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Insurance Certificate Acomo® CERTIFICATE OF LIABILITY INSURANCE DATE(M.DDDWYYY) �' 08/15/2018THIS 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 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 CONTACT - Wish USA Inc. NAME: 411 E.Wisconsin Avenue PHONE FAX -LAS No Exit' (A1C,No): Suite 1300 E-MAIL Mtwaukee,WI 53202 ADDRESS: Attn:JCI.Certrequlst@marsh.com INSURER'S)AFFORDING COVERAGE NAICa CN101230596-5-18-19' INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B:ACE Property and Casualty Insurance Company 20699 Johnson Controls,Inc. Tyco International Holding Sad.i. INSURER c: SimplexGrinned LP (see attached Acord 101) INSURER D: 5757 North Green Bay Avenue INSURER E: Mdwaukee,WI 53289 INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-008724516-02 REVISION NUMBER: 0 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. ILTTRI ADDISUBRTYPE OF INSURANCE IINSDD1WVDI POLICY NUMBER I(MMODIYYYY)UCY EFF I IMMDDIYYYY)ICY EXP I LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY313947 10/012018 10/01/2019 _EACH OCCURRENCE S 10,000.000 CLAIMSIMP DE X OCCUR AM E TO RENTED AMA-C ET R oNTErence) $ 10,000,000 X Contractual Liability MED EXP(Any one person) $ 50,000 X XCU Included PERSONAL 8 ADV INJURY $ 10,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$ 30,000,000 X I POLICY PRD LOC PRODUCTS-COMP/OP AGG $ INC IN GEN AGG JECT OTHER: $ A AUTOMOBILEUABILITY I MWTB 313946(Excludes New Ramp) 10/01/2018 10/012019 CEaOMBINED SINGLE LIMIT S 7500000 Iamieent) __ A X ANY AUTO .MWTB 313949(Primary NH$250k) 10/01/2018 10/01/2019 BODILY INJURY(Per person) S A OWNED ' SCHEDULED MWZX 313950(Excess NH 47.25mm) 10/01/2018 10/012019 BODILY INJURY(Per amCent) $ AUTOS ONLY IhII AUTOS HIRED NON-OWNED Excess NH Auto is Follow Form PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY (Per accident) to Primary NH Auto I$ B X UMBRELLA X 028162509003 10/012018 10/01/2019 5,000,000 _ OCCUR EACH OCCURRENCE S X EXCESS UAB CLAIMS-MADE AGGREGATE $ 5000,000 DED I I RETENTIONS I$ A WORKERS COMPENSATION MWC 31394300(AOS-see page 2) 10/01/2018 10101/2019 X /PER 1 IOTH- A AND EMPLOYERS'LIABILITY YIN MWXS 313944(OH 8 WA) 10/012018 10/012019 STATUTE 1 ER 5,000,000 ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT S (MandaOFFICER/MEMBER EXCLUDED, N NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 5,000,000 II yes.desaie under 5,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) See attached Acord 101 for additional informatics including Additional Insured,PrimaryiNon-contributory,Waiver of Subrogation and Notice of Cancellation provisions. CERTIFICATE HOLDER CANCELLATION City of Saha SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Budding Servltes THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City-Co.Budding ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash,Room 201 Salina,KS 67402-0736 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -.14.43.uao s,c -34...t1 a.."4c._ ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101230596 LOC it: Milwaukee ACO ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Johnson Comms,Inc. Tyco International Holding S.art POLICY NUMBER SimplerGnnve1 LP (see attached Acord 101) 5757 North Green Bay Avenue CARRIER NAIL CODE Mihvaukee,WI 53209 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance WORKERS COMPENSATION: Workers Compensation'AOS'Poky includes coverage for employees twin the rearming States WHILE WORKING IN ANY STATE:AK AL AR,AZ.CA,CO,CT.DC.DE.FL,GA, HI,IA,ID.IL,IN,KS,KY,LA,MA,MD,ME,MI,MN,MO,MS,MT,NC,NE,NH,NJ,NM PI V,NY,OK.OR,PA RI.SC,SD,TN,TX,UT,VA,VT,TM,&WV. PRIMARY COVERAGE: The General Liability and Aummobde Uabitity pokier are primary and not exrecs of or combating with other insurance or sal-insurance,where required by written lease or wntten contract For General Liability.this apples to both ongoing and completed operations. WAIVER OF SUBROGATION: The General Liandity,Automobile liability,Workers'Compensation and Employers Liandily policies include a Waiver of Subrogation in two(of the cemholder and any other person or organization,BUT ONLY to the extent required by written contract. ADDITIONAL INSURED-AUTOMOBILE LIABILITY: The Automobile Liability poky,if required by written contract,Includes coverage for Additional Insureds as required by such written contract. ADDITIONAL INSURED-GENERAL LIABILITY: For General Uaiity,it requirea by wntten contract,the following are included as additions insureds,as required pursuant to a written contract with a named insured,per attached Racy Endorsements A2 and A2A:THE CERTIFICATE HOLDER LISTED ON THIS CERTIFICATE OF UABIUTY INSURANCE,AND EACH OTHER PERSON OR ORGANIZATION REOUIRED TO BE INCLUDED AS AN ADDITIONAL INSURED PURSUANT TO A WRITTEN CONTRACT WITH THE NAMED INSURED. ONGOING OPERATIONS AND COMPLETED OPERATIONS INSURANCE: The General Liability Insurance ndudes'nsurance for ongoing operations and completed operations LIMIT OF LIABILITY: The liability Limit that apples is/e amount indicated on the face of this Certificate of Liability Insurance,or the rnnimum Liability limit that is required by the wntten contract, whichever is less. If there is no contract then the liatdry Umit is limited to$1,000,000. UMBRELLNE%CESS UABIUTY: If the primary insurance prides noted on the face of this Certificate of tiablty Insurance satisfy the combination of minimum primary knits and mnimem UmbrelaPvecc liabibry kris required by the written contract the Umaela&Excess Liability lints shown on the face of this Certifcale of liabiity Insurance do not apply. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS: Should any of the above desaibed polities he canceled,other than for non-payment,before the expiration date thereof,30 days advice of cancellation will be delivered to certificate holders in accordance with the poky endorsements. NAMED INSURED: Insureds include:Al Distribution Technologies IP,LLC;Air System Components,Inc.;Carta Brothers,LLC;CEM Access Systems,Inc.;Central CPVC Corporation;Central Sprinkler LLC;Chenguard,Inc.;Connect 24 Wireless Communications Inc.;Digital Security Controls,Inc.;Eastern Sheet Metal.Inc;Epos,Inc.;Exani Technologies.Inc.;FBN Transportation,Inc.;Grind(LLC;Hat&Cooly Trucking Company:Hat&Cooley.Inc.;Haz-Tank Fabrcators,Inc.;IMECO LIC;Integrated Systems and Power,Inc.;Interstate Battery System International.Inc.;Johnson Controls,Inc.;Johnson Contras(Suisse)SA;Johnson Controls Advanced Power Solutions,LLC;Johnson Controls Air Conditioning and Refrigeration,Inc.;Johnson Controls APS Production,Inc.;Johnson Controls Battery Croup,Inc.;Johnson Controls Building Automation Systems,LLC;Johnson Controls Engineering.LLC;Johnson Controls Federal Systems.the.;Johnson Controls Federal SystensNersar,LLC;Johnson Controls Fire Protection LP VW SimpkxGdnnel LP;Johnson Controls Government Systems LIG;Johnson Controls Navy Systems,LLC;Johnson Controls Security Solutions LLC NJa Tyco Integrated Security,LLC;Koch Filter Corporation; Master Protection,LP dMa FireMaster;Oolsys.Inc.:Elated Expert.Inc.;Ruske Company;Ruskin Rooftop Systems,Inc.;Ruskin Service Company,Selkirk Corporation;Senelco Iberia,Inc.;Sensartnk AsiaPadfc,Inc.;Sensamatic Electronics(Puerto Rico)LLC;Selswmatic Electronics,LLC;Senswmatc International,Inc;ShopperTrak International Investment LLC;ShopperTrak RCT Corporation;Shunoin America,Inc.;SirrplexGhnnell LP,Tyco Fire&Security LLC;Tyco Fire Products LP;Tyco International Holding S.a.r.i.; Vsonc Inc.;Waite HC,LIC;Yak International(SA),Inc.;York Intemationa Corporation;BC Liquidation,Inc.;Grinned Fire Protection Solutions LIC;JCW HVAC Supply Center, LLC;Lau Holdings,LLC;Tyco Integrated Security LLC;and Tyco International Management Company.LLC ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - ENDORSEMENT A2 Named Insured Endorsement Number Policy Prefix Policy Number Policy Period Effective Date of Endorsement 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 persona 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. Wth 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 furnished 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 MWZY 313947 Johnson Controls,Inc.Tyco International Holding 10/01/2018- 10/01/2019 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS - ENDORSEMENT A2A Named Insured Endorsement Number Policy Prefix Policy Number Policy Period Effective Date of Endorsement 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 Persons) 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 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 289 002 1012 MWZY 313947 Johnson Controls,Inc.Tyco International Holding 10/01/2018- 10/01/2019 1 DATE(MM/DD/YYYY) ACORD® CERTIFICATE OF LIABILITY INSURANCE 09/14/2015 `...---" . 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 Marsh USA Inc. NAME: 411 E.Wisconsin Avenue (A/cC.No.Eat): FAX No): Suite 1300 E-MAIL Milwaukee,WI 53202 ADDRESS: Attn:JCI.Certrequest©marsh.corn INSURER(S)AFFORDING COVERAGE NAIC# 011077-CAS-PROJ-15-16 2PZ1-0 12-13 INSURER A:Old Republic Insurance Company • 24147 INSURED INSURER B:North American Elite Insurance Company 29700 Johnson Controls,Inc. York International Corporation INSURER C:Indemnity Insurance Company of North America 43575 Attn:Corp.Risk Mgmt.X-92 INSURER D:ACE American Insurance Company 22667 P.O.Box 591 5757 N.Green Bay Ave. INSURER E:ACE Fire Underwriters Insurance Company 20702 Milwaukee,WI 53201 INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-005668640-04 REVISION NUMBER:2 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER (MM/DD(YYYY) (MM/DDYYYI A X COMMERCIAL GENERAL LIABILITY MWZY305447 10/01/2015 10/01/2016 EACH OCCURRENCE $ 10,000,000 CLAIMS-MADE X OCCUR PREMISES SESO(EaEocw ence) $ 10,000,000 X Contractual Liability MED EXP(Any one person) $ 50,000 X XCU Included PERSONAL 8 ADV INJURY $ 10,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 POLICY X jECT LOC PRODUCTS-COMP/OP AGG $ INC IN GEN AGG OTHER: $ D AUTOMOBILE LIABILITY ISA H08860373 10/01/2015 10/01/2016 COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS - X x NON OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS (Per accident) $ B X UMBRELLA LWB X OCCUR UMB 2000252 00 10/01/2015 10/01/2016 _EACH OCCURRENCE _$ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION MR C48591851(AOS-See page 2) 10/01/2015 10/01/2016 X STATUTE OTH- ER D AND EMPLOYERS'LIABILITY Y/N MR C4859184A(CA,MA) 10/01/2015 10/01/2016 5,000,000 PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ E OFFICER/MEMBER EXCLUDED? SCF 048591875 I 10/01/2015 10/01/2016(Mandatory in NH) �) E.L.DISEASE-EA EMPLOYEE $ 5,000,000 D It yes,describe under WCU C48591863(Excess Excess WC-OH,WA) 10/01/2015 10/01/2016 ■i 5,000,000 ' DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $' DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Re: JCI Contract No.:2PZ1-0033 JCI Project Name:City of Salina FCIP and JCI Additional Scope(Rev 15) Customer,its agents,representatives,officers,officials,and employees as additional insured(s) are included as additional insured per the attached. CERTIFICATE HOLDER CANCELLATION City of Salina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 300 W Ash Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Salina,KS 67401 ACCORDANCE WITH THE POLICY PROVISIONS. • AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ....114-0.u0o1.. ,.N4....t...t.uhawa-e.L- I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD L I AGENCY CUSTOMER ID: 011077 LOC#: Milwaukee ACRD ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Johnson Controls,Inc. York International Corporation POLICY NUMBER Attn:Corp.Risk Mgmt.X-92 P.O.Box 591 5757 N.Green Bay Ave. CARRIER - NAIC CODE Milwaukee,WI 53201 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance WORKERS COMPENSATION Workers Compensation'AOS'Policy includes coverage for the following states:AK,AL,AR,AZ,CO,CT,DC,DE,FL,GA,HI,IA,ID,IL,IN,KS,KY,LA,MD,ME,MI,MN,MO,MS,MT,NC,NE,NH,NJ,NM,NV,NY, OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WV PRIMARY COVERAGE The General Liability and Automobile Liability policies are primary and not excess of or contributing with other insurance or self-insurance,where required by written lease or written contract.For General Liability,this applies to both ongoing and completed operations. WAIVER OF SUBROGATION The General Liability,Automobile Liability,Workers Compensation and Employers Liability policies include a waiver of subrogation in favor of the certificate holder and any other person or organization to the extent required by written contract. ADDITIONAL INSURED-AUTOMOBILE LIABILITY The Automobile Liability policy,if required by written contract,includes coverage for Additional Insureds as required by such written contract. ADDITIONAL INSURED-GENERAL LIABILITY For General Liability,if required by written contract,the following are included as additional insureds,as required pursuant to a written contract with a named insured,per attached Policy Endorsements A2 and A2A:THE CERTIFICATE HOLDER LISTED ON THIS CERTIFICATE OF LIABILITY INSURANCE,AND EACH OTHER PERSON OR ORGANIZATION REQUIRED TO BE INCLUDED AS AN ADDITIONAL INSURED PURSUANT TO A WRITTEN CONTRACT WITH THE NAMED INSURED. PER PROJECT GENERAL AGGREGATE-GENERAL LIABILITY The General Aggregate Limit that applies Per Project is the amount indicated on the face of this Certificate of Liability Insurance,or the minimum Per Project General Aggregate that is required by the written contract, whichever is less. POLICY AGGREGATE-GENERAL LIABILITY The aggregate limit on the General Liability insurance policy is$30,000,000 combined for all General Liability coverages. UMBRELLA/EXCESS LIABILITY The Umbrella/Excess Liability Limit that applies is the amount indicated on the face of this Certificate of Liability Insurance,or the minimum Umbrella/Excess Liability limit that is required by the written contract,whichever is less. However,if the primary insurance policies noted on the face of this Certificate of Liability Insurance satisfy the combination of minimum primary limits and minimum Umbrella/Excess Uability limits'required by the written contract,the Umbrella/Excess Liability limits shown on the face of this Certificate of Liability Insurance do not apply. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i 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 MWZY 305447 10/01/2015 to:10/01/2016 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 pursuantto 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 furnished in connection with such work, on the project (other than'service, maintenance or repairs) to be performed by.or on behalf of the additional ihsured(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 MWZY 305447 Johnson Controls,Inc. 10/01/2015-.10/01/2016 IL 10 (12/06) 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 Policy Period Effective Date of Endorsement MWZY _ 305447 10/01/201510 10/01/2016 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 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 289 002 1012 MWZY 305447 Johnson Controls,Inc. 10/01/2015-10/01/2016 ® CERTIFICATE OF LIABILITY INSURANCE DATE/2014 "YYY) ACORO `�. 09107/2014 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 Marsh USA Inc. NAME: 411 E.Wisconsin Avenue (A/C.No.Ext): FAX No): Suite 1300 EMAIL Milwaukee,WI 53202 ADDRESS: Attn:JCI.Certrequest@marsh.com INSURER(S)AFFORDING COVERAGE NAIC# 011077-Month-CAS-14-15 14ANN INSURER A:Old Republic Insurance Company 24147 INSURED North American Elite Insurance Company 29700 Johnson Controls,Inc. INSURER e York International Corporation INSURER C: Indemnity Insurance Company of North America 43575 Attn:Corp.Risk Mgmt.X-92 INSURER D:ACE American Insurance Company 22667 P.O.Box 591 5757 N.Green Bay Ave. INSURER E: ACE Fire Underwriters Co 20702 Milwaukee,WI 53201 . . INSURER F COVERAGES CERTIFICATE NUMBER: CHI-005004435-01 REVISION NUMBER:0 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 TER_MS_ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY MWZY302769 10/01/2014 10/01/2015 EACH OCCURRENCE $ 10,000,000 X DAMAGE TO RENTED 10,000,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR • MED EXP(Any one person) $ 50,000 X Contractual Liability PERSONAL&ADV INJURY $ 10,000,000 X XCU Included GENERAL AGGREGATE $ 30,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ INC IN GEN AGG POLICY n JE C n LOC $ D AUTOMOBILE LIABILITY ISA H08828623 10/01/2014 10/01/2015 COMBINED SINGLE LIMIT 5,000,000 _ (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X x NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ B X UMBRELLA UAB X OCCUR UMB 2000252 00 10/01/2014 10/01/2015 EACH OCCURRENCE $ 5,000,000 — X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION WLR C48018786(AOS-See page 2) 10/01/2014 10/01/2015 X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WLR C48018804(CA,MA) 10/01/2014 10/01/2015 E.L.EACH ACCIDENT $ 5,000,000 E OFFICER/MEMBER EXCLUDED? N N/A SCF C48018828(WI) 10/01/2014 10/01/2015 5,000,000 (Mandatory in NH) (W) E.L.DISEASE-EA EMPLOYEE $ D DESCRIPTION uOnFleOPERATIONS below WCU C48018816(Excess WC-OH,WA) 10/01/2014 10/01/2015 E.L.DISEASE-POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) JCI Project Number. 2PZ10033,JCI Project Name:City of Salina PC,Customer PO Number:Signed Contract,CITY OF SALINA and CITY OF SALINA are included as additional insured per the attached endorsements A2 and A2A. CERTIFICATE HOLDER CANCELLATION CITY OF SALINA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 300 W ASH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 736 ACCORDANCE WITH THE POLICY PROVISIONS. SALINA,KS 67402-0736 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _Ma+.karau-i -.1 Lc-+wawa-ea- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1 Aco CERTIFICATE OF LIABILITY INSURANCE DATE """' `�- 0911212014 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 Marsh USA Inc. NAME: 411 E.Wisconsin Avenue (A/CNNNo,Ext): (A/C,No): Suite 1300 E-MAIL Milwaukee,WI 53202 ADDRESS: Attn:JCI.Certrequest@marsh.com INSURER(S)AFFORDING COVERAGE NAIC# 011077-CAS-PROJ-14-15 2PZ1-0 12-13 INSURER A: Old Republic Insurance Company 24147 INSURED North American Elite Insurance Company 29700 Johnson Controls,Inc. INSURER e York International Corporation INSURER C: Indemnity Insurance Company of North America 43575 Attn:Corp.Risk Mgmt.X-92 INSURER D:ACE American Insurance Company 22667 P.O.Box 591 5757 N.Green Bay Ave. INSURER E, ACE Fire Underwriters Co 20702 Milwaukee,WI 53201 INSURER F: > COVERAGES CERTIFICATE NUMBER: CHI-004630558-03 REVISION NUMBER:2 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR MD POLICY NUMBER (MM/OD/YYYY) (MMIDD/YYYY) A GENERAL UABIUTY MWZY302769 10/01/2014 10/01/2015 EACH OCCURRENCE $ 10,000,000 X DAMAGE TO RENTED 10,000,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 50,000 X Contractual Liability PERSONAL 8 ADV INJURY $ 10,000,000 X XCU Included GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ INC IN GEN AGG —1 POLICY X ECT LOC $ - D AUTOMOBILE UABIUTY ISA H08828623 10/01/2014 10/01/2015 COMBINED SINGLE LIMIT 5,000,000 (Ea accident) - X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ,BODILY INJURY(Per accident) $ AUTOS AUTOS X x NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ B X UMBRELLA LIAB X OCCUR UMB 2000252 00 10/01/2014 10/01/2015 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION WLR C48018786(AOS-See page 2) 10/01/2014 10/01/2015 X WC STATU- 0TH- AND EMPLOYERS'LIABILITY TORY LIMITS ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WLR C48018804(CA,MA) 10/01/2014 10/01/2015 E.L.EACH ACCIDENT $ 5,000,000 E OFFICER/MEMBER EXCLUDED? N N/A SCF C48018828 I 10/01/2014 10/01/2015 5,000,000 (Mandatory in NH) (W) E.L.DISEASE-EA EMPLOYEE $ D DESCRIPTION uaeOPERATIONS below WCU C48018816(Excess WC-OH,WA) 10/01/2014 10/01/2015 E.L.DISEASE-POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: JCI Contract No.:2PZ1-0033 JCI Project Name:City of Salina FCIP and JCI Additional Scope(Rev 15) Customer,its agents,representatives,officers,officials,and employees as additional insured(s) are included as additional insured per the attached. CERTIFICATE HOLDER CANCELLATION • City of Salina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 300 W Ash Street THE EXPIRATION DATE.THEREOF, NOTICE WILL BE DELIVERED IN Salina,KS 67401 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _M.o ec . C.nu• -e.c ©1988-2010 ACORD CORPORATION. All rights reserved. -ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 011077 LOC#: Milwaukee • Ac oRO ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Johnson Controls,Inc. York International Corporation POLICY NUMBER Attn:Corp.Risk Mgmt.X-92 P.O.Box 591 5757 N.Green Bay Ave. CARRIER NAIC CODE Milwaukee,WI 53201 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance WORKERS COMPENSATION Workers Compensation'AOS'Policy includes coverage for the following states:AK,AL,AR,AZ,CO,CT,DC,DE,FL,GA,HI,IA,ID,IL,IN,KS,KY,LA,MD,ME,MI,MN,MO,MS,MT,NC,NE,NH,NJ,NM,NV,NY, OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WV PRIMARY COVERAGE The General Liability and Automobile Liability policies are primary and not excess of or contributing with other insurance or self-insurance,where required by written lease or written contract.For General Liability,this applies to both ongoing and completed operations. WAIVER OF SUBROGATION The General Liability,Automobile Liability,Workers Compensation and Employers Liability policies include a waiver of subrogation in favor of the certificate holder and any other person or organization to the extent required by written contract. ADDITIONAL INSURED-AUTOMOBILE LIABILITY The Automobile Liability policy,if required by written contract,includes coverage for Additional Insureds as required by such written contract. ADDITIONAL INSURED-GENERAL LIABILITY For General Liability,if required by written contract,the following are included as additional insureds,as required pursuant to a written contract with a named insured,per attached Policy Endorsements A2 and A2A:THE CERTIFICATE HOLDER LISTED ON THIS CERTIFICATE OF LIABILITY INSURANCE,AND EACH OTHER PERSON OR ORGANIZATION REQUIRED TO BE INCLUDED AS AN ADDITIONAL INSURED PURSUANT TO A WRITTEN CONTRACT WITH THE NAMED INSURED. PER PROJECT GENERAL AGGREGATE-GENERAL LIABILITY The General Aggregate Limit that applies Per Project is the amount indicated on the face of this Certificate of Liability Insurance,or the minimum Per Project General Aggregate that is required by the written contract, whichever is less. POLICY AGGREGATE-GENERAL LIABILITY The aggregate limit on the General Liability insurance policy is$30,000,000 combined for all General Liability coverages. UMBRELLA/EXCESS LIABILITY The Umbrella/Excess Liability Limit that applies is the amount indicated on the face of this Certificate of Liability Insurance,or the minimum Umbrella/Excess Liability limit that is required by the written contract,whichever is less. However,if the primary insurance policies noted on the face of this Certificate of Liability Insurance satisfy the combination of minimum primary limits and minimum Umbrella/Excess Liability limits required by the written contract,the Umbrella/Excess Liability limits shown on the face of this Certificate of Liability Insurance do not apply. • ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IL 10 (12/06) 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 MWZY 300317 10/01/2013 to 10/01/2014 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 completethis 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'fix "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 locations)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 furnished 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; 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 MWZ'Y300317 Johnson Controls,Inc. 10/01/2013-10101/2014 IL 10 (12/06) 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 Policy.Period Effective Date of Endorsement MWZY 300317 10/01/2013 to 10/01/2014 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 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 289 002 1012 MWZY 300317 Johnson Controls,Inc. 10101/2013-10/01/2014