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HomeMy WebLinkAboutJOHNSON CONTROLS, INC. - INSURANCE CERTIFICATEA11� 6. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 /4/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh USA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 411 East Wisconsin Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 1600 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Milwaukee, WI53202-4419 '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 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 Corporation 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 DD'L NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE DATE (MM/DD/YY) (MM/DD/YY) A GENERAL LIABILITY (1) (3) (4) HDOG24934056 10/1/2009 10/1/2010 EACH OCCURENCE $ 5,000,000 ® COMMERICAL GENERAL LIABILITY DAMAGET PR M SESOEa occur ence $ 5,000,000, ❑❑ CLAIMS MADE ®OCCUR MED EXP (Any one person) $ 50,000 ® Contractual ® PERSONAL & ADV INJURY $ 5,000,000 X,C,U GENERAL AGGREGATE - $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 5,000,000 POLICY PROJECT D LOG B AUTOMOBILE LIABILITY (2) (3) (4) -10/1 /2009 10/1 /2010 CO COMBINED SINGLE LIMIT $ S,000,OOO ®ANY AUTO (Ea90-04606-01 Accident) ❑ ALL OWNED AUTOS BODILY INJURY $ ❑ SCHEDULED AUTOS (Per person) ® HIRED AUTOS BODILY INJURY (Per accident) $ ® NON -OWNED AUTOS PROPERTY DAMAGE (Per 1 $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ❑ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ D EXCESS/UMBRELLA LIABILITY XOO G24901154 10/1 /2009 10/1/2010 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 ® OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE .... $ - ❑ RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY (4) WLRC45702017 — AOS 10/1/2009 10/1/2010 ® WC LIMIT ❑ O R TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE W LRC45702029 — CA E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? El Y/N SCFC45702030 — WI E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) WCUC45702042 — EX WC E.L. DISEASE - POLICY LIMIT $ 1 ,000,000 If yes, describe under -SPECIAL PROVISIONS hpinw WCUC45702625 — EX WC FL 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 subrogation to the extent required by contract. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS JCI Contract No. 4OM79 JCI Project Name: Cty of FI Collins-NAE Metasys Upgrades Customer PO Number: 9957339 CITY OF FT COLLINS PO BOX 580 FORT COLLINS, CO 80522 ACORD 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL 6NB6AYOR-TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, REPRESENTATIVE MARSH USA INC. © ACORD CORPORATION 17. 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. ACORD 25 (2009/01) AM Best Rating COMPANIES AFFORDING COVERAGE (as of 1/1/10) NAIC # SEE BELOW INSURER A: ACE AMERICAN INSURANCE COMPANY A+ XV 22667 PO Box 41484, Philadelphia, 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, Philadelphia, PA 19101 INSURER D: ACE PROPERTY & CASUALTY INSURANCE A+ XV 20699 COMPANY 436 Walnut Street, Philadelphia, 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 Organization s : If required by contract, CITY OF FT COLLINS and CITY OF FT COLLINS Location(s) Of Covered Operations As required by contract, Cty of Ft Collins-NAE Metasys Upgrades Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Endorsement #A2 Section II —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", "property damage" or "personal and advertising injury" caused solely by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. With respect to the insu afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment 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 insured(s) at the location of the covered operations 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 Endorsement #A2A Section II — 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."