No preview available
PROOF OF INSURANCE (2023) CLOSED1___"`1Ili 10 =(MMIDDIYYYY) ACC31IR" CERTIFICATE OF LIABILITY INSURANCE�" 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). PRODUCER CONTACT NAME Direct All Inquiries to Email Arthur J. Gallagher Risk Management Services, Inc, PHONE FFUt 300 S. Rivcrsidc Plaza, Suite 1500 (A/C, No, Ext): (AVC„ No): E-MAIL Chicago IL 60606 App s , t.hl.Ce111fl gtes4jg com INSURER,(S) AFFORDING COVERAGE NAIC # INSURERA Arch Insurance Company 11150 INSURED ARTHJGA113 INSURERB an Arch Indemnit Insurance Comp y 3 0 830 Gallagher Benefit Services, Inc. Koff & Associates INSURER C Continental American Insurance Company 71730 2835 Seventh Street INSURERD: 1 ®,.,.. �........................... .,....... ,.,.,, Berkeley CA 94710 INSURERS INSURER F COVERAGES CERTIFICATE NUMBER:880826096 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. a , �., , �, ILT R : TYPE OF INSURANCE ltm , WQR POLICY NUMBER MMIDDY/YYYY MMIDDfYYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY Y Y 41GPP4938415 10/1/2022 10/1/2023 EACH OCCURRENCE $2,000,000 CLAIMS -MADE _ OCCUR R qC NCI gT � ' I PREMIS,��,.(Ea,ocgence)p, $1 000 000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY s2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER. '.. '.. '.. GENERAL AGGREGATE $ 4 000,000 !. POLICY D PT RU X LOC PRODUCTS COMP/OP AGG $ 4 000 000 EC 1 = OTHER: A AUTOMOBILE LIABILITY Y 41CAB4938315 10/1/2022 10/1/2023 COMBINED SINGLE LIMIT $5000000 A N""""` - 41CAB4939015 10/1/2022 10/1/2023 RLa c'r `. .......... .... ." X ANY AUTO BODILY INJURY (Per person) $ _.._.. OWNED SCHEDULED ,....,, .., AUTOS ONLY AUTOS BODILY INJURY (Per accident) $. X HIRED X NON -OWNED „ PROPERTYDAMAGE,_. $ { Per accident) AUTOS ONLY o„ AUTOS ONLY C X UMBRELLA LIAB X OCCUR 7034611269 10/1/2022 10/1/2023 EACH OCCURRENCE $ 10,000,000 EXCESS LAB CLAIMS -MADE AGGREGATE $ 10,000,000 DED ....X RETENTION $ $ A WORKERS COMPENSATION Y 41WCI4938115 10/1/2022 10/1/2023 ,X 1 PER OTH- - B AND EMPLOYERS' LIABILITY YIN i € 44WCI0501915 10/1/2022 10/1/2023 STATUTE ®,„, ER ANYPROPRIETOR/PARTNER/EXECUTIVE P""i;,"""'C N / A . E L EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED? I� I� (Mandatory in NH) EL DISEASE - EA EMPLOYEE $ 1,000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000„000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) General Liability: General Aggregate Per Location Subject to $10 Mil Policy aggregate. Cityy' of El Segundo, its officers, officials, employees & volunteers are Additional Insureds as respects General liability policy pursuant to and subject to the policy's terms, definitions conditions and eXCIUsions. The insurance provided in the General Liability is primary and any other' Insurance shalt be excess only, and not contributing. Waiver of Subrogation applies to additional insureds, as respects General (Liability, Autol t�uabilityand Workers Compensation policies pursuant to and subject to the policy's terms, definitions, conditions and exclusions. 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 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ,... DATE (MMIDD/YYYY) AC" CERTIFICATE OF LIABILITY INSURANCE �- 9/20/2022 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). PRODUCER CONTACT NAME Arthur J. Gallagher Risk Management Services, Inc. PHONE " rX 300 S. Riverside Plaza, Suite 1500 {rr,,Ity„t) 312 704 0100 (Afc Nn). 312-803 7443 ® ----- E-MAIL Chicago IL 60606 AuxrrE'ss„ INSURED Arthur J. Gallagher & Co. and its subsidiaries 2850 West Golf Road Rolling Meadows, IL 60008 Itt INSURER D : INSURER E: CAVFRAnFS CFRTIFICATF NIIMRER-A4RASI`141R REVISION NUMBER - NAIC # 19437 37885 15792 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. ., .. ....... ..... ADDLµS'418R . .... L.. INSR ..TYPE �.„„.„„ .„„.„„ LTR OF INSURANCE POLICY NUMBER MMfDD8YP6LiCVYYY MNM1DDY/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE '.. $ UNAd"LAY kL1J L im„„n i CLAIMS -MADE OCCUR PRFMISES,fEaQggj rcnce) , MED EXP (Any one person) S PERSONAL & ADV INJURY '.. $ GEN'L AGGREGATE LIMIT APPLIES PER: '.. GENERAL AGGREGATE '.. S J POLICY I I ,IECT LOG PRODUCTS ,COMPIOP AGG `& OTHER: $ AUTOMOBILE LIABILITY ... COMBINED SINGLE. UMIr $.... OttA10cci m,,,Po .............. '... ANY AUTO '.. BODILY INJURY (Per person) S OWNED SCHEDULED '.. BODILY INJ URY (Per accident) $ AUTOS ONLY ,v RED NO OWNED ' PROPIPRTY"DAi�tAG'L.,„,,, AUTOS ONLY e .; AUTOS ONLY ,.„)Per sCC[d#2nU ,.:,. UMBRELLA LAB OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS -MADE '.. I'll, 1111111-11111 ., AGGREGATE $ DED RETENTION WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN , „,.,.. STATUTE FR ANYPROPRIETOR/PARTNER/EXECUTIVE E L, EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA : •........ ... .. °� ..... ,.... (Mandatory in NH) '.... E L DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E L, DISEASE- POLICY LIMIT $ A I Errors & Omissions 01566449 10/1/2022 10/1/2023 Per Claim/Aggregate $12,000,000 B Excess Errors & Omissions ELU177899-22 10/1/2022 10/1/2023 Per Claim/Aggregate $10,000,000 C Excess Errors & Omissions FI0121922 10/1/2022 10/1/2023 Per Claim/Aggregate $13,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage extends to: Gallagher Benefit Services, Inc Koff & Associates 2835 Seventh Street Berkeley, CA 94710 CERTIFICATE HOLDER City of El Segundo 350 Main Street El Segundo CA 90245 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ;AUTHO. IXEO REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MMIDDIYYYY) c"CERTIFICATE OF LIABILITY INSURANCE 5/6/2022 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). PRODUCER CONTACT Arthur J. Gallagher Risk Management Services, Inc. ,P Hn ex 312 704 0100 FIA 9 9 AX 3 300 S. Riverside Plaza, Suite 1500 C,No):312-803-744 Chicago IL 60606 ADDRESS .. INSURED Arthur J. Gallagher & Co. and its subsidiaries 2850 West Golf Road Rolling Meadows, IL 60008 rnVFRAnPR rFRTIFIrATF NUMBFR: 14.r,44RSR41 INSURERS) AFFORDING COVERAGE NAIC # Indian Harbor Insurance Company 36940 mpany ompany Lexington Insurance Co 19437 Beazlev Insurance Comoanv. Inc. 37540 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. ILTR - - - - --------.. ...... .... ... .00)8. S'U'B,A .. POLICY EEF w , POLICY EXP .,. TYPE OF INSURANCE POLICY NUMBER '... NAMfDD7"�'YYY MMIOD,IYYYY LIMITS '.. COMMERCIAL GENERAL LIABILITY '... !. EACH OCCURRENCE AYJIAGC"YNt�(1 ®. . CLAIMS -MADE OCCUR PREMISES (Ea occurrence,) 7 MED EXP (Any one person) '.... -_� '.. PERSONAL & ADV INJURY GEN'LAGGREGATE LIMIT APPLIES PER. ' '.. '.. !GENERAL AGGREGATE PR4' P• ........ POLICY [ .YEG•r LOC PRODUCTS-COMPIOPAGG .n ... ., _wn, 01 HER:. AUTOMOBILE LIABILITY COMBINED S NIGLE LIMIT $ IEa accidaryg,l '.. ANY AUTO BODILY INJURY (Per person) $ o OWNED .�.,, SCHEDULED BODILY IN J INJURY (Per accident) $ AUTOS ONLY AUTOS .. v HIRED NON -OWNED m nq PROPFRT' DAMAGE �i AUTOS ONLY AUTOS ONLY � � � P c 111 e 'au�'�! en UMBRELLA LIAB '... OCCUR EACH OCCURRENCE $ '.. EXCESS LIAB ... CLAIMS -MADE€ '.. „, ..... ,. ....... AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION '.. X PER STATUTE '..... OTH_ R AND EMPLOYERS'LIABILITY YIN _ - ....... .. ,,.,. .,' ANYPROPRIETORIPARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICE R/MEMBER EXCLUDED? N / A _"" �'• (Mandatory in NH) E.L DISEASE EA EMPLOYEE $ ........ ...... If yes, describe under '.. DESCRIPTION OF OPERATIONS below " E.L. DISEASE POLICY LIMIT $ A CyberLiability- ClainisMade MTP903416504 5/1/2022 5/1/2023 Aggregate/Per Claim: $10.000,000 B ExcessCyber- ClatmsMade 065704256 5/1/2022 '.. 5/1/2023 Aggregate/Per Claim: $10,000,000 C ExcessCyber- CimmsMade V2933A220601 5/1/2022 5/1/2023 'Aggregate/Per Claim: $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage extends to: Gallagher Benefit Services, Inc Koff & Associates 2835 Seventh Street Berkeley, CA 94710 tPIZU41I2t+f-111 —10 1 - 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. AUTHO 2ED REPRESENTATIVE ZZ ✓- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CO 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - 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 wilt 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 (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. CG 20 01 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM LIQOUR LIABILITY FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person or organization who is required under a written contract with you to be included as an insured under this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. All other terms and conditions of this policy remain unchanged Endorsement Number: Policy Number: 41 GPP4938415 Named Insured: ARTHUR J GALLAGHER & COMPANY This endorsement is effective on the inception date of this Policy unless otherwise stated herein; Endorsement Effective Date: 10/01 /2022 00 GLO596 00 04 10 Page 1 of 1 POLICY NUMBER: 41 GPP4938415 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Nari 7 at Name Of RL%rwirw OO ir ir(pi ioin: ANY PEJ.P.SON OR WEIERE WA.�IVER 01.�' CUR C RECOVER Rl,.�QU.ILLIED BY' WR-1T'1'1°,N CONTRAC17 W-1.7.1 i SUCH PERS(-)1q OR, ORGAN 1. ZA'1I ON PROVEDE.',D SUCH C0N'1.'FU%.(.T WAS Fl..�XECU'. TED Pl-.�ICR TC 'T['-.IE LOSS, Information required to complete this Schedule. it not shown above. will be shown in the Declarations. The following is added to Paragraph B. Transfer Of Fights Of Recovery Against Others To Us of Section IV — Condfions: We waive any right of recover we may have against the person or or�anizafl( =n nn the Schedule above because payrnents, we rralke for injury or damage arising g out Of your ongoing operations at "YOW work" done under a contract with that person or organization and included in the "producls- cornpleted operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 c Insurance Services Office, Inc., 2008 Page 1 of 1 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conciitions, A. - Loss Concftions, 5. - Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: However, we will waive any right of recovery we have against any person or organization with whom you have entered into a contract or agreement because of payments we make under this Coverage Form arising out of an "accident" or 'loss" if: (1) The "accident" or 'loss" is due to operations undertaken in accordance with the contract existing between you and such person or organization: and (2) The contract or agreement was entered into prior to any "accident" or 'loss". No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or organization, and we reserve our rights or lien to be reimbursed from any recovered funds obtained by any injured employee. All other terms and conditions of the Policy remain unchanged Endorsement Number: Policy Number: 41 CAB4938315 Named Insured: ARTHUR J . GALLAGHER & COMPANY This endorsement is effective on the inception date of this policy unless otherwise stated herein. Endorsement Effective Date: 10/01/2022 00 CA0080 00 04 08 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 POLICY NUMBER: 41 WC14938115 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 ANY PERSON OR ORGANIZATION WHERE WAIVER OF OUR RIGHT TO RECOVER IS REQUIRED BY WRITTEN CONTRACT WITH SUCH PERSON OR ORGANIZATION PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF THE LOSS. 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 poky.) Endorsement Effective: 10/01/2022 Policy No. 41 WC14938115 Endorsement No. Insured ARTHUR J. GALLAGHER & COMPANY Insurance Company ARCH INSURANCE COMPANY Countersigned By DATE OF ISSUE: Premium $ INCL . 1983 National Council on Compensation Insurance.