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PROOF OF INSURANCE (2023) CLOSEDI"1 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD(YYYY) 06/14/2022 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). IPROI DN.UC'IER CONTACT tJAR H USA INC NAME' _ P'lIoNE... FAX 105000NNF..Ctf CUI AVE.NUI: SUIF1: M0 W.C..C�.�a,P0 WAS[ INCZION DC 20036 5386 E-MAIL — — Attn: C S S 'i E E Pi IONF 202 263 7600 ADDRESS--- 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 OFINSURANCEADDL'SUBR POLICY NUMBER.....MM/OD/YEYYY MMIDD/YVYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLA 8604610 - 00 04/30/2022 04/30/2023 '. EACH OCCURRENCE S 1,000,000 ........ _ X ..fJAIwUAOE f(y 6UEhIiEO. 1,000,000 CLAIMS -MADE OCCUR PFCLDJIISE p,(Eil uriylraenr,r,IJ $ _ , MED EXP (Any one person) S 11 _ 10, 6ci PERSONAL&ADV INJURY $ 1,000,00 GENL AGGREGATE LIMIT APPLIES PER: ', GENERAL AGGREGATE S 2,000,000 . ,..., POLICY PRO- X LOC � '�, � ,,..,,,.. JEC7 ...... PRODUCTS - COMPIOP AGO $ ....... 2,000,000 OIHERl $ B AUTOMOBILE LIABILITY `GLA 8604610 - 0,0 W10r2022 04(30/2.023 COMBINED SINGLE LIPAIT S 100O„00o X ANY AUTO BODILY INJURY (Per person) $ . OWNED SCHEDULED BODILY INJURY (Per accident) S ..................... AUTOS ONLY ,_ AUTOS ,., .. HIRED .. NON -OWNED PPdtiMff F`.I'?'6 Y' cw4GE ... S AUTOS ONLY ,.... AUTOS ONLY _(Par tcvgk9fllp) '.. X UMBRELLALIAB X...O000R ALICO20547401-00 04/30/2022 04/30/2023 EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ .5 0(10,000 DFD RETENTION B WORKERS COMPENSATION WC8604611-00 P (. Pf...l.... 04/30/2.023 j X PER o,r'H AND EMPLOYERS LIABILITY ,aTATUTE , ER _ ANt"PRia9 RIRYCp4S'a"�AFiTN«.F'EYO'NLi0�9'fiS^nl" . " E L EACH ACCIDENT 5 1 CI00,000 OFrIrFROMEI RE REXr,:I.r��d.) D ] NIA ,,.. ,,,,,,„m . _ .... 1,00C,00f .._ 1,Maridaharyr In NH) "' E.L. DISEASE- EA EMPLOYEE S -,. II v w5 dk:�wltR'ti �rdpr -... u ,. OiPO,(00 Cl`Sfi6PlPFION OF QNP(,RAT'UONS below E L DI EASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) THE CITY, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS IStARE INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT WITH RESPECTS TO GENERAL AND AUTO LIABILITY, WAIVER OF SUBROGATION IS APPLICABLE WHERE REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS WITH RESPECT TO WORKER'S COMPENSATION AND GENERAL LIABILITY. L,rKI Ir I1.:Al', 11ULUr—K t. RFNL r_LL#kI IU1Y CI rY CLERK'S OFF ICE CITY OF EL SI::.GUNDO 350 MAIN S F EL SF..GUNDO, 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 i/-irlZ.¢e2 'ZI-151,1c © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLA 8604610 - 00 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED IIINSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: �...... . - --- Navient Corp .... .... ................... �...... Endorsement Effective Date: 04/30/2022 SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization to whom or which you are required to provide additional insured status or additional insured status on a primary, non-contributory basis, in a written contract or written agreement executed prior to loss, except where such contract or agreement is prohibited by law. Name Of Person(s) Or Organization(s): SANDAG C/O: MYCOI Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) 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 anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 04/30/2022 Policy No. WC 8604611 - 00 Endorsement No. Insured Navient Corp Premium $ Insurance Company American Guarantee and Liability Insurance Company Countersigned by .......................................................................................... m.,. ,m...........,.. WC124 (4-84) Copyright 1983 National Council on Compensation Insurance. Inc. 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