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PROOF OF INSURANCE (2022) CLOSED
, i CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/16/2021 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). ER CONTACT 1166 Avenue of the Americas PH N� 1) 3 -8538 cla PRooucMarsh USA, Inc. NAME Thomas 2) 345 8538 PHDNE � 2 .... ... .. New York, NY 10036 E-MAIL .Q. Thomas. Laquercia@marsh.com CN 102238245-DN G-GAU-21-22 INSURED--- Digital Networks Group, Inc. Avidex Industries, LLC 20382 Hermana Circle Lake Forest, CA 92630 INSURER D : PnVFRAnFC CFRTIFICATF NIIMRFR- NYC-010999870-03 REVISION NUMBER: 2 10945 ___ _----......... N/A 20362 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. ..... — IN � ......,.,. ADDLr�SIJ�ii:. ........................ �� MMF tC� i MM bb MEV ..,. TYPE OF INSURANCE POLICY NUMBER " M LIMITS A I X COMMERCIAL GENERAL LIABILITY CLL6403455-11 06/30/2021 06/30/2022 EACH OCCURRENCE $ 1 000 000 ) X ....... ' L�AMAE I �SEra°tEtR .. 1,000,000 E ,OCCUR -MAD... F,'FtCMIy�E(�S oG''4rrgtrtEa) $ MED EXP (Any one person) $ 5,000 .._...CLAIMS ... .. ................. _ ..__ & ADV INJU RY $ .......__ - 1 000 000 .............�........................................................---._._._............... __. GEN'L AGGREGATE LIMIT APPLIES PER: .PERSONAL .. GENERAL AGGREGATE $ 2,0�00,000 X 1:1PRO- POLICY I LOC CO MP/OPAGG - - 1,000,000 .-. .... , �..$.._,,......___ OTHERa ' C A AUTOMOBILE BVR8407292 OB/30/2021 06/30/2022 COMSINEDSINGLE LIMIT �:�c�depn �_BODILY $ 1,000,000 ANY AUTO INJURY (Per person) $ OWNED SCHEDULEDad BODILY INJURY (Per accident) I $ � AUTOS ONLY X HIRED X NON -OWNED PROPERTY ��ll"�AMAGE $ �...._,__ ,........� AUTOS ONLY AUTOS ONLY P�av a�.�:rdearu..).µ._ ......, ... ._--- -....... X UMBRELLA LIAB X OCCUR CU6406757-08 06/30/2021 06/30/2022 _Is __..................... 5,000,000 ..... EXCESS LIARAGGREGATE _..........- � CLAIM MAD..... �EAgHI.00CURRENCE .. ................. ._,.,_..__ _. _ Is 5,000,000E .......,.,......... DED RETENTION $ '... $ WORKERS COMPENSATION PER STATUTE I ORH d AND EMPLOYERS' LIABILITY ANYPROPFiIETOFWARTNCR,iEXECUI'IVE Y"�" Airy ,, E.L, EACH ACCIDENT i S OFFICCWMfMBEREXCLU1 (Mandatory in NH) N /A _ .... E L. DISEASE DISEEA EMPLOYEE $ it CRIPTI'ON OF OPERATIONS below 0 as, E.L.DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of El Segundo, its officials, and employees are included as additional insured where required by written contract This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions. C K fIFIUA I b HULL 1 K VAIVI:tLLA I IUN City of El Segundo 350 Main Street El Segundo, CA 90245 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 of Marsh USA Inc. Mina Cho @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AN I ONCONTRI BUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 Insured Copy POLICY NUMBER: CLL6403455-11 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following, - COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered O rations ANY PERSON OR ANY LOCATION IN CONNECTION ORGANIZATION WHEN YOU AND WITH A WRITTEN CONTRACT OR SUCH PERSON(S) OR ORGANIZATION AGREEMENT EXECUTED WITH THE (S) HAVE AGREED IN WRITING IN ADDITIONAL INSURED SHOWN IN A CONTRACT OR AGREEMENT®WHICH THE SCHEDULE. WAS EXECUTED PRIOR TO THE TIME 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: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. 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. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 Insured Copy POLICY NUMBER: CLL6403455-11 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Oroanizabon(s) "BLANKET" ENDORSEMENT AS FOLL FOLLOWS: ANY PERSON OR ORGANIZATION AND SUCH PERSON(S)OR ORGANIZATION CONTRACTI ► WAS EXECUTED PRIOR TO THE TIME SCHEDULE Location And Description Of Completed Opei ANY LOCATION DESCRIBED IN THE CONTRACT OR AGREEMENT 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the 'products -completed operations hazard". 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. CG 20 37 0413 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 Page 1 of 1 Insured Copy `� DATE (MMIDD/YYYY) ?" CERTIFICATE OF LIABILITY INSURANCE 6/30/2021 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 NAME: Lori Staples Arthur J. Gallagher Risk Management Services, Inc. PHONE 336-217-5767 F 336 27-1776 4700 Homewood Court, Suite 260 g - L )....... IL Raleigh NC 27609-5732oE-MAs Ltrl_aa les a' .corn — .........................__INSURERS AFFORDING COVE .. .... ............ .....RAGE .....__� NAIC# -- INSURER A: Hartford Fire Insurance Company --- 19682 __..., ... ............. INSURED __ _ TELELEA-01 INSURE.. RB rtY Mutual Flre Insurance Company 23035 Digitalp, Inc. A ndustreSGrou INSURE Rc 20382 Hermana Clr. IN$URERD Lake Forest CA 92630 INSURER E „ _ INSURER F f'AVCDArCC CPI2TIPIrATF All IMRFR• 1QR5dFQA17 REVISION NUMRFR- 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. AOD-R..IiBR POLICY EF"F PO-- "...---w LILY EXP ILTR TYPE OF INSURANCE...,..... ---�_, .,. .)wvn ..... .. POLICY NUMBER. I,. MIDD..,,, hMM/DD/YYYY ---- LIMITS............ ......... ---- ( COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR ,..PIfiNI(Sr5 rcal $ ,,...... ......... 4ia occ;ua r —�� MED EXP (Any one person) $ ---- ... ....... ...__ --__ - .... ... PERSONAL &ADVINJURY $ _ 6 GEN'L AGGREGATE LIMIT APPLIES PER: � _. GENERAL �$ _ _ POLICY SET LOC PRODUCTS COMP/OP AGG $ -_ ... CaT1�aER:. � AUTOMOBILE LIABILITY COMB IN ED . INIG9 r L I M IT I'r a acckae-n0 .. ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED ( adept) BODILY INJURY Per accident) $ AUTOS ONLY „AUTOS HIRED NON -OWNED -..._ �_ PdiOP6RTY OAMACE .... AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAR (.—.� CCUR URENCE .. „�.........._ .., ...,.. �............... L EXCESSI CLAIMS -MADE C AGGREGA � .....,- 1 I ..O........... ....1 DED RETENTION $ - $ B WORKERS COMPENSATION Y WC2Z51288604021 6/30/2021 613012122 PER STATU OTH �� ER AND EMPLOYERS' LIABILITY Y / N ANYPROTE OFFICE PRIET RIPART ER/E ER ❑ NIA CCIDENT — �$1 000 000 (Mandatory ' ) DISEASE EA EMPLOYE_E_ $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS beloW , E L DISEASE -POLICY LIMIT1,000,000 A Professional Liability 22TE029939421 6/3112121 6/30/2022 Technology E&O $5,000,000 Excess Professional Liability Aggregate $5,000,000 Retention $100,000 ea claim DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Excess Professional Liability Policy # MKLV2XE0000071 Policy term. Eft Date.613012021 Exp Date:6/3012022 Carrier. Evanston Insurance Company ,NAIC#3537'8 Limit=$5,000,000 %9regate=$5„000,000 El its elver of subrogation under the workers compensation is applicable in favor of the Clty of Segundo and officers,, officials, employees, agents, representatives, and certified volunteers per WC form 04 03 06. The producer will endeavor to mall 30 days written notice to the certificate holder named on the See .Attached — a" OM iCld+A."YC U^1 nCo I`Amrm I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo 350 Main Street El Segundo CA 90245 AUTHOR OREPRfES NTA1'IVE U 1W118-2U15 AGUKU GUKYUKA I IUN. All rlgmS reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: TELELEA-01 AIIIIITWINAI REMARKS SC_HFI ill F Paae 1 of 1 AGENCY NAMEDINSURED Arthur J. Gallagher Risk Management Services, Inc. Digital Networks Group, Inc. _.................................................................. Avidex Industries, LLC POLICY NUMBER 20382 Hermana Cir. Lake Forest CA 92630 CARRIER NAIC CODE E...... _..... ........................................................................................................................................ EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ............................................................. _...�._.. _........... �......... certificate if any policy iisted on the certlflcate is cancelled prior to the expiration date. Failure to do so shall impose no obligation or liability of any kind upon the Producer or otherwise after the policy term. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $250 per policy Person or Organization Job Description Where required by contract or Any written agreement prior to loss and allowed by law. Issued by Liberty Mutual Fire Insurance Company 16586 For attachment to Policy No. WC2-Z51-288604-021 Effective Date Premium $ Issued to Telerent Leasing Corporation Endorsement No. and Avidex Industries Inc WC 04 03 06 R1 Page 1 of 1 Ed. 08/01 /2013