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PROOF OF INSURANCE (2025)
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 10104/2024 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 MARSH RISK & INSURANCE SERVICES FOUR EMBARCADERO CENTER, SUITE 1100 CALIFORNIA LICENSE NO, 0437153 SAN FRANCISCO, CA 94111 Attn: SanFrancisco.Certs@marsh.com / FAX 212-948-0398 INSURED Dell Technologies Inc, and all Subsidiaries One Dell Way - RR1-50 Round Rock, TX 78682 COVERAGES CERTIFICATE NUMBER: INSURER(S) AFFORDING COVERAGE .NAIC # INSURER A ]„grIC�1, AfflerlCan )�surance C,,gmp,n, ,,, 16535 INSURER B : .. N/A _ ...... .. . N/A INSURER C American ZIJr!cb 1psUra,me,..Qompany .... ............ . 4Q142...... .... INSURER D NIA .,_.. .......... ....... .. INSURER E : SEA-003596782-18 REVISION NUMBER: 8 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-.... _. SR f � 0L' 8 MMIUD//YYYY �x LIMITS TYPE OF INSURANCE MMIODIIYYYY LTR� 1 POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY GL0699017800 03/01/2024 03/01/2025 EACH OCCURRENCE $ 5,000,000 �..�AMA<5 { CLAIMS -MADE 1 X f OCCUR Rf=NYELJ .. ...... PIREMISFS (Ea gcgy @ ,pe) $ 5 000 000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 5,000.000 G••I"IN6 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10000000 .... X PO(„td;.Y I O LOC ,., .... .m.$ .................,, PRODUCTS COMP/OP,AGG $ 10,000.000 OTHER' COMBINED SINGFELINUT A AUTOMOBILE LIABILITY BAP699017700 03/01/2024 03/01/2025 $ 5000,000 Lga aecgniW)..... .. ....................... ANY AUTO BODILY INJURY (Per person) $ -X__ I OWNED SCHEDULED �,., ....................... ........................ _ ., BODILY INJURY (Per accident) $ ,J AUTOS ONLY AUTOS ( HIRED NON -OWNED I'ROPLRYDAM,A.GE $ X X .. ,` AUTOS ONLY ,.......... AUTOS ONLY '?P31" YGef7�YRrm(� . Q., .., ......... .,,.. ,,. Is UMBRELLA LIAB ( OCCUR a I EACH OCCURRENCE $ ,...... LI CLAIMS MADE � ..�. _AGGREGATE. .,... $ ----- ,EXCESS fAB -DEC)-- RETENTION $ C WORKERS COMPENSATION f WC699017500 (AOS) 1 03/01/2024 1111112121 PER OTH I X A AND EMPLORL ABII YdN ANYPROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBEREXCLUDED? N N I A WC699017600 MA, NE, WI ( ) 03/01/2024 03/01/2025 E ACCIDENT ...._; .. - � $ 1 000 000 _ ... ......,. Mandatory in NH) ( E L DISEAS E- EA EM PLOYEEI ,.. t $ 1,000,000 If yes, describe under � 1 000,000 DESCRIPTION OF OPERATIONS below ) E.L DISEASE -POLICY LIMIT $ i DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF EL SEGUNDO. ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS & CERTIFIED VOLUNTEERS are included as additional insured (except workers compensation) where required by written contract. Any such coverage extended to the additional insured will apply as primary and non-contributory, to the extent of liability assumed under contract. Waiver of subrogation applies where required by written contract and permitted by law. CERTIFICATE HOLDER CANCELL.A' CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 MAIN ST. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245 1 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i twe �id� & %cr¢unaoue S eeQ ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO 6990178-00 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 11 *A, 0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Of Covered 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. I 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(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 worts, 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 some project. CG 20 10 12 19 ® Insurance Services Office, Inc., 2018 Page 1 of 2 Wolters Kluwer Financial Services, Inc. I Uniform Forms 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