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PROOF OF INSURANCE (2020 - 2020) CLOSEDA �j y C DATE (MM/DDIYYYY) C_C? DI` CERTIFICATE OF LIABILITY INSURANCE I144�1 9/24/2019 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 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 CT NAME PESTSURE CERTIFICATES Arthur J. Gallagher Risk Management Services, Inc. PHONE 800.326.6203 FAXN 972-663-6258 Park 7 WC, No, 0t1. iaa�, 'n9 ,COM 12750 Merit Drive, Suite 1000 E-MAILD�1 :s�; PE'T1�ECERTS(AJ'G„ . Dallas TX 75251 INSURER)S)AFFORDING COVERAGE NAIC# INSURER A; Old Republic Insurance Company 24147 INSURED INSURER B: XL Insurance America, Inc. 24554 DEWEY SERVICES, INC. BRANCH NO, 7 DBA DEWEY PEST CONTROL INsuRERc: 939 EAST UNION STREET INSURER D: PASADENA CA 91106-7214 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1780658349 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 CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ..,, IND''�1JR'k ...., ...., POLICY EPP ' POLICY EXP TRSD TYPE OF INSURANCE WVP POLICY NUMBER IMMIDDIYYYY) IMMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y MWZY313733-19 10/1/2019 10/1/2020 EACH OCCURRENCE $2,000,000 ' DAMAGE TO RENI'LD CLAIMS -MADE X OCCUR PREMISES (Ea occurrence) , S100,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY JECT ,IECT LOC OTHER A AUTOMOBILE LIABILITY MWTB313749-19 X ANY AUTO X OWNED X,„ SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY B X UMBRELLALIAB X OCCUR US00065870L119A EXCESS LIAB CLAIMS -MADE DED X RETENTION $ 1 LWn A WORKERS COMPENSATION Y MWC311397-19 AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) , N I A If yes, describe under DESCRIPTION OF OPERATIONS below MED EXP (Any ane person) s5,000 PERSONAL & ADV INJURY s2,000,000 GENERAL ... ,..,, „........,. AGGREGATE $ 4.0,00,000 PRODUCTS - COMP/OP AEG $ 4,000,000 S 10/1/2019 10/1/2020 COMMNEDSINwGLE LIMIT $2,000,000 4E0k1,�C12P91'YID ., BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ lrROPERI), DAMAGE S Per at riae,n ) 10/1/2019 10/1/2020 EACH OCCURRENCE S1.000,000 AGGREGATE S1.000,000 IS 1/1/2019 1/1/2020 X STATUTE ER OT H- E L EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE, S1,000,000 E L DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ALL LOCATIONS & OPERATIONS. ADD'L INSURED COVERAGE IS PROVIDED BY FORM #CG 2010 (04/13). SEE ATTACHED. THE CITY OF EL SEGUNDO IS NAMED AS ADDITIONAL INSURED. COMPLETED OPERATIONS IS INCLUDED ON THE GENERAL LIABILITY POLICY. A WAIVER OF SUBROGATION IS PROVIDED IN FAVOR OF THE CITY OF EL SEGUNDO. 30 DAYS NOTICE OF CANCELLATION WILL BE PROVIDED TO CERTIFICATE HOLDER (10 DAYS FOR NON-PAYMENT OF PREMIUM.) C0I21:Till!1 01-ll14.110 14014 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF EL SEGUNDOPUBLIC WORKS DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. GENERAL SERVICES DIVISION 150 ILLINOIS STREET AUTHORIZED IREPRESENT TIVE EL SEGUNDO CA 90245 USA" pp ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: MWZY313733-19 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) All persons or organizations as required by contract or agreement. Location(s) Of Covered Operations All locations. 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, in whole or in part, 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. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 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; 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. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 0413 POLICY NUMBER: MWZY313733-19 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All persons or organizations as required by contract or All locations, agreement. 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" or "property damage" caused, in whole or in part, 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". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: MWZY313733-19 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations as required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy } This endorsement, effective 12:01 AM 1/1/2019 forms a part of Policy No. MWC311397-19 Issued to: DEWEY SERVICES, INC. BRANCH NO. 7 DBA DEWEY PEST CONTROL By: Old Republic Insurance Company Premium: INCL We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization CITY OF EL SEGUNDOPUBLIC WORKS DEPARTMENT GENERAL SERVICES DIVISION 150 ILLINOIS STREET EL SEGUNDO CA 90245 The sentence in parenthesis above does not apply Job Description WC 04 03 06 Countersigned by � , (Ed. 4-84) Authorized Representative e