Loading...
HomeMy WebLinkAbout479207 HONEYWELL - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/21/2019 I 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 AOn Risk Services Northeast, Inc. New York NY Office CONTACT NAME: (A/C..NNo. Ext): 866-283-7122 (A/C. No.): 800-363-0105 E-MAIL ADDRESS: One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: XL Insurance America Inc 24554 Honeywell International Inc. INSURER B: XL specialty Insurance CO 37885 115 Tabor Road Morris Plains NJ 07950 USA INSURER C: Greenwich Insurance Company 22322 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570075475753 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY RGC 4 1 4 1 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED $5,000,000 PREMISES Ea occurrence MED EXP (Any one person) $ 50 , 000 PERSONAL &ADV INJURY $5,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $5,000,000 X POLICY ❑ PRO JECT ❑ LOC PRODUCTS - COMP/OPAGG Included OTHER: C AUTOMOBILE LIABILITY RAC943764206 04/01/2019 04/01/2020 COMBINED SINGLE LIMIT Ea accident $1, 000, 000 ADS BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE HIREDAUTOS NON -OWNED Per accident ONLY AUTOS ONLY C UMBRELLA LIAB X OCCUR RA0943764506 04/01/2019 04/01/2020 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS -MADE Excess Auto AGGREGATE DED RETENTION A WORKERS COMPENSATION AND RWD943540306 04/01/2019 04/01/2020 X STATUTE OTH IER EMPLOYERS' LIABILITY Y / N 5 E.L. EACH ACCIDENT $5,000,000 B ANY PROPRIETOR l PARTNER / EXECUTIVE N N/A 04/01/2019 04/01/2020 OFFICERIMEMBEREXCLUDED? (Mandatory in NH) �AROWC943540206 AK , WI E.L. DISEASE -EA EMPLOYEE $ 5 , 000 , 000 • 'f yes, descrbc under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $5 , 000, 000 B Excess WC RWE943540406 04/01/2019 04/01/2020 EL Each Accident $5,000,000 AZ, OH, WA EL Disease - Ea Emp $5,000,000 SIR applies per policy terns & condi ions EL Annual Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Note: Elster, Elster Perfection Corp., Elster Holdings US, Inc., Elster Solutions, LLC; Elster AMCO Water, LLC; Elster American Meter Company, LLC; Elster Instromet, Inc.; Eclipse, Inc.; EnergyICT, Inc.; Exothermics, Inc.; CEC Combustion Safety LLC, and Hauck Manufacturing Company, Inc. are wholly owned subsidiaries of Honeywell International Inc. RE: The City of Fort Collins, Colorado / Elster Solutions LLC Master Services Agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 580 Fort Collins Co 80522 USA ,�/' p � (�/f ���r do I a-Z1 . a . M u0 r r LO 0 0 O Z O M U 0) U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000054391 LOC #: ACORD® _ `.� ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY NAMEDINSURED Aon Risk Services Northeast, Inc. Honeywell International Inc. POLICY NUMBER See certificate Number: 570075475753 CARRIER NAIC CODE See Certificate Number: 570075475753 EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADUL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MM/DD/YYYY LIMITS OTHER B RWE943540506 Excess WC - NM SIR applies per policy to 04/01/2019 ms & conditions 04/01/2020 Excess WC Limits are Statutory in AZ, OH, WA, & NM ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD