PROOF OF INSURANCE (2023 - 2023) CLOSEDDATE (MM/DDNYYY)
"R" CERTIFICATE OF LIABILITY INSURANCE 12112/2022
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 Finn Davis
MARSH USA, INC. RARE:PHONE
~, --- —
99 HIGH STREET IXt➢ (617) 999-7893 ~_.. dIC NrM&c
BOSTON, MA 02110 &MAIL- Finn.Davis marsh.com
INSURER S AFFORDIN
-- L........................._... -G COVERAGE
NAIC #
CN102891976-TTI-GAWX+-22-23 ......_ ..-
INSURER A : Hartford Fire Insurance Co
19682
IN
INSURED
INSURER B Trumbull Insurance Co an
2....
y og_
T ter Technologies, Inc.
..--
y
5101 Tennyson ParkwayINSURER
C QBE S equal Insurance Co m an mmmmm
... P Y
171
1515
515 ...........
Plano, TX 75024
INSURER D; Sentinel Insurance Company.,.,. -._� -. .----..� .. �
11000
^
INSURER E : Hartford Casualty Insurance Comoanv
29
29424
CnVFRAnPR CERTIFICATE NIIMRFR• NYC-011255659-07 REVISION NIIMRFR- 0
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.
_...,..,.._-....-____. . ICY EXP
INSR ..., � T. V�_ .6A ..........mm.... POLY E ICFF PC)L.- .-- ,,."-........-.
LTR TYPE OF INSURANCE POLICY NUMBER ,. MMIDD/ XY MM/DD/YYYY
..... ...... _....._..~..........~~........ ~...,.._......
LIMITS
A X COMMERCIAL GENERAL LIABILITY 10 LIEN DL0437 04/01/2022 04/0112023
EACH OCCURRENCE
$ 1,000,000
X
L_9
t7AMAt(�iiIYlti
300,000
CLAIMS -MADE ,OCCUR
PREMISES LEA ac urrPn
$
..."...:.......................~.......:............:.:.:.:.....:.:........~.,...,._.
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN"L AGGREGATE LIMIT APPLIES PER:
N ~.........AG .GAT
GENERAL AGGREGATE
,000,000,
$ 2,000,000
PRO.
X POLICY D PRO.
LOC
PRODUCTS COMP/OP AGG
$..~........ ~~2,000,000
OTHER
$
®
a.._..uTOMOBILELIABILITY
10 UEN D19897
04101/2022
04/0112023a
COMBINEDaB.ISINGLE LtMIT
$ -.. � 1,000,000,,,,
X ANY AUTO
BODILY INJURY (Per person)
$
OWNED ISCHEDULED
BODILY INJURY (Per accident)
$
._„ AUTOS ONLY AUTOS
HIRED NON -OWNED
I
8 iOPLRTYDAMAGE
$
AUTOS ONLY AUTOS ONLY
(der 2Iw'�"1�?0D,1. �,.,.,.,
.. ....-
$
X
UMBRELLA LIAR X OCCUR
.,-.
10 XHU DLO102
/41/112022
0410112023
EACH OCCURRENCE
$ 25,000,000
~..,..-~......
CLAIMS-.----...---.:.:_.:.:.:.:.:.:.........$
EXCESS LIAB MADE
_ _
AGGREGATE.......-..__._._-...-
25,000,000
_$
DED X RETENTION $10 000
D
WORKERS COMPENSATION
IOWBAK8AGK
K01/2022
0410112023
X PER OTH
STATUTE ER
AND EMPLOYERS' LIABILITY YIN
--~,
„„„„,„, __
1,000,000
ANYPROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N / A
E.L.. EACH ACCIDENT
$
1,000,000
(Mandatory in NH)
E.L DISEASE - EA EMPLOYEE..
$ ,.
If yes, describe under
~~ -
1,000,00000
DESCRIPTION OF OPERATIONS below
E L DISEASE -POLICY LIMIT
$
C
Professional Liability
130001996
12/1712021
0611712023
Limit
5,000,000
Cyber Protection
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate holder including its officers employees and volunteers are listed as additional insured under the GL policy when required by written contract.
1'=0TIICir^AT= IJnl 11=0 CANCFI I ATInN
City of El Segundo
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
350 Main Street
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
El Segundo, CA 902453895
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
U 19BB-ZU16 ACURU GUKPUKA I JUN. All rignts reserveU.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: CN102891976
LOC #: Boston
Al a' AMITIONAL REMARKS SCHEDULE
AGENCY NAMED INSURED
MARSH USA, INC. Tyler Technologies, Inc.
5101 Tennyson Parkway
POLICY NUMBER Plano, TX 75024
I CARRIER I NAIC CODE
EFFECTIVE DATE:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: Certificate of Liabilit Insurance
The Professional LiabilitylCyber policies evidenced contain Self Insured Retentions to various perils covered. If you would like additional information regarding these sublimits or
deductibles, please contact the insured.
Excess Cyber Protection:
$5,000,000 xs $5,000,000
Carrier: Munich Re Syndicate Limited
Policy Number: B0509FINPY2150857
Eff1Exp dates:12/1712021 - 06117/2023
Per Claim and Aggregate Limit: $5,000,000
Business Interruption: $2,500,000
Ransomware: 2,500,000
Page 2 of 2
ACORD 101 (2008/01)
0501-01-00-0000410-0002-0001021
U lUUS AGUKU GUKYUKA I IUN- An rignTs I
The ACORD name and logo are registered marks of ACORD IN