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HomeMy WebLinkAbout491581 SIEMENS INDUSTRY INC - INSURANCE CERTIFICATEMARSH Memo To: To Whom It May Concern Date: September 14, 2012 From: �Nlarsh C6S� Subject: (/ Siemens C rporation e tcates of Insurance 2012 - 2013 Policy Year Marsh USA Inc. 10900-Stonelake Blvd., 2i0 Floor Austin, TX 78759 512 342 4400 Fax 212 948 0622 NsiomGns.csg@marsh.com As a Siemens Corporation Certificate Holder, please find attached your company's renewal certificate for the 10/1/2012 — 10/1/2013 policy period. If you do not require this Certificate of Insurance, please advice by marking "delete" on the certificate and returning it via email (nisiemens.cse@marsh.com) or fax to (212) 948 0622. Best regards, Marsh CSS Marsh a kkter n Companies POLICY NUMBER: AS2-631-004334-212 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SCHEDULE Narne(s) 01 Person(s) Or Organization(s)- The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 0310 0 Insurance Services Office, Inc., 2009 Page 1 of 1 POLICY NUMBER: GLD11101-04 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION TO THE EXTENT REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not 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 IV — 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 only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 �`� " CERTIFICATE OF LIABILITY INSURANCE DATEIMh11DaVVYY) 09I19I2012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME: FA PHONE INC.No E-MAIL ADDRESS: MORRISTOWN, NJ 07960-6454 INSURERS AFFORDING COVERAGE NAICY INSURER A:HDI-Gedirg America Insurance Company 41343 100129 MOBI--12113 MOBI Harper 0704 NOC60 INSURED SIEMENS INDUSTRY INC. INCLUDING: MOBILITY DIVISION INSURER B: Llbeny Mutual Fire INS Co 23035 INSURER C : LM Insurance Corporation 33600 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089-4513 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC 006447212 02 REVISION NUMBER: THIS IS 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY YVY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY GLD1110104 1010112012 10101/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _ CLAIMS MADE OCCUR ETORENTED PREMISES PREMISE$ Ea occurrence $ 1,000,000 MED EXP(my one person) $ 100,000 PERSONAL&ADV INJURY $ 1,000000 GENERAL AGGREGATE $ 7,500,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ INCL. X I POLICY PRO- LOG JFCT $ B AUTOMOBILE LIABILITY AS2631004334212 1010112012 10101/2013 COMBINED SINGLE LIMIT Ea accident 2000000 X BODILY INJURY(Per person) $ N/A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS g BODILY INJURY (Per accident) $ N/A X HIRED AUTOS X ANOOSWNED PerOPERT n DAMAGE $ NIA $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ 1 C WORKERS COMPENSATION WA563DO04334012(AOS) 10/0112012 10101/2013 X WCSTATU- OTH MLT C AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEMEXECUTIVE Y/N OFFICERIMEMBER EXCLUDED? � (Mandatory in NH) N/A WC5631004334022 (OR, WI)1010112012 1010112013 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE EA EMPLOYE $ 1'000'ow If as, describe under DESCRIPTION OF OPERATIONS... E.L. DISEASE-POLICYLIMIT $ 1.000.000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) THE CITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY ADDITIONAL INSURED AS OBLIGAT ED UNDER CONTRACr. SUCH INSURANCE AS IS AT BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY. WAIVER OF SUBROGATION IS EFFECTUAL. $1,00O000 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY. IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILT. DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT. WHICHEVER IS LESS. CITY OF FORT COLLINS ATTN: ED BONNETTE, C.P.M., CPPB, BUYER 215 NOR] H MASON STREET 2ND FLOOR FORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee —JvLo, A " ACORD25 (2010/05) ©1 The ACORD name and logo are registered marks of ACORD All rights renamed MARSH Memo To: To Whom It May Concern Date: September 14, 2012 From: Marsh CSS Subject: Siemens Corporation Certificates of Insurance 2012 - 2013 Policy Year Marsh USA Inc. 10900 Stonelake Blvd., 2° Floor Austin, TX 76759 512 342 4400 Fax 212 948 0622 lqsiomGns.csg@marsh.com As a Siemens Corporation Certificate Holder, please find attached your company's renewal certificate for the 10/1/20 t2 — 10/1/2013 policy period. If you do not require this Certificate of Insurance, please advice by marking "delete" on the certificate and returning it via email (nisiernens.csr@marsh.com) or fax to (212) 948 0622. Best regards, Marsh CSS Marsh & &kLwin n Companies POLICY NUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations ANY PERSON OR ORGANIZATION REQUIRED BY ALL LOCATIONS WHERE THE INSURED IS WRITTEN CONTRACT PERFORMING ONGOING OPERATIONS FOR AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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, in whole or in part, 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring alter: 1. All work, including materials, parts or equip- ment 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 2. That portion of 'your work' out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: AS2-631-004334-212 COMMERCIAL AUTO CA 04 44 0310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SCHEDULE Name(s) Of Person(s) Or Orgenization(s): The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization. CA 04 44 0310 0 Insurance Services Office, Inc., 2009 Page 1 of 1 Ili3�[9'�II113�1:3�:3ilNtla r r 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 required to complete this Schedule, if not 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 IV — 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 only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 i 1 ® A�911 ­BATE(MWDD/YYYY) 912012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET' MORRISTOWN, NJ 07960 6454 CONTACT NAME: PHONE I FAX .IL A/C No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC N 100129- FED -CRIME-12/13 MOBI IIARPE INSURER A: Liberty Mutual Insurance Cornminy 23043 INSURED SIEMENS INDUSTRY INC. INCLUDING INSURER B : MOBILITYIITS DIVISION INSURER C INSURER 0: 1000 DEERFIELD PARKWAY BUFFALO GROVE, II. 60089 4513 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC 006404650-03 REVISION NUMBER: THIS IS 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. INS9 LTR OF INSURANCE AfffjETYPE MISR lffla POLICY NUMBER MWDD/POUCYYYYY MWDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMA6ET RENT D COMMERCIAL GENERAL LIABILITY PREMJSE5 Ea occurrence S CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ $ POLICY PRO-1-1 LOC RCT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acci enl 5 jBODILY INJURY (Per person) S ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LAB CLAIMS MADE DED_­F RETENTIONS S WORKERS COMPENSATION WC STATUJIMJT- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E. L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S II y s describe under DE SCRIPTION OF OPERATIONStolow E. L. DISEASE -POLICY LIMIT $ A FIDEL I'TY/EMPLOYEE YC1631004334152 10/01/2012 10101/2013 5,000,000 DISHONESTY DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is requited) VI A i\ r l a Lqp\ Lii PJ V/ai1 CITY OF FORT COLLINS ATTN: ED BONNETTE, C.P.M.. CPPG, BUYER 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD MARSH Memo To: To Whom It May Concern Date: September 14, 2012 From: Marsh CSS Subject: Siemens Corporation Certificates of Insurance 2012 - 2013 Policy Year Marsh USA Inc. 10900 Slonelake Blvd., 2i0 Floor Austin, TX 78759 512 342 4400 Fax 212 948 0622 Nsiomens.csg@marsh.com As a Siemens Corporation Certificate Holder, please find attached your company's renewal certificate for the 10/1/2012 — 10/1/20t3 policy period. If you do not require this Certificate of Insurance, please advice by marking "delete" on the certificate and returning it via email (nisiemens.csg@marsh.com or fax to (212) 948 0622. Best regards, Marsh CSS 14 Mash B Wt.. Cumpmiim CERTIFICATE OF LIABILITY INSURANCE DMMrD VYVV) 091192012ATE/2012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER CONTACT NAME' MARSH USA, INC. 445 SOUTH STREET loco No law: (A/6 No1: MORRISTOWN, NJ 07960 6454 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC a INSURER A: Liberty Mutual Insurance Company 23043 100129- FED -CRIME -12113 MOBI Harper INSURED SIEMENS INDUSTRY INC. INCLUDING: INSURER B: ' MOBILITY DIVISION INSURER C INSURER D : 1000 DE ERFIELD PARKWAY BUFFALO GROVE, IF 600894513 INSURER E INSURER IF COVERAGES CERTIFICATE NUMBER: NYC 006447226 03 REVISION NUMBER: THIS IS 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 R TYPE OF INSURANCE AWOL SUER POLICY NUMBER POLICY EFF IMIWDDNYYY1 POLICY EXP (MWDDIYYYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMA E TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S CLAIMS -MADE ❑OCCUR MED EXP(My one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE S GATE GEN'L AGGRELIMIT APPLIES PER: PRODUCTS - COMPILE AGO S POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc'Ident BODILY INJURY (Per person) S ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accslenl $ HIRED AUTOS NON2OWNED AUTOS 3 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- TORY LI AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR,'PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) It yas, describe under DESCRIPTION OFOPERATIONS below__J E.DISEASE- POLICY LIMIT $ A FIDELITYIEMPLOYEE YC1631004334152 1010112012 10/0112013 5,000,000 DISHONESTY DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) CITY OF FORT COLLINS ATTN: ED BONNETTE, C.P.M., CPPB, BUYER 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherlee © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 The ACORD name and logo are registered marks of ACORD 1 ® AC oaI CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 09119/2012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME' WGFAx NN . FAU. ac No: E-MAIL ADDRESS: MORRISTOWN, NJ 079606454 I 1 1 P IIJr- l U INSURER(S)AFFORDING COVERAGE NAICM INSURER A: Libeny WIW I Insurance Company 23043 100129 FED CRIME 12113 MOBI HARPE INSURED SIEMENS INDUSTRY INC. INCLUDING INSURER a MOBILITYIITS DIVISION INSURER C INSURER D: 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089 4513 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: NYC 006404650-03 REVISION NUMBER: THIS IS 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 LTRINqR TYPE OF INSURANCE AOOL SIIBR POLICY NUMBER MMIOD/YYYY MWOD/YYYy LIMITS GENERAL LIABILITY CURRENCE $ TO RENTED COMMERCIAL GENERAL LIABILITY S Ea occurrence $ (An one person) rGENEPAL $ CLAIMS -MADE OCCUR L 8 ADV INJURY S AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: S-COMP/OP AGO $ $ POLICY PRO- LOG AUTOMOBILE LIABILITY LIM COMBINED SINGLEIT Ea acockafff � _ BODILY INJURY (Per person) S ANY AUTO BODILY INJURY (Per accident) S ALL OWNED SCHEDULED AUTOS AUTOS PROPERTVDAMAGE Per amid In S NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE WCSTOTH ATU- �- E.L. EACH ACCIDENT S OFFICEWMEMBER EXCLUDED' N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASEPOLICYLIMIT S If yes. describe under OE SCRIPTION OF OPERATIONS below A FIDELITYIEMPLOYEE YC1631004334152 1010112012 1010112013 5,000,000 DISHONESTY DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN. ED BONNETTE, C.P.M., CPPG, BUYER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 NORTH MASON STREET 2ND FLOOR ACCORDANCE WITH THE POLICY PROVISIONS. FORT COLLINS, CO B0524 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherlee QNA,� O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD A� "a CERTIFICATE OF LIABILITY INSURANCE DATE(12012 YVY) 0911912012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME: PHONE I FAK AA/C. RI tF IA/D Not: E-MAIL ADDRESS: MORRISTOWN, NJ 07960 6454 INSURERS AFFORDING COVERAGE NAIC N 100129-MOBI--12113 MOBI HARPE 0704 NOC60 INSURER A:HDI-Gerling Arnerica Insurance Company 41343 INSURED SIEMENS INDIRY INC. INCLUDING: ON MOBILITY DIVISION INSURER B: Liberty Mutual Fire Ins CO 23035 INSURER C : LM Insurance Corporation 33600 INSURER D: 1000 DECRFIELD PARKWAY BUFFALO GROVE, It, 60099 4513 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-006404634-02 REVISION NUMBER: THIS IS 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 TR TYPE OF INSURANCE ADOL SUER POLICY NUMBER MWD�NYVY POLICY EXP MM/DD/YVYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR GLD1110104 1010112012 10/0112013 EACH OCCURRENCE S 1,000,000 DAMAGE T RENTED PREMISES Ea ccirdence $ 1.000,000 MED EXP(M one person) $ 100,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 7,500,000 GENL AGGREGATE X POLICY LIMIT APPLIES PER'. PRQ LOG PRODUCTS - COMP/OP AGO $ INCL $ B AUTOMOBILE LIABILITY % ANY AUTO % ALL OWNED SCHEDULED AUTOS AUTOS X - N NON -OWNED HIRED AUTOSAUTOS AS2631004334212 1010112012 1010112013 COMBINED SINGLE LIMIT -LaccitlnnL_____ 2,000,000 BODILY INJURY (Per person) $ N/A BODILY INJURY (Per accident) $ NIA PROPERTYDAMAGE mcid nt S NIA -(Per UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ H AGGREGATE $ BED RETENTIONS S C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIE%ECUTIVE NH)EXCLUDED? (Mandatory in NH) (Mandatory If yes, describe under DESCRIPTION OF OPERATIONS helow N/A WA563DO04334012(ADS) WC5631004334022 (OR, WI) 1010112012 1010112072 10101/2013 1010112013 X WCSTATu- oTH LN1li TORY1,000,000 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ 1,000.000 E.L. DISEASE -POLICY LIMIT 1,000.00D $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: JOB NO. NIA SEE ATTACHED CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTW ED BONNETTE, C.P.M., CPPG, BUYER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 NORTH MASON STREET 2ND FLOOR ACCORDANCE WITH THE POLICY PROVISIONS. FORT COLLINS, CO 80524 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee-.Maxrarw.: © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 100129 LOC #: Morristown ACOR" kh� ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA, INC. SIEMENS INDUSTRY INC. INCLUDING: MOBILITY DIVISION 1000 DEERFIELD PARKWAY POLICY NUMBER BUFFALO GROVE, IL 60089 4513 CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance CITYOF FORT COLLINS. THE CITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY. WAIVER OF SUBROGATION IS EFFECTUAL. $1,000,000 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY. IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURER WILL DLLIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER 11P TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. ACUHO 101 (2008/01) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 6"1y:l:1rltl11114 Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations ANY PERSON OR ORGANIZATION REQUIRED BY ALL LOCATIONS WHERE THE INSURED IS WRITTEN CONTRACT PERFORMING ONGOING OPERATIONS FOR AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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, in whole or in part, 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to 'bodily injury' or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: AS2-631-004334-212 COMMERCIAL AUTO CA 04 44 0310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SCHEDULE Name(s) Oi Person(s) Or 01 ganization(s): I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 0310 0 Insurance Services Office, Inc., 2009 Page 1 of 1 POLICYNUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG24040509 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 j Information required to complete this Schedule, if not 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 IV —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 only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 i 1 0 A� CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDNYYY) 09/190012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA. INC. 445 SOUTH STREET CONTACT NAME: PHONE FAX .III Ns Ea: A/c No E-MAIL ADDRESS: MORRIS MWN, NJ 07960-6454 INSURERS AFFORDING COVERAGE NAIC p INSURER A; hlDl-Gelling America Insurance Company 41343 100129 MO81--12I13 MOBI HARPE 0704 NOC60 INSURED SIEMENS INDUSTRY INCINCLUDING. . MOBILITY DIVISION INSURER B : Liberty Mutual Fire Ins Co 23035 INSURER C: LM Insurance Corporation 33600 INSURER D 1000 DEERFIELD PARKWAY BUFFALO GROVE, II. 60089 4513 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: NYC 006404634 02 REVISION NUMBER: THfS IS 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 Tfl TYPE OF INSURANCE ADDL SUBn POLICY NUMBER MW ICY EFF DD/YYYY POLICY I MWDDYYYY LIMITS A GENERAL LIABILITY GLD1110104 10/01/2012 10/01/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY EN DAMAGETO RPRoccuTErD rence $ 1,000,000 CLAIMS-MADElxl OCCUR MED EXP(Any one person) $ 100,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 7,500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ INCL. X POLICY PRO- LOC $ B AUTOMOBILE LIABILITY .AS2631004334212 10/0112012 10101/2013 COMBINED SINGLE LIMIT yEa_CCident) 2,000,000 BODILY INJURY (Per Person) S N/A X ANY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S NIA PROPERTY DAMAGE Per accitlent $ NIA X X NON -OWNED HIRED AUTOS AUTOS S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS MADE DIED I I RETENTIONS $ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) N/A WA563DO04334012 (AOS) WC5631004334022 (OR, WI)1010112012 10101/2012 1010112013 1010112013 X VIC STATu- 01 -T-�Y-1 MIT E.L EACH ACCIDENT $ 7,000,000 E. L. DISEASE - EA EMPLOYEE $ 1,000,000 II yes, describe under DESCRIPTION OFOPERATIONS below E. L. DISEASE POLICY LIMIT 1 $ 1, 000U00 DESCRIPTION OF OPERATIONS/ LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: JOB NO. NIA SEE ATTACHED CITY OF FORT COLLINS ATTN: ED BONNETTE, C.P.M., CPPG, BUYER 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Mai Mukherjee pia " ACORD 25 (2010/05) 1988-2010 The ACORD name and logo are registered marks of ACORD All rights reserved- AGENCY CUSTOMER ID: 100129 LOC #: Morristown Ac4c>RL> ® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA, INC. SIEMENS INDUSTRY INC. INCLUDING: MOBILI I Y DIVISION 1000 DEERFIELD PARKWAY POLICY NUMBER BUFFALO GROVE, IL 60089-4513 CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CertifiCate Of CITY OF I OR T COLLINS. THE CITY, IFS OFFICERS, AG EN S AND EMPLOYEES ARE HEREBY ADDITIONAL INSURED AS 0BI.ICA] ED UNDER CONTRACT. SUCII INSURANCE AS IS AFFORDED BY I HE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE d OTHER INSURANCE MAINTAINED BY I HE CERDFICA I E HOLDER SHALL BE EXCESS ONLY E NOT CONTRIBUT ING WITH INSURANCE PROVIDED UNDER THIS POLICY. WAIVER OF SUBROGATION IS EFFECTUAL. $1,000,000 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY. IF THESE POLICIES ARE CANCEL ED FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO TI IE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO In CAN CELLAI ION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHIiVER IS LESS. 101(2008/01) 2008 ACORD CORPORATION. All rinhte r>carvod The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLD 11 101-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oruanization(s): I Locations) Of Covered Ooerations ANY PERSON OR ORGANIZATION REQUIRED BY WRITTEN CONTRACT ALL LOCATIONS WHERE THE INSURED IS PERFORMING ONGOING OPERATIONS FOR AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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, in whole or in part, 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) desig- nated above. B_ With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 2. That portion of "your work' out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: AS2-631-004334-212 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. 6YN:1:4bill g0 Name(s) Of Person(s) Or Organization(s): The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss' under a contract with that person or organization. CA 04 44 0310 0 Insurance Services Office, Inc., 2009 Page 1 of 1 POLICYNUMBER: GLD11101-04 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 RIGNI:1r1I11:11 Name Of Person Or Organization: ANY PERSON OR ORGANIZATION TO THE EXTENT REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not 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 IV — 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 only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 ACCOR" CERTIFICATE OF LIABILITY INSURANCE DATEnvvr) 2012 0911912012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 415 SOUTH STREET CONTACT NAME: PHONE FAX G,.NQ.Enu ac No: E-MAIL ADDRESS: MORRIS TOWN, NJ 07960 6454 INSURERS AFFORDING COVERAGE NAIC k INSURER A; HDI Ceiling America Insurance Company 41343 100129-MOBI-12/13 MOBI IIARPE 0704 NOC60 INSURED SIEMENS INDUSTRY INC. INCLUDING: MOBILITY DIVISION INSURER B : Liberty Mutual Fire Ins CO 23035 INSURER c : LM Insurance Corporation 33600 INSURER D 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 6W89 4513 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: NYC-006404634 02 REVISION NUMBER: THIS IS 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. POLICY ERE POLICY EXP INSR ABC[TYPE OF INSURANCE INSR WVDsuff-Al POLICY NUMBER MWDD/YYYY MWDD/YYYY LIMITS LTA A GENERAL LIABILITY GLD1110104 1010112012 1010112013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EKE (Anyone person) $ 100.000 CLAIMS MADE 19 OCCUR PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 7,500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ INCL. $ X POLICY PRO LOG B AUTOMOBILE LIABILITY AS2631GO4334212 1010112012 10/0112013 COMBINED SINGLE LIMIT Ea accigen!1___._ 2 000 $ '( ANY AUTO BODILY INJURY (Per person) $ N/A X ALL OWNED SCHEDULED AUTOS BODILY INJURY(Pereccident) $ NIA PROPERTY DAMAGE Peraccident $ NIA X X NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS MADE DED RETENTIONS $ C WORKERS COMPENSATION WA563DO04334012(POST 1010112012 10/0112013 X WC STAru- OTH- C AND EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVE YINE.L. OFFICENMEMBER E%CWOED? M (Mandatory in NH) NIA WC5631004334022 (OR. WQ 10/01/2012 �1010112111 EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1'000.000 E.L. DISEASE -POLICY LIMIT 1.000,000 S If Yes, describe uneor OE SCRIPHONOFOPERATIONSIoelow DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE'. JOB NO. NIA SEE ATTACHED CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: ED BONNET TE, C.P.M., CPPG, BUYER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 NORTH MASON STREET 2ND FLOOR ACCORDANCE WITH THE POLICY PROVISIONS. FORT COLLINS, CO 80524 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ,'��Lytpply �+4M.ie.na�e.a 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACOR" CERTIFICATE OF LIABILITY INSURANCE 1`� DATE12012 VYVY) 09/192012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME, PHONE FAX AAI(.Ny NC No: E-MAIL ADDRESS: MORRISTOWN, NJ 07960 6454 INSURERS AFFORDING COVERAGE NAIC N INSURER A: HDI Ceding America insurance Company 41343 100129 MOBI- 12/13 MORI Harper 0704 NOC60 INSURED SIEMENS INDUSTRY INC. INCLUDING: INSURER B : Llbany Mutual Fire Ins Co 23035 INSURER c : LM Inwlance Corporation 33600 MOBILI7 Y DIVISION 1000 DEERFIE-D PARKWAY BUFFALO GROVE, E 60089-4513 INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: NYC-0064472IZ-02 REVISION NUMBER: THIS IS 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 LTfl TYPE OF INSURANCE ADD SUER POLICY NUMBER POLICY EFF MWDDIYYYY POLICY EXP MM/DDNYYY LIMITS A GENERAL LIABILITY GLD1110104 1010112012 10/0112013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR PREMISE Ea occurrence PREMI E$Ea occurrence) $ 1,000,000 MED EXP (Any one pesoA) $ 100,000 PERSONAL&ADV INJURY $ 1.000,000 GENERAL AGGREGATE S 7,500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPIOPAGG $ INCL. X POLICY F7 PRO- LOC $ B AUTOMOBILE LIABILITY AS2631004334212 1010112012 10/01/2013 COMBINED SINGLE LIMIT jFaa�entL_-_ $ 7,000,000 XNONOWNED BODILY INJURY (Per person) S NIA ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS X IX BODILY INJURY Per accident ( 1 $ NIA HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accid m S NIA b UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ C WORKERS COMPENSATION WA563DO04334012 (ADS) 1010112012 1010112013 X WC STATU- OTH C AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/E%ECUTIVE Y/N OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) If yes. of scrioe under DESCRIPTION OF OPERATIONS below N/A WC5631004334022 (OR, W0 1010112012 1010112013 omS EH_ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) THE OF Y, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY ADD I IIONAL INSURED AS OBLIGATED UNDER CONTRACT. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICAI E IiOLDER SHALL BE EXCI7$S ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER I IIIS POLICY. WAIVER OF SUBROGAI ION IS EFFECTUAL. $1,000,000 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY. IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. CITY OF FORT COLLINS ATTN: ED BONNETTE C.P.M., CPPB, BUYER 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _. t_,L r a.: -w.du ig 19tti4U1U AGUHU CUHPUHATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 6'Iy714pill a2 Name Of Additional Insured Person(s) ANY PERSON OR ORGANIZATION REQUIRED BY WRITTEN CONTRACT Location f sl Of ALL LOCATIONS WHERE THE INSURED IS PERFORMING ONGOING OPERATIONS FOR AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. 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, in whole or in part, 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) desig- nated above. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "properly damage" occurring after: 1. All work, including materials, parts or equip- ment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 C POLICY NUMBER: AS2-631-004334-212 COMMERCIAL AUTO CA 04 44 0310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Information The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the 'accident" or the 'loss" under a contract with that person or organization. CA 04 44 03 10 0 Insurance Services Office, Inc., 2009 Page 1 of 1 POLICYNUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG24040509 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 required to complete this Schedule, if not 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 IV — 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 only 10 the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 A� �® CERTIFICATE OF LIABILITY INSURANCE DATE912012DYVYY) 09I19I2012 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME: PHONE I FAX c.t4e_EXU' A/C No: MORRISTOWN, NJ 07960-6454 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Libeny Mutual Insurance Company 23043 100129 FEDCRIME12113 MOBI Harper INSURED SIEMENS INDUSTRY INC. INCLUDING INSURER B : INSURER MOBIL I IY DIVISION 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089 4513 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC 0064722603 REVISION NUMBER: THIS IS 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. INTp TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF IMM/DD1YYYYI POLICY EXP QMMsDDNYYYlLIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAG TTiRENTED PREMISES Ea occurrence S MED EXP (My one person) $ CLAIMS - MADE OCCUR PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ POLICY PRO LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accitlent ( 1 $ PROPERTY DAMAGE Pet accident $ HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE CEO RETENTION$ $ I WORKERS COMPENSATION I WC STATU- OTH- ANDEMPLOYERS' LIABILITY Y/N OBYLIMIT L. E.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA E.L. DISEASE EA EMPLOYE $ (Mandatory in NH) If DySCdescribe Under DESCRIPTION OPERATION ow bel E.L. DISEASE POLICY LIMIT 9 A FIDELITYIEMPLOYEE YCIG31004334152 10/01/2012 10101/2013 5,000,000 DISHONESTY DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FORT COLLINS ALN: ED BONNETTE, C.P.M., CPPB, BUYER 215 NORTH MASON STREET 2NO FLOOR PORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -Matto " ©1988-2010 ACORD CORPORATION- All rinhts rasarvad ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD f`� " CERTIFICATE OF LIABILITY INSURANCE DATE(12012 VV) 911 091201Z 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER CONTACT NAME: MARSH USA, INC. PHONE FAX 445 SOUTH STREET rA/C Nia-M* (AiC, Nol: E-MAIL ADDRESS: MORRISTOWN, N3 07960 6454 INSURERS AFFORDING COVERAGE _ NAICK INSURER A: Libeny Mutual Insurance Company 123043 100129- FED -CRIME-12113 MOBI HARPE INSURED SIEMENS INDUSTRY INC. INCLUDING INSURER B MOBILITYATS DIVISION INSURER C INSURER D 1000 DE ERFIELD PARKWAY BUFFALO GROVE, It. 600894513 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC 00640465003 REVISION NUMBER: - THIS IS 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 LTP TYPE OF INSURANCE ADEL SUER POLICY NUMBER POLICY BEE MMIDD/YYYY POLICY EXP MM/DD/VYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CIAIMS MADE ❑ OCCUR MED EXP (Any one person) S PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP ADS $ $ POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc dAn, BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS MADE DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / NI WHYLUMiTS-L� E L. EACH ACCIDENT $ ANY PROPRIETOR/PARI'NER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) U yas, describe under DE SCRIPTIONOFOPERATIONSbelow EL. DISEASE -POLICY LIMIT I $ A FIDELITYIEMPLOYEE -7 YC1631004334152 10101/2012 1010112013 5,000,000 DISHONESTY DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FORT COLLINS ATTN: ED BONNETTE, C.P.M., CPPG, BUYER 215 NORTH MASON STREET 2ND FLOOR FORTCOIUNS,CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -1*Ctt " 1988-2010 ACORD CORPORATION. All rights reserved ACORD25 (2010/05) The ACORD name and logo are registered marks of ACORD A``R h® CERTIFICATE OF LIABILITY INSURANCE D0.TE/2012 VVY) 09/192072 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME, . PHONE FAx (A/G,.No,.Eaf A/C No E-MAIL ADDRESS: MORRISTOWN, NJ 07960 6454 INSURER § AFFORDING COVERAGE NAIC If INSURER A: Liberty Mutual Insurance Company 23043 100129-FED CRWET 2/13 MOBI Harper INSURED SIEMENS INDUSTRY INC. INCLUDING: INSURER B: INSURER C MOBILITY DIVISION 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089 4513 INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: NYC -006447226-03 REVISION NUMBER: THIS IS 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 LTR TYPE OF INSURANCE I DDL SUSHI POLICY NUMBER POLICY EFF MM/DDNYYY) POLICY EXP JMWDD[YYYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE L1 OCCUR MED EXP(Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ POLICYFI PPrITRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS TOS J BODILY INJURY (Per accitlen) $ IAU PROPERTY DAMAGE Per IIC i, m $ HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAR OCCUR - EACH OCCURRENCE IS AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT 3 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEO - S (Mandatory in NH) Dyes, describe under DESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT § A FIDELITYIEMPLOYEE YC1631004334152 1010112012 1010112013 5.OW,WO DISHONESTY DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FORT COLLINS ATTN: ED BONNETTE, C.P.M., CPPB, BUYER 215 NORTH MASON STREET 2ND FLOOR FORT COLLINS, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _M.auQo�%e.wdu 1988-2010 ACORD CORPORATION- All rinhta reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 100129 LOC #: Morristown ACOR" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA, INC. SIEMENS INDUSI RY INC. INCLUDING: MOBILITY DIVISION 1000 DEERFIELD PARKWAY POLICY NUMBER BUFFALO GROVE, IL 60069 4513 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance CITY OF FORT COLLINS. THE CITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERI IFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY. WAIVER OF SUBROGATION IS EFFECTUAL. S1,OOO,ODO PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY. IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. ACORD 101 (2OO8/01) 02008 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) ANY PERSON OR ORGANIZATION REQUIRED BY WRITTEN CONTRACT ALL LOCATIONS WHERE THE INSURED IS PERFORMING ONGOING OPERATIONS FOR AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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, in whole or in part, 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring alter: 1. All work, including materials, parts or equip- ment 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 2. Thai portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: AS2-631-004334-212 COMMERCIAL AUTO CA 04 44 0310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived.prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 0310 © Insurance Services Office, Inc., 2009 . Page 1 of 1 POLICYNUMBER: GLD11101-04 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 The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —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 only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 11 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE/2012 YYYY) osnsnolz 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 OR 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 policy(ies) must be endorsed. 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). PRODUCER MARSH USA, INC. 445 SOLI FITSTREET CONTACT NAME, PHONE PAx MORRISTOWN, N3 07960-6454 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL i INSURER A:HDI-Gerling America Insurance Company 41343 100129 MODI--12113 MOBI Harper 0704 NOC60 INSURED SIEMENS INDUSTRY INC. INCLUDING: MOBILITY DIVISION INSURER B: hheny Mutual Fire Ins Co 23035 INSURER C : LM Iltsumnce Corporation 33600 1000 DEERFIELD PARKWAY BUFFALO GROVE, IT 60089-4513 INSURER D : INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: NYC 006447212 02 REVISION NUMBER: THIS IS 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 LTR rypE OF ADD L SUER POLICY NUMBER POLICY EFF MWDD/YYYY) POLICY EXP fMMIDDNYYY1 LIMITS A GENERAL LIABILITY GLD1110104 1010112012 1010112013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR D A M A ff E717RENTED PREMISES LEAoccurrence) S 1 000000 MED EXP (My one person) S 100,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 7.500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ INCL X POLICY PRO- TOO $ 8 AUTOMOBILE LIABILITY AS2631004334212 1010112012 10101/2013 COMBINED SINGLE LIMIT Ea accident 2,000,000 X _ BODILY INJURY (Per person) S NIA ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X BODILY INJURY (Per accident) $ N/A X PeOr acciden �AMAGE $ NIA HIRED AUTOS X AOTOSWNED S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAB CLAIMS MADE DED I I RETENTION$ $ C WORKERS COMPENSATION WA563DO04334012(AOS) 1010112012 1010112013 X I STATU. OTH- C AND EMPLOYERS' LIABILITYPH ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A WC5631004334022 (OR, WIT 1010112012 10/01/2013 TWO E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYEE S 1,000,000 Ins, describe under OF OPERATIONS Oelow E.L DISEASE -POLICY LIMIT 1,000,000DESCRIPTION $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) THE CITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY ADDITIONAL INSURED AS OBLIGAIED UNDER CONTRACT. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER I HIS POLICY. WAIVER OF SUBROGATION IS EFFECTUAL. $1,000,000 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY. IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT. WHICHEVER IS LESS. CITY OF FORD COLLINS ATTN: ED BONNETTE, C.P.M., CPPB, BUYER 215 NORTH MASON STREET 2ND FLOOR FORTCOLI.INS,CO B0524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE or Marsh USA Inc. Manashi Mukherjee �iauaor� ACORD 25 (2010/05) 7 The ACORD name and logo are registered marks of ACORD TION. All rights reserved. POLICY NUMBER: GLD11101-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations ANY PERSON OR ORGANIZATION REQUIRED BY ALL LOCATIONS WHERE THE INSURED IS WRITTEN CONTRACT PERFORMING ONGOING OPERATIONS FOR AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organizalion(s) shown in the Schedule, but only with respect to liability for "bodily injury", 'properly damage" or 'personal and advertising injury" caused, in whole or in part, 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring alter: 1. All work, including materials, parts or equip- ment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13