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PROOF OF INSURANCE (2022) CLOSED
Page 1 of 2 DATE (MMJDDIYYYY) L CERTIFICATE OF LIABILITY INSURANCE _� 12/14/2021 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 ri hts to the certificate holder in lieu of such endorsement(s). 1877-945-737g Certificate Center Willis Towers Watson Northeast, Inc. CONTACT PHONE n PRODUCER N ACT Willis Towers Watson c/o 26 Century Blvd A �xt1 — C Not 1 888-467 2373 E'MiAIL certificatea P.O. Box 305191 E'��+xllire com Nashville, TN 372305191 USA INSURERIS' AFFORDING COVERAGE NAIC k INSURERA: Travelers Property Casualty Company of Amel 25674 INSURED ....__ _. INSURER B k Fire Insurance Company Charteerd 25615 y. g g Velocit EHS Holdin s, Inc. (fka MSDsonline Holdings, Inc) a.._._.. 222 W Merchandise Hart Plaza, Suite 1750 Insurance INSURER C e Company 69019 Chicago, IL 60654 _. w--- ....... INSURER"D: ..... .... INSURER.E.:.. ..... ..w. , _,............ _- --------- _... ... ...... INSURER F : COVERAGES CERTIFICATE NUMBER: W23078666 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. ILIA ,„ TYPE OF INSURANCE _ADDLSd)o W POLICY _ ,.,... PCLII EIPF MMLICYE)(P ,_ !DDlYYYY LIMITS X , COMMERCIALGENERALLIABILITY EACHOCCURRENCE $ 1,000,000, X �A U I 1 000 D00 CLAIMS -MADE OCCUR 9 PRE"491�,$EA 9qt� u9r a¢,0_ $ _ A MED EXP (Any one person) # $ 10,000 ZLP-61N21996 112/12/2021 12/12/2022�PERSONAL&ADVINJURY 1,000,000 isLN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ .,,. w...., 2,000,000, TaR7• POLICY X LOC «9EOT -.a PRODUCTS - COMP/OP AGG $ � 2,000,000 OT'HEW $ AUTOMOBILE LIABILITY =1BINED SINGLE WIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED BA-3P725340 12/12/2021 12/12/2022 BODILY INJURY (Per accident) $ X < AUTOS ONLYAUTOS HIRED X s mmX NON -OWNED ROPE �p%CPLRT� D�it(AGE � $ AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB �. OCCURRENCE ... s uAe CC EXCEsIT. FUCC�S-NIADE� � ,,_,... "AGGREGATE { DED RETENTIONS S WORKERS COMPENSATION X f I O AND PL ITY YIN iTATAC ER,_„ 1 , ,, _ " C . ANyyYPROPRIETORIPARTNEFUEXECUTIVE YPR IETORI ARTN N ! A K. E.L.E EACH ACCIDENT ($ '12/12/2022 t 1,000,000 FFIC P M EMBER EXCLUDED? UB-3P717604 (Mandary In 12/12/2021 ONNunder DESCR OF OPERATIONS below E L DISEASE •POLICY UM LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS! LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Named Insured includes: VelocityEHS Holdings, Inc. MSDSonline, Inc. (dba VelocityEHS) Humantech, Inc. City, its officials, and employees are included as Additional Insureds as respects to General Liability and Auto 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, Room 5 r- E1 Segundo, CA 90245-3813 L 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR In: 21933726 BArcx: 2339922 2 of 4 2959 AGENCY CUSTOMER ID: LOC #: ACCORL> ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMED INSURED Willis Towers Watson'Wortheast, Inc, VelocityEHS Holdings, Inc. (fka MSDSonline Holdings, Inc) 222 W Merchandise Mart Plaza, Suite 1750 POLICY NUMBER Chicago, IL 60654 See Page 1 CARRIER NAIL CODE See Page 1 See Page 1 EFFECTIVEDATE: See page""I ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORq SR ID: 21933726 BATCH:2339922 CERT: W23078666 Policy no. ZLP-61 N21996 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. (Includes Products -Completed Operations It Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional Insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III - Limits Of Insurance. b. The insurance provided to such additional insured does not apply to: (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architec- tural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifica- tions; and (b) Supervisory, inspection, architec- tural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and W The nature and location of any injury or damage arising out of the "occurrence" or offense. (2) If a claim is made or "suit" is brought against the additional insured: (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive CG D2 46 04 19 O 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 3 of 4 2959 COMMERCIAL GENERAL LIABILITY written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV - Commercial General Liability Conditions. Page 2 of 2 ® 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 TRAVELERV WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORCa CT 06183 ENDORSEMENT WC 00 03 13 (00) - 001 POLICY NUMBER: UB-3P717604 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. ST ASSIGN: PAGE 1 OF 1 4 of 4 2959