Loading...
PROOF OF INSURANCE (2026)CER IFIC ATE OF LIABILITY INSURANCE ®ATE(MM/DD/YYYY) O6/03/2026 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 Aon Risk Insurance Services West, Inc. NAME. P;AX Denver CO Office (AC, No. Et)c C866) 263-7122 (AaC No 800-363-0105 200 Clayton street, suite 800 E-MAIL Denver CO 80206 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Accident & Indemnity Company 22357 IBI Group, a California Partnership INSURERB: Twin City Fire Insurance Company 29459 537 south Broadway INSURERC: Hartford Fire Insurance Co. 19682 Suite 500 Los Angeles CA 90013 USA INSURERD: Hartford underwriters insurance company 30104 _.. INSURERE: Hartford Casualty Insurance Co 29424 INSURERF: Endurance American Insurance Company 10641 rrn�� tAr:c t..PQTIPh"AT' MIIURPR- Fi7n11PgRR0g4 REVISION NUMBER: 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. Limits shown are as requested INSH TYPE OF INSURANCE I UU1 ue' POLICY NUMBER '.., 9YlI.MRDDfYY'Y9P pDtYYYY LIMITS LTR —POLICY EFF X AL LIABILITY GENERAL COMMERCIALGENE COMMERCIAL ECSOL -� EACH OCCURRENCE $1, 000, 000 SIR applies per policy terns & conditions $1,000,000 ADE OCCUR ElPREM6SES Ea oc currence MED EXP (Any one $10, 000 X Contractual Liability person) _ _ PERSONAL & ADV INJURY $1, 000, 000 LAGGREGATIELIMITAPPLIESPER: GENERALAGGREGATE $2,000,000 POTHER: POLICY EPRO-JECT �LOC PRODUCTS-COMP/OPAGG $2,000,000 C AUTOMOBILE LIABILITY 20 UEN OL5968 06/01/2025 06/01/202611 COMBINED SINGLE LIMIT $1, 000, 000 ADS Ea arrident D X ANYAUTO 20 LIEN OL5973 06/01/2025 06/01/2026 BODILY INJURY ( Per person) OWNED SCHEDULED HI 1. BODILY INJURY (Per accident) AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED AUTOS NON -OWNED (Per accident) ONLY AUTOS ONLY _ E 20XHUOL5972 06/ 1 2025 06/01/2026EACHOCCURRENCE $5,000,000 X UMBRELLALIAB X '.... OCCUR EXCESS LIAB '.. CLAIMS -MADE AGGREGATE $5 , 000, 000 DED x R.E'I'FNTiON $10,000 A WORKERS COMPENSATION AND 20WNOL5971 01 20' S. /M/ 6 X I PER STATUTE I IOTH- EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER/ EXECUTIVE Y W N AOS 20WBROL5970 06/01/2025 06/01/2026 E.L. EACH ACCIDENT $1, 000, 000 B OFFICER/MEMBEREXCLUDED? (Mandatory in NH) NIA MA, WI E.L. DISEASE -EA EMPLOYEE $1, 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below 1 E.L. DISEASE -POLICY LIMIT $1, 000, O00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 AUTHORIZED REPRESENTATIVE Attn: Elias Bassoon 350 Main St. El Sequndo CA 90245 USA Jn , y1warO �'Irm m a d CID d a 0 2 0 00 N O LO ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000005571 LOC #: ADDITIONAL REMA KS SCHEDULE Page _ of _ AGENCY 1131 AMED INSURED Aon Risk Insurance Services West, Inc. Group, a California Partnership POLICY NUMBER see Certificate Number: 570112988094 CARRIER 'NAIC CODE See Certificate Number: 570112988094 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY POLICY EFFECTIVE EXPIRATION LIMITS DATE DATE ''... (MM/DD/YYYY) (MM/DD/YYYY) EXCESS LIABILITY F EXC30001994805 06/01/2025 06/01/2026 Aggregate $5,000,000 Each $5,000,000 occurrence i ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 20 ECS OL5969 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED SO I O ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s) Blanket, as required by written contract. All locations where required by written contract, ......... Information mm� p ... s Schedule, if not shown above, will be shown in the Declarations. Information to complete this mmmmm- � _ . mmmm�� _ � _ wwww 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 the additional insured(s) designated above. However: ongoing operations for at the location(s) 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. CG 20 10 1219 © Insurance Services Office, Inc., 2018 Page 1 of 2 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; of 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 © Insurance Services Office, Inc., 2018 CG 20 10 1219 POLICY NUMBER: 20 ECS OL5969 COMMERCIAL GENERAL LIABILITY CG 20 371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES O 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 Additional Insured Person(s) Or Organization(sJ Location And Description Of Completed Operations Blanket, as required by written contract. .All locations where required by written contract. above, will be shown in the Information required to complete�.... ,..___ . eclarations ��m w this Schedule,.. if shown abo mm� _�_� A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following) is added to organization(s) shown in the Schedule, but only with Section III - Limits Of Insurance: respect to liability for "bodily injury" or "property If coverage provided': to the additional insured! is damage" caused, in whole or in part, by "your work" required by a contract or agreement, the most we at the location designated! and described! in the willi pay on behalf of the additional! insured is the Schedule of this endorsement performed for that amount of insurance: additional insured! and included in the "products -completed operations hazard". 1. Required by the contract or agreement; or However: 2. Available under the applicable limits of 1. The insurance afforded! to such additional insurance; insured! only applies to the extent permitted! by whichever is less. law; and This endorsement shall! not increase the applicable 2. If coverage provided to the additional insured is limits of insurance. 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 © Insurance Services Office, Inc., 2018 Page 1 of 1