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PROOF OF INSURANCE (2022 - 2023) CLOSED (2)
CERTIFICATE OF LIABILITY INSURANCE UATE(MM/°°/YYYY) 1 V112022 08/29/2022 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. ._WWWW� 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 LOCKTON COMPANIES 3657 BRIARPARK DRIVE, SUITE 700 ONTACT NAME•. = HOUSTON TX 77042 E-MAIL � 866-260-3538 -- INSURER S AFFORDING COVERAGE NAIC # INSURER A: The Charter Oak Fire Insurance Company 25615 INSURED CSA Service Solutions, LLC. INSURER. s i Travelers Casualty and Surety Company 19038 mm INSURER c : OrVm ': Forsfi • r ` ecial InsLIr o 44520 1463631 dba EMSAR PO Box 202887 Austin TX 78720 INSURER r�� 25674 INSURER E : INSURER. F COVERAGES CERTIFICATE NUMBER: 167200 !0 REVISION NUMBER.. XXXXXXX. 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 J. THE I S? N_,6RQS,,aDITIQNS,OF SUCH POLI9EaJJM=a!j91 MAYHAV PAID CLAIMS. pNSR ADDL US POLICY EFF (POLICY EXP LTR, TYPE OF INSURANCE INSD WVO POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY 30-OT90914A 02/ 1 022 01/011202 EACH OCCURRENCE $ 1.000.000 CLAIMS -MADE OCCUR DAMAGE ,' TFO : ".. 0�urrecllftl $ 1 000 000 MED EXP (Any oneperson) $ 10,000 Y Y PERSONAL & ADV INJURY $ 1.000 000 GEN't X GENERAL AGGREGATE S 2,000.000 AGGREGATE LIMIT APPLIES PER: POLICY PjRo' ❑ IE,C� LOC PRODUCTS - COMP/OP AGG $See Below $ OTHER, AUTOMOBILE LIABILITY NOT APPLICABLEO-MarnI1NGLE LIMN $XXXXXXX BODILY INJURY (Per person) $ XXXXXXX ANY AUTO BODILY INJURY (Per accident) $ XXXXXXX OWNED SCHEDULED - AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY P,Iy�O'PERTY DAMAGE d urrcclderrtl ••• $ XXXXXXX D X UMBRELLA LIAB IV OCCUR CUP-OT911736 02/01/202 01/01/202 EACH OCCURRENCE $ 10000,000 '.AGGREGATE $ 10,000,000 EXCESS LIAB , LAIM'SWADE; Y Y ' DED RETENTION $ WORKERS COMPENSATION X G B AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? :Mandatory in NH) NIA UB-6N98422A-22-12-G 09/01/202 09/01/202 E..L.. EACH ACCIDENT $ 1,000,000 E,L, DISEASE - EA EMPLOYEE $ 11000,000 It yes, describe under DESCRIPTION OF OPERATIONS below IE.L DISEASE- POLICY LIMIT $ 1 000 000 C Technology EO and Professional Liability Y Y TCM-102301 11/01/2021 11/01/2022 See Attached DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION bee AttSCniments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 16720020 — AUTHORIZED REPRESENTATIVE El Segundo Fire 350 Main St El Segundo CA 90245 ©1988-2015 ACORD CORPORATION. All ric ACORD 25 (2016103) J is reserved The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS (Use only if mope All policies (except Workers' Compensation/EL) include a blanket automatic additional insured [provision] that confers additional insured status to the certificate holder only if there is a written contract between the named insured and the certificate holder that requires the named insured to name the certificate holder as an additional insured. In the absence of such a contractual obligation on the part of the named insured, the certificate holder is not an additional insured under the policy. All policies include a blanket automatic waiver of subrogation endorsement [provision] that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it. In the absence of such a contractual obligation on the part of the named insured, the waiver of subrogation feature does not apply. ACORD 25 (2016/03) Certificate Holder ID: 16720020 Attachment Code : D565158 Master ID: 1462664, Certificate ID: 16127253 The General Liability and Umbrella Liability policies include a blanket automatic additional insured [provisioh] that confers additional insured status to the certificate holder only if there is a written contract between the named insured and the certificate holder that requires the named insured to name the certificate holder as an additional insured. In the absence of such a contractual obligation on the part of the named insured, the certificate holder is not an additional insured under the policy. The General Liability, Umbrella Liability, and Workers' Compensation/EL policies include a blanket automatic waiver of subrogation endorsement [provision] that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it. In the absence of such a contractual obligation on the part of the named insured, the waiver of subrogation feature does not apply. The General Liability policy contains a special endorsement with "primary and noncontributory" wording. Attachment Code : D603537 Master ID: 1462664, Certificate ID: 16127253 Policy Number: ZPP-16P23481 Issuing Company: Travelers Property and Casualty Company of America Effective: 2/1 /22-1 /1 /23 Limits: $10,000,000 General Aggregate $10,000,000 Each Occurrence $25,000 Deductible — Each Claim Attachment Code: D564693 Master ID: 1463631, Certificate ID: 16720020 Technology E&O and Professional Liability Policy Number: TCM-102301 Carrier: Crum & Forster Specialty Insurance Co Policy Term: 11/01/2021 - 11/01/2022 Limits: $5,000,000 Aggregate $5,000,000 Each Claim $50,000 Retention Technology E&O and Professional Liability Retro Date: 09/1/2003 - $2,000,000 limit & 9/1/2017 - $3,000,000 xs $2, 000, 000 Attachment Code : D603537 Master ID: 1463631, Certificate ID: 16720020 Policy Number: ZPP-16P23481 Issuing Company: Travelers Property and Casualty Company of America Effective: 2/1 /22-1 /1 /23 Limits: $10,000,000 General Aggregate $10,000,000 Each Occurrence $25,000 Deductible — Each Claim