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PROOF OF INSURANCE (2023) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 08/24/2023 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 ri hts to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA, LLC. vHOHE.......---------- .................... 1166 Avenue of the Americas "............ .. New York, NY 10036 t MAOL Attn: NewYork.Certs@marsh.com Fax: 212-948-0500 tR'1 '.,....�...... NSU ER S AFFORDING COVERAGE _ .. ............... .....",,,,,,,,,,,,,,,,,,,N,AIC # INSURER A SOm 0 America p Insurance m. n--------- 11126 INSUREDonan INSURER B Tokio Marine America Insurance COm�any 10945 Canon USA, Inc. -One ...... Canon Pak I INSURER c : Sompo America Fire 8 Marine Insurance Company 38997 Melville, NY 11747 INSURER D : INSURER E : rnVFRAAFC rFRTIFIrATF NIIMRFR• NYC-011681413-01 REVISION NUIMRFRr 1 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, SUCH EEN REDUCED BY PAID CLAIMS. H POLICIES. LIMITS SHOWN MAY HAVE B EXCLUSIONS AND CONDITIONS mOF .,,.. Atlb " Su �'v. .. POLICY "' _ ..______.— ._. .... ....- ".... EFF EXP MMLICY INTR TYPE OF I NUMBER MMl1)D pp LIMITS B X COMMERCIAL GENERAL LIABILITY GLD6404741-12 11/0112022 ''11/01/2023 EACH OCCURRENCE $ 1,000,000 ........ . ....MX DAMgGIC ..."., 0 1,000,000 CLAIMS -MADE OCCUR .., FRE tiL E: ,tLa occugTu';n54. $ MED EXP (Any one person) ..._......._ $ 5,000 ,.................. ....,.,.,. ..�..-. ,...... .,..,., .. .. ... .............. PERSONAL S ADV INJURY $ 1,000,000 .......... .....0, GEN'LAGGREGATE LIMIT APKtES_........ PER: ..,..,.....�.....,A GENERAL AGGREGATE $ 2,000,000 1 POLICY X .. PRO LOC JECT PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER. $ A AUTOMOBILELIABILITY AAL30026136800 11101/2022 11/01/2023 COMBINED SINGLE UMII 1Oci.+.edrruwD $ 1,000,000 ...... ...... ._....,....,....... ,.,,,,,, X j ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED $ AUTOS ONLY AUTOS ,BODILYINJURY(Peraccident) -.. HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY ......._.... AUTOS ONLY ..„(F'er Rggi ent ___ .. COMPICOLL DED $ 1,000 UMBRELLALIAB OCCUR ...-....... EACH OCCURRENCE ........._.................... _._—. $ ....... . ,...,.... ,.,.. EXCESS LIAB CLAIMS -MADE " AGGREGATE $ p DED I RETENTION $ I $ C WORKERS COMPENSATION JCD40017RO 1 I 11101 0023 X STATUTE AND EMPLOYERS' LIABILITYYIN '^^ ERH ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT is 1,000,000 OFFICER/MEMBEREXCLUDED? N/ A mm 1,000,000 (Mandatory in NH) E L DISEASE- EA EMPLOYEE i $ If as, describe under-� DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9 talc 'Lt.S�f-G'.L�G� @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: FTA40003DO COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED, FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Canon U.S.A., Inc. Endorsement Effective Date: 11/1/2020 SCHEDULE Name Of Person(s) Or Organization(s): As required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: CLL6404741-10 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OIL CONTRACTORS SCHEDULED PERSON O ORGANIZATION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered O erations Any erson or organization if you are required to do so under As require y written contract with a Named insured a wra"tten contract„ agreement or permit pro\Med the "bodily injury,, or "prop,perty damage"" occurs subsequent to e e cecution of tt�e contract, agreement or permit. 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or 'personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Lirrdts 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: CLL6404741-10 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OIL CONTRACTORS S - COMPLETED, OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Descril2tion Of Com leted Operations Any person or organization if you are required to do so under a written contract, agreement or permit provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract As required by written contract with a Named Insured agreement or permit. Information re uired 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. 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. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 O Insurance Services Office, Inc., 2012 Page 1 of 1 Policy #CLL6404741-10 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY ANC NONCONTRIBUTORY -- OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCT51COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Flamed Insured under such other insurance; and CG 20 01 0413 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. ® Insurance Services Office, Inc., 2012 WmpanY COPY Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VIrG 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule As required by written contract *"THIS ENDORSEMENT DOES NOT APPLY TO KENTUCKY, NEW HAMPSHIRE, AND NEW JERSEY. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. IThe information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective:1110112020 Policy No.JCD40017R0 Endorsement No. Insured: CANON U.S.A., INC. Premium: INCL. Insurance Company: Sompo America Fire & Marine Insurance Company Countersigned by WC 00 0313 (Ed. 4-84) 01993 National Council on Compensation Insurance.