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HomeMy WebLinkAbout479207 HONEYWELL INTERNATIONAL INC - INSURANCE CERTIFICATE® �`k o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/16/2020 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(les) 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 NAME. Aon Risk services Northeast, Inc. New York NY Office PHONE - (A/C. No. Er); 866-283-7122 600-363-0105 E-MAIL ADDRESS: One Liberty Plaza 165 Broadway, suite 3201 INSURER(S) AFFORDING COVERAGE NAIL# New York Hy 10006 USA INSURED INSURER A. Greenwich Insurance company 22322 _ INSURER B: XL Insurance Amefica Inc 24554 Honeywell International Inc. 300 s. Tryon St. Suite 500 6th Floor INSURERC: XL specialty Insurance c0 37885 INSURER D: Charlotte NC 28202 USA INSURER E: INSURER F: -- P.nVFRAr:FS - CERTIFICATE: NUMBER: 570080904131 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 0gp WVD POLICY NUMBER POLICY LIMP POLICY ItAP LIMITS A X COMMERCIAL GENERAL LNBILIrY RGC EACHOCCURRENCE _ $5,000,000 CLAIMS -MADE X❑ OCCUR TEIT PREMISES eoccurrence $5;000,000 MED EXP (Any one person) $ 50 , 000 PERSONAL &ADV INJURY $5,000,000 GEN'LAGGREGATE LIMRAPPLIES PER: GENERAL AGGREGATE $5;000,000 X POLICY ❑PEO- LOC PRODUCTS - GOMP/OPAGG Included OTHER: A AUTOMOBILE LuumiUTY RAC943764207 04/01/202004/01/2021 COMBINED SINGLE LIMB (Ee accident) $1,000,000_ ADS BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED PROPERTY DAMAGE Per accident - ONLY AUTOS ONLY A UMBRELLALUIB X OCCUR RA0943764507 04/01/2020 04/01 2021 EACH OCCURRENCE -$4;000,000 X EXCESS LIAR CLAIMS -MADE Excess Auto AGGREGATE DED RETENTION B WORKERS COMPENSATION AND RWD943540307 04/01/2020 04 01 2621 X PER STATUTE I ETH- C EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N A05 RWC943540207 04/01/2020 04/01/2021 _ E.L. EACH ACCIDENT $51000y.000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) NIA AK, WI E.L. DISEASE -EA EMPLOYEE $5,000,000 If yes, describe under _DESCRIPTIONOFOPERATIONS below - E.L. DISEASE -POLICY LIMIT $5;000;o00 C Excess WC RWE943540407 04/01/2020 04/01/2021 EL Each Accident $5;000,000 I AZ, OH, WA EL Disease - Ea Emp $5;000;000 SIR applies per policy ter s & condi ions EL Annual Aggregate $5,000,600 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addltlonel Remerke Schedule, may be attacked If more apace Is requlred) Note: Elster, Elster Perfection Corp., El Ster Holdings US, Inc., Elster solutions, LLC; Elster AMco Water, LLC;', Elster American Meter Company, LLC; Elster' Instromet, Inc.' Eclipse, Inc,i EnergyICT, Inc - Exothermics, Inc.; CEC combustion .Safety LLC, and are Honeywell International Inc. Hauck Manufacturing Company, Inc. wholly owned subsidiaries of 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 I AUTHORIZED REPRESENTATIVE Attn: city Clerk PO Box l l i C94✓ r�eO�O � 1JL Fort Collins CO 80522 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016163) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000054391 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk services Northeast, Inc. NAMED INSURED Honeywell International Inc. POLICY NUMBER See certificate Number: 570080904131 CARRIER see Certificate. Number: 570080904131 NAIC CODE EFFECTIVE DATE: 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 INSiJRER 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTRE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DDIYYYY) L1M[rrS OTHER - -- -- C RWE943540507 Excess WC - NM sIR applies per policy to 04/01/2020 ms & condit 04/01/2021 ons Excess WC Limits are statutory in AZ, OH, WA, & NM ACORD 101 (2008/01) All rights The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000054391 LOC #: "4 ADDITIONAL REMARKS SCHEDULE Page _ of . \GENCY NAMEDINSURED aon Risk Services Northeast,, Inc,- Honeywell International Inc. 'OLICY NUMBER - - - - See Certificate Number: 570080904131 :ARRIER NAIC CODE See Certificate Number: 570080904131 EFFECTIVE DATE: woi nONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Named Insured schedule 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., Exothermi c5, Inc., CEC Combustion Safety._LLC and Hauck Marfdfactllri ng company,Inc. are wholly Owned subsidiaries of Honeywell international Inc. -- ACORD 101(2008/O1) - � � ®?AOa ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD