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PROOF OF INSURANCE (2022) CLOSEDPage 1 of 1 DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE l0/13/2021 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 ME. T Willis Towers Watson Certificate Center NAME: _ Willis Towers Watson Northeast, Inc. "" .. PAX C/o 26 Century Blvd �P,�xSa 1 877 945 7378 No) 1-888-467-2378 E-MAIL certificates@willis Com P.O. Box 305191 A4pDREy,,,$ ,, ,....®... Nashville, TN 372305191 USA INSURERS AFFORDINGCOVERAGE NAICp .... ,,.., ,,,L.,�............... ---- ------ INSURERA: Citizens Insurance Company of America 31534 INSURED „ ,,,,, ,m _._.._.. .-.-.......- INSURER8: Hanover Insurance,,,,,,,,,,,,,,,,,,,,,, ,. ............................................ , ................ ........ Company 22292 Singlewire Software LLC ,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,, ,,,,m. ............,. .....- . 1002 Deming Way INSURER C---------------------------- Madison, WI 53717 INSURERD: INSURER F : COVFRAGFS CERTIFICATE NUMBER: W22454775 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. %..—e,....... TYPE OF INSURANCE......... ADDL'S�d ... POLICY EXP .. � POLICY IEFP POL ihSk POLICY NUMBER 1 OIYYYY� MWI DIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY j EACH OCCURRENCE Is 1,000,00o ...,. L ....� CLAIMS -MADE X OCCUR j . I - ....... ....................... : CAiVYAC� iil 4iENYC� ... f PREMISE,$ (,Ea occurrerace) , $ ., „.e.. .... ..... -.....-100, 000 .. A L......, j ( MED EXP (Any one person} I,,,,,, 10 000 ... .., ... I ZBY H556455-00 03/31/2021j03/31/2022 ;pER50NAL8ADVINJURY I$ ,,,,,,,,,, 1,000,000 L GEN AGGREGATE LIMIT APPLIES PER: I I AGGREGATE $ 2 , 000,000 I %� F J -i POLICY EC,'6 LOC EC .GENERAL .. , ,,,,,,,„ „ ....... . . --- PRODUCTS-COMP/OP AGG - 2,000 000 OTHER; I IS AUTOMOBILE LIABILITY € COMBINE,tin9G D $1NL,LE fl.IMII 1 $ IE.a cccvtl...... ....... .. 1,000,000 ..,. ANY AUTO = BODILY INJURY (Per person) $ A OWNED SCHEDULED ZBY H556455-00 103/31/2021I03/31/2022 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS ;... ,... ---- ... HIRED N X X i DAMAGE $ ,, ONLY AUTOS ONLY AUTOS ONLY 1 y AUTOS (ROPERTY „Per accident) -„-. ----------------- $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB ,CLAIMS MADE UHY H556471-00-03/31/2021,03/31/2022AGGREGATE 10,000,000 DED ....X 1 RETENTION $ 0 s WORKERS COMPENSATION 1 PER O7FI I STATUTE AND EMPLOYERS' LIABILITY YIN ACCIDENT ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA I I E L EACH $ -- - - (Mandatory in NH) If describe E L DISEASE EA EMPLOYEE $ es, under DI ESCRIPTION OF OPERATIONS below t EL DISEASE - POLICY LIMIT $ f DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) 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. City of El Segundo AUTHORIZED REPRESENTATIVE 350 Main Street El Segundo, CA 90245 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 21695048 saxCH: 2269710 ► DATE (MMIDD/YYYY) A4C4C>RJ�EVIDENCE OF COMMERCIAL PROPERTY INSURANCE 1D/13/2D21 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCERNAME, PHONE _ 534 CONTACT PERSON AND ADDRESS el.. Ioywnq�d"-Fi77-,d 5-�37 COMPANY NAME AND ADDRESS NAIC N0:31 Willis Towers Watson Northeast, Inc, Citizens Insurance Company of America c/o 26 Century Blvd 645 West Grand River Avenue P.O. Box 305191 Howell, MI 48843 Nashville, TN 372305191 USA �C NCI 1-888-467-2378 ADDRESScertificates@willis.com CODE: SUB CODE: NAMED INSURED AND ADDRESS Singlewire Software LLC 1002 Deming Way Madison. WI 53717 ADDITIONAL NAMED INSURED(S) IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH POLICY TYPE Commercial Property LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE 03/31/2021 03/31/2022 THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER ZBY H556455-00 CONTINUED UNTIL TERMINATED IF CHECKED (PROPERTY INFORMATION ACORD 101 may be attached if more space is required) ❑ BUILDING OR 0 BUSINESS PERSONAL PROPERTY LOCATION I DESCRIPTION 1) 1002 Deming Way, Madison WI 53717 2) 5515 Nobel Dr, Fitchburg WI 53711 -_._........_._.................................................................................................._.......... 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERIL 'INSURED I BASIC BROAD I X SPECIAL COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ $2, 910, 000 DED: $5,000 TESNO ._...._..�.............................. NIA... ....................................... ......... ❑x BUSINESS INCOME ❑ RENTAL VALUE X If YES, LIMIT: $4, 500, 000 Actual Loss Sustained; # of months.mmmmmmmmmmm BLANKET COVERAGE _................_.........................................._......... ...._.... X If YES, indicate value(s) reported on property identified above: $ TERRORISM COVERAGE X Attach Disclosure Notice / DEC IS THERE A TERRORISM -SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X ............... .,.,.,.,..................... LIMITED FUNGUS COVERAGE X If YES, LIMIT: INCLUDED DED: $5, 000 FUNGUS EXCLUSION (If "YES", specify organization's form used) .........................................._.._..__.._______ .............._...........____.. .. X REPLACEMENT COST X AGREED VALUE X .................................. ....................................�........... COINSURANCE .--..._ X If YES 100 % ... ..(..a-PP.................................................................................................. EQUIPMENT BREAKDOWN (IfApplicable) _..............._ X ..._.... __........_.�......... If YES, LIMIT: INCLUDED DED: $5,000 ORDINANCE ............._. ......... . ..................................................................... ... OR LAW - Coverage for loss to undamaged portion of bldg X If YES, LIMIT: INCLUDED DED: $5,000 Demolition Costs ................._...... X ._ If YES, LIMIT: INCLUDED DED: $5,000 Incr. Cost of Construction............._.......-............................... X.. ............. . _........................................... �f...............L.�l.............__..____..____........_ w YES, T: INCLUDED DED: $5,000 ......-_.......-_._...........a..................w. EARTH MOVEMENT (If Applicable) -)( LIMIT: $1,000,000 DED: $25,000 If YES, LIMIT: ----- ..---- ------- ........................... FLOOD (IfApplicable) x..... If YES, LIMIT: $1 000,000 DED:$25,000 WIND /HAIL INCL ❑x YES ❑ NO Subject to Different Provisions: X 000 If YES, LIMIT: DED:$5,000 NAMED STORM INCL x❑ YES ❑ NO Subject to Different Provisions: X _.............. ............-.............................................................. ..._._............................................. .. If YES, LIMIT: DED: $5,000 PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE --------------...-..------....--..._................................................................................................_____.--. _. .... . HOLDER PRIOR TO LOSS X 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. ADDITIONAL INTEREST MORTGAGEE GEECT OF SALEmmmmmmmmmm .......1 LEN DERTyS LOSS PAYABLE �....... mmLOSS PAYEE I LENDER SERVICING AGENT NAME AND ADDRESS NAME AND ADDRESS {ll u 11 City of El Segundo AUTHORIZED REPRESENTATIVE 350 Main Street El Segundo, CA 90245 © 2003-2015 ACORD CORPORATION. All rights reserved. ACORD 28 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 21695048 BATCH: 2269710 CERT: W22454776 AGENCY CUSTOMER ID: LOC #: Ate" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc.. Singlewire Software LLC .s Watson .o _...,.�..,...,..... �...�..�..................�........,......................_................................. 1002 Deming Way POLICY NUMBER Madison, WI 53717 '.See Page 1 I.-CARRIER...................................................................................................................�.................. 1.NAIC CODE........ µ See Page 1 See Page 1EFFECTIVE DATE: µSee Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 28 FORM TITLE: Evidence of Commercial LOCATIONS/DESCRIPTION OF PROPERTY: 3) 5 Thompson St, S Burlington VT 05403 BLANKET EARTH MOVEMENT 1002 Deming Way, Madison WI 53717 5515 Nobel Dr, Fitchburg WI 53711 35 Thompson St, S Burlington VT 05403 BLANKET FLOOD 1002 Deming Way, Madison WI 53717 5515 Nobel Dr, Fitchburg WI 53711 35 Thompson St, S Burlington VT 05403 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 2169504E BATCH: 2269710 CERT: W22454776