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CERTIFICATE OF LIABILITY INSURANCE/ Page 1 of 2 DATE (MM/DD/YYYY) :ORO� �TIFICATE OF LIABILITY INSURANCE 70N4/2014 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 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 CONTACT NAME:Willis of Illinois, Inc. Willis of Illinois, Inc. PHONE AIC No.Ext : 312-288-7489 FAX AIC No.Ext : 312-621-6866 233 S. Wacker Drive, Suite 2000 E-MAIL ADDRESS:tke.certificates willis.com CHICAGO, IL 60606 INSURER(S) AFFORDING COVERAGE NAIC # INSURED ThyssenKrupp Elevator Corporation 5100 West Grace Street Tampa 33607 COVERAGES CERTIFICATE NUMBER: 771966 iNSUReR A: HDI-Gerling America Insu iNSURett s: ACE American Insurance iNSUReR c: Indemnity Insurance Com INSURER D: INSURER E: INSURER F: REVISION NUMBER: 41343 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAND!NG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMFNT WITH RESPECT TO WHICH TliIS 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. LTR A TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS-MADE � OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: � POLICY � PROJECT � LOC B UTOMOBILE LIABILITY �( ANY AUTO ALL OWNED � SCHEDULED AUTOS AUTOS HIRED AUTOS � NON-OWNED AUTOS � B C °XCESS LIAB � CLAIMS-MADE DED r� RETENTION $ icn�rca �.vmr�rvar� i i�rv y�N N/A ) EMPLOYERS' LIABILITY PROPRIETOR/PARTNER/EXECUTIVE � CER/MEMBER EXCLUDED? datory in NH) s, describe under POLICY NUMBER GLD12574-01 ISAH08828052 WLRC48017630 (AOS) WLRC48017629 (CA,MA) 10/01 /2014 I 10/01 /2015 10/01/2014 110/01/2015 10I01 /2014 10/01 /2015 10I01 /2014 10/01 /2015 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL 8 ADV INJURY GENERALAGGREGATE PRODUCTS -COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY(Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) OCCURRENCE OTHER L. DISEASE -EA EMPLOYEE L. DISEASE -POLICY LIMIT $ 2,000,000 $ 1,000,000 $ 5,000 $ 2,000,000 $ 2,000,000 $ 2,000,000 $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Division Number: 0001 - Named Insured Includes: ThyssenKrupp Elevator Corporation - Address: 114 Town Park Drive, Suite 300 KENNESAW 30144 Project Number: 245FCB135 - Project Name: NORTHEAST WATER RECLAMATION FACILITY, CLEARWATER, FL RECEIVED CITY OF CI.EARWATER OCT 3 0 201� RISK MANHG iHOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CITY OF CLEARWATER 100 S. MYRTLE AVE. CLEARWATER, FL 33756 United States ,� ,e�—^— ��.-�� 4CORD 25 (2010/05) �O 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � i ACO � L..�' AGENCY POLICY NUMBER See First Page CARRIER See First Page ADDITIONAL REMARKS AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page2of2 NAIC CODE THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FORM NUMBER: 25 FoRM 71T�E: CERTIFICATE OF LIABILITY INSURANCE NAMEDINSURED ThyssenKrupp Elevator Corporation 5100 West Grace Street Tampa 33607 EFFECTIVE DATE: CITY OF CLEARWATER The Additional Insured(s) listed above is/are added as Additional Insured(s) with respect to Automobile and General Liability policies, but only to the extent required by written contract and only to the extent that coverage is afforded under these policies. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD RECEIV�D CITY OF rf FaR�,n��rF� OCT 3 0 201� RISK MANAC,t�vitiy' 9173 O 1988-2010 ACORD CORPORATION. All rights reserved. -5 .e.sz �e �.r ��s5 e � ��e�c- �.��� ' �c �c� � v� .