Loading...
PROOF OF INSURANCE (2024) CLOSEDPage 1 of 2 DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/03/2024 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 endorsements . c/o126 TowersWatson Northeast, Inc. .�..E a 1-877 945 7378 WWWWWWWWWW F ' 1 888-467 2378 CONTACT Wil is JAIC. PRODUCER Y 4 _ �:." No) .. ........ Century E-MAIL P.O. Box 305191 A6_9E,,s§ certificates@willis com (Nashville, TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE- ,,,, .. NAIL# INSURERA: 37478 Hartford insurance Company of the Midwest INSURED INSURERB: Hartford Fire Insurance Company INSURERC 19682 Elecnor Belco Electric, Inc. _.,. XXX -_... 14320 Albers Way .Markel Insurance Company 38970 Chino, CA 91710 INSURERITD: Sentinel ^Insurance CompanyLtd_ 11000 INSURERE: Navigators Insurance Company 42307 ��ry racrr+nTc krr ruroco. w35509747 RFVISI[1N NI.IMRFR'° 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.. ........ AOT1L BR POLICY EFF- POLICY EXP INSRR TYPE OF INSURANCE POLICY NUMBER MMIOD M L401YYYY LIMITS "'X. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1, 000 , 000 .....,..,,_. ..... ....,..... ..., CLAIMS -MADE X OCCUR MAGE T12i'=T�i"I' ITPREMISFS(F .,,Q, „curre... $ 300,000 A . MED FRCP (An one person) $ 10,000 "' `"""""".... Y Y 10 UEA HF1471 11/01/2023 11/01/2029 ''..PERSONAL &ADVINJURY .........._ $ 1,000,000 - .... ATE LIMIT,APf I IES PER: E------ GENL AGGREGATE GENERAL AGGREGATE $ 2,000,000 PRO- JECT 17 LOC PRODUCTS - COMP/OP AGG 2,000,000 _j OTHER: FOaIac.�II�FnD' SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY - W ,o ......... _......,._.,. X ANY AUTO BODILY INJURY (Per person) ............. _ $ ...,............ ..... B OWNED SCHEDULED Y Y 10 UEA HF1837 11/01/2023 11/01/2024 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED X NON -OWNED X PROPERTY DAMAGE Per •••-•— $ AUTOS ONLY !�^ AUTOS ONLY >•9'..n41 •••• $ UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 -.... C X 'EXCESSLIAB CLAIMS -MADE MKLMlEUE100851 11/01/2023 11/01/2024 AGGREGATE $ 5,000,000 DED RETENTION $ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY Y P N STATUTE MER EACH ACCIDENT ,,,,,, 1,000,000 $.... D ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUI No. NIA Y 10 WEA AU9T8V 11/01/2023 11/01/2024 -E.L. .... 1,000,000 (Mandatory in NH) E.L.. DISEASE - EA EMPLOYEE ....- .......... $ _..........._... If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 E Excess Liability MR23EXC918906IV 11/01/2023 11/01/2024 Each Occurrence $5,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: On -Call Traffic Signal Repair Services Project No. ENG 24-56 Certificate Holder is included as an Additional Insured as respects to General Liability and Auto Liability. General Liability and Auto Liability shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured. 4:1=K I ll*IL; ti l MULUCK v«mxaarw a w rw r rvn 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 CLERK AUTHORIZED REPRESENTATIVE City of El Segundo 350 Main Street per,; ei.. El Segundo, CA 90245 W Iy00YV I h%.vr[v wI ynw .v .­ ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 26538885 —ca: 3646472 AGENCY CUSTOMER ID: LOC #: - "'' ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc„ Elecnor Belco Electric, Inc, 14320 Albers Way POLICY NUMBER Chino, CA 91710 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Pace 1 Page 2 of 2 m1 wmu to l I&Wwoiv l l © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 26538885 BATCH:3646472 CERT: W35509747