PROOF OF INSURANCE (2025 - 2026)DATE(MM/DDIYYYY)
A,CC)R" CERTIFICATE OF LIABILITY INSURANCE
x .. 2/28/2025
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).
CONTACT
PRODUCER --._.. FA
Marsh & McLennan Agency LLC PHONE
g y ��r�a�L�"Ste 1lanle Callahan J ( ot 212 948-i IO2
P
15415 Middlebelt Road ar
Livonia MI 48154 gDDBk teoham calla a ta,T rshmma,cona
INSURED
OCLC, Inc.
6565 Kilgour Place
Dublin OH 43017
n— 117 nArc 1,11 Iuo1=171. n&M=c.• nCw
INSURER A:
Federal Insurance Com
INsu KERB.
Illinois Union Insurance
INSURER C
Travelers Property Cas
11
INSURERD:
Landmark Insurance C(
2o2s
P ny �.. 27960
Co of Amer 25674
nv 35637
RFVICIr11d NIIIMRFR-
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.
1( --
INSR.�... .... TYPE OF INSURANCE... „.. „„... „.... J D L � �.„,,,,,,,POLICY NUMBER .��..MMIDDY ���F� MMODIM1'YY'Y.. ,,. LIMITS
LTR
A
X COMMERCIAL GENERAL uaBILITY
� 35756671
3/1/2025
3/1/2026
_ f 000 000
$ 1.�
CLAIMS -MADE X
.� .. OCCUR
UAMA � T ffarEb $ 1 . 000
P„REMI E�„ nt? gcpwrrencg) ......... ......... ,..
.
F
10,000
MED EXP (Any one Person) ,$ .....,.,.._ .....
---- .....................
PERSONAL & ADV INJURY $ 1 000 000
EN L AGGREGATE LIMIT APPLIES PER.
I❑
AGGREGATE $ 2,000 000
GENERAL A
V
%� POLICYPR
5E 11 I, LOC
PRODUCTS,- COMPIOP AGG $ 2,.000 000
....... ,,I
_ _.....
is
OTHER;
i
9 COMBINED SINGE UktI r
� $
AUTOMOBILE LIABILITY
F
i.f�a
ANY AUTO
BODILY INJURY(Perperson)
l $
_
OWNED SCHEDULED
INJURY (Per accident)
$
HIRED AUTOS ONLY J NON -OWNED j
( DAMIAG..E
$ .. -.
..- AUTOS ONLY AUTOS ONLY
UMBRELLALIAB.....
,.
I_
� CC
EXCESS LIAB CLAIMS -MADE
.E.,AC,H...O..C.CURRENCE
... ,..
.$$ _ ... .._
DED y RETENTION $
C
WORKERS COMPENSATION
UB8J443127
12/31/2024
f$
ER
12/31/2025
STATUTE !„,„,,,,11 FRAND
EMPLOYERS'LIABILITY
Y❑
„X
I
_
$;
ANYP OPRI TOR/PARTNE EXECUTIVE
o
OFFICER/MEMBER EXCLUDED.
NH)
NIA
E L EACH ACCIDENT
_,,,„„ .............
E.L. DISEASE EA EMPLOYEE
,000,000
$ 000 000
(Mandatory m
If yes, describe under
��„ „-„„
E.L. DISEASE LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS below
{
-POLICY
B
Cybv LiabfProfpr (onal Liab
F1564509A
3/1/2025
3/1/2026 Limit
Limit
$5,000,000
$5,000,000
D
Ex'csssE&OlCybor
(Claims Made)
LHZ856135
3/1/2025
3l1/2026
Retention
$100,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of El Segundo, Its officials, and employees are included as additional insured for commercial general liability on a primary and non-contributory basis to
the extent provided in the attached form #80-02-2367; and as additional insured for professional/'cyber liability coverage to the extent provided in the attached
form !#PF-48238. The commercial general liability insurance carrier will provide the Certificate Holder with direct notice of cancellation to the extent provided in
the attached form 80-02-9779.
J.\.\ F" ti.111 taxi'.* ra\.\
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of El Segundo
ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
AUTHORIZED REPRESENTATIVE
El Segundo CA 90245
United States
I
V I U50-LU IO A%IVRU VVRrVRA 1 1V1`4. MU I rynw l cacti rasa=.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
C H U B B° Liability Insurance
Endorsement
Policy Period
Effective Date
Policy Number
Insured
Name of Company
Date Issued
This Endorsement applies to the following forms:
GENERAL LIABILITY
LIQUOR LIABILTIY
Who Is An Insured
Additional Insured -
Scheduled Person
Or Organization
Liability Insurance
3575-66-71 CHI
OCLC, INC.
FEDERAL INSURANCE COMPANY
Under Who Is An Insured, the following provision is added
Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are
obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by
this policy.
However, the person or organization is an insured only:
• if and then only to the extent the person or organization is described in the Schedule;
• to the extent such contract or agreement requires the person or organization to be afforded
status as an insured;
• for activities that did not occur, in whole or in part, before the execution of the contract or
agreement; and
• with respect to damages, loss, cost or expense for injury or damage to which this insurance
applies.
No person or organization is an insured under this provision:
• that is more specifically identified under any other provision of the Who Is An Insured
section (regardless of any limitation applicable thereto).
• with respect to any assumption of liability (of another person or organization) by them in a
contract or agreement. This limitation does not apply to the liability for damages, loss, cost or
expense for injury or damage, to which this insurance applies, that the person or organization
would have in the absence of such contract or agreement.
Additional Insured - Scheduled Person Or Organization
Form 80-02-2367 (Rev. 5-07) Endorsement
continued
Page I
CHUBBm
Liability Endorsement
(continued)
Under Conditions, the following provision is added to the condition titled Other Insurance.
Conditions
Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization
Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case
Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person
Person Or Organization or organization.
Schedule
Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with
such insurance as is afforded by this policy.
All other terms and conditions remain unchanged.
Authorized Representative
Liability Insurance Addtttonal Insured - Scheduled Person Or Organization
last page
Form 80-02-2367 (Rev. 5-07) Endorsement Page 2
Policy Conditions
Endorsement
Policy Period
Effective Date
Policy Number
Insured
Name of Company
Date Issued
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This Endorsement applies to the following forms:
COMMON POLICY CONDITIONS
W������������o�����M� �������� ���m�w�� ��n��� ����������• �a��N���oo�N��mN���� ����N ���w���w�� � �����
Under Conditions, the following condition is added.
Conditions
Notice Of Cancellation When we cancel this policy for any reason, other than non-payment of premium, we will notify
To Scheduled Persons person(s) or organization(s) shown in the Schedule at least 30 days in advance of the cancellation
Or Organizations When date.
We Cancel Any failure by us to notify such person(s) or organization(s) will not:
• impose any liability or obligation of any kind upon us; or
• invalidate such cancellation.
Schedule
Person(s) or Organization(s):
Address:
Notice Of Cancei fi d jbA Or Organizations
Policy Conditions (Except Non -Payment Of Premium)
continued
Form 80-02-9779 (Ed. 3-11) Endorsement Page 1
Conditions
(continued)
Policy Conditions
Form 80-02-9779 (Ed. 3-11)
All other terms and conditions remain unchanged.
Authorized Representative
Nolice Of Con,cellationiltefA&BMDVrsaop6i Organizations
(Except Non -Payment Of Premium)
Endorsement
last page
Page 2
Additional Insured - Blanket Pursuant to a Contract - DigiTech®
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
Chubb DigiTech® Enterprise Risk Management Policy
It is agreed that Section II, Definitions, Insured, subparagraph 6 is deleted and replaced with the following:.
6. any natural person or entity for whom an Organization is required by written contract or agreement to
provide insurance coverage under this Policy (hereinafter "Additional Insured"), but only with respect
to Claims:
a. arising out of any Incident committed after the Organization and the Additional Insured
entered into such written contract or agreement;
b. for any Incident committed by, on behalf of, or at the direction of the Organization; and
c. subject to the lesser of the limits of insurance required by stich written contractor agreement between
the Organization and the Additional Insured, or the applicable Limits of Insurance of this
Policy.
However, no natural person or entity shall be an Additional Insured with respect to any Claim arising
solely out of such natural person's or entity's independent act, error, or omission. In the event of a
disagreement between the Named Insured and the natural person or entity as to whether the Claim
arises solely out of such natural person's or entity's independent act, error,, or omission, it is agreed that
the Insurer shall abide by the determination of the Named Insured on this issue, and such
determination shall be made by the Named Insured within 20 days of the notification of the applicable
Claim.
All other terms and conditions of this Policy remain unchanged.
PF-48238 (o9/16)
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