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PROOF OF INSURANCE (2024 - 2024) CLOSEDMILLE-9
ACOROx CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
1166� 1 03/0112024
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 760.471-7116 h MTEA T Michelle Nowell
Alliance Mgt. & Insurance Sery PHONIC 760471 7116 FAX 760-471 9370
355 Via Vera Cruz #7 A1C neo..Ex1) I....... -.-I'll, ..........�__ (AXC Na)
CA A ent/Broker Lic 0737966 E MAIL mnowell6'arriitsdorp.Cam A
San Marcos, CA 92078 AODRss
Michelle A. Nowell
')NsURER)S)AFwy?R�rnNa,cO.,SPfe
Starm.m , 4477
'a�cm�crco n . Stone SDeCialtV' Ins Como 6
Associates Inc
INSURER E:
c10a1101n Lea ■NIi ieaMCIM
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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS .M..
IN' �ADDL POLICY NUMBER
TYPE OF INSURANCE SUBR
POLICY EFF POLICYEXP
LIMITS
1.18
A X COMMERCIAL GENERAL LIABILITY
� 1000,000
EACH OCCURRENC
CLAIMS -MADE OCCUR �( WSGP000122
10113/2023' 10/13/2024 DAMAGE TO RENTED 100,000
$,,
P�EMISEF (Ea gS,�yrrerj,��) , m„
SIOn
Errors & Omission
X s
Q
" ME EXP (Any one p. rs n)m ..A� ..
M, ...
µ ._ ..... ..
,..„ ......... ..,
1.. Ot)0,000
PERSONAL 8 ADV INJURY .6
"
5,000,000
GEWL AGGR'EY,",ATE LIMIT APPLIES PER:
GENERAL,AGGREGATE $ _
X POLICY'.. ?(. jppLOC
Eb
PRODUCTS - COMP/OPAGG" .... 1,000,000:..
O�tMzBD SINGLELIMY 1,000,000
A AUTOMOBILE LIABILITY 7
S _
Z ANY nuro
WSGP000122
10/13/2023' 10/13/2024, BODILY
_
' OWNED ` SCHEDULED
ONLY AUTOS
BODILY INJURY (Per accident)
PROr"EfrtTY DAMAGE.......
_
! HIJR DS X NO' O` ' 9
AUTOS ONLY AU"
le', sll c f ¢rpp $ .... .,..,.
„UMBRELLA LIAB OCCUR 3
I EACH pCGLIRRENCE
.. .,..,., EXCESS LIAB 1 CLAIMS -MADE
....
GGRIMATE �...-._._.-._ .......................
DED i RETENTION $
$
WORKERS COMPENSATION
'. PER
ER _ ...
AND EMPLOYERS LIABILITY Y d N
_OTH .�.,......,
. '
ANY PROPRIETOR/PARTNER/EXECUTIVE
I A
I F L EACH ACCIDENT S .,,,,.,
.,,, ,,,,,,, ®..........
l ,aFn"E"MF'MBER EXCLUDED? IN
andatory In NH)
G-F.L DISEASE - EA EMPLOYEE,, $
I, If yes, describe under
DES .RIPTION OF OPERATIONS below
L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of El aelundo, its directors, officers, employees, and agents, are
named as an additional insured With respects to the Work performed by the
named insured.
Investigation, CA --
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
Human Resource Manager
350 Main Street AUTHORIZED REPRESENTATIVE
El Segundo, CA 90245 (L 1,pw_ r1 !T /1
ACORD 25 (2016/03) © 1988-2015 ACUKU CUKPUKA I IUN. Au rlgnts reservea.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: WSGP000122
COMMERCIAL GENERAL LIABILITY
CIGL 79 03 18
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 valid written contract.
Blanket as required by valid written contract.
Additional Information:
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 or organization
shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and
advertising injury" arising out of:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your operations for the additional insured at the location shown in the Schedule.
However:
a. The insurance afforded to such additional insured only applies to the extent permitted by law;
b. If coverage provided to the additional insured is required by a contract or agreement, the insurance
CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2
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; and
c. Regardless of the date of occurrence or when the injury or damage first occurs or is first discovered, a
person's or organization's status as an additional insured under this endorsement ends upon the earliest
of:
(1) The completion or termination of the contract or agreement between you and the additional insured
for the location shown in the Schedule;
(2) The date you cease actively performing operations for the additional insured at the location shown in
the Schedule; or
(3) The expiration or termination date of the policy or this endorsement.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to liability or damages for "bodily injury", "property damage", or "personal and
advertising injury":
1. Caused by, arising from, or included in the "products -completed operations hazard";
2. Arising out of the additional insured's sole negligence;
3. Arising out of work or operations performed by you that were completed prior to the effective date of this
endorsement; or
4. Which continues or progressively deteriorates after you cease actively performing operations for the
additional insured at the location shown in the Schedule, even if the injury or damage first occurred, or is
alleged to have first occurred, during the course of your operations for the additional injured.
C. Solely for purposes of this endorsement, the following definition is deleted in its entirety and replaced by the
following:
1. ""Products -completed operations hazard":
a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and
arising out of "your product" or "your work" except:
(1) Products that are still in your physical possession; or
(2) Work that has not yet been completed or abandoned. However, "your work" will be deemed
completed at the earliest of the following times:
(a) When all of the work called for in your contract has been completed;
(b) When all of the work to be done at the location shown in the Schedule has been completed if
your contract calls for work at more than one location; or
(c) When that part of the work done at the location shown in the Schedule has been put to its
intended use by any person or organization other than another contractor or subcontractor
working on the same project.
Work that may need service, maintenance, correction, repair or replacement, but which is otherwise
complete, will be treated as completed.
D. 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.
CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2
CERTIFICATE OF LIABILITY INSURANCE DAT/04/2DIYYYY,
O5/04/2023
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 polic,y(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 endorsernent(s).
PRODUCER... NAME: Automatic .......... "......sing InsuranceAgency,Inc...........................
Automatic Data ProcessingInsurance Agency, Inc. c CONTACT 1 8 atic Data Process (AIC No)
PHONE 024
cAlc, f�Q, EXfI 00 524-7.. ........ .......... -...�
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.
........_ --- �..�.. .__.........
A$I$iiC I7SftI ........... m .......... ..................... POLICY E { ..................
INS .... �,.a. INSURANCE IN WVD POLICY NUMBER MMdDDiY ..fir E .J...... LIMITS
TYPE OF IN"" v
Y"A"'1' MMdD�O�Y r
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
CLAIMS -MADE OCCUR
I
PREFuUSFS. a' 'ua n.") $ m
�,..,.. (Any one person) $
........... ...__ , .... .....,
.,............--, .......
PERSO'1111NAL. _......-...
& ADV INJURY
........$
P_ ....
"
GENLAGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE$
._
PRO_
POLICY PR'JEO_ LOC
RODUCTS,,,,-COMP/OP AGG $ ,,,
P ..
I�
$
OTHER,
...
O6'dBiNLD SIN I.]]] T
ABILITY
AUTOMOBILE$
�
.'IE� �w»¢N ............ ....
... ..
ANY AUTO
JI��
INJURY (Per person)
BODILY IN
$
...... ... ..�... ....
p ���
...W'."._. OWNED SCHEDULED
.... ..._
BODILY INJURY (Per accident)
$
�.. HIRED NON -OWNED
.."
AUTOS ONLY AUTOS ONLY
.Peran~r�d'tsn9A"kAM,I'l4'...��
1-°
$... ....w "
UMBRELLA LIAB
OCCUR
-
�� EACH OCCURRENCE
R-- --
$ ...
,(
EXCESS LIAB CLAIMS -MADE
AGGREGATE
$
- _
"
DED RETE.NT'CON$
WORKERS COMPENSATION
PER OTH.
STATU TE ER
AND EMPLOYERS LIABILITY YIN
ACCIDENT
_
$ 00. OOO
1
ANY PROPMETORMAR'TNEWE E'CUTIVE
A Y
orFlc�rIMEnBrR FXCLtIDEC
NIA
N
9294695-2023
03/18/2023
03/18/2024
- -
E.L. DISEASE EA E.M.P'd�.CiYF
........ .....w„„
$ 1,000,000
(Mandatory In NH)
_ ,......�
mm..........
...1,000,000
It n,%, de%c ibe fonder
MSCRIP71ON OF OPERATIONS beIow
7
E-POLICY LIMIT
E L DISEASE
$
DESCRIPTION OF OPERATIONS I 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
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURED COPY
AUTHORIZED REPRESENTATIVE
.---•----
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD