Loading...
PROOF OF INSURANCE (2024 - 2025)CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12128/2023 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, tho policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 andorsement s . PRODUCER CONTACT N PETURE CERTIFICATES Alliant Insurance Services, Inc. ONI , ffiBil-9t"�t-3B13 PH,,hry;21273-3193 16000 N. Dallas Pkwy E u Suite 850 PEST aURECERTS ALLtANTdCOM _..__.._ Dallas TX 75248 INSURa:R19)AFFORpINGCCgRAGE I,Irrap• 0C3 s61 INS _A Old Republic Instsanc Com anw 24147 INSURED DEWESER^0't Iq-A5 PFB : XL Insurance Amedca Inc. 24554 Dowe Services, Inc, Branch No. 7 DCA ge ey Pest Control 939 East Union Street JkLSYRERD Pasadena CA 91106-7214 INSURERE: _ .. INSURER F COVERAGES CERTIFICATE NUMBER:1272271767 REVISION NUMBER: THIS IS TO CERTIFY THAT TI-llc 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, NSR •., PO�LICYEI='F POR.1 SXP LIMITS... L R TYPE OF INSURANCE POLICY NUMBER Ik9IhV0 A X COMMERCIAL GENERAL LIABILITY Y Y MWZY313733-23 10/1/2023 10/1/2024 EACHOCCURRENCE $200000 _ _ � AM CLAIMS -MADE I" OCCUR FRfMES'Eao t q $100.000 MED EXF An oneperF" $10 000 �- PERSONAL&ADVINJURI $2,000,000 GeNIL AGGREGATE LI MIT APPLIES PER, GENERAL AGGREGATE $4,000,000 X POLICY JET LOC .PRODUCTS - COMP/OP AGG $4,000,000 $ OTN-iL,' A AUTOMOBILE LIABILITY MWTB313749-23 10/1/2023 10/1/2024 CCMe1NCD�SiNGLE LIMIT $2000,000 X ANYAUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accldent) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY $ _ AUTOS ONLY AUTOS ONLY -(- r •• ... _.._. - ..$.._ B X UMBRELLALIAS X OCCUR U30006567OL123A 10IV2023 10/1/2024 EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE $2,00Q. 00�. DED RETEN....', .. .......... X TI ON $ $ A ViORKERS COMPENSATION Y MWC311397-24 111/2024 1/l/2025 X S TLITE OTH- AND EMPLOYERS' LIABILITY YIN .. ER ANYPROPRIETOR/PARTNERIEXECUTIVE ❑ N / A E.L. DISEASE EACH ACCIDAEEMP 9i 1 000 000 _ OFFICERJMEMBEREXCLU DED7 (MandatoryIh NH) EMPLOYEE 1 000 000 _ If yes, dWt3rr6tro under It yes Or un OPERATIONS below E-f... DISEASE -POLICY LIMIT $1 g000,000 DESCRIPTION OF OPERATIONS / LOCATIONS f VVflJCL.E$ (ACORD 101, AddUAonat Remarks Schedule, may be attached more a ra Is required) All locations and operations for Dewey Services, Inc, Add`( Insured coverage Is ,prodded by form by CG 20101219, See Attached. The City Of El Segundo Is Named As Additional Insured, Completed Operations Is Included On The General Liability Pollcy. A Waiver Of Subrogation Is Prodded In Favor Of The City Of El Segundo,, 30 Days' Nollce of Cancellation Will Be Provided To Cerllttcate Holder (10 days For Non -Payment Of Premium.) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. General Services Division 150 Illinois Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 a 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD MW7-Y318733-23 COMMERCIAL GENERAL LIABILITY CG 20 01 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. M! QN: RAI 110MOklarl 0 RIIII] 110kof-1-1111 ki 14Nq 0 ::1 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 (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. 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 CG 20 0112 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: MWZY31373323 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED, RED, - OWNERS, LESSEES OR CONTRACTORS FORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". 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 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. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: MN21313733-M COMMERCIAL GENERAL LIABILITY CG24041219 THIS. ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): All persons or organizations when required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV— Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PESTICIDE OR HERBICIDE APPLICATOR COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART/FORM SCHEDULE Description Of Operations: Pesticide and/or Herbicide application With respect to the operations shown in the above Schedule, Paragraph (1)(d) of Exclusion f. Pollution of SECTION I - COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply: 1. If the operations meet all standards of any statute, ordinance, regulation or license requirement of any federal, state or local government which apply to those operations; or 2. With respect to such operations, if there is a failure to meet the standards described in Paragraph 1. above and such failure qualifies as an "occurrence", this will not void coverage under this endorsement. All "bodily injury" and "property damage" occurring during the policy period as a result of such failure to meet standards described in Paragraph 1. above will be considered one "occurrence" and the date of the 'occurrence' will be the date of a single erroneous application or the first application of a series of related erroneous applications; or 3. At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to any insured and used for the purpose of performing the operations listed in the above Schedule. However, in no event does this insurance apply to pesticides and/or herbicides that at the time of the application are banned by government or regulatory authorities. GL 291 008 0122 Includes copyrighted materlal of Insurance Services Office, Inc., w7th its permisslon. Page 1 of 1 POLICY NUMBER: Mv11zz'(313733-23 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 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 Ornanization(s) All persons or organizations when required by contract or agreement. to complete this Schedule, if not 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. Locations Of Cc All locations. vn above, will be shown in t ns 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. CG 20 10 12 119 ©Insurance Services Office, Inc., 2018 Page 1 of 2 M WZY313133-23 C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III — Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the most we limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc., 2018 CG 20 10 12 19 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) POLICY NUMBER: MWC311397-24 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be otherwise due on such remuneration. PERSON OR ORGANIZATION % of the California workers' compensation premium SCHEDULE Al persons or organizations when required by contract or agreement DATE OF ISSUE: 01/11025 JOB DESCRIPTION @1998 by the workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual@ 1999.