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HomeMy WebLinkAboutJOHNSON CONTROLS 3A-2008' ~ ~ t INSURANCE ON FILE WORK i~~i~'~ vROCEED UNTIL INSUkHNL'E EXPIRES 1o-1-c~4 CLERK OF COUNCIL DATE: ~_ 15-U~( ~ ~. a 1 dg MA ~~~} ~ F; r~ nce (~-~ FIRST AMENDMENT TO AGREEMENT ~ariu Gh~zz~ N-2008-004-01 THIS FIRST AMENDMENT TO AGREEMENT is entered into on December 15, 2008, by and between Johnson Controls, a Califomia corporation ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of Califomia (:`City„). RECITALS: A. The parties entered into Agreement N-2008-004 dated November 26, 2007, (hereinafter "said Agreement") by which Consultant has provided HVAC maintenance and repair services. B. In accordance with the terms and conditions of said Agreement, the parties wish to amend the term of said Agreement. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Agreement, the parties agree as follows: 1. Section 2.a., COMPENSATION, shall be deleted in its entirety and replaced with the following: "City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $23,700.00, annually, during the term of this Agreement." 2. Section 3, TERM, shall be deleted in its entirety and replaced with the following: "This Agreement shall commence on November 26, 2007 and terminate on December 31, 2009, unless terminated earlier in accordance with Section 12, below." 3. Except at herein amended, all terms and conditions of said Agreement shall remain in full force and effect. // // // IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. ATTEST: ~~ PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attomey n ~~, ~" 1 BY: ~xr4 ~ tn~a-< ~~z~!~~ Laufa Sheedy Assistant City Attorney RECOMMENDED FOR APPROVAL: FRANCISCO GUTIERREZ -~`" Executive Director Finance and Management Services Agency CITY OF SANTA ANA DAVID N. City Manager JOHNSON CONTROLS (Title) Phillip Claybrooke Metro General Manager EXHIBIT A SCOPE OF SERVICES Consultant shall provide emergency maintenance and repair of the HVAC system at the Santa Ana Police Administration and Detention Facility on an on-call basis. Consultant will also provide consultation and training, as requested by the Executive Director of Finance and Management Services or his destgnated representative. The current repair labor rate for maintenance and consultation is $130/hour during normal business hours (lam to Spm) and $ I95/hour for after hours work. In addition, Consultant shall provide JCI parts at 50% off of list price. Training shall be invoiced per Consultant's current catalog rate. The parties estimate that repairs and parts will be provided in a not to exceed amount of $17,000 during the terns of this Agreement, and that consultation and training will be provided in a not to exceed amount of $6,700 during the term of this Agreement. R MARSH USA INC. 109385E MaBnusAlm. al l Emty~iacgnain Avenue suite tB00 Milwaukee. WlewrlslD 53202+1419 4842 Fea [414) 290-4953 0 - Attn: CPU, Prime (414) 29 CPU MiMreukee~c°m SURER AHn: Com. Rink M9mL x-92 JOI'N190n CDnllda InG JDtvlaaDn CDnVDIa BatlelY Group, Inu P.O. BO%59t MiNVeukee, 4w 59201 JDMIeDn CaNrde Interims, L.L.C. JCIM US LLC cal-aF. Ins. GES An10aCa. L.L.C. MelrD Mechanical Inc. Optirtls Bananas, Inc. u51 Campenla, Inc _`__ _ ,~ ,, . DATE i CERTIFICATE OF {NSURANCE toiz7~zoos __.~...,«nen ASA MATTER OF INFORMATION O~LV pNO CONF NRTHE COMPANIES p,FFORdNG COVERAGE •~ Below Dany ACE Amatiean Insurenee Company PailaDallNll+, PA t910t 414&' A+ XV L rl • P.O Bon Sentry Insurance A Mutual Co. A+ XV y ea 3 teao NaIN PDAI »ma, ~~ a ri c n of Noltlt Ame Indemnity Insurance Comps Y PAY WI and EX WC: ACE nd for CA A+ XV , a American Insurance Canpany P.O BDR 41184 pNilatlal Ilia. PA 19101 lparty InyuranceComparty p ~ C ACE F e A+XV D ~ ~ Pns P,y PA telo 'HIS IS TO LEH nrT ~n..~ - CONOI ULm~N•• °-. •.. ,pf WITHSTANDING ANV REDUWEMENT. TERM OR CERTAIN, THE INSURANCE AFFORDED BY THE POLICNiS DESCRIBED HEREIN IS SUBJECT TO NAY HAVE BEEN REDUCED BY PAID CUIMa POMCY EFRE[ TYPE OFINBURANCE POLICY NUYaER OATS IMWOC GENERAL LIABILITY t11{3114) }{pOG23748396 {10-1-2008 COMMERCIAL GENERAL LIABILITY Ikl CLAIMS MADE OCCUR ER'S a CONTRACTOR'S PROT 31LE LIABILITY (2)(3)(4) I ~-n.erle-0~ AUTO U'~ AUTOS 5 I AUTOS AUTO ExcESSLIAeILm ~ XOOG23B65014 i. CONORIDNS AND 1 pOLJCY E11pIPATION DATE t ~a~-zoos ~o-~-zoos ~~ai-zoos ~o-~-loos ~~o-~-loos OTHER THAN UMBRELLA FORM WLRC42850585-ADS NORKERSCOMPENSATIONAND EMPLOYERS' LIABILITY (4) WLRC42850573 - CA SCFC42850615-WI - WCUC42B5O527 - FCC WC ~- I n INCL -- THE PROPRIETOR! ~ ~ PMTNERS'E%ECUTIVE EXCL MalaaM PK aFWDISaIIMnt a(yehW. IllaalaDa alq Las Psyaa as InqulnMl YFlalatlW Nnaftlu or wNdnwnnu. man ans atlaaai O3MCOnlnaYaR9 5,000,000 5,0011,000 50,000 5,000.000 5,0110,900 s,ao9.o90 s 1,0oo,ooa y 1,000,000 $ 1.000,000 ~mlaD ty aoDVa I^.++re° CANCELLATION O eEFORE THEFYTRATION DPTESHEREOF, DER SNWLDAHY OF THE POLIGFa DISCIDBFD HERON aE C..rc is TEN NOTICE TO THE GERRFIGTE MOUJER 1HElaeIaN000NPµV VALLa1GGM4Ga'TC YNL ~ Clty OF Santa Ana NANED HEaBN. Building Maintenance M-1 I 20 Civic Center P)ezs MARSH u INC. eY: ~, ~~~~~ Basement ~lr~~~'' Santa Arta,CA 92701 _ w,.rr.. I.aIP. a. "'~'N.~~da _ Nn> 4NFW _,_. __ .ran rla l.FSlNa. rN.we LIMITS 8 5,000.000 OMBINFD SINGLE LIMIT 30DILY INJURY ;Par penal ~-~--- BODILYINJURY (Pal eccaar4l N-aooB- 00~-01 '~~ c °R° CERTIFICATE OF LIABILITY INSURANCE oAT10/9/2009 ' . ., PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marsh USA Inc. 10838SE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 411 East Wisconsin Avenue Suite 1600 , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Milwaukee, WI 53202 - 4419 *SEE REVERSE FOR AM BEST RATING Attn: CPU, Phone (414) 290-4912 Fax (414) 290-4953 NAIC # CPU Milwaukee marsh.com INSURERS AFFORDING COVERAGE SEE REVERSE INSURED Johnson Controls, Inc. Attn: Corp Risk Mgmt. X-92 INSURER A: SEE REVERSE SIDE FOR INFORMATION Johnson Controls Battery Group, Inc. P.O. Box 591 Johnson Controls Interiors, L.L.C. Milwaukee, WI 53201 INSURER B: SEE REVERSE SIDE FOR INFORMATION JCIM US LLC Cel-Air, InC. INSURER C: SEE REVERSE SIDE FOR INFORMATION GES America, L.L.C. Metro Mechanical Inc. Optima Batteries, InC. INSURER D: SEE REVERSE SIDE FOR INFORMATION USI Real Estate Brokerage Services Inc. York International Cor oration INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR ADD'L NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE DATE MM/DD/YY MM/DD/YY A GENERAL LIABILITY (i) (3) (4) H DOG24934056 10/1 /2009 10/1 /2010 EACH OCCURENCE $ S~QQQ~QQQ ® COMMERICAL GENERAL LIABILITY DAMAGE TO RENTED $ 5 000 000 PREMISES Ea occunence , , ^^ CLAIMS MADE ®OCCUR ® MED EXP (Any one person) $ SO,000 Contractual ® PERSONAL & ADV INJURY $ 5,000,000 X,C,U GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ S,000,OOO : PRODUCTS-COMP/OP AGG $ 5,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY (2) (3) (4) ~~ g0-04606-01 10/1/2009 10/1/2010 COMBINED SINGLE LIMIT $ S 000 OOO ® ANY AUTO (Ea Accident) , , ^ ALL OWNED AUTOS '{ Al FRO `JL~) ~ `~(`~ ~' i3 T q d\lYl BODILY INJURY $ ^ SCHEDULED AUTOS (Per person) ® HIRED AUTOS ~"~' t % ~ ~ ~ ` '7 ~ BODILY INJURY (Per accident) $ ® NON-OWNED AUTOS ~'- ~ / 1 ! PROPERTY DAMAGE GARAGE LIABILITY - ~ ' C ~' ~" - ~ ' % AUTO ONLY - EA ACCIDENT $ ^ ANY AUTO AJSISI l f1Ci01 ile5 OTHER THAN EA ACC $ AUTO ONLY: AGG $ D EXCESSIUMBRELLA LIABILITY XOO 624901154 10/1/2009 10/1/2010 EACH OCCURRENCE $ S,000~QQQ ® OCCUR ^ CLAIMS MADE AGGREGATE - $ 5,000,000 ^ $ DEDUCTIBLE ^ RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY (4) WLRC45702017 - AOS 10/1/2009 10/1/2010 ® WC STATU- ^ OTH- TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE WLRC45702029 - CA E.L EACH ACCIDENT $ 1 QQQ QQQ SCFC45702030 WI . ~ ~ OFFICER/MEMBER EXCLUDED? ^ Y/N - --~ (Mandatory in NH) WCUC45702042 - EX WC E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under WCUC45702625 - EX WC FL E.L. DISEASE -POLICY LIMIT $ 1 ,000,000 OTHER (1) ADDITIONAL INSURED: If required by contract, includes coverage for Additional Insureds per attached endorsement. (2) ADDITIONAL INSURED: If required by contract, includes coverage for Additional Insureds and Loss Payees as required by contract (3) PRIMARY COVERAGE: Where required by lease or contract, this coverage is primary and not excess of or contributing with other Insurance or self-insurance 4 WAIVER OF SUBROGATION: Insured waives subro ation to the extent re wired b contract. DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS JCI Comroq No. JCI Protect Name:All work paMomred by above IroureG Customer PO Number: VGKIIrIl.A1C 1'7VLUGK ~~ C4NCF11 OTI(]N ~ - ~ - ,.~ ~ ~ City of Santa Ana - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Building Maintenance M 11 !'' ` EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL LMDGAVGA-7a 20 Civic Center Plaza Y I ` _ ; ~ MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, IiliT Basement Santa Ana, CA 92701 • ;.i • y~ `~ ~ ~ f» tr i it „ ,,,yj~, AUTHORIZED REPRESENTATIVE /~ ~' /~,.. - ~ - /' j i .., .. Of MARSH USA INC. ~ ` Na.Vlcu ca (cvvyrv-1~ ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AM Best Rating COMPANIES AFFORDING COVERAGE (as of 9/1/09) NAIC # SEE BELOW INSURER A: ACE AMERICAN INSURANCE COMPANY A+ XV 22667 PO Box 41484, Philadel hia, PA 19101 INSURER B: SENTRY INSURANCE A MUTUAL CO. A+ XV 24988 1800 North Point Dr., Stevens Point, WI 54481 INSURER C: ACE AMERICAN INSURANCE COMPANY FOR A+ XV 43575 CA, FL, WI AND EX WC; INDEMNITY INS. CO OF NORTH AMERICA FOR ALL OTHERS PO Box 41484, Philadel hia, PA 19101 INSURER D: ACE PROPERTY & CASUALTY INSURANCE A+ XV 20699 COMPANY 436 Walnut Street, Philadel hia, PA 19106 *A.M. Best ratings of insurers are provided for information purposes only and are based upon information with respect to such ratings available to Marsh USA Inc. on the date set forth herein with respect to such ratings. Marsh USA Inc. will have no responsibility or obligation to, inform the certificate holder or any person relying upon this certificate of any changes in such A.M. Best ratings occurring after such date. Marsh USA Inc. will have no liability with respect to the solvency or future ability to pay claims of any of the insurance companies which have issued the insurance policies referenced herein. "' The Auto Liability placement was made by Risk Management Resources, Inc., 121 W. Wacker Dr., Suite 2325, Chicago, IL. Marsh USA Inc. acts in the role of consultant to the Insured with respect to this placement, which is indicated for your convenience. POLICY NUMBER: HDOG24934056 COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Persons Or Or anization s If required by contract, City of Santa Ana Location(s) Of Covered Operations As required by contract, All work performed by above insured Information re uired to com lete this Schedule, if not shown above, will be shown in the Declarations. Endorsement #A2 ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -NAMED INSURED'S ACTS OR OMISSIONS ONLY A. Section II -Who is An Insured is amended to B. With respect to the insurance afforded to these additional include as an additional insured the person(s) or insureds, the following additional exclusions apply: organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or This insurance does not apply to "bodily injury" or "personal and advertising injury" caused solely by: "property damage" occurring after: 1. Your acts or omissions; or 1. All work, including materials, parts or equipment 2. The acts or omissions of those acting on your behalf; furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional in the performance of your ongoing operations for the insureds) at the location of the covered operations additional insureds) at the location(s) designated above. has been completed; or 1. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same ro~ect. Endorsement #A2A ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS - NAMED INSURED'S ACTS OR OMISSIONS ONLY Section 11-Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused solely by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard." POLICY NUMBER: HDOG24934056 Endorsement Number: A3 COMMERICAL GENERAL LIABILITY CG 24 04 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHER TO US This endorsement modifies insurance provided under the following: COMMERICAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: If required by contract, City of Santa Ana (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV - COMMERICAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: 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 only to the person or organization shown in the Schedule above. Named Insured Johnson Controls, Inc. Endorsement Number A4 Policy Symbol Policy Numbe Policy Period Effective Date of Endorsement HDO 624934056 10/01/09 to 10/01/10 10/01/09 Issued By (Name of Insurance Company) ACE American Insurance Com an THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE WHERE REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: COMMERICAL GENERAL LIABILITY COVERAGE FORM Section IV -Commercial General Liability Conditions -Item 4. Other Insurance is replaced with the following: a. Excesslnsurance If other collectible insurance with any other insurer is available to the insured and that other insurance covers a loss also covered by this policy, the insurance provided by this policy shall apply excess of and shall not contribute with such other insurance. Excess insurance over the limits of liability in this policy does not prejudice this insurance and the existence of such insurance shall not reduce any liability under this policy. a. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contributions by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. b. Primary Where Required by Contract or Agreement This policy will apply as primary insurance and will not contribute or share with other primary insurance, where required by contract or agreement entered into by the Named Insured. CC-1 E15 Ptd. In U.S.A. Automobile Liability Policy Named Insured: Johnson Controls, Inc. Endorsement Number: A Policy Number: 90-04606-01 Policy Period:10-1-09 TO 10-1-10 Effective Date of Endorsement: 10-1-09 Issued by (Name of Insurance Company): Sentry Insurance A Mutual Co. Insert the policy number. The remainder of the information of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US CONDITION 5. OF BUSINESS AUTO CONDITIONS (SECTION IV) IS AMENDED TO READ FOLLOWS: 5. IT IS AGREED THAT A WAIVER OF SUBROGATION APPLIES TO ANY ENTITY TO WHOM YOU ARE OBLIGATED BY VIRTUE OF A WRITTEN CONTRACT TO WAIVE YOUR RIGHTS OF RECOVERY, BUT ONLY TO THE EXTENT REQUIRED BY SUCH CONTRACT. FOR ALL OTHER ENTITIES, SUBROGATION WILL BE PURSUED, UNLESS THE NAMED INSURED NOTIFIES US THAT SUBROGATION SHOULD NOT BE PURSUED. SPECIAL JOH 90-04606-01 00 041 Change Effective 10-01-06 BLANKET ADDITIONAL INSURED COVERAGE "WHO IS AN INSURED" IS AMENDED TO INCLUDE AS AN INSURED ANY PERSON OR ORGANIZATION TO WHOM THE NAMED INSURED IS OBLIGATED BY VIRTUE OF A CONTRACT, ENTERED INTO BEFORE LOSS, TO PROVIDE INSURANCE SUCH AS IS AFFORDED BY THIS POLICY AND ANY ENDORSEMENT APPLICABLE THERETO, BUT ONLY TO THE EXTENT REQUIRED BY SUCH CONTRACT. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT TO WHICH THIS ENDORSEMENT MAY APPLY, THE INSURANCE AFFORDED AN ADDITIONAL INSURED SHALL BE SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF THIS POLICY AS OTHERWISE APPLICABLE. SPECIAL JOH 90-04606-01 00 041 Workers' Compensation and Employers' Liability Policy Named Insured: Johnson Controls, Inc. Endorsement Number: AA Policy Number: WLRC45702017 - AOS WLRC45702029 - CA SCFC45702030 - WI Policy Period:10-1-09 TO 10-1-10 Effective Date of Endorsement: 10-1-09 Issued by (Name of Insurance Company): Indemnity Insurance Company of North America and for CA and WI: ACE American Insurance Com an Insert the policy number. The remainder of the information of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. Schedule Person or Organization: If required by contract, City of Santa Ana Job Description: All work performed by above insured WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS WC 000313 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 anyone not named in the Schedule. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA WC 04 03 O6 Ed. 4-84 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 required you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be _INCLUDED_% of the California workers' compensation premium otherwise due on such remuneration. Copyright 1982-83, National Council on Compensation Insurance Authorized Agent ? - aoo g - cA4 - oa- '`??OR°? CERTIFICATE OF LIABILITY INSURANCE DAT /1s o 0 9 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION _ _ Marsh USA Inc. 20t'? SEP 29 PM I= I ? ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 411 East Wisconsin Avenue Suite 161X) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Milwaukee, wl 53202-4419 //++ f-, -_- - ,1 /? Attn: CPU Phones (414) 290912 Fax (414) 290-4953{ r ? T Y U ? (? A ? ? 'SEE REVERSE FOR AM BEST RATING N I , . CPU MilwaukeefNmarsM1.com tv - ?? I INSURERS AFFORDING COVERAGE A C # sEE REVERSE INSURED ?? ? ? Johnson Controls, Inc. Attn: Corp Risk Mgmt. X-92 INSURER A: SEE REVERSE SIDE FOR INFORMATION JohnSOn Controls Battery Group, Inc. P.O. Box 591 Johnson Controls Interiors, L.L.C. Milwaukee, WI 53201 INSURER B: SEE REVERSE SIDE FOR INFORMATION JCIM US LLC Cal-Air, Inc. INSURER C: SEE REVERSE SIDE FOR INFORMATION GES America, L.L.C. Metro Mechanical Inc. Optima Batteries, Inc. INSURER D: SEE REVERSE SIDE FOR INFORMATION USI Real Estate Brokerage Services Inc. York International Cor oration INSURER E: :OVE 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR OD'L POLICY POLICY LTR NSRD TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS DATE LATE MM/DD MM/DD/W A GENERAL LIABILITY (1) (3) (4) H D OG 25521 390 1 O/ 1 /201 O 1 O/1 /201 1 EACH OCC UR ENCE $ S,000,OOO ® COMMERICAL GENERAL LIABILITY DAMAGE TO RENTED $ rj 000 000 PREMISES Ea occurrence , OO CLAIMS MADE ® OCCUR ? MED EXP (Any one person) $ j0,000 ® Contractual ® PERSONAL 8 ADV INJURY $ $,000,000 x,c,u ' P GENERAL AGGREGATE $ 5.000.000 GEN PLIES PER: L AGGREGATE LIMIT A PRODUCTS -COMP/OP AGG $ S,000,OOO POLICY PROJECT LOC B AUTOMOBILE LIABILITY (2) (3) (4) 90-04606-O1 10/1/2010 10/1/2011 COMBINED SINGLE LIMIT 000 000 $5 ® ANY AUTO (Eagccitl¢nt) . , O ALL OWNED AUTOS BODILY INJURY Q SCHEDULED AUTOS (Per person) $ ® HIRED AUTOS BODILY INJURY $ (Per accitlen[) ® NON-OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ O ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ D EXCESS/UMBRELLA LIABILITY XOO G2682785r 1U/1 /2D1U 1U/1/2011 EACH OCCURRENCE $ 6,000,000 ® OCCUR O CLAIMS MADE J AGGREGATE $ S,000,OOO $ Q DEDUCTIBLE $ Q RETENTION $ WORKERS COMPENSATION AND W LRC4614014A - AOS ® WC sTATU- O OTH- C EMPLOYERS' LIABILITY (4) W LRC4614O126 - CA 1 O/1 /201 O 1 O/1 /201 1 TORY LIMITS ER ANY PROPRIETOR/PARTNER/E%ECVTIVE SCFC46140151 - WI EL EACH ACCIDENT $ 1,000,000 OFFICEWMEMBER EXCL UDF.O? Q Y/N M tl t I NH WCUC4614O17S - EX WC E.L. DISEASE- EA EMPLOYEE $ 1,000,000 ( an a ory n ) WCUC46140163 - EX WC FL If yes, describe under E-L. DISEASE -POLICY LIMIT $ 1,000,000 OTHER (1) ADDITIONAL INSURED: If requir¢d by contract, includes coverage for Additional Insureds per attest M1ed endorsement. (2) ADDITIONAL INSURED: If req ufretl by contract, Includes coverage for Additional Insureds and Loss Payees as requlretl by contract (3) PRIMARY COVERAGE: WM1ara raqul red by lease o ontract, [M1ls c raga Is primary and no[ ¢xcass of or contributing wl[M1 otM1¢r insurances or sell-Insurance c 4 WAIVER OF SUBROGATION: Insured waives subro atlon [o [M1e extant r ulrad b ontract DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / E%CLDSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS JCI Contract No. JCI Projac[ Nama:All work performed by abov¢ insur¢d Customer PO Number: CERTIFICATE HOLDER A UAT2 (IV F.T7 A R 'TO FORM CANCELLATION City of Santa Ana /? SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Building Maintenance M-11 C EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL GND6.4?VGiiZC 20 CIVIC Center Pala MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, RYi Basemen[ / I' S L Sheedy Santa Ana, CA 92701- aura A SS1Sta IIt 1Cy AttOrlley gUTHORIZED REPRESENTATIVE Ot MARSH USA INC. ACORD 25 (2009/01) ©ACORD CORPORATION 1988 POLICY NUMBER= HDOG25521390 COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Persons Or Or anization s : If required by contractI City of Santa Ana Location(s) Of Covered Operations As required by contract, All work performed by above insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 1. Your acts or omissions; or 1 . All work, including materials, parts or equipment Endorsement #A2 ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -NAMED INSURED'S ACTS OR OMISSIONS ONLY A. Section II -Who is An Insured is amended to B. With respect to the insurance afforded to these additional include as an additional insured the person(s) or insureds, the following additional exclusions apply: organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or This insurance does not apply to "bodily injury" or "personal and advertising injury" caused solely by: "property damage" occurring after: furnished in connection with such work, on the 2. The acts or omissions of those acting on your behalf; project (other than service, maintenance or repairs) to be performed by or on behalf of the additional in the performance of your ongoing operations for the insureds) at the location of the covered operations additional insureds) at the location(s) designated above. has been completed; or " " out of which the injury or 2. That portion of your work damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same ro"ect. Endorsement #A2A ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS - NAMED INSURED'S ACTS OR OMISSIONS ONLY Section 11 -Who Is An Insured is amended to inclutle as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused solely by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard." Named Insured Johnson Controls, Inc. Endorsement Number A4 Policy Symbol Policy Numbe Policy Period Effective Date of Endorsement HDO 625521390 10/01/10 to 10/01/11 10/01/10 Issued By (Name of Insurance Company) ACE American Insurance Com an THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE WHERE REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: COMMERICAL GENERAL LIABILITY COVERAGE FORM Section IV -Commercial General Liability Conditions -Item 4. Other Insurance is replaced with the following: a. Excess Insurance If other collectible insurance with any other insurer is available to the insured and that other insurance covers a loss also covered by this policy, the insurance provided by this policy shall apply excess of and shall not contribute with such other insurance. Excess insurance over the limits of liability in this policy does not prejudice this insurance and the existence of such insurance shall not reduce any liability under this policy. b. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contributions by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. c. Primary Where Required by Contract or Agreement This policy will apply as primary insurance and will not contribute or share with other primary insurance, where required by contract or agreement entered into by the Named Insured. CC-'IE'15 Ptd. In U.S.A. Workers' Compensation and Employers' Liability Policy Named Insured: Johnson Controls, Inc. Endorsement Number: AA Policy Number: W LRC4614014A - AOS WLRC46140126 - CA SCFC46140151 - WI Policy Period:10-1-10 TO 10-1-11 Effective Date of Endorsement: 10-1-10 Issued by (Name of Insurance Company): Indemnity Insurance Company of North America and for CA and WI: ACE American Insurance Company Insert the policy number. The remainder of the information of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. Schedule Person or Organization: If required by contract, City of Santa Ana Job Description: All work performed by above insured WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS W C 00 03 1 3 We have the right to recover our payments from anyone liable for an injury covered by this po 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 anyone not named in the Schedule. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENOO RSEMENT CALIFORNIA WC 99 03 22 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 required you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be -INCLUDED % of the California workers' compensation premium otherwise due on such remuneration. Copyright 1982-83, National Council on Compensation Insurance Authorized Agent Jaclclyn M Lindberg Insurance Assistant MARSH MARSH MERCER KROLL _______ GUY CARPENTER OLIVER WYMAN September 16, 20'10 City of Santa Ana Building Maintenance M-11 20 Civic Center Plaza Basement Santa Ana, CA 92701- Subject: Johnson Controls, Inc. Johnson Controls L.P. Societe De Controle Johnson Ltee. Certificate of Insurance Coverage Period -October ?, 20'10 -October 1, 20'1'1 Dear Ci[y of Santa Ana Marsh USA Inc. 41 ? E. Wisconsin Ave. Suite 1600 Milwaukee, WI 53202 Fax 414 290 4953 Cpu_milwaukee@marsh.com As Johnson Controls' insurance broker, we are providing you a certificate of insurance evidencing their insurance coverages for this coverage period. /f provided to us, the project name and your company's contract number or purchase order number are referenced on the front of the certificate in fhe Oescrintion section. /n the Other section is important information about the insurance coverages, inc/uding additiona/ insured coverage for you if required by contract. If you have any questions or require additional information, email or fax your inquiries to the address and number indicated above. IMPORTANT /f your firm does not require a certificate of insurance, p/ease O/SREGARO this letter and certificate of insurance. You may receive a certificate within the next few days that does not correct/y ref/ect your terms. That certificate is a system generated certificate and can be discarded as the certificate enclosed herein dated September 96, 2090 wi// take precedence. Sincerely, Jacklyn M Lindberg Insurance Assistant