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HomeMy WebLinkAbout250572 SCHINDLER ELEVATOR CORPORATION - INSURANCE CERTIFICATE (17)A� �® CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 02/(05/2014 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 Willis of New York, Inc. c/o 26 Century Blvd. P. O. Box 305191 CONTACT NAM PHONE FAX , 877-945-7378 888-467-2378 E-MAILA DRESS, certificates@willis.com Nashville, IN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Zurich American Insurance Company 16535-003 INSURED Schindler Elevator Corporation INSURERB:Amaricaa Zurich Insurance Company 40142-001 P.O. Box 1935OS1Z INSURER C: 20 Whippany Road Morristown, NJ 07962-1935 INSURER D: INSURER E: INSURER F: CnVFRAL:FA CFRTIFICATF NIIMRFR 21119904 REVISION NUMBER-* See Remarks 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOFINSURANCE LTRwvo D' SUB POUCYNUMBER POLICY EFF POLICYEXP LIMITS A GENERAL LIABILITY Y Y GL0644543524 1/1/2014 1/1/2015 EACH OCCURRENCE $ 2,000,000 PREMISES(Ea ocE TO aurence $ 11000,000 j % COMMERCIAL GENERAL LIABILITY MEDEXP(Anyonspemon) $ 10,000 CLAIMS -MADE OCCUR PERSONAL&ADV INJURY $ 2,000,000 % Contractual Liability GENERALAGGREGATE $ 51000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 5,000,000 $ X POLICY PRO-71 LOC I 1 1 A AUTOMOBILE LIABILITY Y Y _ BAP644543624 1/1/2014 1/1/2015 COMBINEDSINGLELIMI (Ea accident) $ 5,000,000 BODILY INJURY(Per person) $ % ANY AUTO % ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ PROPERTYDAMAGE Per accident $ % HIRED AUTOS % INohDS UMBRELLA LIAR OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y® OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A Y Y WC644543825 WC666818723 'l/l/2014 1/1/2014 1/1/2015 1/1/2015 % E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA EMPLOYEE $ 5,000,000 E.L. DISEASE -POLICY LIMIT Is 5,000,000 fi yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additonal Remarks Schedule, it more space is required) THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 12/7/2013 WITH ID: 20797631 SEC5230 - CONT# 42-12660 THE INSURANCE COVERAGE REFERENCED FOR THE ADDITIONAL INSURED(S), PER POLICY FORM AND WRITTEN CONTRACT, IS PRIMARY AND NON-CONTRIBUTORY. City of Fort Collins Fort Collins CO 80522. rFRTIFIr ATF 41ni nr:p r:ANrFI 1 ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR R ENTA City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 Coll:4330034 Tpl:1738007 Cert:21119904 W-2010AGUMUCUMPUMAIIUn.Anngmsreservea. ACORD 25 (2010/05) The ACORD name and logo are registered mar of ACORD 0 ZURICH Advisory notice to policyholders regarding the U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") regulations No coverage is provided by this policyholder notice nor can it be construed to replace any provisions of your policy You should read your policy and review your declarations page for complete information on the coverages you are provided. This notice provides information concerning possible impact on your insurance coverage due to directives issued by the U.S. Treasury Department's Office of Foreign Assets Control ('OFAC"). Please read this Notice carefully. OFAC administers and enforces sanctions policy based on Presidential declarations of "national emergency'. OFAC has identified and listed numerous: • Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and • Narcotics traffickers; as 'Specially Designated Nationals and Blocked Persons." This list can be located on the United States Treasury's web site - htto //www treasuryOov/abouttorganizational-structure/offices/Paaes/Office-of-Foreian-Assets- Control.asox. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provi- sions of this insurance are immediately subject to OFAC restrictions. When an insurance policy is considered to be such a blocked or frozen contract, no payments or premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. Includes copyrighted material of Insurance Services Office, Inc., with its permission U-GU-1041-A (March 2011) Page 1 of 1 AGENCY CUSTOMER ID: LOC#: A� ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Willis of New POLICY NUMBER See First Page CARRIER See First Page NAMED INSURED Schindler Elevator Corporation Inc. P.O. Box 1935 20 Whippany Road Morristown, NJ 07962-1935 NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE To the extent required by written contract, the following is named as Additional Insured: City of Fort Collins. See Attached Additional Insured Endorsements. Waiver of Subrogation is provided on the referenced policies to the extent required by written contract and where permitted by law. ACORD 101 (2008/01) Coll:4330034 Tpl:1738007 Cert:21119904©2008ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL0644543524 COMMERCIAL GENERAL LIABILITY CG20100413 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 Organization(s): Location(s) Of Covered Operations As required by Written Contract. As required by Written Contract. Ilnformation 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) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the :nsurance 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 2. 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 part of the same project. CG 2010 04 13 ©Insurance Services Office, Inc. 2012 Page I o t 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the declarations; whichever is less. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations. CG 2010 04 13 ©Insurance Services Office, Inc. 2012 Page 2 of 2 POLICY NUMBER: BAP644543624 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO 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 modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. 1/1/2014 Named Insured: Schindler Elevator Corporation Countersigned By: SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A PRIMARY, NOW CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXCUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section 11 of the Coverage Form. ZURICH Other Insurance Amendment — Primary And Non -Contributory Policy No. I Exp. Date of Pol. Eff. Date of End. I Agency No. Addl. Prem. Return Prem. L0644543 5 24 1 /01 /2015 1 /01 /2014 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Schindler Elevator Corporation Address (including ZIP Code): P.O. Box 1935,20 Whippany Road, Morristown, NJ 07962-1935 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part SECTION IV. COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, is amended per the following: 1. The following paragraph is added under a. Primary Insurance: This insurance is primary insurance as respects our coverage to an additional insured person or organiza- tion, where the written contract or written agreement requires that this insurance be primary and non- contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. 2. The following paragraph is added under b. Excess Insurance: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an addi- tional insured, in which the additional insured on our policy is also covered as an additional insured by at- tachment of an endorsement to another policy providing coverage for the same 'occurrence", claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide cov- erage to the additional insured on a primary and non-contributory basis. Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as written. U-GLr1327-A CW (312007) Page I of 1 0 Waiver Of Subrogation (Blanket) Endorsement ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Addl Prem Return Prem. L0644543524 1/1/2014 1/1/2015 1 /1 /2014 $ $ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from oth- ers, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. Countersigned: 'ItN V., � - )nwa,&, (Authorized Representative) U-GL-925-B CW (12/01) Page 1 of 1 Z(JZURICH-AMERICAN INSURANCE GROUP Waiver Of Transfer Of Rights Of Recovery Against Others To Us THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY NO. EFF. DATE OF POL. EXP. DATE OF POL. EFF. EDATE OF END. AGENCY NO. ADD'L PREM. RETURN PREM. BAP6445436: 1/12014 1/12015 1 /1 /2014 Named Insured: Schindler Elevator Corporation Adress: (including ZIP Code) This endorsement modifies insurance provided under the: Business Auto Coverage Part Truckers Coverage Part Garage Coverage Part SCHEDULE Name of Person or Organization: WHERE REQUIRED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS We waive any right of recovery we may have against the designated person or organization shown in the schedule because of payments we make for injury or damage caused by an "accident' or "loss" resulting from the ownership, maintenance, or use of a covered "auto' for which a Waiver of Subrogation is required in conjunction with work performed by you for the designated person or organization. The waiver applies only to the designated person or organization shown in the schedule. Countersigned: (Authorized Representative) U-CA-320-A CW (4/92) WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC000313 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 1/1/2014 at 12:01 A.M. standard time, forms a part of (DATE) Policy No. WC666818723 & WC644543825 of the American Zurich Insurance Company (NAME OF INSURANCE COMPANY) issued to Schindler Elevator Corporation Premium (if any) $ 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. AS REQUIRED BY CONTRACT. Cotmtersimed: Schedule (_Authorized Representative) WC 124 (4-84) WC 00 03 13 Copyright 1983 National Council on Compensation Insurance. Page 1 of 1