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HomeMy WebLinkAboutCOI - Sensus USA, Inc. - Expires 2020-10-31n ACQR�0 I DATE (MM/DDNYYY) CC> CERTIFICATE OF LIABILITY INSURANCE 10/31/2019 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 Marsh USA, Inc. 1166 Avenue of the Americas New York, NY 10036 CONTACT NAME: AX PHONE AIC No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A. See Acord 101 CN108453421-Pure-GAW 19-20 INSURED Sensus USA, Inc. INSURER B: National Union Fire Ins. Co. 19445 INSURER C : which will do business as Sensus Metering Systems, Inc. 8601 Six Forks Road, Suite 700 Raleigh, NC 27615 INSURER D : INSURER E : INSURER F : I J COVERAGES CERTIFICATE NUMBER: NYC-010040392-14 REVISION NUMBER! 0 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 TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF (MWDDIYYYYI POLICY EXP IMMIDDIYYYYILIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_RI OCCUR GL 6862457 10/31/2019 10/31/2020 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 1,000,000 MED EXP Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 SIR: $500,000 $ B B B AUTOMOBILE LIABILITY X ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CA 5320316 (AOS) CA 5320317 (VA) CA 5320318 (MA) 10/31/2019 10131/2019 10/31/2019 10/31/2020 10/31/2020 10/31/2020 Co aBI dEeDISINGLE LIMIT $ 3,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ QED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A SEE ACORD 101 10/31/2020 X IPER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space 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. CERTIFICATE HOLDER CANCELLATION City of Gilroy, its Officers, Officials and Employees 7351 Rosanna Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Lauren Giagrande,,s�,�„o nrc�.nc9.� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN108453421 LOC #: New York Aco ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA, Inc. Sensus USA, Inc. which will do business as Sensus Metering Systems, Inc. 8601 Six Forks Road, Suite 700 POLICY NUMBER Raleigh, NC 27615 CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance WORKERS COMPENSATION: CARRIER: NEW HAMPSHIRE INSURANCE COMPANY POLICY: WC 020608516 (AOS) CARRIER: NEW HAMPSHIRE INSURANCE COMPANY POLICY: WC 020608517 (IL, KY, NC, NH, UT, VT) CARRIER: NEW HAMPSHIRE INSURANCE COMPANY POLICY: WC 020608518 (NJ, PA) CARRIER: NEW HAMPSHIRE INSURANCE COMPANY POLICY: WC 020608519 (MA, OH, WA, WI, WY) CARRIER: AMERICAN HOME ASSURANCE POLICY: WC 020608520 (CA) CARRIER: ILLINOIS NATIONAL INSURANCE COMPANY POLICY: WC 020608521(FL) CARRIER: NEW HAMPSHIRE INSURANCE COMPANY POLICY: WC 020608522 (AZ, VA) ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD