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PROOF OF INSURANCE (2024) CLOSED
DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 09/01/2023 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 endorsement(s). PRODUCER CONTACT ILF C V.................... PHONE TWO ALLIANCE CENTER tA/, w l { 3560 LENOX ROAD, SUITE 2400 EMAIL �`�� ATLANTA, GA 30326 ADDRESS' INSURERS AFFORDING COVERAGE NAIC # CN130114897-EOIC-GAWU-23-24 INSURER A : The Charter Oak Fire Insurance Co. 125615 INSURED................................._.....,...................................................................................................................................................................................................................._.._.m._........._,.�.�......_....�_...--_�-._..._._..�_._......_....�.�._.._�.._..-.___ W.-..........................................................._......._................N674 .�.m.,,, Centr lSq LLC Technologies, LLC INSURER c :Travelers . oraece Company Y623 INSURER B p Casual Company Of America TriTech Software Systems INSURER D : Travelers Casual And Sure Com p�n 19038 1000 Business Center Dr. --�-°° T � Lake Mary, FL 32746 ...INSURER .E..:,AIG Seoial!y..Insurance..Com_pan.1!.............................................._........ m 26883 CnVFRAnFA rFRTIFIC"ATF NI IMIRFR- ATL-005306303-10 RFVISIAN NIIMIIRFR• 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. ILTRADDL Ltd TYPE OF INSURANCE SUBR POLICY NUMBER. POLICY EFF YYY MA04/Y POLICY EXP MMIDD YY _., LIMITS A L LIABILITY co.. H-630-65758660-COF-23 08/31/2023 08/31/2024 EACH OCCURRENCE $ 1,000,000 X-., CLAIMS-MADEE� X OCCUR DAMAGE TG R E PRFiv11SESEamoccurrence)._.ITIT$ �.,. ................... 1,000,000 MED EXP An one erson $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO POLICY E,CT LOC N PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER B AUTOMOBILE LIABILITY BA-6S783539-23-13-G 08131/2023 08131,12024 COMBINED SINGLE I IMa e accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO � OWNED SCHEDULED AUTOS ONLY AUTOS -� BODILY INJURY (Per accident) $ ...,....... X,,,., HIRED X NON -OWNED PROPER NY DAMAGE $ AUTOS ONLY AUTOS ONLY 1F'�rmri,�dutl). _ _. $ X UMBRELLA LIAB OCCUR CUP-6S801390-23-13 08/31/2023 08/31/2024 EACH OCCURRENCE $ 10µ000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 10,000,000 DED I X I RETENTION $10 000 $ D WORKERS COMPENSATION UB-6S783668-23-13-G 0813112023 0813,112024 X PER OTH- AND EMPLOYERS' LIABILITY Y t N STATl1TE . _I ER.._._ w--,_,�,,,,.,•• ANYPROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ ,00,000 OFFICER/MEMBER EXCLUDED? [N] N / A 1 000,000 (Mandatory in NH) E.L DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ E E&O/Cyber 01-424 27-66 08131/2023 08/31/2024 Limit 5,000,000 SIR 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) El Segundo Police Department is included as additional insured where required by written contract with respect to General and Auto Liability. Waiver of subrogation is applicable where required by written contract will respect to General Liability and Workers Compensation. t,tK I Wlt A I t HVLUtK El Segundo Police Department #926, Records Supervisor/Crime Analyst 348 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 of Marsh USA LLC ©1988-2016 ACORD CORPORATION. All rights reserved.. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN130114897 LOC #: Atlanta 0 ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA, LLC. CentralSquare Technologies, LLC Supedon,LLC POLICY NUMBER TriTech Software Systems 1000 Business Center Dr. ... _............. _ Lake Mary, FL 32746 CARRIER NAIC CODE EFFECTIVE DATE: AUDI I IONAL KEMAKK THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE. Certificate of Liability Insurance Excess E&O/Cyber: Carrier: Indian Harbor Insurance Company Policy Number: MTE9043949 02 Effective Date: 08/31/2023 Expiration Date: 08/31/2024 Limit: $51VI x $5M ACORD 101 (008/01) 0305-01-00-0002281-0002-0004795 U 2008 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD '*