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ThyssenKrupp Elevator - Insurance Certificate (2020)� 1 ®ACORN CERTIFICATE OF LIABILITY INSURANCE Page 1 of I DATE 1(MM(MM//2019 DDDD/YYYY) 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 I CONTACT NAME:Aon Risk Services Central, Inc. Aon Risk Services Central, Inc. I PHONE (A/C No.Ext): (866) 283-7122 I FAX (A/C No.Ext): (800) 363-0105 200 East Randolph I E-MAIL ADDRESS:acs.chicago@aon.com CHICAGO, IL 60601 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: HDI Global Insurance Company 41343 INSURED I INSURER B: ACE American Insurance Company 22667 THYSSENKRUPP ELEVATOR CORPORATION (INSURER C: Indemnity Insurance Company of NA 43575 (INSURER D: ACE Fire Underwriters Insurance Company 20702 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1701948 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 TYPE OF INSURANCE LTR A XI COMMERCIAL GENERAL LIABILITY El CLAIMS -MADE M OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: " I POLICY ❑ PROJECT ❑ LOC OTHER: B AUT MOBILE LIABILITY ANY AUTO OWNED AUTOS E] SCHEDULED ONLY AUTOS HIRED AUTOS � NON -OWNED ONLY AUTOS ONLY 7 0 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP INSD WVD (MM/DD/YYYY) (MM/DDIYYYY) GLD12574-06 / GLD11085-11 10/01/2019 10/01/2020 UMBRELLA LIAB I OCCUR EXCESS LIAB uH CLAIMS -MADE DIED RETENTION $ C WORKERS OMPENSATION Y/N N/A AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE FIN D OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Limits shown as requested: ISAH25290318 WLRC65892170 (AOS) WLRC65892212 (CA,MA) SCFC65892225A(WI) 10/01/2019 10/01/2020 10/01/2019 10/01/2020 10/01/2019 1 0/01/2020 10/01/2019 10/01/2020 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY(Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) [EACH OCCURRENCE (AGGREGATE I X PER STATUTE u I I OTHER IE.L. EACH ACCIDENT IE.L. DISEASE -EA EMPLOYEE IE.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Division Number: 108750 - Named Insured Includes: ThyssenKrupp Elevator Corporation - Address: 2140 Zanker Road San Jose, CA 95131 Project Number: US117839 - Project Name: OLD CITY HALL - Address: 7400 MONTEREY RD GILROY, CA 95020 - Project Type (s): Elevator Maintenance CERTIFICATE HOLDER $ 2,000,000 $ 100,000 $ 5,000 $ 2,000,000 $ 2,000,000 $ 2,000,000 $ 2,000,000 $ 1,000,000 $ 1,000,000 $ 1,000,000 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. AUTHORIZED REPRESENTATIVE CITY OF GILROY GILROY, CA 95020 United States © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD