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PROOF OF INSURANCE (2023) CLOSED
Client#: 150916 EJWAR DATE (MM/DD/YYYY) ACORD, CERTIFICATE OF LIABILITY INSURANCE 3/30/2023 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 ............. p 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 any rights to the certificate holder in lieu of such endorsement(s). . PRODUCER CONTACTDanelle Touchstone USI Southwest Austin C/L PHONE" FAQ (ice No Ext 210-524-20.94 _ AID N �610-537-1904 7600-C N. Capital of TX Hwy #200 E-MAILD , danelle.touchstone@usi.com Austin, TX 78731...........................................................__.._.._.� 512 tin, TX 55 INSURER(S) AFFORDING COVERAGE NA INSURER A: Atlantic Specialty Insurance Company liyii�4�1 INSURED INSURER B E.J. Ward, Inc. __........................................................................................................__._...... 8260 N. New Braunfles, Suite 20ON URER CNS I --- ................... San Antonio, TX 78217 INSURER D -- _........._...._ . .__ INSURER E c INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. VN R .__..� ADD SUB ................. LT """"" TYPE OF INSURANCE INSR 6NUO ______"" -„POLICY NUMBER """ POLICY EFF PiSLtCY F..XP """"""""""""" (MINDD/YYYY) jk�?NWODMY AYY '... LIMITS A X' COMMERCIAL GENERAL LIABILITY 7110163580004 9/01/2022 09/01 /202 EACH OCCURRENCE $1 OOO 000 DAMAGE RENTED OOO CLAIMS -MADE OCCUR PREMI,SE,SS Eaoccumance $50O MED EXP (Any one person) $10.000 , PERSONAL & ADV INJURY $1 JOHMO _._.......-..... ......... ..... ..............�.,..�.___ ,... GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2000L000 ,,,,,, POLICY Er LOC PRODUCTS COMP/OPAGG $2,000,,000 OTHER: $ A_. . AUTOMOBILE ,LI 7110.. MOBILE Lu►BluTv 163580004 9/01/2022 09/01/202 COMBINED SINGLE a.lMdT jEa A1 OOOu000 ro�alont $ , �.......... X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY '.. AUTOS BODILY INJURY (Per accident) $ -. ........,. �F"ROPERTYDAMAGE ... ..... _ X''.., HIRED NON -OWNED X $ AUTOS ONLY .. AUTOS ONLY Per gLdAu,,nk,) .................. ............. A X UMBRELLA LIAB X OCCUR 7110163580004 , 9/01/2022 09/0112023 EACH OCCURRENCE $10 000 000 EXCESS LIAR CLAIMS -MADE. .,, AGGREGATE $1 O OOO OOO $ ..^ .. _.......... _ COMPENSATION 40604544300 04 A WORKERAND OERS NABILOITY ________ __-...._r; 9/01/2022 09/01/202 ... __.......-- ."..,,.m...__....� X PsisTur__.,,,,, Y / N ., ANY PROPT;fETO'�'TIPAR'NEttNE EOiD('JO. UTIVE E.L. EACH ACCIDENT $1 OOOLOOO OFFICEWMEMBEREXCLUDE:D? I NJ NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $1 OOO 000 If yes, describe under DESCRIPTION OF OPERATIONS below ........ ......._.._.. .......................... E.L. DISEASE - POLICY LIMIT $1 00O 000 ........_._.....____,-.. A Professional Liab 17600104500004 9/01/2022 09/01/2023 $10,000,000 Each claim $10,000,000 Aggregate A iCyberLiability 7600104500004 9/01/2022 09/01/202 See below* DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) *Information Risk Liability (Cyber) Limit: $10,000,000 each claim $10,006,000 aggregate Retention: $50,000 Retroactive Date: 9/25/2018 (See Attached Descriptions) CERTIFICATE HOLDER. CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ile— ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD #S39583390IM37243760 DDTHZ I DESCRIPTIONS (Continued from Page 1) The General Liability and Auto Liability policy includes an automatic Additional Insured endorsement that provides Additional Insured and a Waiver of Subrogation status to the Certificate holder only when there is a written contract or written agreement between the named insured and the certificate holder that requires such status. The General Liability policy contains "Primary and Noncontributory" endorsement that applies when required by written contract between the named insured and the certificate holder. The Workers Compensation policy provides a Waiver of Subrogation when required by written contract between the named insured and the certificate holder. SAGITTA 25.3 (2016/03) 2 of 2 #S39583390/M37243760