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PROOF OF INSURANCE (2024) CLOSEDPage 1 of 1 DATE (MM/DD/YYYY) ,ACC RO'' CERTIFICATE OF LIABILITY INSURANCE �10/31/2023 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 Willis Towers Watson Certificate Center PHONE ., 1-877-945-73. I. LA,�.,. .. Willis Towers Watson Northeast, Inc. PHONE l c/o 26 Century Blvdq, @fI.Xal 78 _ 1 888 467 2378 Ali.,„ Nta�., _ P.O. Box 305191 ,EAD�SAIL S. certificates@willis.com ..... ,,,,....._. ....... ..._ ........... - Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE I NAIC# INSURER A : rica anc Company 5 INSURED Sokio AmericaAInsurancesCompany INSURERS: 111 Canon Solutions America, Inc, So o America 6 Marine Insurance Com p mp 89 7 3 9 300 Commerce Square Blvd. INSURERC Burlington, NJ 08016 INSURER 0 .. ... ................... ......... .... INSURER E : nwocerc� roc OTIcIPATc MlttUlncO• W30937336 RF'VI.gl tJ NUMRFR- 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. 7--- ... .........,, 1 ........... .. e EXP ...., - "WilkAODuW'`'Ui'....... ... .......-7 POLICY EFF POLL..... _ .... ...- ---- .......... ........ LIMITS a POLICY.�.� TYPE OP,.INSURANCE ` vlrvnNUMBER MMIDD/YYYY MMIDO X t COMMERCIAL GENERAL LIABILITY '.. EACH OCCURRENCE $ 1,000,000 ty CLAIMS -MADE X OCCUR AMAGE'L(i '., PRImMISFS (, EYfi7�1,000,000.,. A one person) MEDEXP An........ $ 5,000 ...... GLD6404741-13 11/01/2023 11/01/2024 ADVINJURY PERSONAL g/ _ ..."...........-.._ 1,000,000 $ ... .... ..... .. p 0 $ 00,000 EN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE RRO'" POLICY J/n'O�T � X,J LOC PRODUCTS-COMP/OP AGG s 1 000 000 $ OTHER: AUTOMOBILE LIABILITY CO BINE SIINGLEUMIT _Ltb_' RoddTit) .........___ ... .............. $ 1,000,000 ,.... .._,_._..__ .---....... X ANY AUTO INJURY (Per person) $ B OWNED SCHEDULED AAL30026136801 11/Ol/2023 11/Ol/2024 BODILY INJURY Per accident) ( $. AUTOS ONLY AUTOS HIRED NON-OWNED IBODILY 0i�6 ERTYDAA_MG $ - AUTOS ONLY ....,., .. _wr ur„a^udon.)p, .. _.-....._.- X UMBRELLALIAB X CH OCCURRENCE $ 5,000 00 _ A EXCESS LIAB CLAIMS -MADE CU6404740-13 11/01/2023 11/01/2024 AGGREGATE �$ - 5,.000 000 ..... DED.._ X I RET E ..__.. ENTION $ 10, 000 _. $ EMPENSATION PER OTH STATU ER AND EMPLOYWORKERS RS' LIA ILIITY Y/N ___CE❑ [EIEAq 1 000,00000FICR ECUTIVE NIA JCD40017RO 11/01/2023 11/01/2024 H A, CIDENT $ MEMER EXCLUDED (Mandatory ) E EA EMPLOYEE ...... --- $ 1,000,000 ................... ... If Dyes, describe under ' DESCRIPTION OF OPERATIONS below E.L DISEAS.... �, E POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of El Segundo is included as Additional Insureds as their business interests may appear by written contract with the Named Insured. 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: Richard Bogate 350 Main Street - Room #5 " E1 Segundo, CA 90245-3895 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 24901356 BATca: 3192173 POLICY NUMBER: GLD6404741-13 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) I Location(s) Of Covered Operations Any person or organization if you are required to do so under As required by written contract witn a Namea insure❑ a written contract, a�y reement or permit provided the "bodily injury or,"propperty afamage"" occurs subsequent to the execution 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 B 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. 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 Page 1 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 0413 POLICY NUMBER: GLD6404741-13 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 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 subse uent to the execution of the contract As required by written contract with a Named Insured 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" 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 Policy #GLD6404741-13 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED 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 Named 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 Company Copy Page 1 of 1 POLICY NUMBER: AAL30026136801 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 1 11FA 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: 11/01/2023 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 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (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. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 11/01/2023 Policy No.JCD40017R0 Endorsement No. Insured: CANON U.S.A., INC. Premium: INCL. Insurance Company: Sompo America Fire & Marine Insurance Company; WC 00 0313 (Ed. 4-84) Countersigned by m 1983 National Council on Compensation Insurance.