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PROOF OF INSURANCE (2026 - 2026)
DATE (MM/DD/YYYY) c"Rtl CERTIFICATE OF LIABILITY INSURANCE 12/3/2025 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(les) 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 NAME PESTSURE CERTIFICATES I.CATES Alliant Insurance Services, Inc. PNONE 1600 850 Dallas Pk s PEST atJREC 13 i NDf 214-273-3193 wy E-MAIL�LrIt�.66�8 9d4 381 APPIRg EI TS, ALLIANT COM Dallas TX 75248 INSURER(S)AFFORDING COVERAGE NAIC# L,ense#: OC36861 INSURER .A.:..Old Republic INSURED DEWESER-01 INSURER B : XL Insurance, DeweyServices, Inc. Branch No. 7 DBA Dewey Pest Control I"suRER-�: 939 East Union Street JNSURER D m..._. Pasadena CA 91106-7214 INSURER E INSURER F : weir-rawi+�c� /^^L^'M4 IM Y ATM \11111A0013• A4aA7nAl RFVISInNI NIIMRFR• 24147 24554 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. � ............_........ _ _................ ._ . POLICY INSR ADOL UeR POLICY EFF POLICY ExP LIMITS L TR TYPE OF INSURANCE POLICY NUMBER MMIDD. M I A X COMMERCIALGENERALLIABILITY Y Y MWZY313733-25 10/1/2025 10/1/2026 EACH OCCURRENCE $2,000,000 ..� E OCCUR m.. CLAIMS -MAD X -i1Al'vl�`� Tt�apmner�l RE PMq';; [, .._......... $ 100.000 .. __........................, MED EXP (Any one person) _.,,...,,__._....._._. $ 10,000 ........................-.. .................... PERSONAL & ADV INJURY _�....... WW............... $ 2,000.000 -W..............mm GEN'LAGGREGATELIMITAPPLIEmmmmmmm----_ .._. S PER: GENERAL AGGREGATE $ 4 000 000 POLICY N " _ 1 JEGOT. LOC PRODUCTS COMP/OP AGG $ 4,000,000 ............ 1 $ OTHER: A AUTOMOBILE LIABILITY Y Y MWTB313749-25 10/1/2025 10/1/2026 COMB! N80SINGLE LIMIT Ea ar ' re;.91 ...........� $21000,000 ....._. X ANY AUTO BODILY INJURY (Per person) ......... $ ..... .................... OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PPI`RT9' DAMtAG"E RO $........................ AUTOS ONLY AUTOS ONLY Par acmi0,@,r�I1_••••• _ -------•••••• - •• B X UMBRELLA LIAB N OCCUR Y Y US0006587OL125A 10/1 /2025 10/1/2026 EACH OCCURRENCE $ 5,000.000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 5,000.000 DED J X I RETENTION $ in ann $ A WORKERS COMPENSATION Y MWC311397-25 1/1/2025 1/1/2026 PE TH X OR E AND EMPLOYERS' LIABILITY Y d N ANYPROPRIETOR/PARTNER/EXECUTIVE I N/A ACCIDENT $^1,000,0000-WWWWm 1 000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH)EA E.L.SEA $ ._. If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) All locations and operations for Dewey Services, Inc. Add'I Insured coverage is provided by form by CG 20 10 12 19, See Attached. WC Excluded officer: Patsy Dewey. The City of El Segundo, its elected and appointed officials, employees, and volunteers are named as an Additional Insured. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies in favor of the Additional Insured. 30 Days Notice of Cancellation (10 Days for Non -Payment of premium). CERTIFICATE HOLDER GANGEL.LA I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo Public Works Department General ACCORDANCE WITH THE POLICY PROVISIONS. Services Division 150 Illinois St. AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: MWTB313749-25 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Dewey Services, Inc. Endorsement Effective Date: 10/01/2025 SCHEDULE Name Of Person(s) Or Organization(s): All persons or organizations as required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 MWTB313749-25 COMMERCIAL AUTO CA 04 43 11 20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF COV Y. AGAINST OTHERS TO US (WAIVER OF SUBROGATION') - AUTOMATIC WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to any person(s) or organization(s) for whom you are required to waive subrogation with respect to the coverage provided under this Coverage Form, but only to the extent that subrogation is waived: A. Under a written contact or agreement with such person(s) or organization(s); and B. Prior to the "accident" or the 'loss." CA 04 43 1120 © Insurance Services Office, Inc., 2019 Page 1 of 1 MWZY313733-25 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. �911 N I alrAill:- 4• This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: MWZY313733-25 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 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 Organ izatiS!n s Location And Descri tion Of Completed Operations All persons or organizations when required by contract All completed operations. or agreement. 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 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 Section III — Limits Of Insurance: with 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 will 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 POLICY NUMBER: 111313733-25 COMMERCIAL GENERAL LIABILITY CG24041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): All persons or organizations when required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: MIIZY313733-25 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART/FORM SCHEDULE Designated Construction Project(s): All persons or organizations when required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by 'occur- damages or under Coverage C for medical ex- rences" under Section I — Coverage A, and for all penses shall reduce the Designated Construc- medical expenses caused by accidents under tion Project General Aggregate Limit for that Section I — Coverage C, which can be attributed designated construction project. Such pay - only to ongoing operations at a single designated ments shall not reduce the General Aggregate construction project shown in the Schedule above: Limit shown in the Declarations nor shall they 1. A separate Designated Construction Project reduce any other Designated Construction Project General Aggregate Limit for any other General Aggregate Limit applies to each des- ignated construction project, and that limit is designated construction project shown in the equal to the amount of the General Aggregate Schedule above. Limit shown in the Declarations. 4. The limits shown in the Declarations for Each 2. The Designated Construction Project General Occurrence, Damage To Premises Rented To Aggregate Limit is the most we will pay for the You and Medical Expense continue to apply. sum of all damages under Coverage A, except However, instead of being subject to the Gen - damages because of "bodily injury" or "prop- "products-com- eral Aggregate Limit shown in the Declara- tions, such limits will be subject to the applica- erty damage" included in the pleted operations hazard", and for medical ex- ble Designated Construction Project General penses under Coverage C regardless of the Aggregate Limit. number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which cannot be at- tributed only to ongoing operations at a single des- ignated construction project shown in the Sched- ule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical ex- penses shall reduce the amount available un- der the General Aggregate Limit or the Prod- ucts -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "prod- ucts -completed operations hazard" is provided, any payments for damages because of "bodily in- jury" or "property damage" included in the "prod- ucts -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Ag- gregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting par- ties deviate from plans, blueprints, designs, spec- ifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PESTICIDE OR HERBICIDE APPLICATOR COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART/FORM SCHEDULE Description Of Operations: Pesticide and/or Herbicide application With respect to the operations shown in the above Schedule, Paragraph (1)(d) of Exclusion f. Pollution of SECTION I - COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply: If the operations meet all standards of any statute, ordinance, regulation or license requirement of any federal, state or local government which apply to those operations; or With respect to such operations, if there is a failure to meet the standards described in Paragraph 1. above and such failure qualifies as an `occurrence", this will not void coverage under this endorsement. All "bodily injury" and "property damage" occurring during the policy period as a result of such failure to meet standards described in Paragraph 1. above will be considered one "occurrence" and the date of the 'occurrence" will be the date of a single erroneous application or the first application of a series of related erroneous applications; or At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to any insured and used for the purpose of performing the operations listed in the above Schedule. However, in no event does this insurance apply to pesticides and/or herbicides that at the time of the application are banned by government or regulatory authorities. GL 291 008 0122 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) POLICY NUMBER: MWC311397-25 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be otherwise due on such remuneration. PERSON OR ORGANIZATION % of the California workers' compensation premium SCHEDULE All persons or organizations when required by contract or agreement. DATE OF ISSUE: 01/01/2025 JOB DESCRIPTION @1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual@ 1999. POLICY NUMBER: MWZY313733-25 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURE - OWNERS, LESSEES O CONTRACTORS - SCHEDULED PERSON OR. ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations All persons or organizations when required by contract All locations. or agreement. 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 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 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 MWZY313733-25 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 © Insurance Services Office, Inc., 2018 CG 20 10 1219