The URL can be used to link to this page

PROOF OF INSURANCE (2021 - 2022) CLOSED0 DATE (MMIDD/YYYY) ACDORO CERTIFICATE OF LIABILITY INSURANCE 04/28/2021 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 CONTAC IT Andrew Safe NAME-, The Evans Agency, LLC ?n O No (716) 549-3500 No . (716) 926-8690 6460 Main Street ADDRESS: asafe@evansagencyins.com Suite 200 INSURER(S) AFFORDING COVERAGE NAIC # Williamsville NY 14221 INSURERA: Philadelphia Indemnity Ins Cc 18058 INSURED I INSURER B : Hartford Ins Cc of The Midwest 37478 Buffalo Computer Graphics Inc INSURER C : 4185 Bayview Rd INSURER D : INSURER E : Blasdell NY 14219 91-99 DC%IlCU11J K111RIDC92- 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 TYPE OF INSURANCE INSD WVD POLICY NUMBER '.. MM/DD MM/DD/YYYY LIMITS "X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR dK°� N - _- PREMISES (Fa accuirancel, 100,000 $ MED EXP (Any one person) $ 5,000 A Y PHPK2267455 04/29/2021 04/29/2022 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS AGG $ 2,000,000 X POLICY PRO- 11eCT ❑ LOC OTHER: AUTOMOBILE LIABILITY COMBINED ao S1N'CwLE LIMITLIMITeaaredd Ee mrnL $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ A .. OWNED SCHEDULED AUTOS ONLY AUTOS HIRED w�, NON -OWNED AUTOS ONLY AUTOS ONLY PHPK2267455 04/29/2021 04/29/2022 PROPER'�TY Li Per accident DAMAGE $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 20,000,000 HCLAIMS-MADE AGGREGATE $ 20,000,000 A EXCESS L,I+AB ..DEC PHUB765665 04/29/2021 04/29/2022 B RETENTION $ '10,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) NIA 01WECGH0169 10/01/2020 10/01/2021 �I STA UTE ERH $ �. E.L. EACH ACCIDENT $ 1,000,000 -- E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1 000,000 ' If yes, describe under DESCRIPTION OF OPERATIONS below A Technology Errors & Omissions PHPK2267436 04/29/2021 04/29/2022 Per Claim 3,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) City of El Segundo,its officials, and employees are included as additional insureds under general liability on a primary and non-contributory basis, as required per written and executed contract. L9_12I"=1 III W_\ ILei L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245 / K MO.. @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY 11 ",1 ? GENERAL LIABILITY DELUXE ENDORSEMENT: INTEGRATED TECHNOLOGY \ TH.-I.S F.,.WDORSEIMENT C71A1.14GEaS IIHE.� POL,ICY. 1'L,EA`3E READ Uf CAREE'ULLY. GENERAL LIABILITY IDELUXE ENDORSEMENT': INITGRA.'_FED T'TECHNOLOGY This endorsernent mod-ifies insurance provided under the foll.owi,nq- COMME..', RC IAL GENERAL LAABELITlY COVERAGE PART It -is understood and agreed Lhat the foil.owinq extensi(:xns only a.pp.J..y in th(.. ver'Lt that no otkier spec-if.j.c coverage for the indicated ioss exposur..'e is provided. undexthis t')oli.Cy. If such spec-i-f-J.-c (:.,.ove2age appi-Les, the terms, condi.t.ions and Iiinits of that cove-r-age are the sole and. exc.].usj..-qe cover -age appii.cab'le undei, thi.s policy, uniess OthO.rWi_se nated on Lhi.s endorseiiient. 'T.'h.e fol.l.ow-inq is as surnmary of thc..,. Lin'�its of in suza.rrce and additional coverage r.,rrovi.(ied by this endo-r-sement,. For complete deta-ils on specific, cove raqes th.e poii.cy conty.act wording. Coverage Appl_icabl.e Lirr,lit Of Page # Damage to Premises Rented to You $a., OC)O, C)OC) Page 2 Expec,ted. or Entended Injury P-roperty Damage I ri cl. u de. d. Page 2 Limited Rental. L,ease Aqi,.eement Cor,�tra.ctua.l Liability $50, 000 Page 2 Non Owned Watercraft Less than 58 feet Page '3 Daynage t.o Property You Own, Rent: or. Oc('.°Llpy $30,000 Page 3 Med_i.ca]. Payments $20, 000 Page 3 All other terms and conditions of this Policy remain unchanged. Page 1 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Medi.cal IIayments CCeport-Lnq Pe.rl-od 3 Yea rs Page 3 ALJn.1..eti.c Amended Page 3 Supp-.Lc,,nerita.a� y Payments BaLl Boar $2, 500 Page 4 Sur,.)],plementa.ry Payments Loss of Earninqs $500 per day PagE. 4 rnp Layee Defense. Cc)verage $25, 000 Page 4 Nho I's An Insured Ernpl.oyees and Volunteer. Workers Good Sarnar.J.Larc Acts, Md..i.ti-onal. Insured. Newly A(,,qul-red or F'onned. Orcjarizriticjn Add.Ltiona.L lnsurc',d Marlagerg and "."upervisors (with Cell ow E�rnj,aIoyee Cover age) Add-itc.ona,l. Insu-ned 1,i,.-o,adened Njarned lnsu-red Add.1 t-i-cma-1. Ensured E31ariket Acid I L.Lona L Tnsu.y.cedes When Requ...red by Contrac:t Add.i..t-lonal. Insured Lessees of Preun.Lses Addl.ti-on.al fnsur-ed Endepend.rent Contractor-s I ncl.uded Pacies 11 to 5 Drat Les J.n the Event of Occurrence,, Off.ense, C.I.a.J.vi or SuLt Included I . lage 6 I ran sf. er of Ri-ghts of Recovery Agai.rcst Others I'o Us C I a.r. J. f. :L.cra t.!.. o z Page G L J, b (,.t r a I., i z as tJ 0 n ] nc Luded Page 6 uni,ntcant ional Failure to Di.sc,Iose Hazay.ds Inc.,-Luded Page 6 All other terms and conditions of this Policy remain unchanged. Page 2 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFU.L Bod�lv Injury Includes Ment-al AIWIU'ish J':.ncluded P'yqe i Per Sona 1. and Adver Lin i nq � i I j ury I nc, Ludr,-< ohuno of P ror-x-,ss, DLscr i Ti'i i nAt i, on uderd P'Aqe / A,, Damage to Preynises Rented to You If darnage by :fire to preen per rented to you is not otherwise ex(-,:1uded Erom this Coverage F..-Iart�: I. T'he Damage To Premises Rented To You L,irnit section of the Declarat.Lons .is amended to the greater of: b. The arnount. shown in the Dec.l.arations as Damage to Premises Rented to Yol..l I.,imit. This is the most we will. pay for all darnage proximately caused by the sarne euent, wfiether such damage results from fire, lightning, explosion, smoke, or leaks Erom automatic Eire protect.i.Ve systems or any comb inat.J_on thereof; 2. 'Me word fire is changed. to fire, lightning, expl.(.,sion, sinok(c:, or leakage front automatic fire prot.ective systems where it appears in. a.. The last paragraph of SEC'PION 1. COVERAGES, COVERAGE A. BOI)IL,Y INJURY AND PROPERTY DAM AGE LIABEL'ITY, Subsection 2. Exclusions; b. SECT [ON II"I !: LIM.LTS OF INSURANCE, Paragraph 6. ; and SFCT1 ON V: DEFINITIONS, Paragrapl�i. 9. a. ; and. 3. The words fire insurance are changed to insi..aran.ce for fire, lightning, exp.J.(-)sJ.on, smok�-,.:, or, leakage from automatic fire protective systems where it appears in SECr J01,j V1, rpy F 1 . . COMMER.ClAL GENERAL LJABI .1 CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insuirance. All other terms and conditions of this Policy remain unchanged. Page 3 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY B . Expected or Intended Enjury Property [)arnage SECTION I: COVEl U: GES, COVERAGE A BODILY ENJURY AND PROPER'IY DAM AGE LEARILITY, 2. Exclus.-Ions, Paragrapl-i. a.. ExpecLed Or. Intended Injury ts deleted in its entir.ety and replaced by the following: a. Expected Or Intended [njury Podily injury or property damage expected or -intended frora rhe standpoint of the insured. Tliis exclusion does not. apE.)I.y to bodily J.n.jUly or, property darriage resulting froni the use of reasonable force to protect person,s or properLy. CLimited. Rental Lease Agreenient Cont.r.actual. Ldabiiity SFCrpION I. COVE: RAGES, COVEI.Z.AGE A. BOI[MLY ENJURY AND PRO'E.JUY DAMAGE 1,1A,BJjjrFY, 2. Exclus.I.Ons, Paragraph. b. Contractual Liabil.l.ty Ls amended. by adding the followijng� Lased on the named insureds r'equest at the time of cla-Lin, we agree to indemnify the nained insured for tlaeir liability assi.rrned in a. contract or agreement regarding the rental. or lease of a prernises on behalf of their cl.ient, up to $50,000. rrhi.s co,,,/er..age extension only app.lies to rental lease agreements and is excess over any renters liabil.ity Lnsurance of the cla.ent. E). NonOwned Watercraft SECq,10N I- COVERAGES, COVERAGE P, BODILY I.NJURY. AND PROPERI'Y DAM AGE IAABILJ.T'Y, 2. Exclus-ions, 9, Aircraft, Auto Or Watercraft, ParagrapIn (2) is amended to read as foliows: (2) A watercraft you do not own that is(a.) Less than 58 feet Long; and (b) Not be.j.nq used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a. waLercr.aft. This LnSU.rance a..s excess over any other val.J.d and collectible Lnsurance availalole to the insured whether. All other terms and conditions of this Policy remain unchanged, Page 4 of 12 PI-MANLI-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY pri.Tnary, excess, or. contingent. E . Darnage to Property You Own, Rent or Occupy SECTION t:�, CO'VERAGES, COVERAGE A BODII,Y IN,JURY AND PROPERTY DAM AGE: 1,1ABILITY, 2. Exclusions, j. Damage To Property, Parag.raph (1) is deleted in .its entirety and rep.Laced with the following� (1) Property you own, rent or occupy, including alny CO3tS or expenses incu.rred by yoti, or any other person, organ.j.zation or.., entity' for. repair, replacement, enhanceriient, restoration or niaintenance of such property for any -reason, JLncluding prevenLion of injury to a pe.rson or damage to anothers property, unless the damage to property is caused by your cl.ient, up to a $30,000 linn i.t. A cal .i.ent is riE fined us a person under your di.rect care and siuperv.i sion F". Medical. Payments I. If COVERAGE C MEDICAL PAYNIENTS is not otherwise excluded froin thi.s Coverage Part:, the Medical. Expense Limit is changed subject. to all. of the tern.is of SECTION H.I. J'IMLrrS OF INSTLIFLANCE to the greater of. a,. $20,000; or b. The Medical Expense 1,-imit shown in the Declaratir,)ns of tti.i.s Crm/erage Part . 2. Under SECTION I. COVERAGES, COVERAGE C MED - ICAL PAYMENTS, Subsection 1. Insuring Agreenient, Paragraph a.,:Ilea". (b) is amended to read.'.: (b) The expenses are Lricur-red and reported to us within three years of the date of the acciderit; and. G. Athletic Activlties SIECI-I-ON 1: COVERAGES, Cr."WERAGE C MEDECAL PAYMENTS, 2. Exciusions, Paragraph. e,, Athletics Activiti.es is deleted. Ln its entirety and re 1.,olac(,-�d with the .f ol. 1. 0 uai r u g All other terms and conditions of this Policy remain unchanged. Page 5 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY (:* . ALhlet'acs AcLM.L-ics To a. person injured while taking loai,.-t i.n athl.et.i.cs. ll. Supp.lemenLary Payments SE,CTlON T. COVERAGES, SUP PLEF[ME'NTARY PAYMENTS: COVERAGES A. AND B, Iterns :lab. and. I.d.a are ainended. as fol.1ows- b. Th.e lArait for the cost of ba.A.A. bonds is changed from. $250 to $2,500; and d.. The IA,.mit for Loss of earnings is ch.anged from $250 a day to $500 as day. :1 . Ernpl.oyee IDdeTnrii.E-icat.i.on Defense Coverage SECrl:,:F.ON 1: COVERAGES, SUPPLEMENTARY PAYMEMTS': COVERAC-3ES A AND B a.s amended to inciude the fo-1.1owing: We wili pay, on your beha1f, defense costs i.ricurred by an empl.oyee in a. cri.xiidnal. proceeding. 'Fhe most we will pay for, any employee who is di.rectLy invol.ved in a crinii-nal. proceeding is $25,000 regardl.ess of the rlUrabers of ernpl.oyees, cl.ai.nis or suits brought or.. persons o r organizat-ions ma.ki.nq c1ai.ais or bri.ng-ing suits. J. Who is An I:nsu.red SECTION u::l:: a WHO IS AN INSURED is amended as follows: 1— Paragraph 2.a,. (1) !.a del.eLed. in its enti.rety and repl.aced wi.th the fol..Lowi.ng. Each of. Lhe fol.-Lowing i.s a1so an insured- s. Your vrol.unteer workers only wh-J.1e performing duties related. to the conduct of your business, or you-r.. empl.oyees, other than either your executi.ve off-J.cers (J.f you are an organizati.on other than a partnership, joint aenture or. IiTnited. Ii.abil.it.y cornpany) or your mana.gers (if you are a. I.A.m.i.ted liabilAty company), but only for acts withi.n the scope of their enqpl.oyanent 1<y you or wh-ile; performing duties -.rel.ated to the conduct of your business. Bowever, none of these einpl..oyees or raol.unteer workers are insureds for. � (1) Bodi1y injury or persona.A. and advertising irajury- All other terms and conditions of this Policy remain unchanged. Page 6 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ypayaitnerhip 3(a) To nrroint VE�'IILUre), to you.r iT.Lernber3 (J.f you are a lirri-ited I.A.a.bility cornparly), to a co employee while in thee cour3e of hi.s or hex. empioyment. o-r pe.rfo.rrning dut-ies related to the conduct of your busa.ness, or.. to your. other volunteer workers wbi.].e perforin.ing dut.l.es related to thEs conduct of your. business; (b) To then spouse, child, pa -rent, brother or s�.ster of that cc) eTTIP.J.oyee or, volunteer worker- as a consequeice ofParagraph (1) (a) above; (c) For which there Ls any ob].J.gatiori. to share daniages wi.th or -repay someone else who must pay darnages because of. the injury desc-ribed -iri Paragraphs (1y (a) or., (b) above; or (d) Ai.ising out of his o-r.. her providing or failing to prov.j.de pr.ofessional. health ca.:r.e ser..'Vj Ces . However: Pax agraphs Q1) (a) and (1) (d) do not. apply to you-Yenq.)Ioyees or vo].unteer. workers, wh.o are not erriployed. by you o.r volunteering for. you as hea".).th care prof ess j. ona.-I s, for toodily irijury ari.s.j.nq o-Lit of Good. Samar.�.tan Acts while the employee or vol.unteer worker. is perfo_rrning duties Y.e_.Iated to the conduct. of your busi.rIaSS, Good Sarnaxi.tan Acts mean any as=..-,istarhce of a rned.-ical nature rendered or. provl.ded Li� an enie-rgency situation for wlaicja no remuneration i.s dernanded or rece-ived. 2. Newly Acquired or.. Formed. Organization If coverage for newly acqu-J..red or forrned organ-iza.ti.ons is riot. otherw_'Lse ex.cluded fromn t h i. s Coverage Part., Paragraph 3.a. Ls aME,Mded to read� a. Cover -age undeT. this provision i.s afforded unt.-I.I. the end of'f the pol.A.cy period; 3. Each of the foll.owing is also an insured: a.,. iAanagens, and Supervisors„ Your inanagers and supervisors are also All other terms and conditions of this Policy remain unchanged, Page 7 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your employees are also insureds for bodily injury to a co employee while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. b. Broadened Named Insured: Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. c. Blanket Additiona:ll. Insureds When Require.d. :by Contract.: Any person or organization where requ..xed by a wr-itten c°ontract executed prior to the occurrence of a loss. Such person or organization is an add::i..t.t.ona7i.. i.nasured for bod.i..]...y injury, property damage or, personal and advertising injury but. only for JJ.ability arising out of the negligence of ttie named .J.-insured. "I'lle I.. imi..ts of insurance applicable to these add.i.t:i.ona:.l.. :insureds are the :I.ews„ eer of the p:o.licy 1...:units or tho se lirnits specified :in a contract ori.. agreement. These 1 .aai>Its are included w..J.thi..n and not in addition to the ltms.f.ts of Lnsuranc.e shown in the Dec :larat.J.ons. d. Lessees of Premises: Any person or organization who leases or rents a part of the premises you own or manage who you are required to add as an additional insured on this policy under a written contract or written agreement, but only with respect to liability arising out of your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or occupancy of such person or organization or any other tenant or lessee. This provision does not apply; (1) To liability arising out of such persons or organizations sole negligence; or All other terms and conditions of this Policy remain unchanged. Page 8of12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY (2) After the person or organization ceases to lease or rent premises from you. e . IndependeriL. ContracLors Any independeriL contractor, but on.Ly wh.J.le acting wi.th.in the scope of a written contract and only With respect to liability arising out. of your products or.. your work. K. Duties in the Event of Oc-cairrence, Offense, Clairn or- Suit 1.. SECq,10N IV: COPIMEPCIAL GENERAL LIABILITY CONIXI.TIONS, 2.a,, the reqUireinenL- that you rnuslt, see to it that we are notified as soon as practicable of an occurrence or an offense, applies only when the occurrence or offense is known to�: a.. YOU, 1.f you are an Lridividual; b. A, partner, if YOU are a. partnersh.ip; or C. An execut.-Lve officei'. or. insuranCe Manager, if YOLY are a. corporation. 2. SECT'ION IV. COI.�IMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to -i..t that we receive mortice of. a claim or suit as soon as practicable w.j.1.1 not be considered breached unless the breach occurs after such claim. or suit is known ter: a. You, if you are an J.ndividual, b. A partner, if you ae:e a. partnershi.p; or C. An executi.,ve officer or.. A.nsurance manager, if you are a corporation. 3, SECTION IV: COMMERCIAL GENERAL, 1 IABIj'Ir.1.1y COND.Irl.IONS, 2. -is amended to include tire fol.lowing additional. Pr.M,7i.si= Your rights under this coverage part will not be prejudiced if you fail to gi.ve us notice of an occurrence, offense, c-1-aicri or- su-it and. that fai.lure is so.Le-Ly due to your reasonable belief. that t1he bod.J.1y injury or property damage is riot covered Under th-.i-s coverage part. However, you sha.1-1 give written notice of this occurrence, offense, cl.aini. or suit to us as soon as All other terms and conditions of this Policy remain unchanged. Page 9 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY you a.-r..e aware tkiat thi.s insurance may appl.y to such occurrenc,,,e, offense claim or suit. L . 111ransfer. of Iight..s of Rec.overy Against. Others To Us SECTFON IVCOMME:RMA.I., GENE'RAI LIABET�F.TY CONDITFONS, Par.aojrar.:rh 8. Transfer Of Rights Of. Recovery Against Others '110 U3 includes th�e fol.lowi.ng c 1. a. ri f i. c a t -1. on : Tl,erefore, the insured can waive the Lnsurers of recovery prior, to the occurrence of a lcosset waiver is made in a written cor, L ract. M. 1,1 bE�ra -I.A. zati on SEX"T.110M ]".V. COMIVIE'RC. EAI., GENERAL, CONDI'FIONS is amc nded. to inchade the following addl.tiontal condition - -Libe-r.. ald. z at J. on Cif we revise this endorsement to provide rnore coverage without additi.onal I.-.)remium, cha-i,.ge, we wl.11 autoniatical-Ly prov.i.de the additi.con a.l. coverage to a.I.A. endorsement holde.r.s as of the day the Y.ev-ision J,s effecti.VC in your state. N. Unintentioj,ral Faiiure To Da dose Ha�r�a.rd.3 SECTI:ON IV, COMMERCPAL, GENERAL, L,IAB EL'UPY GOOD I'17IONS is amended tca include the follow.ing additiona.l. condition- Urd.r)Lentional. Fai..Lure To IDi.sc.Lose. Hazards -It -is agmeed. th.at, based on our rel.iance on your rej,.)resenta.ticans as to existing hazards, j..f you shoulof unintentionally fail to disclo-.;e al.]. such hazards p--rioy. to the beginning of the policy period of this Cove -'rage, Part., we shall. not. deny coverage under thi.s Coverage Pay..t because of such fa-ilure,. 0. Bodily lnjuiy Mental Anqul.sh All other terms and conditions of this Policy remain unchanged. Page 10 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SECTION V: DEFINITI:ONS, Paragraph 3, is amended to readBod.1.1y injur.yo a. Means bodil.y injury, sickness or disease sustained by a. person, and inc-ludes mental. anquish resulting frorn any of these; and }'a. Except for neni al.. anquish, includes deal h resulting frorri the foregoing (Ttem a. above) at any ti.rne. P. Personal and Adverti.sing J.:njury Abuse of Process, Discir..'im.i.nation If COVERAGE B PERSONAL, AND ADVERTISI:NG INJURY LF.ABJ.j'jrj,y COVERAGE is not otherwise excluded from this Coverage Part, the definition of personal. and adverti-sinq injury is a.mended. as foll..ows: 1'. SECTION V, 1E.F'IN:rrY.1IONS, Paragraph. I.A., 1tem b. is revised to read. L) . Ma-L-i-c-ioias prosecution or. abuse of px.ocess; L. SECT.ION V: Paragraph "L/I. is amended to :i.nclude the following - Personal. and advertising in)ury also means discri.mina.t.i.oyi based. on raco, co1or., rel.-igion, sex, age or nationalorigin, except. when: a. Doric, intent-Lonally by or at the direction of, or w-ith the knowledgc or consent of� (1) Any insured; or, (2) Any execuL.J..ve off-icer, director, sLockhoider, partner, or rnember of the insured; or b . D-i.rectly or i.nd.j.rectly re1ated to the erriployment, former or T.,.)rospecti�ve employruent, terMi.nation of erap.l.oyii=t., or appl..-.i.cation for ernpioyment of any person or persons by an Insured, or C E)irectly or indirectly reel .aLed to the ,a ea, rental., 1ea.se or suh1ease or prospective sale, rental., Lease or. sub lease of any roorn, dweiling or prernises by or at the d.irection of any insured; or All other terms and conditions of this Policy remain unchanged. Page 11 of 12 PI-MANU-1 (01/00) d . Insux-once: fo.r such. di.scr-Irrination. is ]p:i,..ohi.b:,.Led by or held in violat.i.on of law, pub.'..Ac Legis.lati.on, court, dec.i.sion or admini..,st-rative ru..I.A.nq . The above does, not apply to fines or pperalties J,Tqposed because of.. All other terms and conditions of this Policy remain unchanged. Page 12 of 12 0 DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 01/21/2021 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 Andrew Safe NAME: The Evans Agency, LLC Ao Nr 6ret (716) 549 3500 FA Nd (716) 926-8690 .... APD. 6460 Main Street ADDRE55: asafe@evansagencyins.com ........... Suite 200 INSURER(S) AFFORDING COVERAGE NAIL # ........ ...... Williamsville NY 14221 INSURERA.. Philadelphia Indemnity Ins Co INSURED INSURER B ............... Buffalo Computer Graphics Inc INSURER C 4185 Bayview Rd INSURER D INSURER E Blasdell NY 14219 INSURER F : COVERAGES CERTIFICATE NUMBER: Cyber 2020-21 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. ............._....._.ADDL SUM POLI ..._.._....... TNSR TYPE OF INSURANCE POLICY NUMBER MMIDCY EFF POLICY EXP LTR INSD yyy ,_, ,, D/YYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S �... .. Fa T"9 ...... A � CLAIMS -MADE OCCUR PREMISES I � „_, .. MED EXP (Any one person) S A PHSD1587332 11/01/2020 11/01/2021 PERSONAL & ADV INJURY $ .... GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE ! $ 6,000,000 ..._ �— POLICY ,IEC'- LOC PRODUCTS - COMPIOP AGG $ Pray OTHER, Per Claim $ 2,000,000 ......... _ __ ......... _. AUTOMOBILE LIABILITY CO'1ui89hdE,0."rlhtOl.E LgtGIT $ Ew atcrstalwtl ANYAUTO BODILY INJURY (Per person) $ mm.................. .. OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTYDANIAG.F S .. AUTOS ONLY AUTOS ONLY ...''! ° 'I�r!'entN .-.m.••••• $ ......_ ............. ........_-.... UMBRELLA LIAB JOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE S DIED I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE r_1 NIA EL EACHACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT_J . .. .. .. $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, may be if more s ..... ...... .. ( y pace is required) Cyber policy includes Network Security & Privacy Liability Coverage in the same amount as the per claim and aggregate limits shown above ($2M/$6M). ,� HOLDER City of El Segundo 350 Main Street 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 ElSegundo CA 90245 I^ K @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD