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HomeMy WebLinkAbout479207 HONEYWELL - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE DATE03) 1 3/22018 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 enciorsement(s). PRODUCER AOn Risk services Northeast, Inc. New York NY Office CONTACT NAME: (A/CC..NNo. Ezt): 866-283-7122 (ac No ): 800-363-0105 E-MAIL ADDRESS: 199 Water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Greenwich Insurance Company 22322 Honevwell International Inc. INSURER B: XL Insurance America Inc 24554 115 Tabor Road Morris Plains N3 07950 USA INSURER C: XL Specialty Insurance Co 37885 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570070514369 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 NSD WVD POLICY NUMBER MM/DDfrr MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY RGC 4 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE E NTED $5,000,000 PREMISES Ea occurrence MED EXP (Any one person) $ 50 , 000 PERSONAL &ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMPIOPAGG Included OTHER: A AUTOMOBILE LIABILITY RAC943764205 04/01/2018 04/01/2019 COMBINED SINGLE LIMIT Ea accident $5,000,000 AOS 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 UMBRELLA LIAR EACH OCCURRENCE AGGREGATE EXCESS LIAB HOCCUR CLAIMS -MADE DED I RETENTION B WORKERS COMPENSATION AND RWD943540305 04/01/2018 04/01/2019 X PER OTH- STATUTE ER EMPLOYERS' LIABILITY Y / N ADS E.L. EACH ACCIDENT $ 5 , 000 , 000 C ANYPROPRIETOR / PARTNER /EXECUTIVE N/A RWC943540205 04/01/2018 04/01/2019 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) AK, WI E.L. DISEASE -EA EMPLOYEE $5,000,000 If yes, describe under DESCRIPTION OF or ERAT!ONS below F.L. DISEASE -POLICY LIMIT $ 5.000.000 C Excess WC RWE943540405 04/01/2018 04/01/2019 EL Each Accident $5,000,000 AZ, OH, WA EL Disease - Ea Emp $5,000,000 SIR applies per policy terins & conditions EL Annual Aggregate $5,000,00o DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe 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 Collinsli Co 80522 USA �Fort rn c� d C) 0 0 0 O Z 0) U d U a� .4Fy mr-Ld a r� ©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 #: ACO �--- ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk services Northeast, Inc. NAMED INSURED Honeywell International Inc. POLICY NUMBER See Certificate Number: 570070514369 CARRIER See Certificate Number: 570070514369 NAIC CODE 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 ITR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MM/DDIYYYY) LIMITS OTHER C RWE943540505 Excess WC - NM SIR applies per policy to 04/01/2018 ms & conditions 04/01/2019 Excess WC Limits are statutory in AZ, OH, WA, & NM ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD