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Home My WebLink About164966 SCHNEIDER ELECTRIC USA INC - INSURANCE CERTIFICATEA4C" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/28/2018 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 have ADDITIONAL INSURED provisions or 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 MARSH USA INC. NAME: 99 HIGH STREET ONE ALCC1N Ext1._ Nc No BOSTON, MA 02110 E-MAIL Attn: Boston. CertRequest@Marsh.com I Fax: 212-948-4377 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # LSPIKE _ __ INSURER A: National Union Fire Ins Co Pittsburgh PA 19445 INSURED _YINSURER B : HDI Global Insurance Com an 41343 Schneider Electric Holdings, Inc. - 200 North Martingale Road, Suite 1000 INSURER c : New Hampshire Insurance Co. 23841 Schaumburg, IL 60173 INSURER D : INSURER E : INSURER F : COVFRArFA CFRTIFICATF All IMRCD• niVr nlnoM117 no 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 SU_BR WVDPOLICY NUMBER MM/DD/YYYY MM/DD/YYYY _ --- -- -- LIMITS A X COMMERCIAL GENERAL LIABILITY X 3629879 01/01/2019 01/01/2020 EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE F-v7 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 5,000,000 Contractual Liability _ X MED EXP (Any one person) $ 5,000 - PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 X POLICY ❑ PRO ❑ JECT LOC PRODUCTS COMP/OP AGG $ 5,000,000 $ OTHER A AUTOMOBILE LIABILITY X 1921780 (ADS) 01/01/2019 01/01/2020 COMBIaccNED SINGLE LIMIT La idenT $ 5,000,000000 A ANY AUTO 1921781 (MA) 01/01/2019 01/01/2020 X BODILY INJURY (Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS 1921779 (VA) 01/01/2019 01/01/2020 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ X UMBRELLA LAB X OCCUR CUD11986-07 01/01/2019 01/01/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DIED 1 1 RETENTION $ $ C WORKERS COMPENSATION 014649569 (AOS) 01/01/2020 X PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER E,LEACHACCIDENT $ 5,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE ER EXCLUDED? OFFICERIM(Mandatory N / A E.L. DISEASE - EA EMPLOYEE $ 5,000,000 in (Mandatory in NH) Additional WC/EL policies are shown P If yes, describe under DESCRIPTION OF OPERATIONS below on the following page E.L. DISEASE -POLICY LIMIT $ 5,000,000 A PROFESSIONAL 04-587-10-64 01/01/2019 01/01/2020 EACH CLAIM/AGGREGATE 5,000,000 E&O LIABILITY POLICY IS CLAIMS MADE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are included as additional insured with respect to General Liability and Auto Liability per the endorsement(s) attached. CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:IT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N Mason St ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee �ttluoNs� �i4�c tt..yrt L v 198t5-ZU16 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD