Loading...
PROOF OF INSURANCE (2021) CLOSEDACCR04 I DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 09/04/2020 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). PRODUCER CONTACT Cathy Service Van Wyke -Stahl Sargeant Insurance Agency, LLC. --........_...56.1.2...00 ............ ... FFA k (8118') 436-5988.......... PHONE 1➢ArC.r_m 818..........................6............................................................................ (Pip, 4* 7740 Painter Avenue #210 ADDRESS,, ........................................................................... m� INSURER(S) AFFORDING COVERAGE NAIC# Whittier CA 90602 INSURERA: Liberty Mutual Insurance .........,, 24082 INSURED INSURERB..'......The Hartford 29424........ .................................................._............................................... INSURERC: Indian Harbor Insurance Co 36940 r BARTEL ASSOCIATES, LLC INSURER D:I ....... 411 BOREL AVE STE 620 INSURER E SAN MATEO CA 94402-3525 INSURERF; 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 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 ..RNE........,. '/O.DLSU3R" , POLICY 90 POLICEX LTR TYPE OF INSURANCE IN. POLICVNUMBERrMMDDWVY IMMIDDM/Wi'LIMITS ". COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1 $ 2,000,000.00 t..ITmm . P5i1NiABF ii"Y iiEN1ES.... _� 2,000,000.00 CLAIMS -MADE OCCUR PREMISE$„(Ea occunenag $mm MED Any one person) $ ..2 0 A ❑ mm m Y N BKS (21) 57 29 73 74 09/01/2020 09/01/2021 PERSONAL & ADV INJURY $.......1 _ .. ITITITITITmIT ITIT......... rsEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ .0,00,00,00.0 4,000,000.00 ................... — POLICY LOC PRODUCTS - COMP/OP AGG F-1c�Mel��tysiNG��LIMir 4,000,000„m00 �a'r'HER T $ AUTOMOBILE LIABILITY $ 1,000,000,;0,0....._............ ANY O BODILY (Per person) $ A OWNED SCHEDULEDAUTOS BODILY INJURY CCI I) $ BAS 21 57297374 09/01/2020 09/01/2021 Y ( ) ................................. ONLY HIRED X „W „LL ...iyo D AM AGE NON -OWNED $ ff y I AUTOS ONLY II III AUTOS ONLY t rO,.a. XXPer.a.........en, .... $ UMBRELLA U OURRENCE $ AB........mm...—..ly,,,, CLAIMS -MADE AGGREGATE —.._...EX ED RETENTION $ $ ..... WORKERS COMPENSATION PERITE T I; �R� B EMPLOYERS'LIABILITY ............. ANYPaOPRI TOSR�PF�� EOREEXEC,UTxVE YIN N/A Y 72 WECAH2RPZ 09/01/2020 09/01/2021 X.uEACACCIDENT $ AN 000,000.00 O and'at ry i $ I EE (�WI'and'afayry in NH E, L, DISEASE - EA EMPLOYEE 1 000,000.00 i?' es, descnbe undeP ID 'SCMPTiON Or OPERATION'S below,E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 _ ��Im ( ) 5,U00,UU0 C MISC. PROFESSIONAL LIABILITY MPPOO1715216 09/01/2020 09/01/2021 (P01 Agg) 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CITY OF EL SEGUNDO, IT'S OFFICERS, DIRECTORS, EMPLOYEES, AGENTS AND VOLUNTEERS ARE HEREBY NAMED AS AN ADDITIONAL INSURED BY CONTRACT ON POLICY # BKS (21) 57297374 and BAS (21) 57297374 AS RESPECTS TO OPERATIONS OF THE NAMED INSURED ONLY, SEE CG2010. COVERAGE UNDER POLICY # BKS (21) 57297374 & BAS (21) 57297374 IS PRIMARY AND NON-CONTRIBUTORY ABOVE ANY OTHER INSURANCE THE CERTIFICATE HOLDER(S) MAY CARRY. 30 DAY NOTICE OF CANCELLATION. CERTIFICATE HOLDER City of EI Segundo 350 Main Street EI Segundo, CA 90245 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Mil ©1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKS (21) 57 29 73 74 COMMERCIAL GENERAL LIABILITY CG 2010 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) Location(s) Of Covered Operations City of EL Segundo, it's officials, officers, employees and agents ALL LOCATIONS OF THE NAMED INSURED 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 0413 0 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 2010 0413 COMMERCIAL GENERAL LIABILITY BARTEL ASSOCIATES, LLC. POLICY# BKS (21) 57297374 & BAS (21) 57297374 CG 20 0104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 Bartel Associates, LLC. Policy # BKS (21) 57297374 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION WHEN REQUIRED IN A WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is deleted and replaced by the following: We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement 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". CG7555(11-04) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72 WEC AH2RPZ Endorsement Number: Effective Date: 09/01/20 Effective hour is the same as stated on the Information Page of the policy, Named Insured and Address: Bartel Associates, LLC. 411 BOREL AVE STE 101 SAN MATEO CA 94402 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 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by ` 4Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 08/31/20 Policy Expiration Date: 09/01/21