PROOF OF INSURANCE (2021) CLOSEDClient#. 1545117 FRSHOLI
ACORD,. CERTIFICATE
EpTIFICATE n ' LIABILITY INSURANCE DATE (MM1DplYYYY)
12/15/2020
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(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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER I NAMEACT Jennifer Beasley
USI Insurance Services, LLC PHONE 964-255-1083 AX,No1: 877-506-0509
(A1C, No, Ext)•INC
8540 Colonnade Center Dr. I ADMDRESS, jennifer.beasley@usi.com
Suite 111
Raleigh, NC 27615
INSURED
FRS Holdings, Inc., Federal Resources
Supply Company and their subsidiaries
235G Log Canoe Circle
Stevensville, MD 21666-2165
INSURER(S) AFFORDING COVERAGE
INSURER A: Hartford Fire Insurance Company
INSURER B : Hartford Casualty Insurance Company
INSURER c : Twin City Fire Insurance Company
INSURER 0: Indian Harbor Insurance Company
1 INSURER E: Trumbull Insurance Company
INSURER F:
NAIC #
19682
129424
129459
36940
,27120
1
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.
I TR TYPE OF INSURANCE INSRL WVo POLICY NUMBER IM°IDDYIi�I IMMIDPOLID�yyl
LIMITS
A XC COMMERCIAL GENERAL LIABILITY 22UENBI9538 10/01/2020 12/01/2021 EACHOCCURRENCE ($1,000,000
DA liG 'rp ENTER
—D CLAIMS -MADE ® OCCUR PREMISS {Ea accunencej $1000,000
MED EXP (Any one person) –$10,000
1 PERSONAL & ADV INJURY 1 x51,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY LOC
PRO- PRODUCTS - COMPIOP AGG 62,040,000
CT
JE
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Evidence of Insurance
CANCELLATION
Cit of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Deena Lee ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE
V" a,�L it &L,
Q 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S30640050/M30638139 SK2ZP
—I
$
OTHER:
E
AUTOMOBILE LIABILITY
22UENBH6529
12/16/2020 12/01/20211 (Eaacciden SINGLE LIMIT $1,000,000
Xi ANY AUTO
i BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident) S
X AUDTEOS ONLY AUTOS ONLY
PROPERTY DAMAGE $
tPer accident)
$
B
X uMBRELLALIAB 1- 1OCCUR
22RHUB19004
10101/2020 12/01/2021 EACH OCCURRENCE $10,000.000
EXCEtSSLIAR CLAIMS -MADE
AGGREGATE $10,000.000
DED I ( RETENTIONS
S
C
WORKERS COMPENSATION
22WBAC30CU
12/1612020 12/01/2021 }C 1pER DTH•
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE �Y 1 N
E.L. EACH ACCIDENT $1.000,000
OFFICERIMEMBER EXCLUDED? t_J N I A
1$1,000,000
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS betow
E.L. DISEASE - POLICY LIMIT
D
Cyber/E&O
BINDER18957681
12/16/2020 12/01/2021 $2,000,000 Aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Evidence of Insurance
CANCELLATION
Cit of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Deena Lee ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE
V" a,�L it &L,
Q 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S30640050/M30638139 SK2ZP
This page has been left blank intentionally,
QUICK REFERENCE
COMMERCIAL GENERAL LIABILITY COVERAGE PAR!
OCCURRENCE
READ YOUR POLICY CAREFULLY
DECLARATIONS PAGES
Named Insured and Mailing Address
Policy Period
Description mfBusiness and Location
Coverages and Limits VfInsurance
Beginning onPage
SECTION U~COVERAGES
CovenageA- Insuring Agreement ........................................ I
Bodily Injury
and Property Exclusions ......................................................
2
Damage Liability
CoverogmB- Insuring Agreement ........................................ 5
Personal and
Advertising Exclusions ......................................................
0
Injury Liability
Coverage C- Insuring Agreement ........................................ 7
Medical Payments Exclusions ......................................................
8
Supplementary Payments Coverages AAnd B ........ .....................................................................
D
SECTION N~WHO *S ANINSURED ................................................................................................
..9
SECTION |UU ~LIYNKTS OF INSURANCE -------.------.....................................................
12
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS ----------------.
13
Bankruptcy.--.----------------..--.--_—''—'—^'---------'---- —'13
Duties in The Event Of Occurrence, Offense, Claim or Suit .........................................................
13
LegalAction Against Us ........................ .......................................................................................
13
OtherInsurance ..........................................................................................................................
..14
Premium Audit .................................................
.15
Representations -----.....................................................................................................
.15
SeparationofInsureds ................... ........ .....................................................................................
15
Transfer of Rights of Recovery Against Ddxans ToUs...................................................................
15
When VVeDoNot Renew --------...._...._.__—.---------------_—.,...
15
SECTION V~DEFINITIONS -------------..._._._...------------- ..............
15
COMMON POLICY CONDITIONS
Cancellation
Changes
Examination mfYour Books and Records
Inspections and Surveys
Premiums
Transfer ofYour Rights and Duties under this Policy
ENDORSEMENTS
These form numbers are shown on the Coverage Part - Declarations Page or on the Common Policy
Declarations Page,
Form HC 7001*605
@ 20U.The Hartford
POLICY NUMBER: 22 UEN B19538
This COMMERCIAL GENERAL LIABILITY COVERAGE PART consists of:
A. This Declarations;
B. Commercial General Liability Schedule;
C. Commercial General Liability Coverage Form; and
D. Any Endorsements issued to be a part of this Coverage Part and listed below.
LIMITS OF INSURANCE
The Limits of Insurance, subject to all the terms of this Policy that apply, are:
Each Occurrence Limit
Damage to Premises Rented to You Limit - Any One Premises
Medical Expense Limit - Any One Person
Personal and Advertising Injury Limit
General Aggregate Limit,
(other than Products -Completed Operations)
Products -Completed Operations Aggregate Limit
ADVANCE PREMIUM:
AUDIT PERIOD: ANNUAL AUDIT
$1,000,000
$300,000
$10,000
$1,000,000
$2,000,000
$2,000,000
$337,916.00
Except in this Declarations, when we use the word "Declarations" in this Coverage Part, we mean this "Declarations" or
the "Common Policy Declarations."
Form Numbers of Coverage Forms, Endorsements and Schedules that are part of this Coverage Part:
HC70010605 HCO0880916 HC23140617 HC23700115 HC30060916
HGO0010916 HG21020204 CG02011217 CG26731204 HC21430914
HC12101185T
Form HC 00 90 07 98
CYBERFLEX
AMENDMENT OF COVERAGE B - PERSONAL AND
ADVERTISING INJURY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement broadens coverage for "your web custody or control by someone not
site" or Internet -related activities. authorized to access or distribute that
A. Section V - Definitions is changed as follows: material.
1. Definition Of Advertisement - Internet 3. Definition of Your Web Site
The following is added to Paragraph a. of
the definition of "advertisement":
"Advertisement" means the widespread
public dissemination of information or
images that has the purpose of inducing the
sale of goods, products or services through:
a. (6) The Internet;
2. Definition of Personal And Advertising
Injury
a. Your Web Site
Paragraphs f. and g. of the definition of
'"personal and advertising injury" are
replaced by the following:
"Personal and advertising injury" means
injury, including consequential "bodily
injury", arising out of one or more of the
following offenses:
f. Copying, in your "advertisement" or
on "your web site", a person's or
organization's "advertising idea" or
style of "advertisement"; or
g. Infringement of copyright, slogan, or
title of any literary or artistic work, in
your "advertisement" or on "your
web site".
b. Publication By Those With
Unauthorized Access
The following is added to the definition
of "personal and advertising injury":
As used in this definition, oral, written or
electronic publication includes
publication of material in your care,
Form HC 00 88 09 16
The following definition is added:
"Your web site" means a web page or set of
interconnected web pages prepared and
maintained by you, or by others on your
behalf, for the purpose of promoting your
business or promoting your goods, products
or services, that is accessible over an
internet.
B. Paragraph 2., Exclusions of Section I -
Coverage B - Personal And Advertising
Injury Liability is amended as follows:
1. Exclusions f., g. and I. are replaced by the
following:
f. Breach Of Contract
"Personal and advertising injury" arising
out of any breach of contract, except an
implied contract to use another's
"advertising idea" in your
"advertisement" or on "your web site";
g. Quality Or Performance Of Goods -
Failure To Conform To Statements
"Personal and advertising injury" arising
out of the failure of goods, products or
services to conform with any statement
of quality or performance made in your
"advertisement" or on "your web site";
I. Infringement Of Intellectual Property
Rights
(1) "Personal and advertising injury'
arising out any actual or alleged
infringement or violation of any
intellectual property right, such as
copyright, patent, trademark, trade
@ 2016, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc. with its permission.)
Page 1 of 2
name, trade secret, trade dress,
service mark mrother designation of
origin or authenticity; or
(2) Any injury ordameQe alleged inany
claim or "suit' that also alleges an
infringement or violation of any
intellectual property hght, whether
such allegation of infringement or
violation is made byyou orbyany
other party involved in the claim or
"suit", regardless of whether this
insurance would otherwise apply.
However, this exclusion does not apply
ifthe only allegation inthe claim or"euit"
involving any intellectual property rightis
limited to:
(1) |nfr|mQement, in your
"advertisement" or on "your web
site", of:
(a) Copyright;
(b) Slogan; or
(c) Title of any literary or artistic
work; or
(2) Copying,in your or
on site^, o person's or
organization's "advertising idea" or
style of"odverbsennent".
2. Exclusions k. - Electronic Chabrooms Or
Bulletin Boards does not apply.
3' Subparagraphs (1). /2\ and (3)ofExclusion
p.-|nternetAdvedisements And Content Of
Others dmnot apply.
Page 2 of 2 Form HC 00 88 09 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
0 A 0 A 1 0 0 0 A
A B - I - I a ILI I IN M0
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
Paragraph h. is added to the definition of "Personal and advertising injury" as follows:
h. Discrimination that results in humiliation or other injury to the feelings or reputation of a natural person,
provided that such discrimination is not committed by or at your direction, or the direction of any partner,
member, manager, "executive officer", director, stockholder or trustee of the insured.
Form HC 30 06 09 16 Page I of I
@ 2016, The Hartford
Various provisions in this policy restrict coverage.
Read the entire policy carefully to determine rights,
duties and what ksand ksnot covered.
Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the
Declarations, and any other person ororganization
qualifying as aNamed Insured under this policy. The
words °vve'', "us" and "our" refer to the stock
insurance company member of The Hartford
providing this insurance.
The wnmJ ''insured" means any person or
organization qualifying as such under Section UU -
Who |sAnInsured.
Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V-
SECTIONU~COVERAGES
COVERAGE ABODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1' Insuring Agreement
a' We will pay those sums that the insured
becomes legally obligated topay modamages
because of "bodily injury" or "property
damage" to which this insurance applies. We
will have the right and dub/ to defend the
insured against any "suit" seeking those
damages. However' we will have moduty to
defend the insured against any "suit'seeking
damages for "bodily injury" or "property
damage" to which this insurance does not
app|y. We may, at our diannebon, investigate
any "moounemce"and settle any claim or"omit"
that may result. But
(1) The amount we will pay for damages is
limited as described in Section UUU- Limits
Of Insurance; and
(2) Our right and duty to defend ends when
we have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.
Noother obligation Vrliability topay sums mr
perform amts or services is covered unless
explicitly provided for under Supplementary
Poymnente-Covenages Aand B.
b. This insurance applies to "bodily injury" and
"property damage" only if:
(1) The "bodily injury" or damage" is
caused by an "occurrence" that takes
place in the "coverage territory";
(2) The "bodily 'injury" or damage
occurs during the policy period; and
(3)Prior to the policy red listed
under Paragraph 1. of Section N - Who Is
An Insured and no~employge"authorized
by you to give or receive notice of an
"occurrence" or o|oinn, knew that the
"bodily injury" or "property damage" had
occurnad, in whole or in pat If such a
listed insured or authorized "employee"
knew, prior to the policy period, that the
"bodily injury" or "property damage"
occurred, then any continuation, change
or resumption of such "bodily injury" or
"property damage" during or after the
policy period will hedeemed bohave been
known prior tothe policy period.
c. "Bodily injury" or "property damage" will be
deemed to have been known to have
occurred at the earliest time when any
insured listed under Paragraph 1.ofSection U1
- Who Is An Insured or any "employee"
authorized byyou togive prreceive notice of
an"onourrenca"orclaim:
(1) Reports all, or any part, of the "bodily
injury" or "property damage" to us or any
other insurer;
,
/2l Receives m written or verbal demand or
claim for damages because of the "bodily
injury" or "property damage"; mr
(3) Becomes aware byany other means that
"bodily injury" or "property damage" has
occurred orhas begun tooccur.
d. Damages because of "bodily injury" include
damages claimed by any person or
organization for cane' loss of services or
death resulting at any time from the "bodily
injuryp,
e. Incidental Medical Malpractice And Good
Samaritan Coverage
"Bodily injury" ohminQ out of the rendering of
or failure to render the following health cape
services by any "employee" or "volunteer
worker" shall bedeemed to be caused by an
"occurrence" for:
Page 1 of 21
g%2O1OThe Hartford