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PROOF OF INSURANCE (2023 - 2024) CLOSEDDATE (MMIDDIYYYY) ARE CERTIFICATE OF LIABILITY INSURANCE 3/22/2023 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 endorsements . PRODUCER CONIT d.T NAME„_ Stacy Paine Marsh & McLennan Agency LLC PHONE FAX 15415 Middlebelt Road AI,L 734 525 2463 FAX c N01 212-"UI I I60 Livonia MI 48154 ADDRESS. stacy painenlarshmma.com ERmAFFORDING COVERAGE NAIC # ..,.. INSUR„. , ........� ......... .......... INSURER A: Federal Insurance Company 20281 INSURED INSURER B Travelers Indemnl CO OfAeica 25666 Inc. m 6565 Kilgour Place INsuREzD Landmark Insurancepy a Dublin OH 43017 "IN SURERD Illinois UnonI insurance Company __ 27960 INSURER E : r nvFRAnPR rFRTIFIrATF NIttMIRFR- ni nr%rtviaSt i RFvmm NI IQkP RF'R- 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. .., .� ........ ......... ..... AP)'�'C..'S�UBmR EFF EXF� fIJSR ............... ...------- --------- ................. .................... MLICY TYPE OF INSURANC.EPOLICY MM DDY t.TR NUMBER IDD �. LIMITS A X COMMERCIAL GENERAL LIABILITY 35756671 3/1/2023 3/1/2024 EACH OCCURRENCE $ 1,000,000 ......... ...... II X .� _...,-_ - DAM/iG'E' O RENTED' CLAIMS -MADE . OCCUR — V 000 PREMI,$1,000................................................. ....P.�~a..i...5?.',,rrrl{..F4?........ ...._.—......................................................................... one arson) $1.0.,0.0. PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 000,000 X X � I POLICY JECT LOC .. JECT ~--ry PRODUCTS COMP/OP AGG $ 2 000.000 ... _. _...... OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (E b acri:I).t�. $ ANY AUTO BODILY INJURY (Per person) $ OWNED - SCHEDULED ...BODILY .INJURY .(Per accii..........dentt) , $ ` AUTOS ONLY ............. AUTOS —.. HIRED NON -OWNED $ AUTOS ONLY AUTOS ONLY fP+�r as�CNstentiq Is UMBRELLA LIAB OCCUR __.._.. EACH OCCURRENCE _ - --------- --------- E s_ ._ ......_... EXCESS LIAB CLAIMS -MADE AGGREGATE $ DE.D A R.ETENTION.$ $ B WORKERS COMPENSATION UBBJ443127 12/31/2022 12/31/2023 X PE x T o1H S.' E G ER AND EMPLOYERS' LIABILITY YIN .. ..." . w ....., ......' ...... ... ANYPROPRIETOR/PARTNER/EXECUTIVE E L. EACH ACCIDENT $ 1 000,000 OFFICER/MEMBEREXCLUE ❑ NIA "' """ "`.... . " (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE. $ 1,000,000 If yes, describe under .. .. _ ,...". .. ..... ... ..—..... ............ DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000,000 D Cyber LinblPcotessNonal Liab F1564509A 4/2/2023 3/1/2024 Limit $5,000,000 C Excess E4OlCybur LHZ802125 4/2/2023 3/1/2024 Limit $2,000,000 (Claims Made) Retention $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space 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 professional/cyber liability coverage 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. am 04 ill .Ilid 10"I'llI VJ Mimi ■f�A+GRIP 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. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CH U B B® Liability Insurance Endorsement Policy Period MARCH 1, 2019 TO MARCH 1, 2020 Effective Date MARCH 1, 2019 Policy Number 3575-66-71 CHI Insured OCLC, INC. Name of Company FEDERAL INSURANCE COMPANY Date Issued MARCH 19, 2019 This Endorsement applies to the following forms: GENERAL LIABILITY LIQUOR LIABILITY Under Who Is An Insured, the following provision is added Who Is An Insured 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 Orpanizadon Form 80-02-23671Rev. 5-07) Endorsement continued Page I Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Other Insurance — If you are obligated, pursuant to a contractor 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 agreement, to provide with such insurance as is afforded by this policy. All other terms and conditions remain unchanged Authorized Representative,_ Liability Insurance AdditnalInsured - Scheduled Person OrOrganiraffon last page Form 80.02-2887 (Rev. 5-07) Endorsement Page 2 Policy Conditions Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued 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. W. �.... ��,� dN0i0bM91MR�NW1010N fmww�Wwu9WwWUwVw.WA6WIM00wu�e' � Schedule Person(s) or Organization(s): Address: Notice Of CancekR9bJf d d &PAN Or Organizations Policy Conditions (Except Non -Payment Of Premium) continued Form 80-02-9779 (Ed. 3-11) Endorsement Page 1 Conditions (continued) All other terms and conditions remain unchanged. Authorized Representative Notice Of CancellationRBfdSaZMOVrsQVPaOrganizations Policy Conditions (Except Non -Payment Of Premium) last page Form 80-02-9779 (Ed. 3-11) Endorsement 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. PF-48238 (og/16) Page i of i