31 2020
Extended Warranty'
Madison Park:
$ 12,500.00
Che as Park 6/27/2020 to 7/3 2
Extended Warran
_ _
Santa Anita Park (7/12/2020 i?0
Extended Warrant
Windsor.
ExcfudW
Memorial;
Exctudedr
Jerome:
Exclude&
Micha ie I17irect: (619) 865-7609
Sr, Client E. tive I Siemens Industry, Inc.
SIEMENS
1,�tuiuilY {nrG'fc
'Siemens shall include warranty services through 7/31/2020 at no additional charge
z Excluded from services agreement. Location may be under construction or under warranty for the duration of the
agreement term. Site shall be added to subsequent agreements.
Unrestricted SOW Page 14
CALIFORNIA GOVERNOR'S OFFICE
OF EMERGENCY SERVICES
CaI DES
GOVERNOR'S OFFICE
OF EMERGENCY SERVICES
Grant Program:
Grant Award No.:
Cal OES ID#:
Urban Areas Security Initiative
#2018-0054
059-95050
Subrecipient Name:
Proj ect No:
City of Santa Ana
OC Civic Center Camera System
Maintenance
REQUEST FOR NONCOMPETITVE PROCUREMENT AUTHORIZATION
Activity: OC Civic Center Camera System Maintenance Cost: $181,400(of $261,000)
2. Describe what the proposed vendor/contractor will provide.
One year of all-inclusive maintenance for the entire City system. Currently, the City of Santa Ana is
under a three year Master Services Agreement with Siemens Industry, Inc. for individual expansion
projects, as well as maintenance. The Agreement is due to expire in November of 2020, and this request
is for the third and final year of maintenance (renewed via contract amendment each of the three years
of the agreement based on the availability of funding). Due to efforts by the City to streamline and
maintain accountability of expenditures with vendors, a Master Services Agreement was established
under which several City Departments provided funding for their individual share of maintenance of the
city-wide camera system (i.e. Parks & Recreation paid for their maintenance portion, Santa Ana City Jail
paid for their maintenance portion, etc.). The total cost for maintenance for the entire system in year
three is $261,000. The City seeks to use FY2018 UASI funding for maintenance on only that portion of
the system that was originally acquired with grant funds (system network backbone, Police Department
cameras/hardware, and Civic Center Area cameras/hardware). The grant portion for that maintenance
alone equates to $181,400, which is the sole basis for this request for noncompetitive procurement
authorization.
Describe your organization's standard procedures when considering a noncompetitive contract, including
the conditions under which a noncompetitive contract is allowed, and any other applicable criteria (i.e.
approval requirements, monetary thresholds, etc.).
The City of Santa Ana permits sole source procurements when the product or services are only available
from a single supplier who is the sole distributor or manufacturer of a product or service for which no
acceptable substitute is available. This exclusiveness should be documented by the requesting
department and is subject to verification. Council authorization shall be required for sole source
procurements in excess of, or in the aggregate of $25,000.
4. Indicate which of the following circumstances resulted in your organization's need to enter into a
noncompetitive contract. See 2 C.F.R. Part 200, Subpart D, §200.320.
a. The item is available only from a single source. (Describe and detail the process used to make that
determination.).
The current vendor (Siemens Industry, Inc.) has unique institutional knowledge of a very complex,
integrated solution that involves several sub -systems they designed, built, and have been maintaining
since 2010. Furthermore, Siemens has dedicated a single engineer who possesses the pre -requisite
certifications in our primary software (Milestone Video Management) and hardware, and in which no
other vendor in our region possesses. Cisco Gold, HP OEM or equivalent, and Milestone Platinum
certifications are minimum requirements due to the mission -critical nature of the systems. These
certifications provide evidence of technical expertise and experience in supporting similar systems in
similar environments.
The current vendor is able to single-handedly address and maintain all repairs, troubleshooting,
expansion efforts, and perform system monitoring. Other vendors will either not execute a contract to
do this work (because they did not design/build/install it), or, they will have to sub -contract with several
third -party companies to maintain the varying sub -systems within our solution, which will increase the
overall contract costs. Lastly, the current vendor owns remote monitoring services that are custom
designed to monitor the overall health of our system and rapidly report on any failures or malfunctions.
This remote monitoring has been built to include redundant processes to ensure operational reliability.
This service is currently being provided at no additional cost to the City. The monitoring platform is built
to cover the City's customized system environment. The cost to implement an outside party equivalent
is unknown, but would require additional hardware and software due to the customized nature of the
existing service. No budget has been established for this service, which is already included in the current
vendor's Service Program.
b. A public exigency or emergency for the requirement will not permit a delay resulting from
competitive solicitation. (Describe the exigency or emergency. Provide details.)
c. After solicitation of a number of sources, competition was determined inadequate. (Describe the
solicitation process that determined competition was inadequate. Provide details, and attach relevant
supporting material, Request for Proposal, etc.)
Did your organization confirm that the contractor/vendor is not debarred or suspended?
Yes.
6. Will all activities be completed within the period of performance?
Yes.
Please attach a copy of the cost or price analysis prepared for this procurement.
Attached.
Certification: This is to certify that, to the best of our knowledge and belief, the data furnished an this
form is accurate, complete and current. We further certify that this procurement has followed local
procurement policies, and state and federal guidelines. We underst
any fraudulent information
thfo
contained on this form may have an effect on future Cal OES fun
this oat
organization.
Submitted By:
Name:
Signature:
Date:
Oft. Otto Laufer
11/01/2019
Purchasing Agent:
Name:
Signature:
Date:
spy '4rcz
►, -5-�q
Cal OES Internal Use Only
(rev.
Program Representative Review - Comment:
Date:
Unit Chief Review - Comment:
Date:
Unit Chief Approval:
Date:
Division Chief Review - Comment:
Date:
Division Chief Approval:
Date:
Page 3 of
October 31, 2019
Otto Laufer
City of Santa Ana — Police Department
60 Civic Center Plaza
Santa Ana, Ca. 92701
Siemens Industry, Inc
Attn: Jacob Bargas
6141 Katella Avenue
Cypress, Ca. 90630
Mr. Bargas,
We received the Statement of Work you submitted in response to the City of Santa
Ana's request for a third and final year of maintenance services for the City's Video
Surveillance System. The third year of maintenance services is pursuant to the current
Master Services Agreement (#A-2017-289) between Siemens Industry, Inc. and the City
of Santa Ana, entered into on November 9, 2017 and expiring November 8, 2020. At
this time the city is requesting you submit a Best & Final Pricing Offer for year three of
maintenance services.
A portion of the overall maintenance will be funded by grant monies and requires
compliance with the uniform guidance under 2 C.F.R. 200 — 200.323(b) which states:
The non -Federal entity must negotiate profit as a separate element of the price
for each contract in which there is no price competition and in all cases where
cost analysis is performed. To establish a fair and reasonable profit,
consideration must be given to the complexity of the work to be performed, the
risk borne by the contractor, the contractor's investment, the amount of
subcontracting, the quality of its record of past performance, and industry profit
rates in the surrounding geographical area for work.
We are requesting your Best & Final Pricing Offer be returned in writing by Friday
November 8, 2019 via email to Officer Otto Laufer at olaufer(cD-santa-ana.org. Please feel
free to contact me at (714) 245-8739 if you have any questions.
Si#tto�
ly,
ufer, Officer
Project Manager
Anaheim/Santa Ana UASI • 60 Civic Center Plaza • Santa Ana, CA 92701
CERTIFICATE OF LIABILITY INSURANCE
DATE omvYl
0923f20W
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 CR 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 pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polidles may require an endorsement, A statement on
this cortificate, does not confer rights to the certificate holder in lieu of such endorsements ,
PRODUCER
MARSH USA, INC.
445 SOUTH STREET
MORRISTOWN. NJ 07960.6454
CONTACT
NAM 1'
PHONE
_nag L$$1 ^__---'_• —
INSURERS) AFFORDING COVERAGE
RAID#
f001299DT-18@0 010 Kapusl NOC80
INSURER A I HDI Global Insurance Cauvery
41343
INSURED IEMENS INDUSTRY, INC.
INSURER B: Traveler Pi0peny Casudty Co.OfAmeJm �25674
INSURER C : TN Travelers Indemnity Company
2585E
1000 DEERFIELD PARKWAY
BUFFALO GROVE, IL BDOM4513
INSURERO•
INSURER E I
INSURER F.-
COVERAGES CERTIFICATE NUMBER: NYC-009188797.20 REVISION NUMBER;
THISl3 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
TYPEOFINSURANCE
A L
R
POLICY NUMBER
POLICY EFP
1010V2019
POLrMMIODNMI �n,
r LIMITS
A
X
T_
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
GLD1110111
IDMI12020
OCCURRENCE
$ 1,000,000
_EACH
faREM
REMISES tEe aieunmrca]_
$� 1,000,000
MED E%Pelro9na P91'a90
$ 100.000
I�
PERSONALSAOV INJURY _
S 1'00.0"
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY n j� LOU
:
GENERALAGGREGATE
$. 10.000,000
PRODUCTS COMPOP AOG
$ INCL
S
OTHER:
B
AOTGMODILELIADILITY
T=-CAP7440L34A-19
1010112019
107mf2020
C MBINROSWGLELMIT
„BODILYINJ1
$ 21000,000
X
ANY AUTO
BODILY INJURY (Par person)
$ NIA
g
OWNED - ONLY AUTOS SCHEDULED
AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY INJURY(Para¢Idon11
$ NIA
��
OPER IN\W�raE
Ar
_ _
$ NIA
$
%
UMORELLALIAO
X
T
OCCUR
CUD1110211
100112019
101O.U2020
EACHOCCURRENCE
s 1,000,000
AGGREGATE
S 1.000,000
EXCESS UAB
CUUMS-MADE
DED.1
1 RETENBONSf��mm
$
S
C
B
WORKERS COMPENSATION
ANDEMPLOYERS'LIAOILRV
VL,
OFKICERIMEMOERE%CLUDEDT CCUI'IVE N
(Mandatory In NH)
NIA
TC2J-UM49X508.19(ADS)
7RK•U&8049%51A-19 A2, MA, OR, WI
( )
TWXJ•U&7440L33&19 (ONSWA) .1W01/2019
20
f0f0112019
101=0
1D101f2020
10N11f2020
�X PEa QQ]1L-
_
E.L. EACH ACCIDENT
$ 1,000,000
�
E.4 DISEASE - EA EMPLOYEE
$ 1,000,00D
nyy9a,da T"NVnder
DESDRIPT10 OF OPEIa1YlON$below
^°'•'$500K LIMITI$500K SIR^""
�'--
CA- DISEASN• POLICY LIMB
s 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlllanal Ramarke Schedule, may ho altaahod If morn apace Is ro9ulrod)
RE: SIIN2600070990 PO#32001015 PROJECT# 31007058 PROJECT NAME: BCA6-SES-CRY OF SANTA ANA POLICE DEPT
SEEATTACHE
REVIEWED
yRsk &M[ APPROVED
MANNET oN
1"I
CERTIFICATE HOLDER A-V, AT) !tN A IN A (/ CANCELLArioi
CITY OFSANTAANA FR CINE R. VIL Il
RISK MANAGEMENT DIVISION
`SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 CIVIC CENTER PLAh1,4TH FLOOR
ACCORDANCE WITH THE POLICY PROVISIONS,
SANTAANACA 92702
AUTHORIZED REPRESENTATIVE
at Marah USA Ina.
Manashl Mukharlee _Ma•.AnEa k.: JM..._ee..nu.(}el.
m 19BO-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: TC2J-CAP-744OL34A-TIL-19
COMMERCIAL AUTO
ISSUE DATE. 08-23-19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following -
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fied by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds' for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage pro-
vided in the Coverage Form.
SCHEDULE
Name Of Person(s) Or Organization(s):
ANY PERSON OR ORGANIZATION WHOM YOU HAVE
AGREED TO ADD AS ADDITIONAL INSURED, BUT
ONLY TO COVERAGE AND MINIMUM LIMITS
REQUIRED IN A WRITTEN CONTRACT
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies
as an "insured" under the Who Is An Insured provi-
sion contained in Paragraph A.I. of Section II — Cov-
ered Autos Liability Coverage in the Business Auto
and Motor Carrier Coverage Forms and Paragraph
D.2. of Section I — Covered Autos Coverages of the
Auto Dealers Coverage Form.
CA 20 48 10 13 ® Insurance Services Office, Inc., 2D11
:D & APPROVED
;NACiEMEw DIVISION
5 2019
XiA M. LAMBERT
Page 1 of 1
POLICY NUMBER: TC2Jr-CAP-7440L34A-TIL-19
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies Insurance provided under the following.
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.S., Transfer of
Rights Of Recovery Against Others To Us, of the
CONDITIONS Section
S. Transfer Of Rights Of Recovery Against Oth-
ers To Us
We waive any right of recovery we may have
against any person or organization to the extent
required of you by a written contract executed
prior to any "accident" or "loss", provided that the
"accident' or 'loss" apses out of the operations
contemplated by such contract. The waiver ap-
plies only to the person or organization desig-
nated in such contract.
REVIEWED & APPROVED
By MISMANAqEMEW DIVISION
05 2019
M. LAMBERT
GA T3 40 02 15 C 2015The Travelers Indemnity company. All rights reserved rage 1 of 1
Includes copyrighted material of Inwrance Services Office , Inc. with as permission.
HDI GLOBAL INSURANCE COMPANY
MANUSCRIPT ENDORSEMENT#32
Policy Number Named Insured
GLD11101-11 SIEMENS CORPORATION
Policy Period: Inception(M-0-Y) Expiration(M-D-Y) Effective Date and
Time of Endorsement
10-01-2019 10-01-2020 10-01-2019 12:01 a.m. Standard Time
at Address of the
Insured.
This Endorsement Changes The Policy. Please Read It Carefully
This endorsement modifies insurance provided under the following:
Commercial General Liability Coverage Form
Who is an insured is amended to include as an additional insured any person whom you are required to add as an
additional insured on this policy under a written agreement, but only with respect to liability for "bodiy injury", "property
damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts
or orrissions of those acting on your behalf. The insurance coverage provided to such additional insured applies only
to the extent required within the written agreement.
The insurance coverage provided to the additioral insured person shall not provide any broader coverage than you a re
required to provide to the additional insured person in the written agreement and shall not provide limits of insurance that
exceed the lower of the Limits of Insurance provided to you in this policy, or the limits of insurance you are required to
provide in the written agreement.
The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other
insurance, whether primary, excess, contingent, or on any other basis, that is available to the additional insured for a loss
we cover under this endorsement. However, if the written agreement specifically requires that this insurance apply on a
primary basis, this insurance is primary. If the written agreement specifically requires this insurance apply on a primary
and non-contributory basis this insurance is primary to other insurance available to the additional insured and vie will not
share vdth that other insurance
Thisendorsement shall prevail over additional insured endorsements that may apply under this policy unless required
otherwise in the written agreement.
Authorimd Representative
Ail terms and conditions of the policy remain unchanged.
THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY
IS WRfTTEN.
Page.
& APPROVED
1QEMENI DIVISION
b 5 2019
M. LAMBERT
POLICYNUMBERGLD11101-11
COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
ANY PERSON OR ORGANIZATION TO THE EXTENT REQUIRED BY WRITTEN CONTRACT
Information re fired to complete this Schedule if riot shown above will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section N— Conditions:
We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
'your work' done under a contract with that person
or organization and included in the 'products -
completed operations hazard' This waiver applies
orty to the person or organization shown in the
Schedule above.
RENEWED & APPROVED
By k MANAGEMENT DIVISION
052019
M. LAMBERT
CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 11 of 1 0
AM
TRAVELERS J WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 00 0313 (00)_
POLICY NUMBER. (TC2JUB-6049x50-9-19)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us )
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED PERSON:
DESIGNATED ORGANIZATION:
ANY PERSON OR ORGANIZATION FOR WHOM A WAIVER OF
SUBROGATION IS REQUIRED BY CONTRACT OR AGREEMENT OR
PERMIT, BUT COVERAGE IS LIMITED TO THE SCOPE OF THE
WORK PERFORMED BY THE INSURED UNDER SUCH CONTRACT,
AGREEMENT OR PERMIT.
& APPROVED
1gEMENf DIVISION
05 2019
M. LAMBERT
DATE OF ISSUE: 08-23-19 STASSIGN: