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2025-348-E-AMS-Siemens Industry-WCOB Data Room - Temp Sensor
Revised 01/24 1 [Departmental Use Only] TITLE Liebert Sensor FY 2024-2025 ORANGE COUNTY CONTRACT UNDER $5,000.00 NORTH CAROLINA THIS AGREEMENT, is between Orange County, North Carolina, a political subdivision of the State of North Carolina, (the "County"), and Siemens Industry, Inc (the "Provider"). W I T N E S S E T H: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the services set out below to the County in accordance with the terms of this Agreement, time being of the essence. The services or materials or construction (hereinafter referred to collectively as “Services”) to be furnished under this Agreement are as follows: Provide and install new wall sensor. Sensor to be mounted to the existing server rack to obtain and accurate temperature reading of the space. Provide and instal wiring from the existing control cabinet in the adjacent room to the new sensor location per proposal dated 06/05/2025. The term of this agreement rendered shall be from June 16, 2025 to July 30, 2025. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement, without the prior written approval of the County. SPECIFIC TERMS 1. Payment: The County agrees to pay at the rates specified for Services satisfactorily (as determined by the County) performed in accord with this Agreement. The amount to be paid by the County shall not exceed Two Thousand Nine Hundred Seventy Dollars, ($2,970.00). Payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non–waiver: Failure by County at any time to require the performance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non-Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent contractor, and the County shall not be responsible for any of the Provider’s acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Revised 01/24 2 be required by County’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here NA (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 5. Indemnity: To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify, and hold harmless Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or destruction of any property caused in whole or in part by any negligent or intentional act or omission on the part of the Provider in carrying out Provider’s duties and obligations related to the Services to be provided in this Agreement . It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 6. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon written notice to the Provider. County may suspend this Agreement upon reasonable notice to Provider. 7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. Modifications may be evidenced by telefacsimile signature. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. 8. Governing Law and Priority: Both parties agree this Agreement is governed by the laws of the State of North Carolina and Orange County. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each Orange County policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.). Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. By executing this Agreement Provider affirms Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits. 9. Third Party Beneficiaries: There are no third-party beneficiaries of this Agreement and nothing in this Agreement, express or implied, is intended to confer on any person other than the parties hereto (and their respective successors, heirs and permitted assigns), any rights, remedies, or obligations. Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Revised 01/24 3 10. Dispute Resolution: Neither party may initiate binding arbitration. Any disputes shall be resolved by nonbinding mediation. If such mediation fails either party may initiate litigation to resolve the dispute. Should either party initiate litigation to settle any dispute involving the terms of this Agreement such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County, North Carolina. Regardless of the outcome of said litigation each party is responsible for its own costs and fees, including attorneys’ fees. 11. Non Appropriation: Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its s tatutory mandate. In the event that public funds are unavailable or not appropriated for the performance of County’s obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability or non-appropriation of public funds. IN WITNESS WHEREOF, this Agreement is effective upon its execution by Orange County and the Provider. ORANGE COUNTY PROVIDER By: _________________________ By: _________________________ Department Director Title: ________________________ 200 S. Cameron St. Siemens Industry, Inc P.O. Box 8181 4242 Six Forks Road, Ste 1400 Hillsborough, NC 27278 Raleigh, NC 27609 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 6/12/2025 Area Geneeral Manager 6/19/2025 Revised 01/24 4 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Siemens Industry, Inc Vendor Contact Person: Joe Latore (joseph.latore@siemens.com) Phone: 984.292.7638 Address: 4242 Six Forks Rd, Suite 1400 City Raleigh State: NC Zip: 27609 Department: AMS Amount: $2,970.00 Purpose: WCOB Data Room - Temp Sensor Budget Code(s): 61370035-800000-11002 Vendor # 53325 Vendor Status with NCSOS: Current Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 06/16/2025 End Date 07/30/2025 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by AMS Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: 11002) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content . Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specification s, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 6/13/2025 6/15/2025 6/17/2025 6/18/2025 Revised 01/24 5 Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 PROPOSAL OC Office Bldg Leibert Wall Sensor PREPARED BY Siemens Industry, Inc. ("Siemens") PREPARED FOR ORANGE COUNTY ASSET MANAGEMENT SERVICES DELIVERED ON June 05, 2025 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Table of Contents SIEMENS PROPOSAL .......................................................................................................3 Contact Information ..............................................................................................3 Scope of Work .......................................................................................................4 Sell Price ................................................................................................................5 Payment Terms ......................................................................................................6 Terms and Conditions .....................................................................................................7 Terms & Conditions Link(s)....................................................................................7 Signature Page ...............................................................................................................8 Signature Page ......................................................................................................8 Page 2 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Proposal #:9804092 Date:June 05, 2025 Contact Information Sales Executive:Joe Latore Branch Address:4242 Six Forks Road, Suite 1400 Raleigh,NC 27609 Telephone:984-292-7638 Email Address:joseph.latore@siemens.com Customer Contact:Angel Barnes Customer:ORANGE COUNTY ASSET MANAGEMENT SERVICES Address:600 NC HIGHWAY 86 N HILLSBOROUGH NC 27278-8225 Services shall be provided at:Orange County WCOB Page 3 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Scope of Work Siemens is pleased to present this NTE proposal for adding a space mounted temperature sensor for control of the Leibert unit. The following is included: •Provide and install new wall sensor. Sensor to be mounted to the current server rack to get an accurate temperature reading of the equipment space •Siemens electrician run wiring from the existing control cabinet (in adjacent room) to new sensor location. ◦Wiring to be in open cable utilizing existing data cabling tray and path to drop ceiling. ◦Sensor will be mounted on front of central server rack. ◦Termination in existing PXCM controller with available I/O. ◦Upto 8 hours of Siemens Electrician included •Siemens Specialist time for sensor tie-in, programming to integrate the space temperature conditions with a start signal to the new Liebert unit, monitoring and alarming of the temperature at the DesigoCC system graphic. Upto 4 hours of onsite Siemens Specialist is included. •Project management for material procurement, technician scheduling and coordination with Orange County. Clarifications & Exclusions: •All work will be during normal business hours •This proposal is set-up as a Not-to-Exceed project. Any hours not used will not be charged to Orange County. •Applicable sales taxes as required by law are excluded from this proposal. Sales tax will be billed at the time of invoicing. Page 4 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Sell Price Total NTE Quote Price $2,970.00* This price is firm for 30 days from the date of this proposal. *Siemens' pricing is subject to adjustment for any direct or indirect new or modified taxes, duties, tariffs, or equivalent measures imposed by any U.S. or foreign governmental authority that are applicable to our offering, including any hardware, software, or service components contained therein. Siemens shall be entitled to an equitable adjustment in pricing to reflect the impacts of any such measures. Please note that the aforementioned measures specifically include any price adjustments required as a result of increased costs incurred by Siemens due to tariffs imposed by any governmental authority (including, without limitation, increased costs due to tariffs imposed by any governmental authority on Siemens' vendors). Page 5 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Payment Terms Payment Terms Acceptance Agreement The total price of:$2,970.00 and the estimated return on investment are based on the items outlined in this proposal.ANY STATEMENTS MADE HEREIN REGARDING SAVINGS THAT MAY BE ACHIEVED BY IMPLEMENTING THE SERVICES OFFERED IN THIS PROPOSAL ARE ESTIMATES ONLY. NO WARRANTY, EITHER EXPRESSED OR IMPLIED, SHALL BE CONSTRUED TO ARISE FROM SUCH STATEMENTS, NOR SHALL SUCH STATEMENTS BE CONSTRUED AS CONSTITUTING A GUARANTEE BY SIEMENS THAT SUCH SAVINGS WILL OCCUR IF THE SERVICES ARE IMPLEMENTED. The Buyer acknowledges that when accepted by the Buyer as proposed by Siemens Industry, Inc., this Proposal and the Siemens RAM Projects Business Standard Terms and Conditions, (together with any other documents incorporated into the forgoing) shall constitute the entire agreement of the parties with respect to its subject matter.BY EXECUTION HEREOF, THE SIGNER CERTIFIES THAT (S)HE HAS READ ALL OF THE TERMS AND CONDITIONS AND DOCUMENTS, THAT SIEMENS OR ITS REPRESENTATIVES HAVE MADE NO AGREEMENTS OR REPRESENTATIONS EXCEPT AS SET FORTH THEREIN, AND THAT (S)HE IS DULY AUTHORIZED TO EXECUTE THE SIGNATURE PAGE ON BEHALF OF THE BUYER. Proposal is valid for thirty (30) days from the delivery date of June 05, 2025. Payment is due within 30 days of invoice date. Total:$2,970.00 Siemens Industry, Inc. invoices paid by credit card may be subject to a surcharge of up to 2%. Page 6 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Terms & Conditions Link(s) Terms and Conditions (Click to download) Terms & Conditions (Unrestricted) (www.siemens.com/standard-terms-project-unrestricted) Price Escalation.If, during the term of this Contract, the price of various materials or labor or logistics are increased as reflected by CRU/IHS Markit/CMAI/COMEX market index, then Siemens may increase the Contract Sum or apply a surcharge to Customer accordingly. Page 7 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 Signature Page Proposed by:Accepted by: Siemens Industry, Inc. ______________________________________ Company ORANGE COUNTY ASSET MANAGEMENT SERVICES _____________________________________ Company Joe Latore ______________________________________ Name _____________________________________ Name (Printed) 9804092 ______________________________________ Proposal # _____________________________________ Signature $2,970.00 ______________________________________ Proposal Amount _____________________________________ Title June 05, 2025 ______________________________________ Date _____________________________________ Date _____________________________________ Purchase Order #⬜PO for billing/pmnt only ⬜PO not required Page 8 of 8 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 SHOULD 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 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. $ $ $ $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 below If 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 HIRED AUTOS ONLY B 10/01/2024 N/A 4433 of Marsh USA LLC X RENTA C N/A 10,000,000 UB-8P79233A-24-51-R (AZ,MA,WI) 41343 A 10/01/2025 X Travelers Casualty & Surety Company CN102147003-RAM--24/25 1,000,000 25674 ... NYC-009196547-33 10/01/2024 X INCL 10/16/2024 10/01/2025 '''''''''''$500K LIMIT / $500K SIR''''''''''' 10 N/A 10/01/2025 NOC60 1,000,000 X 1,000,000 1,000,000 B 10/01/2025 10/01/2024 19038 TC2J-CAP-7440L34A-TIL-24 100,000 10/01/2024 UB-8P83929A-24-51-K (AOS) TWXJUB-7440L338-TIL-24 (OH) X 1,000,000 SEE ATTACHED RE: JOB NO. N/A 1000 DEERFIELD PARKWAY SIEMENS INDUSTRY, INC. BUFFALO GROVE, IL 60089-4513 1,000,000 HDI Global Insurance Company X 445 SOUTH STREET MARSH USA, LLC. MORRISTOWN, NJ 07960-6454 GLD1110116 Travelers Property Casualty Co. of America N PO BOX 8181 HILLSBOROUGH, NC 27278 ORANGE COUNTY ATTN: RISK MANAGEMENT 10/01/2024 B 2,000,000 X X 10/01/2025 Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704 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: MARSH USA, LLC. �� EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE CONTRIBUTORY INSURANCE TO THE�� ORANGE COUNTY, ITS OFFICERS, OFFICIAL AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL �� LIABILITY INSURANCE POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NON- LIABILITY AND AUTOMOBILE�� �� �� �� �� �� �� �� WAIVER OF SUBROGATION IS EFFECTUAL WHERE REQUIRED BY WRITTEN CONTRACT. �� �� INSURED BUT ONLY WITH�� �� �� �� �� �� �� 2 Morristown Certificate of Liability Insurance �� �� �� �� IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO �� �� �� �� �� �� �� RESPECT TO ALL WORK PERFORMED BY AND ON BEHALF OF THE NAMED INSURED, SIEMENS INDUSTRY, INC. FOR CERTIFICATE HOLDER UNDER CONTRACT. �� THE CERTIFICATE HOLDER UP�� �� �� �� �� 25 �� RE: JOB NO. N/A�� �� �� UMBRELLA IS FOLLOW FORM OF PRIMARY SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. �� �� 1000 DEERFIELD PARKWAY��SIEMENS INDUSTRY, INC.�� �� BUFFALO GROVE,IL 60089-4513�� �� TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. �� �� 2 CN102147003 �� �� �� �� Docusign Envelope ID: 7D9C1ED8-8628-4939-96EC-1D4FE12E9704