Loading...
PROOF OF INSURANCE (2024 - 2024) CLOSEDA�/20 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/25/2023 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 AOn Risk Services South, Inc. Franklin TN Office CONTACT NAME: (A/C. o. Ext): C866) 283-7122 A/C. No.: (800) 363-0105 E-MAIL ADDRESS: 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA INSURER(S) AFFORDING COVERAGE NAIC ft INSURED INSURER A: Twin City Fire Insurance Company 29459 Arcadis, a California Partnership 537 South Broadway, suite 500 Los Angeles CA 90013 USA INSURERB: Hartford Fire Insurance Co. 19682 INSURERC: Hartford Accident & Indemnity Company 22357 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570101699665 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 20ECSOLS318EACH OCCURRENCE $1,000,000 CLAIMS -MADE - OCCUR SIR applies per policy terns & condi ions UAMAGE I U HEN I EU PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10, 000 PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ElPRO JECT ElLOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY 20 UEN OL5319 10/01/2023 10/01/2024 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HI RED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION C A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED,N (Mandatory in NH) N/A 20WNOL5323 ADS 20WPROL5321 MA, WI 10/01/2023 10/01/2023 10/01/2024 10/01/2024 X I PERSTATUTE I OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Engineering and Architechtural detail and Design and Consultant Services for the Urho Saari swim stadium. The City of El Segundo, its officials and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo AUTHORIZED REPRESENTATIVE Attn: Elias Sassoon 350 Main St. E1 Sequndo CA 90245 USA Jv. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 20 ECS OL5318 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket, as required by written contract. All locations where required by written contract. 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 © Insurance Services Office, Inc., 2012 Pagel of 2 C. 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: 20 ECS OL5318 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - 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 Description Of Completed Operations Blanket, as required by written contract. All locations where required by written contract. 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" 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 © Insurance Services Office, Inc., 2012 Page 1 of 1 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 09/21/2023 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 NAME:, Aon Risk Services South, Inc. PHONE (866) 263 7122 FPx (600) 363-0105 (� Cu•Ext)µ ac.Ne.: .-.................................. Franklin TN office 501 Corporate Centre Drive E-MAIL Suite 300 ADDRESS: Franklin TN 37067 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED __............................ INSURER A:: Indian Harbor Insurance Company 36940 Arcadis, a California Partnership ............._....__.�............ _.��................................................. 537 South Broadway, Suite 500 IINSURER B: ......-•-•---------..... ........ •----•-•-••••......_-- Los Angeles CA 90013 USA ''. INSURER C: INSURER D: ......... ................_............ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570101622429 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 TERM$ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Limits shown are as reuested INSn TYPE OF INSURANCE ADOL INqO "SUBR WVO POLICY NUMBER POLICYEFF fMMfnONYYY1 POLICY EXp IMM0UOIYYyyl, LIMITS COMMERCIALGENERALLUIBILITY EACH OCCURRENCE CLAIMS-MADE OCCUR OAWYAG.k 1O REN"J4'0� PI" ,MPS 4,.p'. Irv:;aa»reearc�Rf' .� MED EXP (Any one person) PERSONAL& ADV INJURY GE.IgLAIGG'R5EGAI E L➢ NT APFILI F 9 Pr.R. GENERAL AGGREGATE POLICY PRO- LOC ..... .... .................._ JEIC1 I PRODUCTS- COMP/OPAGG ()DiER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JUa%a=L__ BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUT05 NON -OWNED ..... -•-----....-.-.. PROPERTY DAMAGE ONLY AUTOS ONLY Pe ccident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LWB CLAIMS -MADE DED I ''..RIET"ENTION WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS' LIABILT' tl I N ......_........................._,...�.�...... .......... .�...... ANY PROPRIETOR / PARTNER / EXECUTIVE E L EACH ACCIDENT OFFICERIMEMBER EXCLUDED? E,NIA E L DISEASE -EA EMPLOYEE (Mandatary In NH) Ifyes, describe under •-•--•__._._._.—•_.-- •— _,_ •- .• ����--------...... DFSCRIPTION OF OPERATIONS below 11 E.L DISEASE -POLICY LIMIT A Contractors Pollution US00101061EO23A 06/01/2023 06/01/2024'Each Claim $1,000,00 Liability Professional & Pollution Annual Aggregate $1,000,000 SIR applies per policy ter s & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H mare space is required) For Professional Liability and Pollution Liability coverage, the Aggregate Limit is the total insurance available for claims presented within the policy period for all operations of the insured. The Limit will be reduced byy payments of indemnity and RE: Engineering and Architechtural detail and Design Consultant Services for the urho Saari Swim Stadium. expense. and CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, City Of El Segundo AUTHORIZED -REPRESENTATIVE Attn: Elias Sassoon 350 main St. E1 Sequndo CA 90245 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks ofACORD AGENCY CUSTOMER ID: 570000005571 LOC Ii: . - ADDITIONAL REMARKS SCHEDULE '�..-•-��"" Page _ of _ AGENCY NAMEDINSURED Aon Risk services south, Inc. Arcadis, a California Partnership POLICY NUMBER See certificate Number: 570101622429 CARRIER I NAIC CODE see certificate Number: 570101622429 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits.. INSR LTR TYPEOFINSURANCE IADDL ''.. INSD SUBR WVD POLICYNUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MMMDIYYYY) LIMITS OTHER I FTms-made Fp ution Liability I Contractors gtr essional Liability ACORD 101 (2000101) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD