Loading...
PROOF OF INSURANCE (2023 - 2023) CLOSEDDATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE lam„✓" 10/20/2022 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). CONTACT PRODUCER NAME: Christina Hernandez, CIC Edgewood Partners Insurance Center PHA° t�� Faiki:619�52-1374 _•_. FAX Na: 425 California Street, Suite 2400 EMAIL San Francisco CA 94105 AODRESS. cliiistina.hemaildez epicbroker com ........._(s) AFFORDING COVERAGE NAIC # INSURER ............. ..... ............. ...� �..!?. y ...7 4 INSURER A: Atlantic S ecialt_y Insurance Com an 2715 INSURED BELLEVE-01 p � .y 7 Bell Event Services, Inc. ..IN :Com West Insurance Com wan 1217 531 Main St. #228 El Segundo rnvConr_ce d r-DTlCIrATC KII1MRCR• 4A107A AAA RFVICInN NIIMRFR- 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. TYPEOFINSURA•�SUOR1NM ......... _.... ..... INSR INSURANCE DOL WVD POLICY NUMBER ''. MMIDDY� MMIDOMYPy LIMITS LTR A X COMMERCIAL GENERAL LIABILITY Y Y GLO549602 9/25/2022 9/25/2023 1 EACH OCCURRENCE $1,000,000 l 100,000 CLAIMS -MADE OCCUR PREMRSE"5 Ea ro-c7cuR/ence $ MED EXP (Any one person) $ 15,000 ........... ..._.._.._. PERSONAL & ADV INJURY ........._.-.... $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X PI POLICY❑ JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: 1 $ A AUTOMOBILE LIABILITY Y 7100396780002 9/25/2022 9/25/2023 COMBINED SINGLE ILWIT Ea agr dggjj ........ $1,000,000 ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULEDAUTOS BODILY INJURY (Per accident) $ ONLY AUTOSX HIRED NON -OWNED IPROPER'T'YDAMAGE -_.• $ AUTOS ONLY AUTOS ONLY L Pqr �'B.nt ......... HifedAutoPhs cial Dm $ Included A X UMBRELLA LIAB X OCCUR Y Y EX0394102 9/25/2022 9/25/2023 OCCURRENCE $1.000.000 EXCESS LIAB CLAIMS -MADE �AACH GGREGATE $ 1,000.000 DED RETENTION $ $ B WORKERSCOMPENSATION Y WCV5505108 SI25/2022 5/25l2023 X STATUTE OR 1 000,,000 AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Y N / A E.L. EACH ACCIDENT ••-• $1,000,000 """"""""""" (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE. $ 1.000,000 If es, describe under '', DESCRIPTION OF OPERATIONS below E,L. DISEASE - POLICY LIMIT $ A Misc. Equipment 7100410500001 9/25/2022 9/25/2023 Limit $310,000 Rented/Owned Deductible $2.500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured on the General Liability, on a Primary & Contributory basis„ as required by a written contract or agreement. Waiver of Subrogation in favor of the Additional Insureds applies to the General Liability & Auto Liability policies, as required by a mitten contract or agreement. Certificate Holder is included as Additional Insured on the Auto Liability as required by a written contract or agreement and as their interest may appear. Umbrella is follow form. trtK I II'IUANk 11= MULUt:.K liFi1V <.CLLN 11UN ------------ The City of El Segundo its officers, officials, employees, agents, and volunteers 3501 Main St El Segundo CA 90425 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 U 1988-2U15 ACORD GORPOKA I ION. All rights reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL05496-02 COMMERCIAL GENERAL LIABILITY CG 20 12 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: All States or Political Subdivisions -issuing such permits to the insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: GLO5496-02 COMMERCIAL GENERAL LIABILITY ECG 24 520 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - OTHER INSURANCE (PRIMARY NONCONTRIBUTORY) This endorsement modifies insurance provided under the following:. COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph a. Primary Insurance of 4. Other Insurance of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: a. Primary Insurance This insurance is primary except when b. be- low applies. If this insurance is primary, our ob- ligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below, except that we will not seek contribution from any party with whom you have agreed in a written contract or agreement that this insurance will be primary and noncontributory, if the written contract or agreement was made prior to the subject "oc- currence" or offense. ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 ❑ with its permission. POLICY NUMBER:GL05496-02 COMMERCIAL GENERAL LIABILITY CG 24 0412 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following:: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): Organizations as required by written contract executed prior to the date of an "Occurrence" Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 0412 19 © Insurance Services Office, Inc., 2018 Page 1 of 1