The URL can be used to link to this page

Home My WebLink About280216 JOHNSON CONTROLS INC - INSURANCE CERTIFICATE (4)® DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 09/16/2015 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). CONTACT PRODUCER NAME: Marsh USA Inc. PHONE FAX 411 E. Wisconsin Avenue / o A1c No Suite 1300 E-MAIL ADDRESS: Milwaukee, WI 53202 Attn: JCI.Certrequest@marsh.com INSURERS AFFORDING COVERAGE NAIC # 011077-Month-CAS-15-16 15Sep INSURER A: Old Republic Insurance Company 24147 INSURED INSURER B : North American Elite Insurance Company 29700 Johnson Controls, Inc. York International Corporation INSURER c : Indemnity Insurance Company of North America 43575 Attn: Corp. Risk Mgmt. X-92 INSURER D : ACE American Insurance Company 22667 P.O. Box 591 5757 N. Green Bay Ave. INSURER E: ACE Fire Underwriters Insurance Company 20702 Milwaukee, WI 53201 INSURER F 111=OT1C1/�AT0 r,uuaQco• C11017)6407221-01 RFV191t7N NIIMRFR-0 vTHIS 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 A X COMMERCIAL GENERAL LIABILITY MWZY305447 10/01/2015 10/01/2016 EACH OCCURRENCE $ 10,000,000 CLAIMS -MADE � OCCUR DA AGE PREM SESOE. occurrence) nce $ 10,000,000 X MED EXP (Any one person) $ 50,000 Contractual Liability X XCU Included PERSONAL & ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 30,000,000 PRODUCTS - COMP/OP AGG $ INC IN GEN AGG POLICY ❑ PRO ❑ LOC NJECT OTHER D AUTOMOBILE LIABILITY ISA H08860373 10/01/2015 10/01/2016 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAR X OCCUR UMB 2000252 00 10/01/2015 10/01/2016 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A WLR C48591851 (ADS -See page 2) WLR C4859184A CA, MA ( ) SCF C48591875 WI ( ) 10101/2015 10101/2015 10/01/2015 1010112016 10/01/2016 10/01/2016 X SPER TATUTE I ERH - E.L. EACH ACCIDENT $ 5,000,000 E.L DISEASE - EA EMPLOYE $ 5,000,000 E.L. DISEASE -POLICY LIMIT $ 5,000,000 D If yes, describe under DESCRIPTION OF OPERATIONS below WCU C48591863 (Excess WC - OH, WA) 10/01/2015 10/01/2016 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) JCI Project Number: 5N490102, JCI Project Name: Ctrl - City of Fort Collins Park Shop, Customer PO Number 9154887, CITY OF FORT COLLINS is included as additional insured per the attached endorsements A2 and A2A. CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 4316 W LAPORTE AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FORT COLLINS, CO 80521 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee�- V 7y88-LV14 AI.VRV tiV rtrVrtA11v1r. r�u nynw lcacrvcar. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 011077 LOC #: Milwaukee AC40R L7 ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Johnson Controls, Inc. York International Corporation Attn: Corp. Risk Mgmt. X-92 POLICY NUMBER P.O. Box 591 5757 N. Green Bay Ave. Milwaukee, WI 53201 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance WORKERS COMPENSATION Workers Compensation "AOS" Policy includes coverage for the following states: AK, AL, AR, AZ, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, M0, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WV PRIMARY COVERAGE The General Liability and Automobile Liability policies are primary and not excess of or contributing with other insurance or self-insurance, where required by written lease or written contract. For General Liability, this applies to both ongoing and completed operations. WAIVER OF SUBROGATION The General Liability, Automobile Liability, Workers Compensation and Employers Liability policies include a waiver of subrogation in favor of the certificate holder and additional insureds to the extent required by written contract. ADDITIONAL INSURED - AUTOMOBILE LIABILITY The Automobile Liability policy, if required by written contract, includes coverage for Additional Insureds as required by such written contract. ADDITIONAL INSURED - GENERAL LIABILITY For General Liability, if required by written contract, the following are included as additional insureds, as required pursuant to a written contract with a named insured, per attached Policy Endorsements A2 and A2A: THE CERTIFICATE HOLDER LISTED ON THIS CERTIFICATE OF LIABILITY INSURANCE, AND EACH OTHER PERSON OR ORGANIZATION REQUIRED TO BE INCLUDED AS AN ADDITIONAL INSURED PURSUANT TO A WRITTEN CONTRACT WITH THE NAMED INSURED. UMBRELLA/EXCESS LIABILITY The Umbrella/Excess Liability Limit that applies is the amount indicated on the face of this Certificate of Liability Insurance, or the minimum Umbrella/Excess Liability limit that is required by the written contract, whichever is less. However, if the primary insurance policies noted on the face of this Certificate of Liability Insurance satisfy the combination of minimum primary limits and minimum Umbrella/Excess Liability limits required by the written contract, the Umbrella/Excess Liability limits shown on the face of this Certificate of Liability Insurance do not apply. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD