CERTIFICATE OF LIABILITY INSURANCE (3) DATE(Mh�°ot]I"t'YYY)
IFILI ILITi Y I D 78120
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,ANIS THE CERTIFICATE HOLDER..
IMPORTANT:It the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or he endorsed.It
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($).
PRODUCER CONTACTNAIlIE. -�
Aon rusk Services Northeast, Inc. PHONE -2 -7122 FAX 800-363-0105a
New York NY office {Ac Ne.Extl: Aro.NoJ: ra
one Liberty Plaza E-MAIL p
1.65 Broadway, Shite 3201 ADDRESS:
New York NY 10006 USA
INSURER(S)AFFORDING COVERAGE NAac�
INSURED INSURER A: Greenwich Insurance Company 22322
Honeywell International Inc, INSURER B, XL Insurance America Inc 24554
300 S. Tryon St. suite 500
6th Floor INSURERC XL Specialty Insurance Cc 378$5
Charlotte NC 28202 USA
INSURER o.
INSURER E.
INSURER.Fs.
COVERAGES CERTIFICATE NUMBER:570080904065 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 CONDITUNS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
INSR POLICY EXP
LTR TYPE OF INSURANCE INSD wiV0. POLICY NUMBER. pifDDFYV N71int®D!"YYV LIMITS
A X COMMERCIALRTENERAL.LIABILrrY RGC- EACH faCGUR:RIr•NGE.. $5,000,000
DA
CLAIMSDE XX OCCUR PREMISETO RENTED S Ea e�ccuraence $5,000,000
MED EXP(Arlt+one person) $50,000
PERSONAL&ADV INJURY $5,000,000
GEN`L AGGREGATE LIMIT APPLIES PER:. GENEFIALAGGREGATE S5,000,000
77 Y POLICY JET F-1LOC PRODUCTS-COMPKOPAGG Included
Q
OTHER; r'
A. AUTOMOBILE.LIABILITY RAc943764207 04/01,/2020 04/01/20ZII COMBINED'SINGLE LIMIT $1,000,000 �
AOS fEaacoldeqfi _
BODILY IN,AURY(Per person) Q
X ANYAUT{a Z
OWNED SCHEDULED BODILY INJURY(Per accidont)
AUTOS ONLY AUTOS
MIRED AUTOS NON-OWNED PROPERTY DAMAGE
ONLY AUTOS ONLY €Peracdc,ent
A UMBRELLALIAB x OCCUR RA0943764507 04/01/2020 04/01/2021 EACHOsCCUR'RENCE $4,000,YO_0 0
Excess Auto AGGREGATE
X EXCESS LIAS CLAIMS-MADE
DED RETENTION
B WORKERS COMPENSATION AND R;VD9435403017 t14..01/2020 D4, (31 2021 X tPER'STATUTE f3T�k1• _-- -.
EMPLOYERS`LIABILITY YIN ADS •�
ANY PROPRIETOR,'PARTNER J E5[ECtATIVE E.L.EACH.ACCIDENT S5,000,000
C 0FFOFRJMEMBER£XCLUDED,
N NIA Rwc943540207 04101/2020 04/01/2021
(Mandatory In NM AIC, WI E.L.DISEASE-EA EMPLOYEE $5,000,000
If yyes descrlkre,snrEer _
ODES RIPTION OF OPERATIONS.bebw E.L.DISEASE-POLICY LIMIT $5,000,000
C Excess WC RWE943540407 04/01/2020 04/01/2621 EL Each Accident $5,000,000
A2, CAH, DVA. EL Disease - Ea Emp' $5,000,000
SIR applies per policy ter n s & condi ions EL Annual Aggregate $5,0300,000
DESCRIPTION OF OPERATIONS d LOCATIONS A VEHICLES(ACORD 787,Additional Remark£Sche.duie,may be attached it more space 6 required) r"y
9
RE. The City of Clearwater Blanket Order BR5111.09-2 to Elster American Meter Co, The City of Clearwater 1� ded as
Additional insured for the General Liabilitand Automobile Liability policies With respect to Elster American Deter Co. 'R1_1
operations in connection with the city of Clearwater Blanket order B11511109•-2.
NI MN3
z
CERTIFICATE HOLDER 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.
city Of Clearwater AUTHORIZED REPRESENTATIVE
Attn:. Alyce Benge
400 Avenue N. Myrtle
Clearwater FL 33755 USA
01988-2015 ACORD CORPORATION.All rights reserved.
ACORD 2 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY.CUSTOMER ID: 570000054391
LOC#:.
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMEDINSUFiED
Aon Risk services Northeast, Inc:. Honeywell International Inc.
POLICY NUMBER
Seecertificate Number: 570080904065
CARRIER NA1C CODE
See Certificate Number: 570080904065 EFFECnVE DATE,
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM.IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: .Certii.icate.cf Liability Insurance
Named insured .schedule
Elster.;. Elster Perfection carp., Elster Pald-ings us, Inc., Elster solutions, L1_C. Elster AMCO. water,
LLC. , £lster American Meter company, .LLC., Elster instrvmet, xnc., Ecl.ipse., Inq..., EriergyICT., Inc:,
EX thermics, Inc., CEC Combustion Safety LLC..and Hauck Manufacturing Company, In..C. are wholly owned
subsidiaries of Honeywell international Inc.
ACORD 101(200810.1) @2008 ACORD COR PORA170N.All rights reserved,
The ACO ND:name and Iogo.are.reg istered marks of ACORD