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PROOF OF INSURANCE (2021) CLOSEDPage 1 of 2 AC L> 11/ CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DD/YY 09/20200 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 Willis Towers Watson Certificate Center NAME: Willis Towers Watson Northeast, Inc. PHE c/o 26 Century Blvd I (A/CNNo. Extl: 1-877-945-7378 (AJC, No): 1-888-467-2378 E-MAIL certificates@willis.com P.O. Box 305191 ADDRESS: Nashville, TN 372305191 USA I INSURER(S) AFFORDING COVERAGE NAIC# (INSURER A: ACE American Insurance Company 22667 INSURED INSURERS: Indemnity Insurance Company of North Ameri 43575 UniFirst Corporation and its Subsidiaries 68 Jonspin Road IINSURERC: ACE Fire Underwriters Insurance Company 20702 Wilmington, MA 01887 (INSURER D: I INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: W18705922 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/DD/YYYYI (MM/DD/YYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ F%1171 To CLAIMS -MADE OCCUR DAMAGEPREMISES RENTED PREMISES (Ea occurrence) $ A X Contractual MED EXP (Any one person) $ y y HDOG71444351 10/01/2020 10/01/2021 PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO � LOC OTHER: JECT AUTOMOBILE LIABILITY X ANY AUTO A' ID SCHEDULED y AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EXCESS LIAB HCLAIMS-MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N B ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? No N/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below A Workers Compensation and Employers Liability Per Statute y ISAH25312260 GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT $ fEa accident) BODILY INJURY (Per person) $ 10/01/2020 10/01/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) EACH OCCURRENCE $ AGGREGATE $ 2,000,000 1,000,000 5,000 1,000,000 4,000,000 4,000,000 4,000,000 X I PER STATUTE I I EERH y WLRC67459271 (AOS) 10/01/2020 10/01/2021 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 y WLRC67459313 (CA, MA) 10/01/2020 10/01/2021 EL Each Accident $1,000,000 EL Disease-Pol Limit $1,000,000 EL Disease - Each Eml $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 11/09/2020 WITH ID: W18705467. Division/Location: 324 SEE ATTACHED CERTIFICATE HOLDER 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. E1 Segundo Police Dept. AUTHORIZED REPRESENTATIVE Attn: Julissa Solano 348 Main St. El Segundo, CA 90245 © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 20322754 BATCH: 1879907 AGENCY CUSTOMER ID: LOC #: ACORNADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc. UniFirst Corporation and its Subsidiaries 68 Jonspin Road POLICY NUMBER Wilmington, MA 01887 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Certificate Holder is an Additional Insured for General Liability and Auto Liability as their interest may appear if required by written contract but only with respect to liability arising out of operations of the Named Insured. It is understood and agreed that UniFirst Corporation waives its right of subrogation against the Additional Insured which may arise by reason of a payment of claim under General Liability, Auto Liability and Workers Compensation policies if required by written contract and as permitted by law. General Liability shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured. INSURER AFFORDING COVERAGE: ACE American Insurance Company POLICY NUMBER: WCUC67459398 (ME, OH) EFF DATE: 10/01/2020 SUBROGATION WAIVED: Y TYPE OF INSURANCE: Workers Compensation and Employers Liability Per Statute LIMIT DESCRIPTION: EL Each Accident EL Disease -Pol Limit EL Disease - Each Emp EXP DATE: 10/01/2021 LIMIT AMOUNT: $1,000,000 $1,000,000 $1,000,000 INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company POLICY NUMBER: SCFC67459350 (WI) EFF DATE: 10/01/2020 EXP DATE: 10/01/2021 SUBROGATION WAIVED: Y TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation and EL Each Accident $1,000,000 Employers Liability EL Disease -Pol Limit $1,000,000 Per Statute EL Disease - Each Emp $1,000,000 NAIC#: 22667 NAIC#: 20702 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 20322754 BATCH: 1879907 CERT: W18705922 POLICY NUMBER: HDO G71444351 14 Endorsement Number: 69 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART •. 1 Name Of Additional Insured Person(s) Or Organization (s): Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number UNIFIRST CORPORATION 68 JONSPIN ROAD Policy Number WILMINGTON MA 01887 Symbol:WLR Number: C67459313 Policy Period Effective Date of Endorsement 10-01-2020 TO 10-01-2021 10-01-2020 1 Issued By (Name of Insurance Comganv) ACE AMERICAN INSURANCE COMPANY 1 Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization: (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL OPERATIONS CONDUCTED BY AN INSURED PURSUANT TO SUCH WRITTEN CONTRACT 3. Premium: The premium charge for this endorsement shall be 1.0 percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: $0 Authorized Representative WC 90 03 75 (05/18)