CERTIFICATE OF LIABILITY INSURANCE AC�® DATE(2312U11YYYYy
CERTIFICATE OF LIABILITY INSURANCE
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 po11cy(les)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). c
m
PRODUCER CONTACT -p
NAME:
Aon Risk services Northeast, Inc. PHONE 865-283-7122 FA7C 890-363-9195 d
New York NY Office LAIC.No.Exty: NC.NO.: �
199 Water street EMAIL ss: 0
New York NY 10038-3551 USA
INSURER(SI AFFORDING COVERAGE NAIC 9
INSURED INSDRERA: Greenwich insurance company 22322
Honeywell international Inc. INSURER 8: XL Insurance America Inc 24554
115 Tabor Road --
INSURER C: XL specialty insurance Cc 37885
Morris Plains N3 07950 USA
INSURER D:
INSURER E:
INSUTR F:
COVERAGES CERTIFICATE NUMBER: 570070513981 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. Limits shown are as requested
INSR L R TYPE OF INSURANCE INSD 4YVD POLICY NUMBER M PDlYYYY MMIDDJYYYY LIMITS
A X COMMERCFAL GENERAL LIASILITY RGC 4 4 EACH OCCURRENCE $5,000,00()
DAMAGE CLAIMS-MADE X 'OCCUR PREMISES RE ❑ $5,000,004
S Ea occurrence
MED EXP(Any one person) $50,000
PERSONAL&APV INJURY $5.000,000 q;
GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $5,000,000
PRO-
POLICY F7JECT ❑LqC PRODUCTS-COMPIOPAGG Included fl
t7
OTHER °
ry
A AUTOMOBILE LIABILITY RAC943764205 04/D1/2018 04/01/2019 COMBINED SINGLE LIMIT S5,000,000
AOS Ea acq.4entl
BODILY INJURY(Per person} G
X ANYAUTO z
O*NED SCHEDULED BODILY INJURY(Per accident) tli
AUTOS ONLY AUTOS eG
iIIREDAUTOS NON-OWN£D PROPERTY DAMAGE �y
ONLY AUTOS ONLY Per accidenn '—
Q1
UMBRE"LTAB OCCUR EACH OCCURRENCE L7
EXCESS LIAR HCLAIMS-MAQE AGGREGATE
DED I RETENTION
B WORISERS COMPENSATION ANb RWD943540305 04/01/2018!04/01/2019 X st rUre OTH-
EMPLOYER$'L.ULBILITY
ANY PROPRIETOR!PARTNER I EXECl7TIVE YIN N AOS E.L.EACH ACCIDENT 5 5,000,004
* ❑FFICERIMEMSE:REXCLUDFt'7 N NIA RWC943540205 04/01/2018 04/01/2019
{Mandatary In NH) AK, WI E.L.DISEASE-EA EMPLOYEE 5 5,000,000
If ves.describe under
. .DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-FOLK C UM i S S,flCfl,CCfl�_
C Excess WC RwE943540405 04/01/2018 04/01/2019 EL Each Accident 551000,000
AZ, OH, WA EL Disease - Ea Emp $5,000,000I♦
SIR applies per policy terms & condi ions EL Annual Aggregate $5,e00,o00
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
Note: Elster, Elster Perfection Corp., Elster Holdings us, Inc., Elster solutions, LLC; Elster AMCO Water, LLC; Elster American
Meter Company, LLC; Elster Instromet, Inc.' Eclipse, Inc.; EnergyICT, Inc.; Exothermics, Inc.; CEC Combustion safety LLC, and J
Hauck Manufacturing company, Inc, are wholly owned subsidiaries of Honeywell international Inc. '
RE: The City of Clearwater Blanket Order BR511109-2 to Elster American Meter Co. The City of Clearwater is included as
Additional Insured for the General Liability and Automobile Liability policies with respect to Elster American Meter Co.
operations in connection with the City of Clearwater Blanket order BR511109-2.
CERTIFICATE HOLDER ]RECE:a:ED CANCELLATION �r
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
APR 21 W 2018 POLICY PROVISIONS,
City of Clearwater LI {} AUTHORIZED REPRESENTATIVE
Attn: Alyce Bengt
Clearwater Avenue N. Myrtle GAS AI_DMIN r� ��o
clear�aater FL 33755 USA eLJ.{�
Q1988-2095 ACORD CORPORATION.All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER 1D: 5700.00054391
LOC#:
A ADDITIONAL REMARKS SCHEDULE Page _ of
AGENCY NAMED iNSURED
Ann Risk services Northeast, inc. Honeywell international inc.
POLICY NUMBER
see certificate Number: 570070513981
CARRIER NAIC CODE
See .Certificate Number: 570070513981 EFFECTIVE DATE
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER
INSURER
bNSLIRER
INSURER
ADDITIONAL POLICIES If a policy below does not include limit inforination,refer to the corresponding policy on the ACORD
certificate form for policy limits.
POLSCY POLICY
INSR AADE, SURR EFrF.CTI�'!; E7CI'IR.KCFOti
LTR TYPE OF ENS1'1tAtiCE IN3E7 WE'D POLICY N!NIBEH 1_ISI7rCF
DATE DATE
(M_Mfj)DIYYYYI (mM/DDlYYYY
OTHER
C RWE943540505 04/01/2018 04/01/2019
Excess WC - NM
SIR applies per policy to ms & conditions
Excess WC Limits
are Statutory in
AZ, OH, WA, & NM
ACORD 101(2008101) @ 2008 ACORD CORPORATION.All rights reserved.
The ACORO name and logo are registered marks of ACORD