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Home My WebLink AboutInsurance Certificate: Johnson Controls CERTIFICATE OF LIABILITY INSURANCE DA~SEr ;;3D YYY) THIS CERTIFICATE S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW . THE CERTIFICATE OF NSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the ceLiiGCare holieris an ADDITIONAL INSURED, the polLyties) m ustbe endorsed. if SUBROGATION S W AIVED, subectuo the term s and condtbns ofthe policy, certain policies m By requite as endomem enL A statem enton this ce3riflCate does notconferzghts to the ceLtiBcare hollerin lieu ofsuch endorem ent(s). PRODUCER CONTACT MalEh USA 1C NAME: FAX 411 E.W i UXZIDA~E[rE PHO N.3. Xd x Sule 13M EM AL M3Wau3E,W 153202 ADDRESS Am:XICemEq ma2shmn NSURER B)APFORDNG COVERAGE NAEM 011077-1..51314- 1243 NSURERA: OhReprhlc lire CO 24147 NSUREO NSURERB SaDy I193$[EAMUGHICO 24988 ~r~C E, K. YO]kYitcxuiiTal('C ldenniyl>SuEwEm Can~ryOfNmthAmetiID 43575 p~ptXy NSURER C Amh:Cap.RicMgntX 92 NBURERD :ACE Ameri>~lsumare Canperv 21557 - PO.BCX591 M 33Wau1~,W 153201 Nsu¢eR E: ACE PZK I& Cas3aly 1Auxw E CmpmV 20699 MEURER F : COVERAGES CERTIFICATE NUM BER: CH1004640217-03 REVSDN NUM BER:2 THE S TO CERTFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERDD INDICATED. NOM rHSTANDNG ANY REQUIREMENT, TERM OR CONDrDN OF ANY CONTRACT OR OTHER DOCUMENT W UH RESPECT TO W HrH THIS ' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,: EXCLUSDNS AND CONDrDNS OF SUCH POLr ES.LM rS SHOW N MAY HAVE BEEN REDUCED BY PAD CLAMS. NSA ADDLSUBR POLEYBFF POLICY SAP LYN TYPEOPNSU0.ANCE POLEYNUMBER M D TYT M D YYY LIMAS A GENERALLABLIIY MWZY300317 10,01,0013 1OA1,2014 EACH OCCURRENCE $ 10,000p00 X COMMERCALGENERALLABL] DAM AGE TO RENTED 10,600,600 AEM SE a $ CLANSMADE M OCCUR NED EXP %Wcne 1 $ 50DOC X CataoLaUaity PERSONALRADV NJURY $ 10MO)DOC X XCU Tr1xhd GENERALAGGRBGATE $ 30,000= G EN L AG GREGATE LM E APPLES PER PRODUCTS-COMP,OP AGO $ NC NGEN AGG X POLICY PRO- IDD $ jErT B AUTOMLBX.ELREME7 90{ 6C6-01 10/014073 10,01A014 COMEXIED ENGLE LIMA a n SpoOpa B X ANY AUTO 90-0460602 MA) 10pIP.013 10p1R014 BODLY NJURY @erpe.) $ X ALLOWNED SCHEDULED AUTOS AUTOS BODLY NJDAY @eramBem3 $ X HARD AUTOS X NONOWNED PRO PERTY DAM AGE $ AUTOS E X UMBRELLA LAB X OCCUR XOOG27053439 10,01013 10,014014 EACH OCCURRENCE $ 5pw= X EXCESS LAB CLANS-MADE AGGREGATE $ 5p0 = ICED RETENTDN $ C WORKERSCOMPENSATDN WERC47324117 ROB-Seepege2) 10p1,2013 10014014 X WCSTAN- OTH- AND EM PLOYER$'LAB 1LAY D ANY PRO PA ETD RRARTNERSXRCUTNE YIN WIAC47324075 CA,AZ,MA) 10,614013 10414019 5p00pOC D O M FFEBRMEMSER EXCLUDED? N N/A SGFL47324191 W).1 10,01P013 10,014014 EL.EACN ACCDENT $ SpJD anCamry n ME) EL.D SEASE-¢A EM PLC YE $ D gESa N 0 F O eS PEAATDNS Eels, DISCR VTDN OF W CUC47324233 W C-0H,W A) 10,614013 10,014014 E L.D S EASE -FO LEY LM II' $ 5p0ODOC DBSCRBTDNOFOPERATDNS/LOCATDNS/VEHrLES Reach ACORD 101,AEEivnalRem ail Schedule, im ore spaces mui ) The ClycfAd]Srd Omegw ard.setcBdotH>ak.off=aridmpbWe ag Xr3ajaia ba li3s plfieadaded. CERTIFICATE HOLDER CANCELLATION ' CiyoDd,brTh SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20EastMaDSt*et THE EXPRATDN DATE THEREOF, NOTTE W LL BE DELIVERED N Adllati,OR 97502 ACCORDANCE W 1TH THE POLICY PROVEDNS. AUTHORISED REPRESENTATNS of Marsh USA Inc. Manashi Mukhedee _Mauao~ ~4...[e.wu 1988-2010ACORD CORPORATION. AIL3ightsmserved. ACORD 25 R010/05) The ACORD nameand bgoam DegstemdmEu sofACORD AGENCY CUSTOMER D: 011077 LOC u: Milwaukee ACC>R O ADDIPI)NAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED NSURED MadtUSA Ix:. Jdl Ca=b, ls. Ymlc Ym.m t;..alr•O¢zmdn . POLICY NUM DER AGn;Cap.Ri3cMgntX 92 PD.BM591 M9aadwe,W 153201 CAREER NAIC CODE BPF8CTN8 DATE; ADD B'D NAL REMARKS THE ADD3rDNAL REMARKS FORM S A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TIPLE: Certificate of Liability Insurance W ORKERS COM PENSATON WmI Canpa®DZ'AOS°PDE.Ysiihs m.®3efxd bmwss3~R:AK,AL,AR,CO,C,DC,DE,FL,GA,H;A,D,L,N,KS,KY,U,MD,ME,M;MN,MO,MS,MT,NC,NE,NH,NS,NM,NV,NY,OK, OR,PA,R;SC,SD,TN,TX,UT,VA,VT,W V PRNARY COVERAGE 11e G..o~.1*.at.sx.,anlAUmnchl=Lalnlly~~axF~a4'arclrctn~oC>am'ID~¢Y3wih aha~ec ~teF-m»srx.vt~ s}ii~b,'wv`~ Is~ewv`mm m'~baiFb~Gr~~.l~', the aRalesbbiha j:pgardmnplmicFemtus. W AVER OF SUBROGAT'DN TtE,Gexalrab3lt,AUbncbilnLab*(Wo I Canpesaanard Empby~LzdmLypDSis 1.bawai¢~afi~=ofde~e:lobarardarycde<p~crcrjmikrnnbtlmn ADDrDNAL NSURED -AUIOMOBIE LAB= '1YeA cba bl b2hrpok:/,fggls b/wd M=10=s1~~me®3e faAdiGn3llam3sas egri~3b~eairwd~maart MDIfDNAS,NSIJP.SD !:ENERAL [.AB?~'Y ' FsGmralia6$y, Pa~ialbywd>ermIDa4de bIlxigac sldalasaddiiialmre~,as a2ds3pns~2bawd~arsactwdh a ran al isra3l,p°tiatradsi POHyErcbv93nemA2 arslA2A:THE CERTF MHODIERLETEDONTHSCF3tT7i MOFLAB NSURANCE,ANDEACHOTHERPERSONORORGANYATDNRHDURMMBENCWDEDASANADDrDNALNSUREDPURSUANT 'R) A W RIlTIIi CONTRACT W IlH THE NAMED NSUAEO. UMBREUAjD(CESS LWBLPY T}e DmlmBgL%mdyL tdkcaWlssdean xirli'dmdmhmofdm Cra~mre~Lsb~y lsaBax,OSdemiimUmbeA,flma Lsmlly rm 3'dets a}iadkydewdtatozsagwhiiaser slm.HaueM fdepmiaryna pD3~snnmdmdefxOfdmCamimeOfLsmlLY Ia,>ffitcaats*demnbbaCcncnmbmpdnaThdeaadmm=Um 1h L%billy7mt3Xg31Edbyde wGmG o den bxeMkE.es Lsb~HyAi±.da+nmde&o Cfths CrSI'iste otl smRY ~d'nOctap],. ' ACORD 101 (2008,01) ° 2008ACORD CORPORATDN. Allrghtsmserved. The A C O R D name and bgo am reg smmd m arks ofA C O R D IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - ENDORSEMENT A2 Named Insured Endorsement Number Johnson Controls, Inc. . Policy Prefix Policy Number Policy Period Effective Date of Endorsement MINZY 300317 1010112013to1o101M14 Issued By Old Republic Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): If required by contract, the person or organization listed on the certificate of Insurance as additional Insured, and each other person or organization required to be included as an additional insured pursuant to a contract with a named insured. Location(s) Of Covered Operations; As required by contract- 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 solely by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project GL 289 001 1012 MWZY300317 Johnson Controls, Inc. 70/01/2013-10/07/20!4 IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS - ENDORSEMENT A2A Named Insured Endorsement Number Johnson Controls, Inc. Policy Prefix Policy Number I Policy Period Effective Date of Endorsement MWZY 300317 10 fOV2013to10/0112014 Issued By Old Republic Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): If required by contract, the person or organization listed on the rartilicate of insurance as additional insured, and each other person or organization required to be included as an additional Insured pursuant to a contract with a named Insured. Location And Description Of Completed Operations: As required by contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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" or "property damage" caused solely by your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". GL 289 0021012 MWZY300317 Johnson Controls, Ina 1010112 013 -1010112014 Marsh USA Inc 10900 SImelake Blvd. Suite 200 9948 8 516 MARSH Fax: Austin, 2122TX 78759 516 7 JCI.Certreques1 c@rnarsh.oom September 2013 Subject: Johnson Controls, Inc. Certificate of Insurance Coverage Period - October 1, 2013 - October 1, 2014 Dear Valued Johnson Controls Customer: Enclosed is your Certificate of Liability Insurance for Johnson Controls' renewal as of October 1, 2013. If provided to us, the project name and your company's contract number or purchase order number are referenced on the front of the certificate In the Description section. On the Additional Remarks Schedule page Is important Information about the Insurance coverages. Also attached to the certificate is the complete additional Insured endorsement from the General Liability policy. If you have any questions or require additional information, email or fax your inquiries to the address and number indicated above. IMPORTANT You may received additional certificates of insurance in the next few days that do not correctly reflect your terms. Those certificates are system generated so please disregard any duplicate certificates that do not reflect your terms as they are shown on the enclosed certificate. If your firm does not require the enclosed certificate of insurance, please write "DELETE" on the face of the certificate and FAX it to (212) 948-5167 or scan and email it to JCI.Certrequest@marsh.com. c4►lf\ MAR916MCLENNAN LEADVLSHIR KNOWLEDGE. SOUrrIONS...WORLDWIDE. s~ COMPANIES