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Honeywell - Insurance Certificate (2020)DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 03/21 /2019 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 CONTACT NAME: Aon Risk Services Northeast, Inc. PHONE (g66) 283-7122 I FAX 800-363-0105 New York NY Office (A/C. No. Ext): (A/C. No.): one Liberty Plaza E-MAIL 165 Broadway, Suite 3201 ADDRESS: New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED Honeywell International Inc. 115 Tabor Road Morris Plains N3 07950 USA INSURERA: XL Insurance America Inc 24554 INSURER B: XL Specialty Insurance Co 37885 INSURERC: Greenwich Insurance Company 22322 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570075476741 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 INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS C X COMMERCIAL GENERAL LIABILITY RGC943763006 04/01/2019 04/01/2020 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $5,000,000 MED EXP (Any one person) $ 50 , 000 PERSONAL & ADV INJURY $5,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $5 , 000 000 X POLICY ❑ PRO ❑ LOC JECT OTHER: C AUTOMOBILE LIABILITY X ANYAUTO OWNED - SCHEDULED _ AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED - ONLY AUTOS ONLY C UMBRELLA LIAB H OCCUR X EXCESS LIAB CLAIMS -MADE DIED I IRETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE B OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If ves, describe under DESCRIPTION OF OPERATIONS below B Excess WC PRODUCTS - COMP/OP AGG RAC943764206 04/01/2019 04/01/2020 COMBINED SINGLE LIMIT AOS (Ea accident) BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) RA0943764506 04/01/2019 04/01/2020I EACH OCCURRENCE Excess Auto (AGGREGATE I Included $1,000,000 L. D c O .a L .a 0 1 ti ti 0 0 I- LO O Z M tE O $4,000,000 V RWD943540306 04/01/2019 04/01/2020 X IPERSTATUTE I AOS EOTH RWC943540206 04/01/2019 04/01/2020 E.L. EACH ACCIDENT $5,000,000 AK, WI E.L. DISEASE -EA EMPLOYEE $5,000,000 E.L. DISEASE -POLICY LIMIT $5,000,000 e RWE943540406 04/01/2019 04/01/2020 EL Each Accident $5,000,000 AZ, OH, WA EL Disease - Ea Emp' $5,000,000 0 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) [Proj: RE: City of Gilroy; Gilroy CA; Honeywell Contract # 40098419] [AI: City of Gilroy, its officers and employees] are -Included as additional insured for General Liability and Automobile Liability with respect to Honeywell operations in connection with Honeywell contract # 40098419. 1 CERTIFICATE HOLDER CANCELLATION Jd_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Gilroy AUTHORIZED REPRESENTATIVE+ 7351 Rosanna St CC -- Gilroy CA 95020 USA ©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 #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon Risk Services Northeast, Inc. Honeywell International Inc. POLICY NUMBER see Certificate Number: 570075476741 CARRIER NAIC CODE see certificate Number: 570075476741 I 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. POLICY POLICY INSR ADDL SUBR EFFECTIVE EXPIRATION LTR TYPE OF INSURANCE INSD W VD POLICY NUMBER DATE DATE LIMITS (MM/DD/YYYY) (MM/DD/YYYY) OTHER s RWE943540506 04/01/2019 04/01/2020 Excess WC - NM sIR applies per policy terms & conditions 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 POLICY NUMBER: RGC943763006 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations City of Gilroy, its officers and employees RE: City of Gilroy; Gilroy CA; Honeywell Contract # 40098419 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed .by or on -behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 ©Insurance Services Office. Inc. ISO I Commercial General Liability Forms 1 07/01/04 POLICY NUMBER: RGC943763006 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Gilroy, its officers and employees Location And Description Of Completed Operations RE: City of Gilroy; Gilroy CA; Honeywell Contract # 40098419 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004