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PROOF OF INSURANCE (2024) CLOSEDPage 1 of 2 DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 1 09/29/2023 ACORD 25 (2016/03) 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 Tn Pm,,,� 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. it 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 endorsernent(s). PRODUCER N/1 Willis 11 877 945-737gson�CertificsteCenter1-888-467- 8 Willie Towers Watson Northeast, Inc. PHONE 237 c/o 26 Century Blvd E-MAIL ,.i�F,fm$S'x. . com P.O. Box 305191 certificates@vi is...� Nashville, TN 372305191 USA INSURER'SiAEFORDIN�GCOVER,AOF NAICaf INSURERA Insurance Company -- :, ........._..�. ACE American �. . ��.�. � ........� � ..... 43575 INSURED INSURER B: Indemnity Insurance Company of North A rij __ uniriret corporation and its Subsidiaries ACE Fire Underwriters Insurance Company 20702 68 Jonspin Road BNURCR C Wilmington, afA 018871086 YI'4SUR. 0 COVERAGES CERTIFICATE NUMBER: W30451918 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. It!Ii% r AOOL SUaR� LTR TYPEOFINSURANCE POLICY NUMBER R I ICY E F POLICY EXP LIFTS MM+DOGVVYY MPAMONYVY COMMERCIAL GENERAL LIABILITY EACHoccURRENCE S 21000,0001 I CLAIMS -MADE � OCCUR XI° r$ 1 PRF 000 0000 A X Contractual r MV A ®o) 4n) � 5,0 0 Y Y - HDOG47359624 10/01/2023 10/01/20241PERSONAL &ADVINJURY S 2,000,000 ..........,,_,_ GFN LACOPGEC,AT'E LIMIT APPLtlCS PER: GENERAL AGGREGATE S 0,000,000 .._..24,000,000 PRO- � + LOG I POLICY ��. JECT G•-„�; .E PRODUCTE"w __ IP AGC S G S OTHER � COMBING SINGLE LtlY�11t 000 1 4000' AUTOMOBILE LIABILITY &A,gfa4tlrrnV)I_,,, .. ....,. .--.- --BODILY XANY AUTO INJURY (Per person) $ . .... ,I A SCHEDULED Y Y ISAH10773544 AUTOS 44 10/01/2023I10/01/2024 BODILY INJURY (Per accident) AU OS ONLY .. HIRED NON -OWNED PIVCIPEEi VDAMA4 E S AUTOS ONLY - AUTOSONLY I$ UMBRELLA i OCCUR EM1(HOCCURRENC EXCESLIALI tLAtlgJ�AJ( ACGREGA"IE Is _. DED tIETCNfVm')hG' I R WORNE'RSCOMP 4%TK ER .� PLOYERSLIA LIABILITY AND EMPLOYERS* Y f 14 E.L.EL EACH AiCtlDN1 ) 1, 000, 000'. 8 ANVI ICCGHCLGdi%1*FIGNE6iiEE;UftlE OP 1ICE111MEmIBEAEXCLUDED? NoY NIA T oiLRC50739004 (A05) 10/Ol/2023 10/Ol/2024p.µ'TAT 1,000,000 E L DISEASE EA EMPLOYLEI......... (Ma,ndetory In NH) Id yet, �uW'tl a rwCl r . ' E L, DisrASE POLICY LIMO q $ 1, 000, 000 DESCRIPTION OF OPEa :RATIONS i e o A iWorkers Compensation and Y WCUC50739181(OH) 10/01/2023 10/01/2024 EL Each Accident 1$1,000,000 Employers Liability EL Disease -Pol Limitl$1,000,000 )EL Disease - Each SurPs1, 000, 000 :Per Statute DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) Division/Location: 324 Additional Insured under the General Liability policy for bodily injury and/or property Certificate Holder is an damage resulting from the work or product of the Named Insured where required by a written contract with the Named Insured. SEE ATTACHED City of El Segundo Attn: City Clerk City Clerk's Office, 350 Main Street Room 5 El Sogas'ndo, CA 90245-3813 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 9R xc: 24733338 RATcHl 3149273 6631: 2 - of 2 AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc„ UniFirst Corporation and its subsidiaries ^---- �- 68 Jonspin Road POLICY NUMBER Wilmington, NA 018871086 See Page 1 CARRIER See Page 1 NAIC CODE Se® Page 1 EFFECTIVE DATE: See Page q 1 Page 2 Of 2 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: ,Certificate of Liability Insurance �.._. _ e^ _.. . ,.. . ..�........ ..... _.._v „—.........� .. .._ _ Certificate Holder is an Additional Insured for Auto Liability as their interest may appear ear if required bywrittencontract. It is understood and agreed that UniFirst Corporation waives its right of subrogation against the Additional Insured which may arise by reason of a payment of claim under General Liability, Auto Liability and Workers Compensation policies, if required by written contract and as permitted by law. Additional Insureds: City of E1 Segundo, its officials, and employees. General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured's. INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company NAIC#: 20702 POLICY NUMBER: SCFC50739065 (WI) EFF DATE: 10/01/2023 EXP DATE: 10/01/2024 SUBROGATION WAIVED: Y TYPE OF INSURANCE: Workers Compensation and Employers Liability Per Statute LIMIT DESCRIPTION: EL Each Accident EL Disease -Pol Limit EL Disease - Each Emp LIMIT AMOUNT: $1,000,000 $1,000,000 $1,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID:24733338 BATCR:3149273 CERT: W30451918 6631: 2 of 2