HomeMy WebLinkAboutCOI - Sensus USA Inc. - Expires 2023-10-31Aolli CERTIFICATE OF LIABILITY INSURANCE
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DATE 12022 YYYYI
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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
Marsh USA, Inc.
1166 Avenueof the Amaims
New York, NY 10D36
CONTACT
NAME:
PHONE NC No:
E-MAIL
ADDRESS:
INSURERS) AFFORDING COVERAGE
NAIC#
INSURER A: AIU Insurance Co.
19399
CN108453421-SEN&GAW-22-23
INSURED
SENSUS USA INC.
INSURER B: National Union Fire Ins. Co.
19445
INSURER C :
DBA SENSUS METERING SYSTEMS INC.
637 DAVIS DRIVE
MORRISVILLE, NC 27560
INSURER D:
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: NYC-010040392-24 REVISION NUMBER: 1
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
rypE OF INSURANCE
ADD
R
POUCYNUMBER
POUCYEFF
IMMIDDIYYYYI
POLICY EXP
IMMIDDIVY(Y)LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
GL 9594128
1013112022
10/3112023
EACH OCCURRENCE
$ 1,000,000
PREMISES Me occurrence
$ 1,000,000
MED EXP (My one person)
$ 10,000
PERSONAL& ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMITAPPLIES PER:
X POLICY 0 PRO-
ECT ❑ LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS-COMP/OP AGG
$ 2,000,000
OTHER
SIR: $500,000
$
B
B
AUTOMOBILELIABILITY
ANY AUTO
CA 7281067 (ADS)
CA 7281069 (VA)
10/31/2022
10/31/2022
10/3112023
10/3112023
COMBINED SINGLE LIMIT
Ea accident
$ 3,000,0D0
X
BODILY INJURY (Per persrn)
$
A
OWNED F—] AUTOS ONLY AUTOSULED
CA 7281068(MA)
10/31/2022
10131/2023
BODILY INJURY (Per accident)
$
PROPERTY OAMAGE
Per accident
$
HIRED NON-0INNED
AUTOS ONLY AUTOS ONLY
8
UMBRELLA UAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
E%CESS LIAB
CLAIMS -MADE
DED RETENTION$
$
A
A
A
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
ANYPROPRIETORIPARTNERIEXECUTIVE YIN
OFFICERIMEMBEREXCLUOE07 N
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WC 35901966(ADS)
WC 35901967 I
(W)
WC 35901965 (CA)
1013112022
1013112022
101311202
1013112023
10131/2023
J( PER OTH-
STATUTE Eft
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
S 2,000,000
E.L. DISEASE -POLICY LIMIT
$ 2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required)
Repair of tow base stations including, all testing and weatherproofing, check waveguide and antenna for exact location of trouble, check antenna connection to LMR 400 jumper cable, site performance has
deteriorated since heavy rains, repair as required, weather proof connections, retest antenna and cable for VSWR and DTF.
City of Gilroy, its Officers, Officials and Employees are named as Additional Insureds under General Liability where required by written contract.
City of Gilroy, its Officers, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Officials and Employees NOV 07 2022 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS.
Gilroy, CA 95020 GILROY Cmr CLERK"S LFFICE
AUTHORIZED REPRESENTATIVE
vZlws¢!a 7L15114 Tee.
91988-2016 ACORD CORPORATION. All rights reserved.
ACORD 2512016/03) The ACORD name and logo are registered marks of ACORD
ENDORSEMENT
This endorsement, effective 12:01 A.M. 10/31/2022 forms a part of
policy No. CA 7281067 issued to Xylem Inc.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -INHERE REQUIRED UNDER CONTRACT OR
AGREEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
ADDITIONAL INSURED:
Any person or organization for whom you are contractually bound to provide Additional Insured status. But
only to the extent of such person's or organization's liability arising out of use of a covered "auto".
L SECTION 11- LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add:
d Any person or organization, shown in the schedule above, to whom you become obligated to include
as an additional insured under this policy, as a result of any contract or agreement you enter into
which requires you to furnish insurance to that person or organization of the type provided by this
policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance
provided will not exceed the lesser of:
(1) The coverage and/or limits of this policy, or
(2) The coverage and/or limits required by said contract or agreement.
Authorized Representative or
Countersl
Applicable naturein States Where
87950 (10/05) Page 1 of 1
rwil
0427-01-00.0001937-0002-0004624
POLICY NUMBER:
GL 9584128
COMMERCIAL GENERAL LIABILITY
CG 20 26 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
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):
ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL
INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO.
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 your acts or
omissions or the acts or omissions of those acting
on your behalf:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or
rented to you.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to provide
for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
CG 20 26 0413 ® Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER: GL 9584128
COMMERCIAL GENERAL LIABILITY
CG 20 010413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your
CG 20 01 0413
policy provided that:
t1j The additional insured is a Named Insured
under such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution from
any other insurance available to the additional
insured.
p Insurance Services Office, Inc., 2012
Page 1 of 1
0427-01-00.0001937-0003-0004625
AM