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Home My WebLink AboutSIEMENS INDUSTRY, INC. 15A -2016INSURANCE ON f°Id.P WORK MAY PROCE1<t7 WL IN URANCEEXPIRE' CLERK COUNCIL � �,__o...�._.,.. DATE, MAY 1_ 0 2016, FIRST AMENDMENT TO SANTA ANA VIDEO SECURITY_ ENHANCEMENT PROGRAM AGREEMENT A-2016-054 TFUS FIRST AMENDMENT to the Santa Ana Video Security Enhancement Program Agreement is made and, entered into on. April 5, 2016, by and between SIEMENS INDUSTRY, INC., a Delaware corporation, ("Siemens"), and the City of Santa. Ana, a charter city and municipal corporation, ("City"). RECITALS A. The parties entered into Agreement #A-2015-277, dated December 1, 2015, (hereinafter "said Agreement") by which Siemens will be providing video security system design, enhancement, and installation, and maintenance of the downtown security system and the detention security system. B. Thereafter, it was realized that the Agreement was subject to payment of prevailing wages which was not accounted for in the original Agreement. However, the original agreement amount included a contingency and the contingency will more than cover the increase of the Agreement due to the fact that prevailing wages are required. Accordingly, the parties mutually agree to add a section to the Agreement specifying that the Agreement requires prevailing wage and revising the language of the Agreement to account for an additional $66,000 to the base contract amount (taken from the approved contingency) for prevailing wages. C. The parties would also like to add four (4) cameras to the detention security system at a cost of $15,041; add to the scope of services the conversion of the City Hall security system to the same software system as the detention center and down town security systems at a cost of $1.9,060; and add a system software enhancement at a cost of $9.720. WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter contained and made, and subject to all of the terms and conditions of the Agreement as hereby amended, the Parties hereby agree as follows: 1. Section I, SCOPE OF SERVICES, shall be amended as follows: a) Exhibit A shall be amended to include the conversion of the City Hall security system cameras to the same software system as the detention center and down town security systems as outlined in the attached Exhibit A-'1; b) Exhibit B shall be amended to add the purchase and installation four (4) additional cameras as part of the detention center security system as outlined in the attached. Exhibit B-1; and c) To provide for a system software enhancement as outlined in the attached Exhibit D. 2. Section 2a, COMPENSATION, shall be amended to change the base cost of the Agreement from $1,377,493.00 to $1,487,314.00 and amending the contingency from 10% ($1.37,750) to 5% ($74,365). The total agreement amount shall increase slightly from $1,515,243 to $1;561,679.00. 3. Section 2d, COMPENSATION, shall be added and state as follows: Siemens is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Siemens agrees to fully comply with such Prevailing Wage Laws. Siemens shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 4. Except as modified by this First Amendment, the terms and conditions of this Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Santa Ana Video Security Enhancement Program Agreement the date and year first above written. ATTEST: MARIA D. U ZIAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By; Laura Rossini Senior Assistant City Attorney RECOMMENDED FOR APPROVAL: C\ARLOS 10 T4 Chief of Police C TA NA DAVIT C VA OS City Manager SIEMENS INDUSTRY, INC. l� Ile" ERIC ACKERMAN Area Fire Safety & Security Manager EXHIBIT A -l. Conversion of City Hall Cameras SIEMENS March 29, 2016 City of Santa Ana 20 Civic Plaza Santa Ana, California 92701 Michael Dietsch Enterprise Account Executive Southern California Project Name: City Rall Security Enhancements Objectives: Replace existing City Hall Operations DVR Replace existing City Hall Cashiers Office DVR • Provide expansion capability, including [P and HD integration • 30 days video storage Statement of Work: 1. Siemens to furnish and install a new Milestone Husky digital video recording appliances (2). 2. Siemens to program Husky for inclusion of 11 existing analog cameras, for City Hall Operations, but allow for expansion and/or replacementwith HD cameras, in the future. a. Husky shall provide a minimum of 30 days storage for 11 analog cameras and up to 10 HD cameras (future cameras). 3. Siemens to program Husky for inclusion of 6 existing analog cameras, for City Hall Cashiers Office, but allow for expansion and/or replacement with HD cameras, in the future. a. Husky shall provide a minimum of 30 days storage for 6 analog cameras. 4. Husky Appliances shall be integrated with SAPD Milestone system for remote viewing of cameras in PD system, but autonomous recording and control by City Hall facility staff (Operations and Cashiers Office, autonomously) a. Siemens to provide and install Interconnect licenses 5. Siemens to provide training for up to three City Hall personnel at the time of installation, for each system. One (1) Milestone Husky M30 8TB One (1) Milestone Husky M30 4TB Seventeen (17) Interconnect Licenses Lot Connectors, Misc. Materials SOW Page 1 1 SIEMENS Clarifications and Exclusions: Michael Pietsch Enterprise Account Executive Southern California • Engineering Drawings are excluded. Engineered drawings with camera locations may be provided for an additional $ 2,300.00. • Siemens excludes Monitor, mouse and keyboards. Siemens assumes City IT to provide suitable network connection and configuration details (1P address). • Siemens assumes all cameras are in good working order and terminate at the existing DVR. Siemens has not included any camera replacement or repair to existing system. components. • Siemens excludes UPS from this proposal. • Siemens includes Prevailing Wage rates. • Siemens requires signed agreement or acceptable client Purchase Order, prior to all work commencement, including parts acquisition or project mobilization. • All equipment not itemized on detailed bill of materials will be at additional cost. Siemens has provided equipment based on submittals and drawings, Locations or devices not indicated on drawings will be at additional cost. City Hall Security Systems Enhancements......... Respectfully: lffWWI Ale e/ /Uls-aAc 29, 2016 Michael Dietsch s Industry, Inc. SOW Page 12 EXIHBIT B-1 Detention Center Security System Purchase and Installation of Four Additional Cameras SIEMENS January 29, 2016 City of Santa Ana Santa Ana, California 92701 Project Name: SAPD Loading Dock Camera Additions Michael Dietsch Enterprise Account Executive Southern California Objectives: • Provide additional video coverage to loading dock area at Santa Ana Police Department 1. Siemens to furnish and install a new Axis Q3505 outdoor HD cameras for installation at the loading dock. 2. Siemens to provide and install CAT6 cabling and include in expanded video security systems. 3. Siemens to provide any necessary conduits for the additional camera locations. 4. Siemens to provide design drawings for approval prior to installation. Four (4) Axis Q3505 Four (4) Milestone Licenses Lot Cable, Connectors, Misc. Materials Lot Conduit (NTE 2001ft) Siemens include Prevailing Wage rates. Siemens requires signed agreement or acceptable client Purchase Order, prior to all work commencement, including parts acquisition or project mobilization. All equipment not itemized on detailed bill of materials will be at additional cost. Siemens has provided equipment based on submittals and drawings. Locations or devices not indicated on drawings will be at additional cost. Respectfully Iffilishol it reGrek t7y,ruawry 29, 2076 Michael Dietsch SIEMENS industry, Inc. SOW Page I 1 EXHIBIT D Sofhvare Enhancement Leiffl Quotation ay „ Tax ID 9 26-3043481 clla L1LLPLITIA as 1431 Opus Placa 5lemanv Downers Grave, IL 60515 Mike Dletuch USDA 10100 Willow Coma Rd. Phone: 630.303.9558 Son Diego, CA. 92131 Fax: 630 839.0113 3/2!16 2010-0.000 30 Boys 3/2116 d/8/1] Jim Arplropoulos Oase 24x] su ort 6 135 00 810.00 9,720,00 14310puu Placa Downnre6mvn, IL 80515 Piaasecomact ma wim any ouaeuonsats50so39c03. Subtotal ---- T Total $9,720.00 Thenkynu, Jim Apiimpnuine mfj IIMA .xi n This Quota is offeotive for 30 days from the date indicated above. "� �A4dIW)�,.' CERTIFICATE OF LIABILITY INSURANCE �i212V12015 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 CERYIPICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ?01!6�i :T, (?1 IMPORTANT; It the certificate holder is an ADDITIONAL INSURED, the policy(los) must be onClOrsod. 0 SUIS ROGATION IS WAIVED,subject to the terms crud conditions of the policy, certain policies may require an enor.�A�rnt, A sk tamont on this certificate does Dot confer rights to the certificate holder In Ifou of such endorsemsnitfs , � I '1 1 !;', PRODUCER MARSH USA, INC, 445 SOUTH STREET MORRISTOWN, NJ 07060-6484 ''�j'' ------- PHONE E4, - --. -...1. R.LLCN�t�.. _ gE`peR�SS: INSURER(s) AFFORDING COVERAGE NAIC4 LIMITS INSURER A: HDI-GerIlN America Insurance Company 41349 100129 8 T&MS8 N-15118 610 RCLLIN NMI] INSUREDSIEMENSINDUSTRY INC. BUILDING TECHNOLOGIES2.9°7 1060 DEERFIELD PARKWAY2015. A - BUFFALO GROVE, IL 600847 IN8URER a The Trevoors InBemnlly Company 26669 INSURERC: Travelers Property Casually Co. ofATorleB 26674 INSURER D : ...—_.._...-......____.._.__...,.._..............� RACHOOCURRENCE $ 1.000,000 INSURER E t INSURER F: COVERAGES CERTIFICATE NUMBER NYC 00630690701 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. JADDL SUER POLICY'IDD. POLICY SRI' pOLICV EggP MHID M'W LIMITS A X CQMMERCIALGENERALLIABILITY CLD111m07 i0l0112015 106112016 RACHOOCURRENCE $ 1.000,000 GIAIMS-MADE OCCURPROMISE'-5C EMGES»R —' ••••••••••••••••••••_. . ' Ea occurranca $ 1,000,6GU FAED EXP IAIfYMe PeMon $ i00,MQ _...-._.._ __ PERSONAL& AOV IWILRY _ If 1�U,QQU GEN'L AGGREGATE LIMIT APPLIES PER X POLLCY❑J'INT DLOC GENERALACOREGATE PRODUCTS-COMP/OP ADD $ $ OTHER; AUTOMOBILE LIABILITY TC2JCAP7440L34A15 (4010112015 10101/2016 SaeBINEDSI E I IT $ 2,OOP,000 SOOIIV INJURY Pae Rerean Is N/A ANY Al17O X .X ALLOVJNED 'Hk-DOLED Af1T05 _ FlUTQ19 HIRER AUTOS X AN NED BODILY INJURY ecelldent) $ NIA ,P nDAWIA6C $ NIA UMBRELLALIAB __ OCCUR , EACHOCCURRENCE $ AGGREGATE $ EXC899 LIAR CLAIMS -MADE DEOI RETENTIONS $ C B C WORKERS COMPENSATION AND ENIPLOYERS' LIABILITY ANY PROPRICTCRUPARTNERIEXEOUTIVE ri1N OPFICSRIMEMBEReXCLUDE04 In NH) Ifyyrerea,daecribe under OESORIP➢ON OF OPERATIONS halovn NIA TC2,IUEi7440L27115(k09) TRKUB744AL28215(AZ, MA, OR VPI/ 11=874401-33815IOH&WA) ,� UQ0K LIMIT I$500K SIR""' 1010111015 106112-01& 106120/5 10/0112016 10/0112016 10101/216(Mandatary X P Rt D" E.L. EACHACCMENr 9 �� 1000,000 E.L. DISEASE - EA EMPLOYE II 1,000,000 C.L. DISEASE- POI.IGV LIMIT' $ 1,600,000 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES pACORO 19 1, AnldltlnnaB Romarka Selradoln, may ba ANhOod If mores "bJ,, , k +`� O '� RE:AEMA-820J5U CITY OF SAW ACLS DOWNTOWN SAFETY PROGRAM AND DETENTION CENTER .'4.2 + 8EE ATTACI IED La9tra Cao ROssilli Assistant City Attow"Y SANTA ANA POLICE DEPARTMENT 60 CIVIC CENTER PLAZA SANTA ANA, CA 92702 SHOULD ANY OK THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 1HEREOF, NOTICE WILL. BE DELIVERED IIN ACCORDANCE WITH TWE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Alf Marsh USA Ino. Manashi Mukherlee ...'6.tJ.-wa,cwaR+- .Klw:.cLvtrn,en.. Q 108.2014 ACORD CORPORATION. All (ICIMs ACORD 25 (2094109) The ACORD Rama and logo are registered marks of ACORD AGENCY CUSTOMER IO: 100129 _ LOC T{: 1iMorrstmn ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMES INSURED MARSH UEA, INH SIEMENS INDUSTRY, INC. GUILD@N TECHNOLOGIES 1000 OEERF'IELLI PARKWAY PoLACN NUMBER GUP=ALO GROVE, IL 60080 CARRIER NAIL CODE EFFECTNE DATE: v hN UMVINA1 INCIVIARr1U THIS ADDITIONAL RE'MARNSFORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 26 FORM TITLE: Certificate of Llabllity lnauranoe REQ AEMA-52MU CITY OF SANTAANA DOWNTOWN SAFETY PROGRAM AMG OETMITION CENTER SANTA ANA POLICE DEPARTMENT, CITY OF SANTA. ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNI EERS ARE IMCLUUM A.S ACOITIONAL IDISUR'EO UNDER THE ABOVE REFERENCED GENIERAL LIABILITY ANtl AUTOMOBILE LIABILITY INSURANCE POUCIES AND THE COVERAGE AFFORDED NE ADD TONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NON-CONTRIBUTORY INSURANCE TO THE EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE INSURED BU'rONLY WITH RESPECT TO ALL WORK PERFORMED BY AND Old BEHALF Of THE NAMED INSURED, SIEMENS INDU51'RY, INC. FOR CERTIFtC1A.TE HOLDER UNDER CONTRACT, THE OWNER AND CONTRACTOR WAIVE ALL RIGHTS AGAINST EACH OTHER AND A,M' OTHER CONTRACTOR, SUBCONTRACTORS, SUP -SUBCONTRACTORS, AGENTS, AND EMPLOYEES, FOR OAMAGBE OR INJUR SE CAUSED BY PERILS TO THE EXTENT COVERS BY INSURANCE, EXCEPT SUCH RIGHTS AS THEY MAY HAVE TO PROCEEDS OF SUCH INSURANCE HELD BY THE OWN ER ASA FIDUCIARY. COMPLETED OPERATIONS COVERAGE IS INCLUDED IN THE GENERAL LIABILITY POLICY, If THESE POLICIES ARE CANCELLED FOR AN9 REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION To THE CERTIFICATE HOLDER UP TOOL DAYS irFKX TO THE CANCELLATION ORAS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. ACORD 101 (2006/01) _..__. 0 2006 ACORD CORPORATION. All rights reserved.. I he AGURID name and logo areregistered marRa of ACORD MANUSCRIPT ENDORSEMENT#34 Policy Number GLD11101.07 Named Insured SII;NIENS CORPORATION '75FARWIl `..Oi Policy Period:. Inception; jMMD Yj Expiration (M -D -Y) EfteCt➢ve Date and Time of Endorsement 10-01-2015 10-01.20'18 10-01-2015 12:01 a.m. Standard Time at Address of the Insured, This Endorsement Changes The Porky. Please Read It Carefully, BLANKET OITMI VW',SURE This endorsement modifies insurance provided under the following; Commercial General Liability Coverage Form Who is an insured is amended to include as an insured any person whom you are required to add as an additional insured on this policy under a weitten agreement. The insurance coverage provided to such additional insured applies only to the extent required within the written agrecm ant. The insurance coverage provided to the additional insured person shall not provide any broader coverage than you are required to provide to the additional insured person in the written agreement and shalt not provide limits of insurance that exceed the lower of the Limits of Insurance provided to you in this policy, or the limits of Insurance; you are required to provide in Che written agreement. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other insurance, whether primary, excess, contingent, or on any other bads, that Is available to the additional insured for a loss we coverunderthis endorsement. However, if the written agreement specifically requiresthatthis Insurance apply on aprimary basis, this insurances is primary, If the written agreement specifically requires this insurance apply on a prim ary and non-contributory basis this insurance is primary to other insurance available to the additional insured and we vri11 not share with that other Insurance. Thls endorsem ant snhall prevail over additional insured endorsements that may apply under this policy unless required, othenidse in the written agreement. �)pnoVZD AS TO FORM Authorized Representative , attire A. Rossini sit City Attorney All terms and conditions of the policy remain unchanged. THIS ENDORSEMENTMUST BE ATTACHED TC ACHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY iS WRITTEN. Eye ge ... POLICYNUMBER: GLD11101-07 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLEfED OPERATIONS LIABILITY COVERAGE PARI' SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION TO THE EXTENT REQUIRED BY WRITTEN CONTRACT shown The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV- Conditions;: We waive any right of recovery we may have against. the person or organization shown in the Schedule above because of payments we make for tlnjuryor damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard This waiver applies only to the person or organization shown in the Schedule above. a xe p -n (..)VED ASTO FORM ftatrney CG 24 04 05 09 0 Insurance SeNces Office, Inc., 2008 Page 1 of 1 0 I PCA!' LER rJ WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (OPJ)_, POLICYNUMBER: TC2JUB-744aL2'7-I-Ie WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our paymants from anyone liable for an Injury Covered by this policy, We will not enforce our right against the person or organization named In the Schedule. (This agreement appiies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shell rot operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANISATION FOR WHOM A WA=,R or SUBROGATION IS REQUIRED BY CONTRACT OR AC"EMENT OR PERMIT, BUT COVERAGE IS LIMITED TO THE SCOPE Or THE WORK PERFORMED BY THE INSURED UN"R SUCH CONTRACT, AOREPMENT OR. PERMIT, rro"TD AS To FORM' raaey DATEOFISSUE: 09-14-15 STASSIGN: POLICY NUM ER: TC2J-CP-744OL34A-T1L-15 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: EUSIMESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorse- required of you by a written contract executed ment, the provisions of the Coverage Porn apply prior to any '"accident" or "loss", provided that the unless modified by the endorsement, "accident" or "loss" arises out of the operations Paragraph 5. Transfer of Rights Of Recovery contemplated by such contract. The waiver ap- Against Others To Us of the CONDITIONS section plies only to the person or organization desig-, is replaced 6ythe folVow+iny: Hated in such contract. a. Transfer Of Rights Of Recovery Against Oth- ers Tolls We ",valva any right of recovery we may have against any person or organization to the extent Laura A, Rossini Assust,axt£ tarty Attorney CA T3 40 08 08 0 2008 1 ne 9'raveim Qornpanios, Inc, Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE DAT"'ODfyyyy) 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( ss) must 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 endorsernent(s). PRODUCER CONTAcr N ALRE�1 V NU 1415,30)TH S�RE-. PHONE A jr, ALA % fAtj: N ----- --- --- E W A kL z 0 LTR TYPE OF INSURANCE INSO Mr) POLtlCY NUMBER ["POIL-ItY (MWDQYYYY1: WMMC)fyy_yYi LiMItS A COMMERCIAL GENERAL LJABILiTY 4,R1111 1 IQU'1`8 INSURER A 39.3 iNSLIRE0 INSURER 3 The Frovelers sle.mnq Coripary SEMENS 110US f Rr, K INSURER C Jr Id lar PaperCy ""aaj;Aty Co of Aoiorca 21i Cr; PARKWA'� INSURER D B6,FFALO GROI/E, 11. FQE81) wo MED EXP Ony �v,o pw,�oW INSURER F COVERAGES CERTIFICATE NUMBER, NYC-0I)720W1 3 09 REVISION NUMBER: TMS IS TO CERTIFY THAT THE POLKAES OF INSURANCE LISTED BELOW HAVE BEEN gSSUED To TIRE INSURED NAMEO ASOVE FOR THE POLICY PEROD INDICATED N(DI'VOTHs,rANCING ANY REQUIREMENT, TERM OR I.",ONMflOIA OF ANY CONTRACT OR OTHER OCCUMENT OTH RESPECT TO wHw,H rHIIS CERTIFICATE MAY BE kSSUED OR MAY PERrAiN THE INSURANCE AFFORDED BY THE POLIOES DESCIRMED IHEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDffONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA0 CLAIMS ----- --- --- EFS.. LTR TYPE OF INSURANCE INSO Mr) POLtlCY NUMBER ["POIL-ItY (MWDQYYYY1: WMMC)fyy_yYi LiMItS A COMMERCIAL GENERAL LJABILiTY 4,R1111 1 IQU'1`8 1 0,,t) i, 20 16 0XI 1'(2017 EACH WUPRENCF- (1100 00 OCCIAk . . . . . . . . wo MED EXP Ony �v,o pw,�oW '(110 060 aRSONAI &ADVINJURY T1000 000 (3EN1 AGCREGArE 0,10 APPI lES PII�R GEN ERAL AGGREGAT X_� JE PRO- 1 "RQfPJC,'rS COMP'OPAGG I NCL C AUTOMOBILE LIAMUT� !T`,2,CAP,440L34A 6 10,01,26'6 1101 211'7 COMBINED SINGLE UN UT 2,;x10 C0 Js) x:190AL . ....... X ANY AU 10 NA X A6 I. SCHEDuLEIJ A)TOS AU T 0S .... 8001LY NAiRY �Pefacoduli) ..... . .. NA x. Hi+a F 1) A0 IS AIJTOS . ...... IT UMBRELLA WAS EAcil OccuRRENCr EXCESS LEAS CLAWS -MADE -- - ------- ... ... I;F,rCNTH)N S C WORK ERS COMPENSATION T 0 2i U [344",L12 ,11, 13 iA C S 1010' 2016 201� x L I AND EMPLOYERS' LIASPLI TY YIN MKUUNV)0_,8jl�j (AL MA OR&Wl�i El IN i A �1001 1010',2016 10,0Q01i imm E L EACHACCOENT 3 000 NXJ0B,1140J�816 �(,'H (Mandatory Ill NH� r hA) F, ENSEASE EA EMPq OYEE 5 if des m0e wdqy D�WP'hON ()F OPIERAIIGNS,,�qfqw ullIH SR 7 E DISEASE POLICYLAW CEscRIP'noN OF OPERATIONS fLOCAruONSi VEHICLES EACORD 101, AOOHional Rafnarki Schedule, may be altarhed ifinowe space, is required) RE K,032C2'015 P4�()JEC'l 310070,138FIROJECF NAME 9CA,,ES, CI F'(QF SAIJA ANA PO1 IU: DEPT S,'E"i: At AC" iED CERTIFICATE HOLDER I T'fJi-"30� I A ANA M 93 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 �1,jfV(,,,�'E'V'ER PtAZ4 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN W 34,', MI(A (•A 1 ACCORDANCE WITH THE POLICY PROVISIONS, AUrHORIZED REPRESENTArtlVE of Marsh USA Inc Manash� Mu0erjee 198,8-2014 ACORD CAlMtT7Aff-''rights —reserved. ACORD 25 (2014/01) The ACORD name and Iogo are registered marks of ACOR� U 7 0 AGENCY CUSTOMER lD: W0129 LOC #: fvfOrrlStOWrl Page 2 �Of.-.2 AGENCY NAMED INSURED MAR ,"H Tj,3A N(: 3VAENS INCuSrR,r Ac - POLICY NUMBER 10(116 DEER l-.-,, PARK1h,"O' K,FFA�.o ,ROVE q- �30089 CARRIER NAIL GC1aE I =VIEVIVE DATE THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE; Certificate of babiliky Insurance RE 91,%2Pf,,Y)7119G0 P093'2(rX)W5 PRQdEC T# W)(,'7C5�3 "R,0JE;17 NAW b(,'Ad 'SE'S C I 'Y QF SAW A ANA P(A ICE DEP F cIr,f oir rA %NA i rrE ()F,CERG, EMPLOYEES. A(]EN F, AND VCLUIN"F�1-RS ARE IN( UXED AE ACA 1'10NAL IWijRED UNDER 1"HE A BOVF REP ERENC ED I J'f A NO AUTOMOBILE ( ABIUTY I NSUPA�9,�' POIJ0ES A NID THE IOvERAArFt)RrEC r HE A D01"NONAL I NSUPkH) IJNDER ` HE POLQE5 G)rALL 8F. PRiARV AND N C0I,1rR1q1JT(.1R I I NSLRANO..' %) rHE EXTEN'T rrr,A- A C( ,AW A RISES -RO&I FHE NEOUGENCE OF Sir ME 4,'3 NL('S'{'Y (NO OR M� RAC,,")NTRA(,'T()RS Ni 'If R ESP TO ALI- ()I'I:RATW)N3 ;IF THE NSuRK 310 ()NT,( WT'H RE',EP;:;1' LM_ NCiRK PFRF0 RMEF, BY AND ON BEHALF OF THE NAMED N.IJR,'F,-D 51EMEN,'; R" NU PUR CERMF ICA C:-' HOLDEq JN DER Jr." )WhIcR AND C ON 'RAC FCR NAIvEAi.I- AGA �NS' EACH W},ER AND AWfOTHEIR C'01,TTRACTOR 3USC ON I RA;',711RS SI)B-3U8C01N!'RAC7)R ,(SEhjr3 ANC LWLOYEES IOR ")R N,4)R I ES (,A4SFD Be PF;jj_�S ro T,(E EXTENCuO(E REE, 9Y fWSURANCF, E,XCEPT 3')CH R!CHTS A", THEY MAY HA /F TU OF SI)CH INSW?ANCE HE,D BY THE OWNER, ASA RC]LICARY CUMPLE I ED OPERA -IONS tS INCILL)CED N TI IF GET,0:RAL uABIUTY PCAUCY IF TF, ESE `O[JCES ARE CMTfCEU ED -OR AN I REASON OTHER THAN 40", PA'MErV CF PREVIJM TI,E INSURER APT -i. DE PiER NOTNCOF _A Dtf rC,) TFE CER, 'IF CA HDJOEP uP rC,-)C DAYS F�5JCR TO TI E CAWTLi-ATV,OIA A3, PE -Eu ,R,ED RYWR I 7EN . jN T5VG Ir NMjAC_dpj;7p SLJSa ACORD 101 12008101) '� 2008 ACORD The ACORD name and logo are registered marks of ACORD M MANUSCRIPT ENDORSEMENT # 32 Policy Number Named Insured G LD 11101 -08 SIEMENS CORPORATION Policy Period: Inception (M -D -Y) Expiration (M -0-Y) Effective Date and Time of Endorsement 10-01-2016 10-01-2017 '10-01-2016 12V a.m. Standard Time at Address of the insured, This Endorsement Changes The Policy. Please Read It Carefully. This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Form: Who is an insured 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 written agreement, 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. The insurance coverage provided to, such additional insured applies only to the extent required within the written agreement The insurance coverage provided to the additional insured person shall not provide any broadercoverage than you are required to provide to the additional insured person in the written agreement and shall not provide limits of insurance that exceed the lower of the Limits of Insurance provided to you in this policy, or the limits of insurance you are required to provide in the written agreement. The insurance provided to the additional insured by this endorsementis excess over any, valid and collectible other insurance, whether primary, excess, contingent, cr on any other basis, that is available to the additional insured for a loss we cover under this endorsement, However, if the written agreement specifically requires that this insurance apply on a primary basis, this insurance is primary. If the written agreement specifically requires this insurance apply on a primary and non-contributory basis this insurance is prima,ryto other insurance available to the additional insured and we VMI not share, with thaitother insurance. This endorsement shall prevail over additional insured endorsements that mayapply Linder this policy unless required otherwise in the written agreement, Authorized Representative All terms and conditions of the policy remain unchanged, THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY IS WRITTEN. Page ENTBaED- ` BY: POLiCYNIUMBER. GLD11101-08 This endorsement modifies insurance provided under the following, COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 COM MERCIAL GENERAL LIABill-FrYCOVE "AGE PART PRODUCT /COMPLETED OPERATIONS LIABILITY COVERAGE PART 6*01W- U091[14# 'ANY PERSON OR ORGANIZATION TO THE EXJEI`J REQUIRED BY WRI TTEN CONTRACT I Information required,10.20m2iete this Schedule, If not shown above will be shown in the Declarations --i The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any night of recovery we may have against the person or organization shown in the Schedule, above because of payments we snake for inp.�ry or damage ansing out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard", This waiver applies only to the person or organization shown in the Schedule atx.)ve OCT 7 "1101I�'i CG 24 04 05 09 0 insurarce Services Office Inc, 2008 BY AM, TRAVELERSJ WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY POLIO YNUMBER TC2JUB-7440L27-I-16 NTI-ALT14 V4 e have the right to recover our payments from anyone liable for an injury covered by thas pohcy- VVe 41 not enforce our right against the person or organizzatiion named in the Sche&fle. (This agreement applies only to the extent that you perform work under a wrftten contract that requires YOU to obtain this agreement from LIS This agreement shall not Operate cfiredy or indirectl� to benefit any one not named in the Scheduit, A.N'f PERSON OR ORGANIZATION FOR WHC A WAIVER OF SUBROGATION IS REQUIRED BY CONTRACT OR AGREEMENT OR PERMIT, BUT COVERAGE IS LIMITED TO THE SCOPE OF THE WORX PERFORI*MD BY THE INSURED UNDER SUCH CONTRACT, AGREEMENT OR PERMIT, GATE OFISSUE og-oa-i6 ST ASSIGN, E T, R E D 7 2 ]l F fy CERTIFICATE OF LIABILITY INSURANCE DAT "'ODYyy) 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( ss) Imust 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 endorsernent(s). PRODUCER CONTAcr N ALRE 0.11A 1415,30)TH S�RE-. 1,�) � -1 F1 A jr, -1 PHONE ALA % fAtj: N EIFP E W A kL z 0 C)!5 ["POIL-ItY (MWDQYYYY1 WMMC)fyy_yYi Limits A COMMERCIAL GENERAL LABILiTY FR1111 1 IQU'1`8 1 0,,t) i, 20 16 0XI 1,(201 INSURER A N)l Gbnalos,ar3ncc D139.3 iNSLIRE0 INSURER 3 The Frovelers s,,1e.mnq Coripary SEMENS !NDUS f Rr, K� - . ...... AUJILDINJI,'r:-QHN()LQ(,'�IC: 5 INSURER C #r1A IAr P�aperCy ""aaj;Aty Co ofkiiorca eIi CT PARKWA'� INSURER D BLFFALO GROI/E, 11. FQE81) 1(110 060 INSURER F COVERAGES CERTIFICATE NUMBER, NYC -0I)72,9,)1309 REVISION NUMBER: TMS IS TO CERTIFY THAT TH;E POLKAES ()F INSURANCE LISTED BELOW HAVE BEEN NSSUED To TIRE INSURED NAMED ASOVE FOR THE POLICY PEROD INDICATED N()TV0THs,rAN0]NG ANY REQUIREMENT, TERM OR I.",ONMflOIN OF ANY COwRACT OR OTHER OCCUMENT NTH RESPECT TO wHw,H rHIIS CERTIFICATE MAY BE ISSUED OR MAY PERrANN THE INSURANCE AFFORDED BY THE POLIOES DESCIRMED HEREN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDffIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA0 CLAIMS ........... . ... AOOL�SUBRI EIFP LTR PIPE OF INSURANCE INSO WVC I POLCY NUMBER ["POIL-ItY (MWDQYYYY1 WMMC)fyy_yYi Limits A COMMERCIAL GENERAL LABILiTY FR1111 1 IQU'1`8 1 0,,t) i, 20 16 0XI 1,(201 W,�UPRENCF- 0100 00 x _bAMxP1"rFT_r) 7r9TT_D__ OCCIAk 000 1(110 060 ffRSONAI & ArJV INJURY 1 000 000 (3EN1 AGCREGAni 0,10 APPI !ES PII�R J j GENER i0 LI' X_� PRO -LCAT. jECT If, F4 1 "R(AAJC,'rS COMP'OPAGG I NCL C AUTOMOBILE LIAMUTW !T,`,2,CAP,440L34A 6 10,01,26'6 I �Jl 1 211'7 -7—OMBINED SINGLE UNUT 2,; 0,000 X ANYAU10 W)Oq Y �NJIJRY �Pqr pem.O 5 X --SCHEDuLEIJ A AU TOS 80CILY NAiRY �Pefacoduli) .... ..... . .. NA PNON,OWNED AIJTOS UMBRELLA WAS EAcil OcMJRRENCC EXCESS SAS CLAMIS-MAD E -- - ------- ... ... i;FjCNTH)N CWORK ERS COMPENSA TION T02juB;*,146A2,11, 16 iACS� 2016 2017 x 1,.P1,`R R L 12 ' '_1 if AND EMPLOYERS' LIASPLI TY Y I N MKU674,V)�_,�8J16 �AL MA OR &wl�i OFP �CE'RW MSE"R N1 i A �010' �1001 0, 0 T 20 1 E L EACHACCOENT S 1000.1000 �Mandatiary Ill NH� hA) F, � ENSEASE EA EMPq OYES 5 'x)0 Ip desmi)e wdqy DPWP'hON ()F OPIERAIIGNS ,14fqw LE DISEASE POLICYUNW 100011"4110 CEscRIP'noN OF OPERATIONS fLOCArtiONS i VEHICLES CACORD 101, AOOHional Ramarki Schedule, i'nay be altarhed if ino,il space, is requlmd) RE 1 1,,032CO'015 P4()JEC'l 31AG 70,138FIR OJECF NAME 9CA6,,ES, CI F'< QF SAIJA ANA POl IU: DEPT S,'E"i: At AC;',1IT D CERTIFICATE HOLDER I T'rJi-"30� I A ANA M 93 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 �1,j9V(,,�'E'V'ER PtAZ4 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN W 34,', MIfA 1'•A 1 ACCORDANCE WITH THE POLICY PROVISIONS, AUrHORIZED REPRESENTArtlVE of Marsh USA Inc Man shy Mu0erjee @ 198,8-2014 ACORD CC$ZPCFfAMtT7Aff-''rights —reserved. ACORD 25 (2014/01) The ACORD name and Iogo are registered marks of ACOR 7 e /4 AGENCY CUSTOMER lD: W0129 LOC #: fvfOrrlStOWrl Page 2 of 2 AGENCY NAMED INSURED MAR ,H Tj,3A N( 3VAENS iNDvSTR,, Ac EIJI! "'W" r"CHNO�.CGES POLICY NUMSER 10(116 DEE Rf--,'E PARK1h,"O' K,FFA�.o ,ROVE tI- �300)9 CARRIER NAIL GC1aE EFFECnVE DATE THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE; Certificate of babiliky Insurance RE 91,T2Pf,,Y)7119G0 P093'2(rX)W5 "RQ( EC F# 9'I Q)(,'7C5�3 "R,0JE;17 NAW b(,'Ad 'SE'S C I 'Y QF SAW A ANA P(A ICE D&P F c11,f oir rA %NA i rrE ()F,CERG, EMPLOYEES. A (]EN F, AND VCLUIN"F=1-RS ARE iNCUXED AE ADCA 1'10NAL INSURED UNDER 1"HE A BOVF REP ERIN(' ED GENFRX [,%I',� I J'f A NO AUTOMOBILE ( ABIUTY I NSUPA�9,�' POIJ0ES A NID THE (OvERATaF- AFF�)RrEC r HE A D01"NONAL I NSUPkH) IJND�p r HE:, P QE5 rrr,A-A'�"Ar MAi�,l'aEti',-RON,IFliEiE6 ',L.GENCEDFI)IrME�f3]NL'9r'Sr{:"' (NC ORM� RAC,"% TRACTrOPS ANTI R ESP EC; " TO Ai .,Pv�fPr'1r I11r1' 3 ;IF T 9 N SU RK 31j 7 (.NT,. W'H RE ,;P;: NAMED NIJR,'F,-D NU P UR CER'7 [FICA C:-' HOLDER 1JN DER 1-(,N SRA ,,,, r Jr." )Wh cR AND C ON 'RAC FC R NA IvE A I. I- R�((i Fq l SAGA �N S' EA(,H 0 �'�IER AN D AN'f'0 THEIR C' 01,TTRACTOR 3USCONTRA;,711RS ,�SEhjr3 ANCLWLOYEES rOoCDAYS F�;JCR TO !'IEDRYWR17EN( . jNT5VG Ir NPjlC pj; :S 7p ACORD 101 12008101) '� 2008 ACORD The ACORD name and logo are registered marks of ACORD M JC � , 0 ��, , 1 * 2 1 MANUSCRIPT ENDORSEMENT # 32 Policy Number Named Insured G LD 11101 -08 SIEMENS CORPORATION Policy Period: Inception (M -D-Y) Expiration (M -0-Y) Effective Date and Time of Endorsement 10-01-2016 '10-01-2016 12V a.m. Standard Time at Address of the insured, This Endorsement Changes The Policy. Please Read It Carefully. This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Form; Who is an insured 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 written agreement, 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. The insurance coverage provided to, such additional insured applies only to the extent required within the written agreement The insurance coverage provided to the additional insured person shall not provide any broadercoverage than you are required to provide to the additional insured person in the written agreement and shall not provide limits of insurance that exceed the lower of the Limits of Insurance provided to you in this policy, or the limits of insurance you are required to provide in the written agreement. The insurance provided to the additional insured by this endorsementis excess over any, valid and collectible other insurance, whether primary, excess, contingent, cr on any other basis, that is available to the additional insured for a loss we cover under this endorsement, However, if the written agreement specifically requires that this insurance apply on a primary basis, this insurance is primary. If the written agreement specifically requires this insurance apply on a primary and non-contributory basis this insurance is prima,ryto other insurance available to the additional insured and we VMI not share, with thatother insurance. This endorsement shall prevail over additional insured endorsements that mayapply Linder this policy unless required otherwise in the written agreement, Authorized Representative All terms and conditions of the policy remain unchanged, THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY IS WRITTEN. Page BY:- POLiCYNIUMBER. GLD11101-08 This endorsement modifies insurance provided under the following, COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 COM MERCIAL GENERAL LIABill-FrYCOVERAGE PART PRODUCT /COMPLETED OPERATIONS LIABILITY COVERAGE PART 6*01:D- U091[14# 'ANY PERSON OR ORGANIZATION TO THE EXJEI`J REQUIRED BY WRi TTEI`,J CONTRACT I Information required,10.20m2iete this Schedule, If not shown above will be shown in the Declarations --i The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any night of recovery we may have against the person or organization shown in the Schedule, above because of payments we make for inp.�ry or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard", This waiver applies only to the person or organization shown in the Schedule atx.)ve ()C T 7 "? 0 V i1i CG 24 04 05 09 0 insurarce Services Office Iric, 2008 BY AM, TRAVELERSJ WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY POLIO "NUMBER TC2JUB-7440L27-I-16 NTI-ALT14 V4 e have the right to recover our payments from anyone liable for an injury covered by thas pohcy- VVe 41 not enforce our right against the person or organizzatiion named in the Sche&fle. (This agreement applies Only to the extent that you perform work under a wrftten contract that requires YOU to obtain this agreement from Lis This agreement shall not operatt, cfiredy or indirectl� to benefit any one not named in the Scheduit, AN'f PERSON OR ORGANIZATION FOR WHO A WAIVER OF SUBROGATION IS REQUIRED BY CONTRACT OR AGREEMENT OR PERMIT, BUT COVERAGE IS LIMITED TO THE SCOPE OF THE WORX PERFORIblIED BY THE INSURED UNDER SUCH CONTRACT, AGREEMENT OR PERMIT, DATEOF ISSUE og-oa-i6 ST ASSIGN, EN'FE RED 7 2u'li" By;