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PROOF OF INSURANCE (2025 - 2025)
DATE (MM/DDYYY) .�t�"+l >R" IYCERTIFICATE OF LIABILITY INSURANCE 4/2/2024 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 Greyling Ins. Brokerage/EPIC tPHO Niatb xtt r NAME _ Sharon Brubaker 3780 Mansell Road, Suite 370 re 11 carts tkc�N`") 770"iSC�a59 Alpharetta GA 30022 ADDRESS 9 9 _ .. q 770.756 6599 p ADD RL ra lln Com......:...... INSURERS) AFFORDING COVERAGE NAIC # .... ....... _. ......... R,A INSURE:::: Continental Casual Com an --- �.�.P.„,.,,..X_. .. 0443 .... ---.:.:.:.:........................ INSURED ......,�.. __...... INSURER.B The Continental Insurance Com p y.. 5289 & Inc. Irfsu__ m„ National Union Fire Insurance Company 1 .....5 9445 2oodard Mountfort Street — .. ........... ..... Portland, ME 04101 INSURERD .... INSURER F n��it•ewr�c� f%GCTIC11%ATC k1"RA000• VVM'30001n RFVIAWIN PJI11141I1 FP — 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. ....... -- _. ....... ......,...M ...... .....�...... ._..... ....... .. _....---- ILTR ...., - --- .... Al�'i :L 2Y[iEtR PMMDI ExP '. LIMITS TYPEOFINSURANCE~.. POLICY NUMBER MIDO. - M RDIbryY'NY' C X COMMERCIAL GENERAL LIABILITY GL3960965 4/1/2024 4I1I2025 EACH OCCURRENCE $ 000 000 CLAIMS MADE OCCUR .. tJAMAR' Frc d'i� RFiWfl�t� PREMteE„(_ ^f) �m .-.. (Any one p 000 _._ __ PER ONAL & ADV INJURY $ 2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: T GENERAL AGGREGA E ........ $ 4,000,000 m --- ----. X.::. X.W OLICY ` `� PRO LOC POLICY[`JECT („ PRODUCTS -COMP/O P AGG $ 4.000 000 _�. .. „,J OTHER: $ C AUTOMOBILE LIABILITY CA4629109 4/1/2024 4I1I2025 NEaaccldcnf) COMBINED SINGLE UMIT $2,,000,000 .$ . X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED accident) BODILY INJURY (Per ac B $ ....: AUTOS ONLY AUTOS HIRED NON -OWNED P ROPERTYDAraIAGE $ X,,,, AUTOS ONLY ...,X AUTOS ONLY �) —_ B UMBRELLA ua6�] 7063893898 2I23I2024 4l1l2025 EACH OCCURRENCE $1,000.000OCCUR X : EXCETSSSLIAR CLAIMS -MADE GGREGA E A„ T ....._......� $ 1, 000,000 ........... .... DED { n l RETENTION $ H O WORKERS COMPENSATION WC38240185(AOS) 4/1/2024 4I1I2025 X STATUTE,„ OR _ C AND EMPLOYERS' LIABILITY Y YIN WC38240184 CA ( ) 2 000 000 ECUTIVE E ACCIDENT s2,000,000 E.L.EACH --- ,,...-.._ CERI N / A OFF Bator ... 000,000 m NH L DISEASE - EA EMPLOYEE $ 2 v Ma n NH) (Mandatory ... ...... ry ) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 A Professional Liability AEH114135520 2/23/2024 2/23/2025 Per Claim 1„000,000 Aggregate 1,000,000 ind. Pollution DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD101, Additional Remarks Schedule, may be attached if more space is required) Re. Agreement No. 6804 The City of El Segundo, its officials and employees are nanled as Additional Insureds With respects to General & Automobile (Liability where required by Written contract, The above referenced liability policies are primary & non-contributory Where required by Written contract, 'Should any of the above described policies be cancelled by the issuing Insurer before the expiration date thereof, We will endeavor to provide 30 days" written notice (except 10 days for nonpayment of premiurn) to the Certificate Holder. wasurrJ4l 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 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 z J� © 1988-2015 AGOKU COKPOKA I ION. Au rfgnis reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER; GL3960965 COMMERCIAL GENERAL LIABILITY CG20101219 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 __ ----- Insured Persons) Name Of Additional I Or Organizations) . Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO._ mation required to complete this Schedule, if not shown above, will ......� �mmITITITITIT ------ Information q p shown in the Declarations. I be sho CG 20 10 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 2 0 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", "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. B. 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. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 0 Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER„ GL3960965 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE .._ ..... _-_---Name Of InsuredPerson(s) ____ Or Oronal ------ -----. --� . . - ....._ .--..... Location An d Description Of Completed Operations- _ _.. ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. -__ . • Declarations. Information required to complete this Schedule, if not shown above, will be shown in ...—........-- .... .._ ---- ..............� . ..... ....the A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or B. With respect to the insurance afforded to organization(s) shown in the Schedule, but only these additional insureds, the following is with respect to liability for "bodily injury" or added to Section III - Limits Of Insurance: "property damage" caused, in whole or in part, If coverage provided to the additional insured is by "your work" at the location designated and required by a contract or agreement, the most described in the Schedule of this endorsement we will pay on behalf of the additional insured performed for that additional insured and is the amount of insurance: included in the "products -completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable limits of However: insurance; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted by law; and This endorsement shall not increase the 2. If coverage provided to the additional applicable limits of insurance. 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. CG 20 37 12 19 4 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: GL3960965 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 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 LIQUOR 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 (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. CG 20 01 12 19 9 Insurance Services Office, Inc., 2018 Page 1 of 1 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2024 forms a part of Policy No. CA4629109 issued to Woodard & Curran, Inc. by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON'S OR ORGANIZATION'S LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO". I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. AUTHORIZED REPRESENTATIVE 87950 (9/14) Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2024 forms a part of Policy No. CA4629109 issued to Woodard & Curran, Inc. by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence°. The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. Authorized Representative or Counters! nature (in States Where Applicable 74445 (10/99) Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1