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PROOF OF INSURANCE (2025 - 2025)
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: _ THIS IS TO CERTIFY THAT FHEi POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO I HI. INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH T1 ilS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, i11E INSURANCE AFFORDED BY THE J CLAIMS I .ES LIMITS DESCRIBED HEREIN S SUB ECTTO ALL7 HI -TERM CONDITIONS OF SUCH POLICIES. 1 INSR f TYPEOFINSURANCE LTR ADDTL D INSD '..SIONSANDCO... SUBR WVD PO CYNUMBER POLICY EFF (MM/DD/YYYY).....-(MM/DD/YYYY) POLICY EXP LIMITS ........._ ..POLICIES ............ COMMERCIAL GENERAL LIABILITY .IN _ ... ..... .. ............... .... .............. ... ...,.,...._... HOCCURRENCE& EACH 2�,000000� 4/ E S CLAIMS -MADE X OCCUR MIS(Ea Occurrence) 100,00 �r l RENTED ..,,., ...----- m IVIED EXP (AnI one person") �S000 .......... 5,00 ...•�� Y N6043g5'5 08/27/2024 08/27/2025 RSONAL & ADV INJURY 1 2, 00 "'LAG "' GENAGGREGATE GENERAL 1 ......... �S.i( i? 001Nt X, POLICY PROJECT C LOC „ -- oPAGG ODUCTS C ..... 2,00000 i t OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE IT d1 2,00000 ANYAUTO "(Ea BODILY INJURY(PerpeNrson)' C OWNEDAUTOS SCHEDULED BODILY INJURY(Peracc"d � f ONLY �': AUTOS N 60439584,5 08/27/2024 08/27/2025 ----- J AUTOS X PROPERTY DAMAGE ONLY AUTOS ONLY (Per accident) .... ....-- -- ........ ........... ....... UMBRELLA LIAB OCCUR .. _ _..... OCCURGGREGATERENCE _ S EXCESS LIAB CLAIMS MADE AGGREGATE .... _ S ., ........... -_ DED RETENTION $ ,.. S WORKERS COMPENSATION PER OTHER SAND EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/ Y/N E.L EACH ACCIDENT S EXECUTIVE OFFICER/MEMBER •" N/A ........ """"""" L. DISEASE EA EMPLOYEE EXCLUDED? (Mandatory in NH) , 11 IFyes, describe under DESCRIPTION OF DISEASE -POLICY LIMIT S OPERATIONSbelow 1 " Each Claim 1,0100,000 Professional Liability E&O Coverage": P100.094.653 4 2 24 2/10/ 0 02/10/2025 Aggregate: 1,0100,000 ..---- ..... "" """"""..... . ' .....,--- ....... ....... _. ......... _ _..... DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 10 W BIRCH ST STE 207, BREA, CA 92821 ityof El Segundo Police Department is listed as an additional insured CERTIFICATE HOLDER CANCELLATION """"" CITY OF EL SEGUNDO POLICE DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR E THE EXPIRATION 348 MAIN ST DATE THEREOF NOTICE WILL BEDELIVEREDINACCORDANCEWITHTHEPOLICYPROVISIONS. AUTHORIZED REPRESENTATIVE ... ,.,..,..- John Ekno ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All Rights Reserved 31-1769 11-15 The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY NUMBER: 604395845 0;�A- , FARMERS INSURANCE ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COVERAGE FORM APARTM ENTOWN ERS LIABILITY COVERAGE FORM CONDOMINIUM LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): MTY FEU EGUNDO. rZI EPWR TENT. .........r.. ...___ required to completethis Schedule, If no .........___ __. ------------- Information ' Declarations. t shown above, well be shown in the Dec A. The following is added to Paragraph C. Who Is An Insured of the applicable Coverage Form: 17238 1 st Edition Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf in the performance of your ongoing operations or in connection with your premises owned by or rented to you. However: a. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and b. If coverage provided to the additional insured is required by a contractor 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 Paragraph D. Liability And Medical Expenses Limits Of Insurance of the applicable Coverage Form: 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 bythe contractor agreement; or 2. Available under the applicable Limits Of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations. This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all the terms of the policy. J7238-ED1 02-19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 937238 J7238101 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 11 /04/2024 .......... 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 HOLDER. IMPORTANT: URESte hecertif certificate deR EPRESENTATIVE Oan ADDITIONALINSURED, the policy(ies) must be PRODUCER, AND THE CERTIFICATE endorsed. If SUBROGATIONIS 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 NAME: PIA SELECT INSURANCE SOLUTIONS LLC PHONE (925) 217-4688 FAX 57128382 (AIC, No, Ext): (AIC, No) 850 INDUSTRIAL ST STE 200 ...... E-MAIL ADDRESS: REDDING CA 96002........... ____ _....... ..... _ .._...............-. ... INSURER(S) AFFORDING COVERAGE NAIC# ............ INSURERA: Hartford Fire and Its P&C Affiliates .......... INSURED INSURER B; CROSSROADS SOFTWARE, INC. INSURER C 407 W IMPERIAL HWY PMB 378 ......... .._........... ..... _. .............. INSURER D ; BREA CA 92821-4832 ............ ... ...... ...... ..... ............... .. INSURER E INSURER F :...... _... ... ... ........_.... .....__. ........ ......._ .. ........ _.._ _.......... COVERAGES CERTIFICATE NUMBER: _ REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEDBELOWHAVE 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 SHO WN MAY HAVE REDUCED BY PAID CLAIMS. TYPE OF INSURANCE NPOLICY NUMBER LIMITS XP COMMERCIAL GENERAL LIABILITY D R WV R INSR """ IMM1.P Y EFF POLICY E� _•_ �°° EACH OCCURRENCE BWACE I_0 _ CLAIMS -MADE ❑OCCUR PR MA.909M1...S_J. - ....._. MED EXP (Any one person) ....._........_....-.-...... .......°....... ...........„ ...... PERSONAL & ADV INJURY ......_ ..................�,... .._. ...... ......... GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ......... ...... m ...... POLICY PRO 0 LOC PRODUCTS - COMPIOP AGG ...... JECT ..._.. ........ OTHFR ......_ ....... .................. m................. ....._. COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY (Per person) ........ ._......... ._..,-., ._.......... ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS ••••• . HIRED NON -OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) .1 ......... .................. .....-... ......� ........ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS - MADE AGGREGATE ED RETENTION $ WOR KERS COMPENSATION STATUTE X TH- AND EMPLOYERS' LIABILITY ER .,-„,,,._ ...... ANY Y/N EL. EACH ACCIDENT $1,000,000 PROPRIETOR/PARTNER/EXECUTIVE N/A 57 WEC BLIFXF 10/31/2024 10/31/2025 A '.OFFICER/MEMBEREXCLUDED7 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E°L,. DISEASE - POLICY LIMIT $1,000,000 '.....----- DESCRIPTION OF OP RATIf1NS hel. w .. ........._. ........-._.. —. ................ ......... ._. ......... _... DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE MOLDER _ .....___ _ ...... ANCELLAT Cityof El Segundo Police Department SHOULD ANYTHE OF THE ABOVE ES EXPIRATION mmITITmm 348 M 9 N DATE THEREOF D POLICIES BE CANCELLED MAIN ST , NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245 IN ACCORDANCE WITH THE POLICY PROVISIONS. _.... ............. AUTHORIZED REPRESENTATIVE - '�_Y4190tll 'If O 1988-2015 ACORD CORPORATION.. � 11 _.....__ ....... ................ c All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD