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PROOF OF INSURANCE (2022 - 2025)
Erie CERTIFICATE OF INSURANCE Insurance' - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY - 100 Erie Ins., PI, • Erie, PA 16530 CERTIFICATE HOLDER COPY NAME AND NUMBER OF AGENCY .......,.. DATE I UED 08/27/2023 BOYLES INSURANCE AGENCY A A4408 400 S ATHERTON ST ITITITIT—��mmmmm . .... NAME AND ADDRESS OF CERTIFICATE HOLDER STATE COLLEGE, PA 16801--4047 814-234-1991 NAME AND ADDRESS OF NAMED INSURED CITY OF EL SEGUNDO ALL TRAFFIC SOLUTIONS INC 348 MAIN ST 14201 SULLYFIELD CIRCLE EL SEGUNDO CA 90245— SUITE 300 CHANTILLY VA 20151 — 1 687 This Is to certify that policies, as indicated by Policy Number below, are in force for the Named Insured at the time that the certificate is being issued. Iry oF � � �� -77777— 1��1� � IItIIt � F�CiI'E t1T 6?�L1R� � ettttAT611 riff OMITS a tt a IrA� _.._.._. _ _ , GENERAL LIABILITY Q460154717 10/01 /2023 10/01 /2024 EACH OCCURRENCE '$ 1000000— COMMERCIALGENERAL LIABILITY OCCURRENCE FORM FIRE DAMAGE _.0 $ GEN'LAGGREGATELIMITAPPLIES (Any one premises) 1000000 PER: POLICY .... �........,.._ ADDITIONAL INSURED MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1 000000 GENERAL AGGREGATE $ 2000000 PROPUCts-COMPIOPAGO $ 2000000 BODILY INJURY uu $ (EACH PERSON) BODILY INJURY $ EACH ACCIDENT) PROPERTY DAMAGE ..._...� b(L' II - $ -------- I PI9OPRTY DAMAGE $ _..�........ �..... m... . Q.......�._w—........ INE EACH OCCURRENCE ............. AGGREGATE ........ —,STATUTORY.... _,µWm,r _ B ACCIDENT $ EACH ACCIDmm BODILY ENT INJURY DISEASE $ POLICY LIMIT BY DISEASE $ EACH EMPLOYEE OTHER — . ............. # SCRI'PTIO �Y OPERAfi]ONSILOCATj N /VEHICLESI'E LU IONS,I�I'5DEDIB'Y ENC)0' #MERIT/SPACIALPRO (l4 N ....... 30 DAYS CANCELLATION NOTICE APPLIES TO THE GL POLICY _...... _�....� ._ ... —..� 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, 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), THIS CERTIFICATE IS ISSUED FOR INFORMATION PURPOSES ONLY AND CONFERS NO RIGHTS ON THE CERTIFICATE HOLDER. IT DOES NOT AFFIRMATIVELY OR NEGATIVELY LIST, AMEND, EXTEND OR OTHERWISE ALTER THE TERMS, EXCLUSIONS AND CONDITIONS OF INSURANCE COVERAGE CONTAINED IN THE POLICY'(I'ES) INDICATED ABOVE. THE TERMS AND CONDITIONS OF THE POLIC'Y(IES) GOVERN THE INSURANCE COVERAGE AS APPLIED TO ANY GIVEN SITUATION. LIMITS SHOWN MAY HAVE BEEN REDUCED BY CLAIMS PAID. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ERIE INSURANCE GROUP SEE REVERSE SIDE OF-1568B 0912 CIF AUTHORIZED REPRESENTATIVE— . . COMPLETE NAME AND ADDRESS OF CERTIFICATE HOLDER OR ADDITIONAL INSURED CITY OF EL SEGUNDO 348 MAIN ST EL SEGUNDO CA 90245 CERTIFICATE OF LIABILITY INSURANCE °ATE`MM,D°"YYY' 9/9/2022 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 naAME Certificate IOe artrneni Preferred Ins. Services, Inc PHONE FAx mm ° AIL REse referrns com µnnw 4035 Ridge Top Rd MkQ_f — � Fairfax VA 22030 7 5940 AFlC Npt 703 991 4836 Ste 150 'NSUREMS) AFFORDING COVERAGE NAIL 4 : INSURER B Continental CaSU I.IySYRFff,A; Erie Insurancexman a 26271 AF _e.. 7 INSURED ALLTR-D1 IT mmaCDmlt an 20442 All Traffic Solutions, Inc. Y p y mm 14201 Sullyfield CIT., Ste., 300 INSURERC Chantilly VA 20151 INSURERD: r nVPRAnPA rf,»R7"tlPmir AT= htlilU10lo 10- Ilaan�97DO nr_^s xres .' . 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 L.#k..-.,.,.,... POLICY NUMBER .... �... .,-_ TN —SR T TYPE OF INSURANCE i'MOILICYIXXYI'... MPINOEL.71'tiI'Y. .. LIMITS e. ,, .. _.__,.. ..... A COMMMI X RCIALGENERALLIABILITY Q97-1393611 9/16/2021 9/16/2022 EACH OCCURRENCE $2,000,000 � X� .... CLAIMS -MADE OCCUR PRE�MPSFS EwENrEn a mm � ....1, $2,000,0 --- OD .., person) $ 5,000 PERSONAL 8 ADV INJURY ... -� $ 2 000 000 ..._._--_... GEN'L AGGREGATE LIMIT APPLIES PER �_.... GEN ERAL AGGREGATE $4000.000 ,�. LOC PRODUCTS COMP/OP AGG $ 4,000 $.............00D.........................._�, C'7•I HER: B $ A AUTOMOBILE ABILITY Q97-1393611 9/16/2021 9/16/2022 COMBINED $50LE LYMIT �... mmmm $1,000.000 AUTO BODy'9kmrH LY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY .'AUTOS I BODILY INJURY Per accident ( ) $ mmmmm .. _.. �mmmITITITmm X X NON -OWNED _....a..... PROPERTYO'13ddEAh.`,E ..... AUTOS ONLY. AUTOS ONLY P $ .._...,. $ A " X UMBRELLA LIAB X OCCUR Q33-1670301 9116121121 911612122 EACH OCCURRENCE $,0'CN0,C4K60 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 5 000 D00 DED X RETENTION $ $ _ WORKERS COMPENSATION .PER 01H STATUTE �,, ER AND EMPLOYERS' LIABILITY YIN _, ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? �, NIA E L EACH ACCIDENT ..... $ ry ) (Mandatory In NHDISEASE... EL.. -EA EMPLOYEE $ If es, describe under D ESCRIPTION OF OPERATIONS below E..L. DISEASE -POLICY LIMIT $ B Professional Liability 6024610700 5/3/2D-- 5/3/2023 Each Claim 2,000,000 Aggregate 2,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Traffic Safety Equipment and Software I;LK 11FIL:A I E t1ULUEK CANCELLATION City of El Segundo 348 Main Street El Segundo CA 90245-3713 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 9)1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD M, DATE (MM/DDIYYYY) CERTIFICATE04/22/2024 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 NAMIE Mary Storti PHONEpk c/o Paychex Insurance Agency, Inc. (AIq'No Ext1(888) 627 4735 � IAc _ N!I 150 Sawgrass Drive, ADDREss, PEOorlcC omplIaaychex. tom Rochester, NY 14620 AFFORDING COVERAGE NAIC# ........ .... .. INSURERA: American Zurich Insurance Company �40142 .... ,. -.-.- ---- ... IN SURED INSURER B Paychex PEO Holdings, LLC Alt. Emp: All Traffic Solutions Inc INSURERC 911 Panorama Trail South INSURERo Rochester NY 14625 INSURERS INSURER F COVERAGES CERTIFICATE NUMBER: 20084904 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. IR ADDL P.Q.Ufi�P IPOLICYNYYYCYEXP DdY1 LIMITS LTR TYPEOFINSURANCE 9LIGYNUMBER YY} ........ .-m COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE O RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) S PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POII ICY 1 PE� L-OC PRODUCTS - COMP/OPAGG $ S ' COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident} ANY AUTO BODILY INJURY (Per person) S OWNED "( SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LI,I S CLAIMS -MADE AGGREGATE $ CRETENTION S,. WORFCERSCOMPENSATION I PER ( ( OTRII.. p AND EMPLOYERS' LIABILITY YIN WC 12-68-329-04 06/01/2024 ;06/01/2025 rATuuu I:R ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT s 2,000,000 '..OFFICER/MEMBEREXCLUDED? N N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE': s 2,000,000 If yes, depsc6W under ... IONS below E,L DISEASE - POLICY LIMIT $ 2,000,000 DESCRP(.1'ga:7�P*lpF.�_O..,,..PER,A,,,T�.�..,�........:.._.�.-...�,.......-...--� ..-_ ...._.-. ....w.w__,.....---�,,,,, Location Coverage Perioda06/01/2024 06/01/2025 Client# 20013546-VA u , DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Coverage is provided for only those co -employees of, but not subcontractors to: All Traffic Solutions Inc, 14201 SULLYFIELD CIR, STE 300, CHANTILLY VA 20151 ICATE HOLDER CA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 348 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo CA 90245 AUTHORIZED REPRESENTATIVE iI 1q0k,9CyP6' © 1933-ZU15 ACOKU GUKPUKA 1 IUN. Ali ngnis reserves. AC RD 25 (01 1 ) The ACORD name and logo are registered ar s of AC RD 20084904 1 PaychexPEOHoldingsLLC MAST (VA) WC126832904 I MR 1 04/22/2024 12:57:21 AM PDT I Page 1 of 1