Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
PROOF OF INSURANCE (2024) CLOSED`+��► CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
9d25/20'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.N
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR
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).
777 Manners Island Blvd Suite 250 PH E _
PHONE
PRODUCER CONTA T cert Request
Newfront Insurance Services NAME,
650 488 8565 FA9C
E �AAIL a..Batp. tic Na ...........�.�....._
San Mateo, CA 94404 „,ApPREm ,.. _ _. Tech�Celast st r n inrrant corTx
wGOV wfront.com INSURER B Berkley Regional Insurance Company„v ! mmm 2958C
www.newfront.com
SURED COtYt Inc NE._INSURERA BerkleyNationallnsuranceCom an 38911
Government obs, ( OGOV)
21, Park t Suite l6o z ERc INSUR
El Segundo �A 90245 INSURERD
CNSUrtEa c . Fed.
m an ._.".1
_._-_. �.-__�ra1 In�u�..amCo2
...mm._ _� X......a—......._-........ 028�
INSURER F r.
COVERAGES CERTIFICATE NUMBER: 76466814 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,
ILTaIEXCLUSIONSAND CONDITIONS OF SUCH POooLCIIESaLIMITS SHOWN c�V MBER�M DDd BY PAID CLAIMS. mmm
pr TM
PE OF INSURANCE REDUCED
POLMCY ExP
Y'Y MMNDDI1"YYY LIMITS
4 uLIABILITY ✓ TCP 7011473 9/25/2023 9/25/2024 EACH 9CCURRLNcr 1 000,0001
✓ COMMERCIALGENERAL
✓ OCCUR kHA7t, 1/,N FNYk-t°�. �'$..., .... ..... ...._.
A .. ,m._. ... PREMN ES __,
s 1 000 ON��1
N'LAGC'RE GATE LIMIT APPLIES PER:
r ✓ J POLICY "0' LOC
JE:C'T
� �iTCA 7011-474
-"
~ u4 _
9/25/20239/25/2024N%IrNr111r19LE
_ nnp $'15 000
PERSONAL & ADV INJURY I $
t FvhJEtALAGGREGATE �s3 000 000
....—
.,.,U'"RODUCTS COMP/OPAGf S:- 000000 _^
-
LIMIT
1I!kO C141
B
AUTOMOBILE LIABILITY'
ANY AUTO
T
'BODILY INJURY (Per person) $
OWNED
SCHEDULEDAUTOS
DONLY
AUTOS
"
BODILY INJURY (Pe�--�-_-�
HIRED NON -OWNED
AUTOS ONLY wN'� � AUTOS ONLY
".....-..�
'_PaLr,
cmcircSarnA@�rUAaEaccident).'._$ ... .
.t-
-.
"
�
� $$
A
✓ UMBRELLALIAB ✓ OCCUR
� �-
TCP 7011473
9/25/2023 9/25/2024
URRENCE r
s aQ00t7 C04
, EXCESS LIAB CLAIMS MADE
✓ 0 0 ..
_
T
AGGREGA E �5 000 QQQ
—J,00
DED l RE"NSNTgCtiN510I
$
A
WORKERS COMPENSATION
EMPLOYERS'
•P ' 7011475 -�®
'9%25023 9/25/2024
PER JTp f-
LIABILITY Y�N
TA:71,i"fE
LL .` ....
FICER/MEMBER REXCTNER/E
OFFICE /MEMB R/PARTNER/EXECUTIVE
OF
NIA
(✓
E L EACH ACCIDENT $ 1 QQQ OOO
(Mandatory in NH)
If$'g��es describe under
.....R.—} _.,.,a ,.
E L. DISEASE EA EM1IPLOYE,IFi $ ^'
..m , ._... �„ ... o _ 1'..,40,.0t)„ .......,..
-
13LSCRNP7lO'q OF OPERATIONS below
E.L. DISEASE �
- POLICY LIM iT $ 1 1000 000
E �CRIME
T
8255 8026
8/25/2023 8/25/2024
Per Occur/A . Limit: 1 000 000
99 $ ,
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: All Operations of the Named Insured.
City of El Segundo, CA is included as an additional insured as respects to General Liability, but only to the extent required by written contract or
written agreement.
CERTIFICATE HOL
City of El Segundo, CA
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
Rod Sockolov t
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
7646G,81.4 1 1.6440 1 23...24 A11. 7&.0 $5M/Crj.rRe$I.I!4(P'.II 1'xa.i.1. I i�atr.a (1) 1 9/25/2023 '1.0.11::1.3 AM (P;S'r) I Pa.!..ae 1. of 6
TCP 7011473 09/25/2023
COMMERCIAL GENERAL LIABILITY
CG83601216
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY EXTENSION FOR TECHNOLOGY
COMPANIES ENDORSEMENT
This Endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
This endorsement broadens coverage. The following schedule of coverage extensions is a general coverage
description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this
endorsement along with your entire policy carefully to determine the extent of coverage afforded.
SCHEDULE OF COVERAGE
EXTENSIONS
_.� _...._
A,
Additional Insured - Lessors of Leased
K.
.--__ce, Offense.
Duties in the Event of Occ urren
mmB._
Eg-- ..� ent..._. ��.._ ."""_..".
Claim or Suit.-__..-
.._....""....._ ..
Additional Insured - Owners, Managers or
._..�._.—
L
Expected or Intended Injury or Damage
Premises
_"or
..r erty Dam q
C.
_.�-
Additional l _.-.�..
.
_.....
alPayments
D.
AdditLessors
n�al
Insured -Written Contr
.-.....
No-ow_e.dA_ircraf
"Areement
E.
Limit Per Location
O
Non-owned�
Watercraft
F.
Amateur Athletic Particiants� - -
_�_
P.
_ Formed
Newly Ac�"....� Or ar�izations
G
Bodil Ir1 ur Definition
.:..` _ � y _..."".. -. ._...�.._
Q.
��°
Su rnentaedPa m nts
H.
Broadened Named Insured
R.
Unintentional Omission
i.
Damage to Property - Borrowedquipment, .... m. "
S._
Waiver of Subrogation - Blanket ....""
"--Good
Customer Goods Use of Elevators
".. m.;
J.
_ _-__ ._.._" _ ._.__mm
Samaritan Services
__ __. _..... .. ._..........
A. -ADDITIONAL INSURED - LESSORS OF LEASED EQUIPMENT
Under Section II - Who Is An Insured, the following is added:
Any person or organization that is an equipment lessor is an insured, but only with respect to liability for "bodily
injury", "property damage", "personal and advertising injury' caused , in whole or in part, by your acts or
omissions in the maintenance, operation or use by you of equipment leased to you by such equipment lessor.
The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage"
caused by an "occurrence" that takes place, or "personal and advertising injury' caused by an offense that is
committed after the equipment lease expires.
B. ADDITIONAL INSURED - OWNERS, MANAGERS OR LESSORS OF PREMISES
Under Section II - Who Is An Insured, the following is added:
Any person or organization that is a premises owner, manager or lessor is an insured, but only with respect to
liability arising out of the ownership, maintenance or use of that part of any premises leased to you.
The insured provided to such premises owner, manager or lessor does not apply to:
1. Any "bodily injury' or "property damage" caused by an "occurrence" that takes place, or "personal and
advertising injury" caused by an offense that is committed, after you cease to be a tenant in that premises;
or
2. Structural alterations, new construction or demolition operations performed by or on behalf of such
premises owner, manager or lessor.
a
Includes copyrighted material of Insurance
Services Office, Inc., with its permission.
Page 1 of 5
76466814 1 16440 1 23-24 All/E&0 $SM/Crime $1M/ML Tail I Petra (1) 1 9/25/2023 10:11:13 AM (PST) I Page 2 of 6
C. ADDITIONAL INSURED - VENDORS
Under Section II - Who Is An Insured, the following is added:
Any person or organization that is a vendor and that you have agreed in a written contract or agreement to
include as an additional insured on this Coverage Part is an insured, buy only with respect to liability for "bodily
injury" or "property damage" that:
1. Is caused by an "occurrence" that takes place after you have signed and executed that contract or
agreement; and
2. Arises out of "your products" which are distributed or sold in the regular course of such vendor's business.
The insurance provided to such vendor is subject to the following provisions:
1. The limits of insurance provided to such vendor will be the limits which you agreed to provide in the written
contract or agreement, or the limits shown in the Declarations, whichever are less.
2. The insurance provided to such vendor does not apply to:
a. Any express warranty not authorized by you;
b. Any change in "your products" made by such vendor;
c. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the
substitution of part under instructions from the manufacturer, and then repackaged in the original
container;
d. Any failure to make such inspections, adjustments, tests or servicing as vendors agree to perform or
normally undertake to perform in the regular course of business, in connection with the distribution or
sale of "your products";
e. Demonstration, installation, servicing or repair operations, excepts such operations performed at such
vendor's premises in connection with the sale of "your products"; or
f. "Your products" which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or substance by or on behalf of such vendor.
Coverage under this provision does not apply to:
1. Any person or organization from whom you have acquired "your products", or any ingredient, part or
container entering into, accompanying or containing such products; or
2. Any vendor for which coverage as an additional insured specifically is scheduled by endorsement.
D. ADDITIONAL INSURED - WRITTEN CONTRACT OR AGREEMENT
Under Section II - Who Is An Insured, the following is added:
Any person or organization that is not otherwise an insured under this Coverage Part and that you have agreed
in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but
only with respect to liability for "bodily injury" or "property damage" that:
1. Is caused by an "occurrence" that takes place after you have signed and executed that contract or
agreement; and
2. Is caused, in whole or in part, by your acts or omissions in performance of your ongoing operations to
which that contract or agreement applies or the acts or omissions of any person or organization performing
such operations on your behalf.
The limits of insurance provided to such insured will be the limits which you agreed to provide in the written
contract or agreement, or the limits shown in the Declarations, whichever are less.
E. AGGREGATE LIMIT PER LOCATION
Under Section III - Limits Of Insurance, the following is added:
The General Aggregate Limit applies separately to each of your "locations" owned by or rented or leased to
you.
Under Section V - Definitions, the following is added:
"Location" means premises involving the same or connecting lots, or premises whose connection is
interrupted only by a street, roadway, waterway or right-of-way of a railroad.
Includes copyrighted material of Insurance
Services Office, Inc., with its permission.
CG83601216
No-
764GG814 116440 123-24 All/r&o $5M/Crime $lM/ML Tail I Petra (1) 19/25/2023 10:11:13 AM (PST) I Page 3 of 6
F. AMATEUR ATHLETIC PARTICIPANTS
Under Section U'Who |eAnInsured, the following inadded:
Any person representing you whileporticipaUnginamatuurathleUoaoUvitieothatyouupnnoor.Huwevor,no
Such person is an insured for:
1. "Bodily injury" to:
a. A co -participant, your "employee" or "volunteer worker" while participating in amateur athletic activities
that you sponsor; ur
b. You, any partner or member (if you are a partnership orjoint venture), or any member (if you are a
limited liability compaoy)'or any "executive officer" (if you are anorganization other than oportnorahip
joint venture, or|UnnbU �dab|l�ycmmpamy):or '
2. "Property damage" to property owned by, occupied or used by, rented to, in the care, custody, or control of,
orover which physical control inbeing exercised for any purpose by:
n. Aoo'partioipant. your "employee" or"volunteer wmrker"; or
b. You, any partner or member (if you are a partnership or joint venture), or any member (if you are a
limited liability oompany).orany "executive officer" (if you are anorganization other than apartnership,
joint venture, or limited liability company); or
G. BODILY INJURY
Under Section V'Definitions, the definition of "bodily injury" is deleted and replaced by the following:
"Bodily means physical injury, sickness, ordisease sustained byaperson, including death resulting from
any o¢these, "Bodily injury" mental injury, mental anguish, humiliation, mrshock sustained bya
person, |Ydirectly resulting from physical injury, sickness, ordisease sustained bythat person.
H. BROADENED NAMED INSURED
Under Section |1'Who hoInsured, the following ieadded:
Any person nrorganization named inthe Declarations and any organization you own, newly acquire orfonn otherMhanapar�erohijoint t venture, limi
ted �x�ompa�and over wh�h mdnhsnm�ethan 5O`cf
the ,interests entitled `" vote generally w/the election c*the governing body of such will queHfyaoo
Name�Insured �there |s noother sinmNeminsurance available &osuch o�yen�o0-- mm organization`-�n'- of the policy
period. --
Coverage under this provision does not apply hoany person cvorganizaUonfor which coverage ioexcluded by
endorsement.
|. BROADENED PROPERTY DAMAGE - BORROWED EQUIPMENT, CUSTOMERS'GOODS AND USE OF
ELEVATORS
The insurance for "property damage" liability is subject to the following:
1. Under Section |- Coverages, Coverage A.Bodily Injury and Property Damage L|ab|||typanogrmph�
Eon/us|ons"item]..�nm���Tm������yia�nm�ndedaofoN��e� ' ''
��
a. The exclusion for personal �rm��y | nthecare,nustmdyoroontno|oftheinnuveddmamucdapp|yto"Pm7pertydanage^toequ|pmentyuub000wwhi|eata]obo/teandpnovideditianotbeimguaedby anyone toperform operations aLthe time #floss.
b. The exclusions for:
(1) Property loaned toyou;
(3) Personal property inthe care, custody orcontrol ofthe insured; and
(3) That particular part ofany property that must be nauUnnad, repaired or replaced because "your work"
was incorrectly performed onit;
dmnot apply bo"property damage" to "customers' goods" while on your premises nor do they apply to
~property damage" arising from the use Of elevators at premises you own, rent, lease or occupy.
2. Subjmct*otheEamhC>ccurrenoeLim|t,the,moet,wew)Upayfor^pnuportydomage''tn^ouatomere'goodo^ia
$25.00Oper °mmourremce~.
3. Under Section V'Definitions, the following isadded:
"Customers' goods" means goods of your customer on your premises for the purpose of being:
a. Repaired; or
b Used inyour manufacturing prooeno.
Includes copyrighted material ofInsurance
Services Office, Inc., with its permission.
Page 3 of 5
76466814 1 16440 1 23-24^u/E" $-9w/C,im" $In*",aiz | ,== u/ 1 */25*023 `".o.z`um 'PST) | Page of 6
4. Under Section IV - Commercial General Liability Conditions, the insurance afforded by this provision is
excess over any other valid and collectible property insurance (including any deductible) available to the
insured whether such insurance is primary, excess, contingent or on any other basis. Any payments by us
will follow the Other Insurance - Excess Insurance provisions.
GOOD SAMARITAN SERVICES
Under Section II - Who Is Insured, paragraph 2., item d., the following is added:
This exclusion does not apply to your employees or volunteer workers, other than an employed or
volunteer physician, rendering "Good Samaritan services".
2. Under Section V - Definitions, the following definition is added:
"Good Samaritan services" means any emergency medical services for which no compensation is
demanded or received.
K. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section IV - Commercial General Liability Conditions, paragraph 2., Duties In The Event Of
Occurrence, Claim or Suit is amended to include the following:
1. The requirements that you must:
a. Notify us of an "occurrence" offense, claim or "suit"; and
b. Send us documents concerning a claim or "suit" apply only when such accident claim, "suit" or loss is
known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) An executive officer of the corporation or insurance manager, if you are a corporation; or
(4) A manager, if you are a limited liability company.
2. The requirement that you must notify us as soon as practicable of an "occurrence" or an offense that may
result in a claim does not apply if you report an "occurrence" to your workers compensation insurer which
later develops into a liability claim for which coverage is provided by this policy. However, as soon as you
have definite knowledge that the particular "occurrence" is a liability claim rather than a workers'
compensation claim, you must comply with the Duties In The Event Of Occurrence, Offense, Claim Or Suit
Condition.
L. EXPECTED OR INTENDED INJURY OR DAMAGE (PROPERTY DAMAGE)
Under Section I - Coverages, Coverage A, Bodily Injury And Property 'Damage Liability, paragraph 2.,
Exclusions, item a., Expected' Or Intended Injury, is deleted and replaced by the following:
a. Expected or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable
force to protect persons or property.
M. MEDICAL PAYMENTS
1. Under Section I - Coverages, Coverage C, Medical Payments, paragraph 1., Insuring Agreement, the
requirement that expenses are incurred and reported to us within one year of the date of the accident is
changed to three years.
2. The Medical Expense Limit is $15,000 per person or the amount shown in the Declarations as the Medical
Expense Limit, whichever is greater.
3. This provision M. does not apply if Coverage C, Medical Payments, is otherwise excluded either by the
provisions of the Coverage Form or by endorsement.
N. NON -OWNED AIRCRAFT
1. Under Section I - Coverages, Coverage A, Bodily Injury and Property Damage Liability, item 2.,
Exclusions, item g., Aircraft, Auto Or Watercraft, does not apply to an aircraft that is:
a. Hired, chartered or loaned with a paid crew; and
b. Not owned by any insured.
2. The insurance afforded by this provision N. is excess over any other valid and collectible insurance
(including any deductible or Self Insured Retention) available to the insured, whether such insurance is
primary, excess, contingent or on any other basis. Any payments by us will follow the Other Insurance -
Excess Insurance provisions in the Commercial General Liability Conditions.
Page 4 of 5 Includes copyrighted material of Insurance CG 83 60 12 16
Services Office, Inc., with its permission.
76466814 1 16440 1 23-24 All/E&O $SM/Crime $lM/ML Tail I Patra (1) 1 9/25/2023 10:11:13 AM (PST) I Page 5 of 6
O. NON -OWNED WATERCRAFT
1. Under Section II - Who Is Insured, is amended as follows:
To include as an insured for any watercraft that is covered by this policy, any person who, with your
expressed or implied consent, either uses or is responsible for the use of a watercraft. However, no person
or organization is an insured with respect to:
a. "Bodily injury" to a co -"employee" of the person operating the watercraft; or
"Property damage" to property owned by, rented to, in the charge of or occupied by you or the
employer of any person who is an insured under this provision.
2. In the exception to the Aircraft, Auto Or Watercraft exclusion under Coverage A, Bodily Injury And
Property Damage Liability, the limitation on the length of a watercraft is increased to 75 feet.
3. The insurance afforded by this provision O. is excess over any other valid and collectible insurance
(including any deductible or Self Insured Retention) available to the insured, whether such insurance is
primary, excess, contingent or on any other basis. Any payments by us will follow the Other Insurance -
Excess Insurance provisions in the Commercial General Liability Conditions.
P. NEWLY ACQUIRED OR FORMED ORGANIZATIONS
Under Section II - Who Is An Insured, item 3.a. is deleted and replaced by the following:
a. Coverage under this provision is afforded only until the end of the current policy period.
Q. SUPPLEMENTARY PAYMENTS
Under Section I - Coverages, Supplementary Payments - Coverages A and B is amended as follows:
The limit for the cost of bail bonds is amended to $2,500; and
2. The limit for reasonable expenses incurred by the "insured" is amended to $500 a day.
R. UNINTENTIONAL OMISSION
Under Section IV - Commercial General Liability Conditions, paragraph 6., Representations, the following
is added';..
The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in
issuing this policy will not prejudice your rights under this insurance.. However, this provision does not affect our
right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with
applicable insurance laws or regulations.
S. WAIVER OF SUBROGATION - BLANKET
Under Section IV - Commercial GeneralLiability Conditions, paragraph B., Transfer of Rights of
Recovery Against Others to Us the following is added:
We will waive any right of recovery we may have against any person or organization because of payments we
make for injury or damage arising out of Your ongoing operations done under a written contract or agreement
with that person or organization and included in "your work" or the "products -completed operations hazard".
This waiver applies only to persons or organizations with whom you have a written contrast, executed prior to
the "bodily injury" or "property damage", that requires you to waive your rights of recovery.
•- .• . s -
-
Office,Services Inc., with its permission.
Page 5 of 5
ON
76466814 116440 1 23-24 All/E&O $SM/Crime $1M/ML Tail I Patra (1) 1 9/25/2023 10:11:13 AM (PST) I Page 6 of 6