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PROOF OF INSURANCE (2021 - 2021) CLOSEDC" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I^ ` 1 12/7/2020 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 I REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 525-24 Marsh &McLennan Agency LLC E-MAIL PHONE Nlccle' tFAX e 15415 Middlebelt Road f Nss. n af4-5 m 03 AIC, Ngy 212-607-1179 Livonia MI 48154 .� 9__... y� n1a-mi.com p, .. !N, „URER(S) AFFORDING COVERAGE . AIC # _ INSURER A: Federal Insurance Company 20281 INSURED INSURER B : Travelers Indemnity Co of America 25666 6565 OCLC, Inc. — - Dublin OH 43017e INSURER D: Westchester 72 g ERC: Sur Lines Insurance Co 101 MSURER E INSURER F : — .... ...., -.... .. COVERAGES CERTIFICATE NUMBER: 546081461 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. LTR .�'iNSn wVBD P041CY'NUMBER.... ---- TYPE OF INSURANCE POLICY EFF POLICY EXP ��- LIMITS GENERALLIABILITY 35756671 fM3/1/2020Yf IM3/D2/021 Y)„PEACH REM DAMAOF F TE ,, Y $1,000000 _.— . . „4 yrenrq) — t 1,,000„',004 .............. _ A COMMERCIALCLAIMS-MADE I X OCCUR PE — ..... _ _. ( y _ 000 ED EXP Awd on PERSONAL &ADV INJURY $ 1 p ... --- .... 00.0'00 E. (' LAGGREG%A�TEIMITAPPLIESPER: GENERAL AGGREGATE �U$2,040,000 %POLICYE PRLOC PRODUCTS -COMP/OP AGG $2,000,000 OTHER ($ AUTOMOBILE ANY AUTOINJURY Per ABILITY I�,1'I,b ( $ BODILY person) $ OWNED ” SCHEDULED Ea aBcP^LIMIT t AUTOS ONLY i _ ( cadent) $ AUTOS ONLY AUTOS ONLY BODILY PeEac _ r - NON -OWNED PROraF6�'TYDAP.1Arv' $ UMBRELLA LIAB OCCUR EACH OCCURRENCE$ EXCESS „I EX S CLAIMS -MADE 111 AGI '^ GREGATE $ DED REr'E:N'fION $ $ B RS. COMPENSATION UB8J443127 12/31/2020 12/31/2021 X PER OTH• AND EMPLOYERS' LIABILITY Y Y/N PT'A1"U'1 E....,,,, ER _..S ..,....... APiYP'ROPFRR ETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? N/A _ ACCIDENT �'$ 1,,000,000 (Mandatory in NH) q yyer;, describe under __ EL DISEASE EA EMPLOYEE $ 1„000.000 0 SCRIP'TI'OPI OF OPERATIONS bclo,v E I. .185 . DISEASE - POLICY LIMIT $ 1,000.000 C Cyber Liab/Professional Liab F1564509A 4/2/2020 4/2/2021 Limit $7,000,000 (Claims Made) DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Addll,lonol Remarks Schedule„ may be attached If :more space is required) The City of El Segundo, its officials, and employees are included as additional insured for commercial general liability on a primary and non-contributory basis to the extent provided in the attached form #80-02-236T and as additional insured for profdssionali'cybe'r liability coverage to the extent provided in the attached form #PF -48238, The commercial general liability insurance carrier will provide the Certificate Holder with direct notice of cancellation to the extent provided in the attached form 80-02-9779. CERTIFICATE HOLDER City of EI Segundo 350 Main Street EI Segundo CA 90245 ACORD 25 (2016/03) 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 .. .. .... ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C H U B B° Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY LIQUOR LIABILITY Who Is An Insured Additional Insured - Scheduled Person Or Organization MARCH 1, 2019 TO MARCH 1, 2020 MARCH 1, 2019 3575-66-71 CHI OCLC, INC. FEDERAL INSURANCE COMPANY MARCH 19, 2019 Under Who Is An Insured, the following provision is added. Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto). with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Liability Insurance Additional Insured - Scheduled Person Or Organization continued Form 80-02-2367 (Rev. 5-07) Endorsement Page 1 CHUBB'm Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Conditions Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with such insurance as is afforded by this policy. All other terms and conditions remain unchanged. Authorized Representative " "„ Liability Insurance Additional Insured - Scheduled Person Or Organization lastpage Form 80-02-2367 (Rev. 5-07) Endorsement Page 2 Policy Conditions Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued a✓o✓rrw ^'"rooe�a w�yp,�mnau�rc,oar,ma�rmmuarvnmoi urwm,�ae�m ��wumn�,��mrrrn�v�aramxa�arraoNes�,aw awotaa�owarrann�anwaesaeanaww'�o��wv,�;adi„rm���rare.�w,�,w,au,:,,u��mv�naazr,����w,wroue�,a'esu:w mm,nr+,nr���ra�ww'aeaocrwao,µrxamarwma'a�nn�wwmarra�..¢wuM �wmamww�srro�,�xmwv��v�mar�o�iw�rv�ne�rHa,taa�u��w� Hnwr �,mm,.,�u, um�,xw��i�o ,r This Endorsement applies to the following forms: COMMON POLICY CONDITIONS w��,�u���au�a�w�a��d„�aa�+�s�atta�;&a+yw�au�umm��aprr,�'ix+�;t��s�zswad�m�am�����ur��t�uuu��a»www?nw:aamrv��ww�'aan,�tva�wwv �a��.�mmm�.„wwonava!in�mu°:�+aw�rem�w�aaaaw,wa������omrartm>xantr�w,a�^,�vernam����,�,,m�^:ncw^x�cr�wa���r�:a«mzrvwwrawwc�^ttssr�*.ww��wwwr:r✓:mat���auuuwuuuurranww�w;and���..:.ovw�.w.uxi,ww�var���,av�arvvi+Pinrcuu,�u, Under Conditions, the following condition is added. Conditions Notice Of Cancellation When we cancel this policy for any reason, other than non-payment of premium, we will notify To Scheduled Persons person(s) or organization(s) shown in the Schedule at least 30 days in advance of the cancellation Or Organizations When date. We Cancel Any failure by us to notify such person(s) or organization(s) will not: • impose any liability or obligation of any kind upon us; or • invalidate such cancellation. ollho�wumiuiww�mim"•w'4,V w,^w�w�W:uww,,�tn2umuWvuW$OPIWoiwmimory^i, �!Paroa,iiCFXflwt"vWM1id�l4i°wy ro:9'SFtlSmoN�m°ram,.m�44v,ww¢bw9vn47.lwd$u'bWA$I,nd+r"1.1wi�uraw�umuumwv1+°,r:=.;a �wmw ammMW4JC �zaPX44' MOMONMM.imm,mumaw uiw�wrwuwwr,:NVNwUxww,m:lol,uamwtlpm�C,,AAUw:,q«vvruo+:,4"4wZN,41M1,,4,Vg Schedule Person(s) or Organization(s): Address: Notice Of Cance/if t `d:t d 0jbp%- Or Organizations Policy Conditions (Except Non -Payment Of Premium) continued Form 80-02-9779 (Ed. 3-11) Endorsement Page 1 Conditions (continued) Policy Conditions Form 80-02-9779 (Ed. 3-11) All other terms and conditions remain unchanged. Authorized Representative Notice Of Car7cellati4)r rs OP rganizations (Except Non -Payment Of Premium) Endorsement last page Page 2 Additional Insured — Blanket Pursuant to a Contract — DigiTech® THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Chubb DigiTech® Enterprise Risk Management Policy It is agreed that Section II, Definitions, Insured, subparagraph 6 is deleted and replaced with the following: 6. any natural person or entity for whom an Organization is required by written contract or agreement to provide insurance coverage under this Policy (hereinafter "Additional Insured"), but only with respect to Claims: a. arising out of any Incident committed after the Organization and the Additional Insured entered into such written contract or agreement; b. for any Incident committed by, on behalf of, or at the direction of the Organization; and c. subject to the lesser of the limits of insurance required by such written contract or agreement between the Organization and the Additional Insured, or the applicable Limits of Insurance of this Policy. However, no natural person or entity shall be an Additional Insured with respect to any Claim arising solely out of such natural person's or entity's independent act, error, or omission. In the event of a disagreement between the Named Insured and the natural person or entity as to whether the Claim arises solely out of such natural person's or entity's independent act, error, or omission, it is agreed that the Insurer shall abide by the determination of the Named Insured on this issue, and such determination shall be made by the Named Insured within 20 days of the notification of the applicable Claim. All other terms and conditions of this Policy remain unchanged. PF -48238 (o9/16) Page i of i