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PROOF OF INSURANCE (2020) CLOSEDilCORO'
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
04/13/2020
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).
.... ea
PRODUCER CONTACT
NAML Annette Lop... .....-................ .... ...
Jones & Maulding Insurance PHONE
, t ,.E t'. 1.0 )...4.8.6-470.1....xZ.Z.S...............................................................1 WC, NOL (8 5�...4.8.6:.20.8.7.
P.O. Box 1312 MAm anne!tBTjandminsurance.com
IL u
................................................................
Oxnard CA 93032tRERtRI AE GROIN.C?.Gs9v.ERc?.PFe............................................... .....................NAIC. ,.,.........,.
)NsuRER A , Travelers Casualty Insurance Co. of America
INSURED
Boiling Point Creative Group
-1932-Curtis Avenu' IN,$41RER D
Redondo Beach CA 90278 INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 �,ADDL,' UBR POLICY EFF POLICY EXP
J TR TYPE OF INSURANCE INS %�.rvn POLICY NUMBER IMM/DOdYYYYI dMM/DD(YYM LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $$_ 1,000,000
DX
DAMAGE TO RENTED
A —... CLAIMS -MADE OCCUR' $ 300,000
P@EpidiES lEa.pC WLt�Ge................................
X 680-5D878300 0912112019 09/2112020 MED EXP rAny one person) S 5,000
C'£N L R,GGREC,ATE LIMIT APPLIES PER:
POLICY FRO -LOC
ECT
OTHER
AUTOMOBILE LIABILITY
ANY AUTO
AO WNED OS ONLY SCHEDULED
AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
C
- UMBRELLA LIAB OCCUR
....,, �........�m[CLNM§-"MAqE,pEpESLI�9.... -. ,
RETENTION S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y,1 N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
PERSONAL & ADV RY
S 1,000,000
II GENERAL AGGREGATE
$ 2.000.000
„PRO. �.,. ,.,.-...,.,.COMP/OP AGG ...�..?t
DUCTS - _.,.�.,...� ..S._
,000,0,.....
00
.,.,.,.,.,.,. .,.,.,.,.,
o-;G7urffi£:•Y�INEDti9h;C�m7�.E��'�:.ItlolT
$
iFn of pr. rrrrGj .................................................
,BODILY INJURY (Per person)
$
L...............................................................................................................................................................
$
PROPERTYDAMAGEaoadenQ
ROPERTY
. .,,. ....
P t�
$
EACH OCCURRENCE S
AGGREGATE $
$
STATIITP FORH
E L EACH ACCIDENT S
EL DISEASE - EA EMPLOYEE S
EL DISEASE -POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate holder is named as an Additional Insured in accordance with the policy provisions of the General Liability per form CG D2 47 0419 -
Scheduled Additional Insured
CERTIFICATE HOLDER
CANCELLATION
The City of EI Segundo, its Officers, Officials, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Employees, Agents and Volunteers ACCORDANCE WITH THE POLICY PROVISIONS.
401 Sheldon St.
EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE
©1988 20W ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: 680-5D878300-19-42
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 04/10/2020
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SCHEDULED ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE OF ADDITIONAL INSUREDS AND COVERED OPERATIONS
NAME OF PERSON OR ORGANIZATION:
THE CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS
401 SHELDON ST
EL SEGUNDO CA 90245
PROJECT/LOCATION OF COVERED OPERATIONS:
GRAPHICS DESIGNS
PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:
Any person or organization shown in the Schedule
Of Additional Insureds And Covered Operations that
you agree in a written contract or agreement to
include as an additional insured on this Coverage
Part is an insured, but only:
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" on or for the project, or at the location,
shown in the Schedule Of Additional Insureds
And Covered Operations, to which the written
contract or agreement applies. Such person or
organization does not qualify as an additional
insured with respect to the independent acts or
omissions of such person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
b. The insurance provided to such additional
insured does not apply to:
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
CG D2 47 04 19 © 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "property damage"
caused by "your work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an 'occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the 'occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the 'occurrence"
or offense.
(2) If a claim is made or "suit' is brought against
the additional insured:
(a) Immediately record the specifics of the
claim or "suit' and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit' as soon as practicable.
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit', cooperate with us in the
investigation or settlement of the claim or
defense against the "suit', and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit' to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 47 04 19