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PROOF OF INSURANCE (2023 - 2023) CLOSED
CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/6/2022 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(les) 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 Marsh & McLennan Agency LLC 15415 Middlebelt Road Livonia MI 48154 INSURED swauacca+ OCLC, Inc. INSURERC 6565 Kilgour Place Dublin OH 430171_'1N_SIIRERD F Paine mma.com -1160 FederalInsurance Com(aa y_ ... ..�.. ....,. .._,--.... _— 81 .20 ._, Travelers hidemnnty Co of America . — �,..__ rt566 stchester us Lines IeCCompany rand Co 10172 Landmark dmark Insurance 35637 COVERAGES CERTIFICATE NUMBER: 1850750680 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, AID CLAIMS .... . ...�__ r. .... ...... ......._...._ .._ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES" LIMITS SHOWN MAY HAVE BEEN REDUCED BY P— TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE � „X J OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: IPOLICY & X-I rIE ; � LOC AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EXCESS LIAR MADE tlfves, CLAIMS ED RETENTION S ERS COMPENSATION MPLOYERS'LIABILITY YIN OPR4ETOFVPARTNER/EXF':CUr VE ERIM E MBE RE XCLUDI,atory in NH) describe ender C Cyber WWI onal Liab D Excess E80FCybW (Claims Made) PDl _lf9Ft POLICY NUMBER t'OLIC"Y OFF MMIDDiYYYY POLNCY EXP MM DDIYYYY' LIMITS 35756671 3/1/2022 3/1/2023 EACH OCCURRENCE — $1 000,000 DAMAGE O tl f-N'f8 "t7 PREMISI, S 1 000 000 i MED EXP QAra on�ersuaatl Wm_ $ IiY 000__ .� ...------.. PERSONAL & ADV INJURY ' $1 000 0 „_ _.- GENERAL AGGREGATE $ 2,000000 __ ......-.- PRODUCTS COMPJtd AGG $2„w 000,000 ...... ..., $ I CiMSINED SiNULE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ — POI° REEtTY OAM , if -- .... $ "mm(PeP aCCtyiG.nlJ.. _.... .. ......... ..".........,,_ ... $ EACH OCCURRENCE .. $-- ....._._... ....._--- AGGREGATE ... $ ...�....-, TUB8J443127 12/31/2022 12/31/2023 ?C 16 UTF."I __Lc ...." — EL, EACH ACCIDENT $ 1 000 _ V 1 A .._ — E.L. DISEASE EA EMPLOYE .: $ 1.000 _ 000' ..._ ... E.L. DISEASE - POLICY LIMIT $ 1,000,00'0 F1564509A 4/2/2022 4/2/2023 Limit Limit $5,000,000 $2,000,000 LHZ788093 4/2/2022 4/2/2023 Retention $100,000 DESCRIPTfON OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarlis Schedule, ronay be attached If more apace Is required) The City of El Segundo, its officials, and employees are included as additional insured for commercial general liability on a primary and non-contributory basis to the extent provided in the attached! form ##80-02.2367„ and as additional Insured for professiona,llcyber liability coveaage to the extent provided in the attached form #PF-48238. The commercial general liability insurance carrier Will provide the Certificate Holder With direct notice of cancellation to the extent provided in the attached form 80-02-9779. .. ........ TE 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 AUTHORIZEDREPRES,F,NTATIVE 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 C H U 8 Be Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY LIQUOR LIABILITY Who Is An Insured MARCH 1, 2019 TO MARCH 1, 2020 MARCH 1, 2019 3575-66-71 CHI OCLC, INC. FEDERAL INSURANCE COMPANY MARCH 19, 2019 Under who Is An Insured, the following provision is added Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the who Is An Insured section (regardless of any limitation applicable thereto). • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Liability Insurance Additional Insured - Scheduled Person Or Organization continued Form 8042 2367 (Rev. 5-07) Endomernent Page 1 Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Conditions Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule Persons or organizations that you are obligated, pursuant to a contract or agreernent, to provide with such insurance as is afforded by this policy. All other terms and conditions remain unchanged. Authorized Representative �.., Liability Insurance Additional Insured - Scheduled Person Or Organization last page Form 80-02-2367 (Rev. 5-07) Endorsement Page 2 Policy Conditions Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued mom This Endorsement applies to the following forms: COMMON POLICY CONDITIONS Under Conditions, the following condition is added, Conditions Notice Of Cancellation When we cancel this policy for any reason, other than non-payment of premium, we will notify To Scheduled Persons person(s) or organization(s) shown in the Schedule at least 30 days in advance of the cancellation Or Organizations When date. We Cancel Any failure by us to notify such person(s) or organization(s) will not: • impose any liability or obligation of any kind upon us; or • invalidate such cancellation. Schedule Person(s) or Organization(s): Address; Notice Of Cancyi, d d@' PA Or OrgarlizatioM Policy Conditions (Except Non -Payment Of Premium) continued Form 80-02-9779 (Ed. 3-11) Endorsement Page 1 Conditions (continued) Policy Conditions Form 80-02-9779 (Ed. 3-11) All other terms and conditions remain unchanged. Authorized Representative Notice Of Cancellation rs ° organizations (Except Non -Payment Of Premium) Endorsement last page Page 2 Additional Insured - Blanket Pursuant to a Contract - DigiTech® THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Chubb DigiTech® Enterprise Risk Management Policy It is agreed that Section II, Definitions, Insured, subparagraph 6 is deleted and replaced with the following: 6. any natural person or entity for whom an Organization is required by written contract or agreement to provide insurance coverage under this Policy (hereinafter "Additional Insured"), but only with respect to Claims: a. arising out of any Incident committed after the Organization and the Additional Insured entered into such written contract or agreement; b. for any Incident committed by, on behalf of, or at the direction of the Organization; and c. subject to the lesser of the limits of insurance required by such written contract or agreement between the Organization and the Additional Insured, or the applicable Limits of Insurance of this Policy. However, no natural person or entity shall be an Additional Insured with respect to any Claim arising solely out of such natural person's or entity's independent act, error, or omission. In the event of a disagreement between the Named Insured and the natural person or entity as to whether the Claim arises solely out of such natural person's or entity's independent act, error, or omission, it is agreed that the Insurer shall abide by the determination of the Named Insured on this issue, and such determination shall be made by the Named Insured within 20 days of the notification of the applicable Claim. All other terms and conditions of this Policy remain unchanged. Pa eiof1 PF-48238 (o9/16) g