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PROOF OF INSURANCE (2022) CLOSED
Page 1 of 2 ACaRV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY 06/ 29/2021 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 Willis Towers Watson Northeast, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT Willis Towers Watson Certificate Center NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 A/C No Ext : A/C, No : E-MAIL ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURERA: ACE American Insurance Company 22667 INSURED Pitney Bowes Inc. Attn: Susan Ciliberti INSURERB: Commerce & Industry Insurance Company 19410 INSURERC: Indemnity Insurance Company of North Ameri 43575 INSURERD: ACE Fire Underwriters Insurance Company 20702 3001 Summer Street Stamford, CT 06926 National Fire & Marine Insurance Company INSURER E : P y 20079 INSURER F : COVERAGES CERTIFICATE NUMBER: W21417093 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 A PERSONAL & ADV INJURY $ 2,000,000 HDO G72491075 07/01/2021 07/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY D PRO- JECT LOC x PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 x BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS ISA H25550511 07/01/2021 07/01/2022 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY B x UMBRELLALIAB x OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE 66323214 07/01/2021 07/01/2022 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICE R/M EMBER EXCLUDED? No (Mandatory in NH) N/A WLRC C67814630 07/01/2021 07/01/2022 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 2,000,000 $ A Workers Compensation and WLR C67814678 07/01/2021 07/01/2022 E.L. Each Accident $2,000,000 Employers' Liability E.L. Disease -Ea Emp. $2,000,000 Per Statute E.L. Disease Policy $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) BPN 0015327128 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. AUTHORIZED REPRESENTATIVE CITY OF EL SEGUNDO LIBRARY 111 W MARIPOSA AVE EL SEGUNDO, CA 90245-2201 © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SR ID: 21274504 BATCH: 2147879 AGENCY CUSTOMER ID: LOC #: vino® ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc. Pitney Bowes Inc. Attn: Susan Ciliberti POLICY NUMBER 3001 Summer Street See Pa— 1 Stamford. CT 06926 CARRIER See Page 1 ADDITIONAL REMARKS NAIC CODE See Page 11 EFFECTIVE DATE: See Page 1 Page 2 Of 2 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company NAIC#: 20702 POLICY NUMBER: SCF C6781471A EFF DATE: 07/01/2021 EXP DATE: 07/01/2022 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation and E.L. Each Accident $2,000,000 Employers' Liability E.L. Disease -Ea Emp. $2,000,000 Per Statute E.L. Disease Policy $2,000,000 INSURER AFFORDING COVERAGE: National Fire & Marine Insurance Company NAIC#: 20079 POLICY NUMBER: 42-XSF-316064-01 EFF DATE: 07/01/2021 EXP DATE: 07/01/2022 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Business Auto Limit: $lM xs $2M ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 21274504 BATCH: 2147879 CERT: W21417093