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Home My WebLink About504949 SIEMENS INDUSTRY INC - INSURANCE CERTIFICATE (4)A�RD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09123/2015 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 IA/C No Fat): _ A/C No): _. E-MAIL ADDRESS: MORRISTOWN, NJ 07960-6454 INSURERS AFFORDING COVERAGE NAIC # INSURER A: HDI-Geding America Insurance Company 41343 100129-MOBI--15A6 MOBI Harper 0704 NOC60 INSURED SIEMENS INDUSTRY, INC. MOBILITY DIVISION INSURER B : The Travelers Indemnity Company 25658 INSURER C : Travelers Property Casualty Co. of Amedca 25674 INSURER D : 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089-4513 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC-007206882-12 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 MM POLICY EFF /DD/YYYYI POLICY EXP 1MM/DDtYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY GLD1110107 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 X CLAIMS -MADE OCCUR DAMAGE RENTED PREMISESTO Ea ccurrence occurrence) $ 1,000,000 MED EXP (Any one person) $ 100,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 10,000,000 X POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ INCL. $ OTHER. C AUTOMOBILE LIABILITY TC2JCAP7440L34A15 10/01/2015 10/01/2016 COMEaaccdentSBINED INGLE LIMIT $ 2,000,000 BODILY INJURY (Per person) $ N/A X ANY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ N/A PROPERTY DAMAGE Per accdent $ N/A X HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ C B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YNN (Mandatory in H) EXCLUDED? (Mandatory in NH) N / A TC2JUB7440L27115(AOS) TRKUB744OL28315 (AZ, MA, OR & WI) TWXJUB744OL33815 OH & WA ( ) 10/01/2015 10/01/2015 10/01/2015 10/01/2016 10/01/2016 10/01/2016 X STATurE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEJ $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below """$500K LIMIT / $500K SIR""" E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT UNDER THE REFERENCED GENERAL LIABILITY AND AUTOMOBILE LIABILITY INSURANCE POLICIES. 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 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. K-ha►i112LaSL1l;1111; laJR► hGVL"a III AL\ILai 0 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 �icxuaea �Q ,w LL.�.tJL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ACORL7® CERTIFICATE OF LIABILITY INSURANCE ATE D09/2312015D/vyyV) 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 arc No): E-MAIL ADDRESS: MORRISTOWN, NJ 07960-6454 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Travelers Property Casualty Company of America 100129-FED-CRIME-15/16 MOB] Harper 25674 INSURED SIEMENS INDUSTRY, INC. INSURER B : -- - - MOBILITY DIVISION INSURER C INSURER D : 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 60089-4513 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC-007713953-12 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 EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISES Ea occurrence) ence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑PRO r LOC JECT PRODUCTS - COMP/OP AGG $ $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 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 LIAB OCCUR EACH OCCURRENCE $ H AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA A (Mandatory in NH) E.L DISEASE - EA EMPLOYE $ If yes describe under DESCRIPTION OF OPERATIONS below $ E L DISEASE - POLICY LIMIT A FIDELITY/EMPLOYEE TC2JFID744OL39915 10/0112015 10/01/2016 5,000,000 DISHONESTY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) �ha►1$17C�llll�il#1�Ua► �lGliLh�AA�\ll#1� 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 _JA1Muru>" JA-1Ae_nrA�<z. © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD