CERTIFICATE OF LIABILITY INSURANCE (4).tet Rte®
DAT0312I2DIYYYY,
CERTIFICATE OF LIABILITY INSURANCE
pS.+S 212021
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 certiffcate holder is an ADDITIONAL INSURED, the policy(ies) 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).
PRODUCER
Aon Risk services Northeast, Inc.
New York NY Office
one Liberty Plaza
165 Broadway, suite 3241
CONTACT
NAME:
(AIC.No.Ext): 866-283-7122 PHONE—FAXe No : 800-363-0105
E-MAIL
ADDRESS:
New York NY 10006 USA
EACH OCCURRENCE S 5 , 000 , 000
INSURER(S) AFFORDING COVERAGE NAIC p
INSURED
INSURER A: XL insurance America Inc 24554
Honeywell lnternational Inc.
300 S. Tryon St. suite 500
6th Floor
INSURER B: XL Specialty Insurance Co 37885
INSURER C: Greenwich Insurance Company 22322
charlotte NC 28202 USA
INSURER D;
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570086348428 REVISION NIAURFR-
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 LTR
TYPE OF INSURANCE
INSD
WVO
POLICY NUMBER
pOIYYY
MMIDDIYYYY
LIMITS
X COMMERCIAL GENERAL LIABILITY
RGC
EACH OCCURRENCE S 5 , 000 , 000
CLAIMS -MADE MOCCUR
DAMAUE TO RENTED PREMISES Ea xcurrenca $ 5 , o00 , 000
MED EXP (Arty one person) $50,000
PERSONAL & ADV INFJURY $5,000,Doo
GE N'L AGG REGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $5P000,000
PRO -
X POLICY JECT LOC
PRODUCTS -COMWOPAGG Included
OTHER:
C
AUTOMOBILE LIABILITY
RAC943764208
AOS
04/01/2021
04/01/2022
COMBINED SINGLE LIMIT
Ea accident)$� ' 000, 000
BOO ILY INJURY ( Per person)
X ANYALRO
OWNED SCHEDULED
AUTOS ONLYAUTOS
HIRED AUTOS NON -OWNED
ONLY AUTOS ONLY
BOO ILY INJURY (Per a(;cident)
PROPERTY DAMAGE
Per accident)
C
UMBRELLALIAB
H
OCCUR
RA0943764 08
04/01/2021
04/01/2022
EACH OCCURRENCE $4,000,000
X
EXCESS LIAR
CLAIMS -MADE
Excess AUty
AGGREGATE
DED I IRFTENTION
A
e
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR; PARTNEri + E%ECUTIVE
EXCLUDED?
OFFICEWMEM(Mandniory
NIA
RWD94354 -
AOS
04/R/2021
44/01/2021
4/01/20 2
04/01/2022
X I PER STATUTE I OTiN-
ER
El- EACH ACCIDENT S 5 , DOO , 000
E L- DISEASE -EA EMPLOYEE $5P000,000
n NNy
lies describe under
NC9wi540208
A
E -L. DISEASE-POLIGY LIMIT $5 , 000, 000
d
DCRIPTION OF OPERATIONS below
B
Excess WC
RWE9415404
04/01/2021
04/01/2022
EL Each Accident 5,000,000
A2, ON, WA
SIR applies per polity ter
s & condi
ions
EL Disease - Ea Emp $5,000,000
EL Annual Aggregate 85,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additionai Remarks Schedule, may be attached 9 more apace Is required)
RE: The City of Clearwater Blanket order BRSII109-2 to Eister American Meter Co. The City of Clearwater is included as
Additional Insured for the General Liability and Automobile Liability polities with respect to Elster American Meter Co.
operations in connection with the City of Clearwater Blanket Order BR511109-2.
M."
N
a
ODD
Q
0
P,
47
8
CERTIFICATE HOLDER CANCELLATION r
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
'• Attn: ofAlycerBenge MAR 2 2 2021
water ALIT HDRI2EDREPRESENTATIVE
400 Avenue N. Myrtle N �y �� �
Clearwater FL 33755 USA
IYIM
GAS ADMIN
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
rmgzm
AGENCY CUSTOMER iD: 5.7000OG.54391
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY
Aon Risk Services Northeast, Inc.
NAMED INSUPEe
Honeywell Intzrnational Inc..
POLICY NUMBER
seeCertificate Number: 570086348428
CARRIER
See Certificate Number: 570.086348428:
NAIC CO QE
EFFECTVEDATE;
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM I.5 ASCHEDULE .TO ACORD FORM,
FORM NUMBER: ACORD 25. FORM TITLE: Certificate of Liability Insurance
Named Insured schedule
Elster, Elster Perfection Corp., Elster Holdings. us, Inc., E.Ister solutions, LLC., Elster AMCO Watell,
LLC., Elster' American deter Company, LLC., Elster instromet, Inc., EClips,e, Inc., EnergyXT, Inc.
Exothermics, Inc.., clic Combustion safety LLC and Hauck Manufacturing company, Inc --are wholly owned
subsidiaries of Honeywell Internati.onal.Inc.
ACORD 101 (2008101) 02068 ACORD CORPORATION. All rights'reserved:
The ACORD name and la go are registered marks of: :ACO RD