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Home My WebLink AboutSIEMENS INDUSTRY, INC. (3)A-2015-078-02 INSURANCE NOT ON FILE WORK MAY NO! PROCEED CI CRK OF COUNCIL MAYOR Miguel A. Pufida DATE' JUe J 2019 MAYOR PRO TEM G Juan Village$ p GOUNCILMEMBERS Cecilia Iglesias (� �• rh�� (t) David Penaloza Vacant eyO}r# 5%1t0 viconie Sarmlento Jose Solodo CITY OF SANTA ANA PUBLIC WORKS AGENCY 2e Civic Center Plaza +. P.O, Boat 1088 Santa. Ana, Californla 92702 MW aanta-anLM April 18, 2019 Siemens Industry, Inc. Attn: Julie Stick 10775 Business Center Drive Cypress, CA 90630 ACTING CITY MANAGER Steven A. Mendoza CITY ATTORNEY Sonia R. Carvalho ACTING CLERK OF THE COUNCIL Nouns Mitre Rw Second Extension of Agreement #A-2015-078 to provide HVAC and fighting controls technical support Dear Ms, Slick to Section 3 (`"Perm") of Agreement No. A-2015-078 C Agreament") entered into by Siemens Inc, and the City of Santa Ana, dated May 5, 2015, the time period of said Agreement is extended ditional one (1) year period, from May 1, 2019 to April 30, 2020, The insurance certificates are to be extended and/or renewed to cover this extension. All other terms and conditions of said in remain unchanged and in full force and effect. Public Wtkks Agency CITY OF IIIANTAAAA,N� A: Kristine Ridge City Manager APPROVED AS TO FORM: SoniaR, Carvalho City Attorney 341in M.Funk Assistant City Attorney 7 7ULTANT �Ju1ie 5i,c�. Title: Scd-e c, tithe vic t a A`1 S'P orma Mitre Acting Clerk of the Council SANTAANA CITY COUNCIL. MIVAA NWtl AIMVWl 3 Wme&.4614a DnW Pmlele,a jo. sdWo V6 l CMTal&l . Maya MapM Pro Tam WatlS NO wwZ Wadi Wwdd W a a-0smmal itWsamrm..nsaneam AXn&r12Mk& AaA= *MftDAINA Al 6Ra CERTIFICATE OF LIABILITY INSURANCE bU911912WIW IpD,YYYYI 01D. 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 INSVRER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND 'THE CERTIFICATE HOLDER. IMPORTANTI If the certificate holder Is an ADDITIONAL INSURED, the poliay(ies) must have ADDITIONAL. INSURED provisions or be ondorsia 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 Ilou of auch andorsoment s . PRCOUCaR MnRSH USA, INC. 446 SOUTH STREET MORRISTOWN, NJ 07960,6454 N E CT ----( P 1 a �o„ Alc o ExO� I Ic Ngp •MAIL .___._ _ _ INSURERSAFFORDINGCOVERAGE ---_ NAICq INSURER A t HDI Global lnau[andeC rn Ian 41343 10012"11--l8719 SII ANDRI NOC60 INSURED SIEMENS INDUSTRY, INC. _ U(„{SURERe; TfaV afs rtllee SaaII Ce.21Atl10rlca 26674 , t suRan c: The Travelers lndwwK(0om2g 26668 1000 DEERFIFLO PARKWAY BUFFALO GROVE, It 60080-4613 2suRERDI,,,,_—"— NSURER EI COVERAGES CERTIFICATE NUMBER: NYO-010271339-11 REVISION NUMBERS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTVMTHSTANDING 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS. 'IFBR ^—_ .�_. - '1VPEOFIN$URANCE .00 tea. _ ,, %iLIOYNUMRRR PO ICV EPF POLICY EI(P-_—"- Y , LIMITS A X COMMFROIALaENER�ALLIABU.ITY CLAIMs-MADE 111 OCCUR GLD11101•10 40/0112018 1010112019 EACH OCCURRENCE $ 1,000,000 oNT€D' G $ 11000.000 $ 100,000 MEDEXP(Anycne areor) PERSONAL &ADV INJURY $ 1,000,000 SENT AGGREGATE UMII"APPLIES PER X POLICY El vi ❑ LOG GENERALAGGREGATE I$ 10,000,C00 PRODUCTS •COMPIOP AOG $ INCL $ OTHER'. B AUTOMOSILa LIABILITY _..... TG2T-74A9L3Qh16 11011207 1018112019 I a � Efl fiGCI Onl $ 2,900,090 BODILY INdI1RY(Par Parson) $ NIA X ANY AUTO X OWNED FCHEDULED „ AUTO5 ONLY AUTOS X HIRE X NON OWNED _ AU70SONLY AUTOS ONLY BOOILYINJURY(Poreccidant) __ _ $ NIA gqOPERTYDANIAGE —' Por am del S NIA , $ X UMBRELLA t.IAD X OCCUR ... OUD11102-10 1010112018 1010112019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS.LIAD CLAIM$ -MADE �.„m _ -�' C DES RETENTION$ WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNEWEXEOUTIVE YIN OFFICCRIMEMBER EXOWDEO9 N❑ (hlandalory 61 NH) NIA TC2 •096018 (AO)�"„„�1'0/OT7iG1'6" TRK„UB•0049X51A48(AL NA,OR,WI) 1010112010 "fd10i7'ZTi1' 1010112019 X P.q H EL ACHACCIDLNT $ """"'"'""""""'"""""" ��1000000 E.I. DISEASE-EAEMFLOYEE ---_ $ 1,000,000 Vatl, 7a90Aba bador SCRIP' IION OF OPE TIONS below E, L, DISEASE -POLICY LIMIT $ 1,000,000 ......,.., .spao..Is rom.. d_ ray bo allaohad It mono eDyco la myulmd) DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 161,Addltlondl RBmarNa Sahedula,n.y7b'a"„.._.m....... more RE: 17.076 SEE ATTACHED REVIEWED EUNICE HEREDIA (PC :I OF�)., CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA, TYRONE CHESANEK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. 20 CIVIC CENTER PLAZA N"a T-„�4 ' ''N::;'• �• THE EXPIRATION DATE THI REOP, NOTICE WILL BE DELIVERED IN SANTA ANA, CA 02702 "'-- =S 'rr ACCORDANCE WITH THE POLICY PROVISIONS. SEP 9 � 2018 AUTHORIZED REPRESENTATIVE of Marsh USA Ioo, Y. •.__„.._.__._"`^:^.. Manashl Mukherjee.,.i'+tAn,r,.:..,}A.wf,:,.n„y.ea. 01988.2016 ACORD CORPORATION. All rights reserved. AGORD 26 (2018103) The ACORD name and logo are registered marks of ACORD A'-T L 7 -611 - AGENCY CUSTOMER ID: 100129 LOG#: Morrlstown ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA, INC. NAMED INSURED SIEMENS INDUSTRY, INC. IWAY BUFFALO GROVE, IL 006E-4513 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: AVVI FIVINAL KCNIAKNO THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: — FORM TITLE: Certificate of Liabillty Insurance RB 11476 CITY OF SANTA ANA, TYRONE CHESANEK IS HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT UNDERTHE REFERENCED GENERAL LIABILITYAND AUTOMOBILE LIABILITY INSURANCE POLICIES. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENTBHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY& NOT CONTRIBUTING WITH IN8URANCE PROVIDED UNDER THIS POLICY, 111,00,1100 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY AND$1,000,001S INCLUDED UNDER THE UMBRELLA LIABILITY POLICY, IFTHESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BYWR17EN CONTRACT, WHICHEVER 18 LE88, REVIEWEb BY. EUNICE,kIEREDIA,(aG OF_ j ACORD 101 (2008101) 0 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HDI GLOBAL INSURANCE COMPANY MANUSCRIPT ENDORSEMENT# 32 Policy Number CLD11101-10 Perlod: Insured, Named Insured SIEMENS CORPORATION 10-01-2018 10r01.2019 This 9ndorsernentPharrge.4 The Polloy. Please Roasllt Pareftrlly„ • .i N IJ kk XI UM12104 IS Thlg.endorsemanttnodiflea Ineurarice provided undorihe following: Time of Endorsement 10-01.2018 12r01 a.m. Standard Time ai.Addross of the C.omrnercial Geneval Liability Coverage Form Who is an'insurod is amended to include as an additional Insured any person whom you are required to add as an additional insured on this policy under a wrltton agreement, but only.with respect to Ilobihty For "bodily injury.", "property damayye'l',or "personal and advertising. Injury' caused, in whole or in part, by: 1. Your aote.gr omissions; or 2. The acts or omisslo.ns of those'Acting on your behalf, The Insurance coverage provided to such additionahrisurod applies only to the extent required Wthln.tho written agreoment.. The insurance coverage provided to the additlonal Insured parson shall not provide gny broader coverage than you are required to provide to the additional Insured person in the written IgreeMont and shall not proVido limits of insurance that exceed the lower of the Limits of Insurance provided to you in this policy, or the limitq of insuranoe.you are, required to pro.Vldo in the written ograoMenf. The insutapce provided to the additional insured by this endorsement is excess over any validand golloatilile other insurance, whoth,er primary, excess, cc'ntingent, or on anyotherbasis, that Is,ovailable to the additlonalinsui"ddfor a loss ode cover underthis endorsement However, if the written agreement specifically requires that this Insurance apply on a primary basis, this 1psurance is primary, If the writto.ri agreement specifically re'qunroe this insurance' apply on a primary and non-oaritributory basis this insurance is primalyto other, insurance eyallabie to the additional Insured and wA Will not share 'with that other insurance provided that the additional insured is a Named Insured under•such other insurance, This endorsomentshall prevall over additional Insured endorsements that may apply tinder this policy unless required othorwlse 16 the written agreement. eg Authorized Representative .All terms and conditions of the policy remain unchanged. THIS ENDORSEMENTMUST SE ATTACHED TO A CHANCE ENDOR6EMENT WHEN ISSUED AFTER THE POLICY IS WRIT.TEN. page ., EUNICE "'.. AI— bQF