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cert_NYC_City of Salina_11859559_1SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION$ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY C 5,000,000 6862538 Additional WC/EL policies are shown NYC-011859559-01 5,000,000 5,000,000 X 01/01/2023 19399 5,000,000 SIR:POLICY IS CLAIMS MADE Attn: Boston.CertRequest@Marsh.com | Fax: 212-948-4377 N 01/01/2023 X Contractual Liability 01/01/2023 A 1 01/01/2024 01/01/2023 B 19437 01/01/2024 6631153 (AOS) PROFESSIONAL B 5,000,000 5,000,000 on the following page 41343 AIU Insurance Co 5,000,000 X D X 12/08/2023 5,000,000 01/01/2023 5,000,000 City of Salina is included as additional insured with respect to General Liability and Auto Liability per the endorsement(s) attached. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured for General Liability and Automobile Liability per the endorsement(s) attached. Waiver of Subrogation is included in favor of the Certificate Holder X 01/01/2024 300 W Ash St Salina, KS 67401 City of Salina Lexington Insurance Company under General Liability, Auto Liability, and Worker's Compensation per the endorsement(s) attached. X 6631152 (VA) A HDI Global Insurance Company EACH CLAIM / AGGREGATE 5,000 01/01/2024 5,000,000 CUD11986-11 01/01/2024 E&O LIABILITY 6631154 (MA) 5,000,000 19445 5,000,000 MTIRIT 5,000,000 01/01/2024 WC080880552 (AOS) 99 HIGH STREET MARSH USA LLC. X BOSTON, MA 02110 1111 Pasquinelli Drive, Suite 100 Schneider Electric Holdings, Inc. Westmont, IL 60559 X 21433000 01/01/2023 Attn: Jacob Wood X X 01/01/2023 X A ... X 01/01/2024 National Union Fire Ins Co Pittsburgh PA X ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: **ADDITIONAL WORKER'S COMP POLICIES**� Schneider Electric Smart Grid Solutions, LLC� CARRIER: AIU INSURANCE COMPANY� ASCO Power Services, Inc. � � - WC080880552 (AOS: AK, AL, AR, AZ, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, Schneider Electric Advisory Services, Inc.� Buildings Control Systems, Inc. � Automatic Control Engineering Corporation (effective 6/30/2023)� Schneider Electric Energy Management Software, Inc. � Umbrella Liability follows the underlying on additional insured and waiver of subrogation status pursuant to policy terms, conditions, and exclusions.� 2 Schneider Electric Holdings, Inc. has agreed that, within 30 days after receipt of notice of cancellation of the insurance policies referenced above from the applicable insurers, Schneider Electric Holdings, Inc. or VA, VT, WA, WV, WY) � LIMITS: EACH ACCIDENT: $3,000,000 / DISEASE-POLICY LIMIT: 3,000,000 / DISEASE-EACH EMPLOYEE: $3,000,000; SELF-INSURED RETENTION: $2,000,000� or representatives. 2 Schneider Electric Solar Inverters USA, Inc.� Schneider Electric Buildings Critical Systems, Inc.� Boston Pro-Face America, LLC� Veris Industries, LLC� Schneider Electric Buildings Americas, Inc.� Schneider Electric IT Corporation � ADDITIONAL NAMED INSUREDS INCLUDE THE FOLLOWING:� �� Schneider Electric Engineering Services, LLC� Schneider Electric USA, Inc. � Certificate of Liability Insurance ETAP Automation, Inc. (Excluding Workers Compensation)� CN102662751 - WC080880553 (CA) � Schneider Electric Power Services, Inc.� � Schneider Electric IT Mission Critical Services, Inc.� POLICY PERIOD: 01/01/2023 - 01/01/2024� Schneider Electric Systems USA, Inc. � Schneider Electric Digital, Inc.� ASCO Power Technologies, L.P. � - WC080880554 (WI) � BIM-Electrical Corp.� Adaptive Instruments Corp.� Operation Technology, Inc. (DBA ETAP) (Excluding Workers Compensation)� � - OHIO ONLY EXCESS WORKERS COMP:� IGE+XAO USA, Inc.� cancellation date and it will not negate any cancellation of the policy. Failure to provide a copy of such notice to the Certificate Holder shall impose no obligation or liability of any kind upon the insurer or its agents MARSH USA LLC.� - PUERTO RICO: WC IS PURCHASED THROUGH THE STATE FUND AS PUERTO RICO IS MONOPOLISTIC.� its designee will send a copy of such notice to the Certificate Holder of this Certificate. Such notice is not a right or obligation within the policies, it does not alter or amend any coverage, it will not extend any policy 1111 Pasquinelli Drive, Suite 100� Schneider Electric Holdings, Inc.� Westmont, IL 60559 Schneider Electric Foundries LLC� POLICY NUMBERS AND STATES:� ProLeit Corp.� � 25 POLICY NUMBER: XWC1647376; CARRIER: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA� Summit Energy Services, Inc.�