Loading...
PROOF OF INSURANCE (2024 - 2025) CLOSEDUTILCOS-01 ...., C'PARR DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/21 /2024 _ . ......._ - ........... ................... ........... _•___a..._ 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,_nnWWWWWmm or _... the pollcy(ies) must have ADDITIONAL INSURED provisions 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 License # 0757776 CONTACT Verity Racht A/CNExt) ..,'-•_°° ............ HUB International Insurance Services Inc. HONE Cromwell Avenue Suite 101AvM6� S,, veil .r,acthCbine.r. at�nB..i ,.0.. (FAAICX__, Nol� ...- _, -....._.,...�............. ,.. Fresno, CA 93711 ------....., .. .....INSURER(S�AFFORDIN,,,,G COVERAGE .... ... NAIC # ....... i, Insurance C41840 -. ......... _ ._ - INsuRRn:Allmerca FinancialBe - nefit Lnsurncompany .w_..._ INSURED INSURga, a �, Employers Assurance Company 25402 �, g lers Casualty and Surety Company 19038 Utili Cost Mana ement LLC INsuRER„c Trave __ 1100 W. Shaw Avenue, Suite 126 INSURER D :..............�....,._------ .. ......,.,.,.,.._ .....__ .... ...,...,.--- ....... Fresno, CA 93711 INSUREREr:,._. ... .............----.....,....,... ... ..._�.. INSURER F : _ COVERAGES _ -CERTIFICATE NUMBER: _ _ REVISION NUMBER: _...... m 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, BY PAID CLAIMS A X EXCLUSIONS coMMERC AND GeN. CONDITIONSREDUCED.. SHOWN MAY HAVE B INSR ADDL SUBR POLICY EFF POLICY UP, LIMITS TYPE OF INSURANCE POLICY NUMBER MMMJ? r ,EACH OCCURRENCE $ 1,000,000 DAMA(38 TO ENTED 0,000 MIED E�XP{AnR..pe1.. 305 000, CLAIMS MADE �X OCCUR X J636703 2/5/2024 2/5/2025 6 S u PER4PNAl, & AOV INJURY 1,000,000 gEN'L AGGRFGATE LIMIT APPLIES P 2,000 000 .m, ❑ GENERAL AGGREGATE S , 2,000 000 PER: X POLICY LOC PROL�I ITS COMP/OP,AGG Symn,n,n _ {}Ttl„iEl2', ............. �..w.............. ...... � $ry . �._ A AUTOMOBILE LIABILITY ©dd' lo 100,011"i LIMIT S 1,000 000 ANY AUTO J636703 2/5/2024 2/5/2025 ODILY INJURY dPer,P$ .....,�. OWNED' SCHEDULED AUTOS ONLY AUTOS BODI;hmY_JNJURYtFeraecident)yS, .XHNR LT NON -OWNED �{ ..., AU'1bONLY X,,. AUTOS ONLY ,P!�07ar�RYn4"d+ti'MfvG9:.�_'�._ _. _ 0 A X UMBRELLA LIAB X OCCUR �E;A.GH.QGGIJRRENC,E yu„ 2000,000 EXCESS LIAB CLAIMS -MADE J636703 215/2024 215/2025 .rormcAT s 466606 ._.........DED RETENTIO.N.$ ......................._.._ B WORKERS COMPENSATION X, ,TAT!„IT OTH AND EMPLOYERS' LIABILITY ER YIN FN 032700220 2/4/2024 2/4/2025 1,000 000 ANY PROPRIETOR/PARTNERIEXECUTIVE [ F„l F,/�CH ACCIDENT m„ $, OFFICER.Ra9EMBER EXCLUDED? N / A 1,000 000 lMandattoryn NH) E L. DISEASE. EA, EMPLOYE S If yes, describe under Fri., 1,000,000 C P o Liab I ty FDPERATIONs aelow 107256057 5/23/2023 5/23/2024 Each l ClaimSEASE PpLlcY LIMY _$ 1,000,000 C Pro Liability 107256057 5/23/2023 5/23/2024 Retention 25,000 City of El Segundo, its officials, and employees as additional insured, Umbrella Coverage isf l Irmo 9 focemi. required) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHVCL.ES (AGGRO 101, Additional' Remarks Schedule„ may f a. a Is following Endorsements attached : CG2012 0413, PB6072 0711 .... _. .............. .... _. 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. Attn: Joe Lillio, Director 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ........ .. ____..,.. ....__. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: J636703 COMMERCIAL GENERAL LIABILITY CG20120413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE tate Or Governmental Agency Or Subdivision Or Political Subdivision-. ity of El SegundoAttn: Joe Lillio, Director 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a B. permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. CIS 20120413 2. This insurance does not apply to: a. "Bodily injury" "property damage" or ""persona'l and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard"". 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 re�wired try a contract or agreement, the most we wilt 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 Insured Copy Effective Date: 2/4/2024 - Expiration Date:2/4/2025 Policy Number: J636703 BUSINESSOWNERS PB 60 72 07 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT TO OTHER INSURANCE CLAUSE FOR ADDITIONAL INSUREDS - PRIMARY AND NON- CONTRIBUTORY WHEN REQUIRED IN A WRITTEN AGREEMENT OR CONTRACT WITH YOU This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS Only with respect to any additional insured, in the COMMON POLICY CONDITIONS, form PB 00 09, under condition H. OTHER INSURANCE, paragraph 2.a. is replaced by the following: H. OTHER INSURANCE 2. Under any liability coverage provided by this policy, a. If for injury or loss we cover, there is other valid and collectible insurance available to any additional insured under another policy, our obligations are limited as follows: (1) Issued by another insurer, or if there is self insurance or similar risk retention that applies to a loss covered by this policy, then this insurance provided by us shall be excess over such other insurance, unless you have agreed in a written contract or written agreement signed prior to the loss that this insurance shall be primary: (a) Then this insurance is primary. If other insurance is also primary, we will share with all that other insurance as described in d. below; and (b) The coverage afforded by this insurance is non-contributory with the additional insured's own insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured to any other person or organization's policy.; or (2) Issued by us or any of our affiliate companies, that applies to a loss covered by this policy, then only the highest applicable Limit of Insurance shall apply to such loss. This condition does not apply to any policy issued by us that is designed to provide Excess or Umbrella liability insurance. All terms and conditions of this policy apply unless modified by this endorsement. PB 60 72 07 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ACP BPO 7872036862 INSURED COPY 47 01680