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PROOF OF INSURANCE (2024 - 2024) CLOSEDDATE (MMIDDIYYYY) ACC>RL> CERTIFICATE OF LIABILITY INSURANCE 06/06/2023 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 Certificates Dept. NAME: Colony West Financial Insurance Services, Inc. APCNNW (714) 542-4870 AIC Nol: (714) 542-4871 License # OC42420 E-MAIL certificates@Colony-west.com ADDRESS: 3843 S. Bristol Street #606 INSURER(S) AFFORDING COVERAGE NAIC # Santa Ana CA 92704 INSURER A: GreatAmerican Insurance Company 16691 INSURED INSURER B : Liberty Insurance Underwriters Inc 19917 Excelsior Elevator Corp INSURER C : CompWest Insurance Company 12177 1961 Blair Ave INSURER D INSURER E : Santa Ana CA 92705 11 INSURER F : COVERAGES CERTIFICATE NUMBER: 23-24 Master Cert 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. - INSR LTR TYPE OF INSURANCE ADD INSD SUB D ..... POLICY NUMBER �� POLICYEF MMIDD POLICY P.....: MMIDD LIMITS '" COMMERCIAL GENERAL LIABILITY .EACH OCCURRENCE $ 1.000,000 300,000 CLAIMS -MADE ❑X OCCUR PREMISES Baoct,uirrenee� $ MED EXP (Any one person)) $ 10,000 A GLP132442606 04/01/2023 04/01/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY � PRO LOC JECT PRODUCTS-COMP/OPAGG $ 4,000,000 Elevator Project General $ 4,000,000 OTHER: _ Eta d gNGLE LIru91T $ AUTOMOBILE LIABILITY i EtM atu:ldrarttl '.. ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY HIRED AUTOS NON -OWNED PROPER'@"Y DAMAGE —w---- $ AUTOS ONLY AUTOS ONLY.. Per accident UMBRELLA LIAB X --'"'""" OCCUR EACH OCCURRENCE '.. $ 1,000,000 B X EXCESS LIAB CLAIMS -MADE 1000473122-03 04/01/2023 04/01/2024 AGGREGATE I $ 1,000,000 DED RETENTION $ $ WORKERS COMPENSATION _ X. ST,GTUTE EERH AND EMPLOYERS' LIABILITY YIN �NIA� $ 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE CW WCP 100056512 02 06/12/2023 06/12/2024 E.L, EACH ACCIDENT -- -,�.__ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) j E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below m E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule, may be attached if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD „,ly�� ' DATE (MMIDD/YY2 1"'E��41'4 CERTIFICATE OF LIABILITY INSURANCE o6�19�zo�3 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 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 C IN Insurance Center PHONE 626 447-8�g68 � F q� ; 626-447-6068 4115 E LIVE OAR AVENUE SUITE 4 EIA-1&1 INSURERS AFFORDING COVERAGE NAIC # ARCADIA CA 91006 INSURER A:Infinity Select Insurance Compan-,� 20260 INSURED INSURER B : I.....„,,........ Excelsior Elevator Corp. wsuRERc: INSURER O: 1961 Blair Avenue INSURiERE - ••• Santa Ana CA 92705 INSURERF: COVERAGES CERTIFICATE NUMBER: 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. INTSTI 1 .... F/PE OF INSURAN i9DI. (1'f)FG . ............. PIJY.I- Y' EFF P ICY EXP . W CE n POLICY NUMBER MMIDDIWy'YY MMPD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ „• „ CLAIMS -MADE D OCCUR I P d•I�- M ED EXPMiru, one . S ._ w. _. ERSONAL�S Af�U"IfdJItlR'� S ..,...... ..- .. _. .......0 GEN'L AG GREGATE LIMIT APPLIES PER. GAENERAI�. AGGREGATE S PRO- LOC _PRODLCTS IaC%'MPIP;7 AGG 5... POLICY � JECT AUTO OTHER' ...... _. MOBILE LIABILITY ' INGLE L.IMi7 g 1 00,0001 504-59867-2275-001 06111/2f�23 a6/ii/202.4' Il:aa�cldd�n3m . ANY AUTO _ URY {Per person) S BODILY IN , NON -OWNED x RcWOREsld A. I INJURY (Per accident) S ........__,_,_,.. AALL UTOS OWNED r � AUTOS $ BODILY J � M 3. _ _ •,. S HIRED AUTOS � � AUTOS IS UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESSLIAB _ CLAIMS -MADE AGGREGATEa S DED RETENTION'S LVO'R4C,E'RS COMPENSATION PA71.1!E ERH AND EMPLOYERS' LIABILITY YIN 1 J......,.,. ANY PROPRIETOR/PP.RTNERIEXECUTIVEi 'wIDEhIT S E.L. E L EACH OFFICEMMEW GIEIEREXCLUDED? N!A ••• IMarldafdry in NH,) E L DISEASE CA EMTrLOYEE $ E” y dOscrlh0•" E.... D05FJM.SE. POLVCY LIMIT S D SCRIP'TiON OF OPERATIONS bell ar DESCRIPTIDN OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 1101, Additional Remarks Schedule, may be attached if more spare Is required) City of El Segundo - Public Works Department is named as Additional Insured per Form 50461AIS01. 30 days notice of cancellation. All terms and conditions are based upon the actual policy form. - CERTIFICATE HOLDER CANCELLATION City of El Segundo - Public Works Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 -• � ©1 988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD