PROOF OF INSURANCE (2008) CLOSEDr
00VERACIES
THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ASOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM DR 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 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
own
LTR
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
TYPE OF INSURANCE
POLICY NUMBER
PULIUY
DATE
REPRESENTATIVES.
LNOTS
GENERAL LIABILITY
EACH OCCURRENCE
$1,000 000
•
X
X COMMERCIAL GENERAL LIABILITY
08 UUN AB1553
03/01/07
03 /01/08
PREM&S Ea"oom'uw .
s 300 000
CLAIMS MADE a OCCUR
NED EXP (Arty ono person)
$10,000
PERSONAL AADV INJURY
$1,000,000_
GENERAL AGGMATE
s2,000,000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS • OOMPNOP AGG
s2,000,000
POLICY 0 JECT LAC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$1,000,000
•
X
ANY AUTO
08 VON A81553
03/01/07
03/01/08
(Ea&=dsm)
BODILY INJURY
$
ALL OWNED AUTOS
SCHEDULEDAUTOS
(�P—)
X
HIRED AUTOS
8001LY INJURY
$
X
NON-OWNED AUTOS
(Peraccideat)
PROPERTY DAMAGE
$
(Par accident)
GARAGE LIABILITY
AUTO ONLY • EA ACCIDENT
8
OTHER THAN EA ACC
s _
ANY AUTO
s
AUTO ONLY: A130
axe E88NMBRELLA'ABILITY
EACH OCCURRENCE
$15,000,000
8
X OCCUR r7 CLAIMSMADE
08 R8U AR1435
03/01/07
03/01/08
AGGREGATE
$15,000,000
$
$
DEDUCTIBLE
X RETENTION $10,000
s
WORKERS COMPENSATION AND
X TWTATUn R
C
EMPLOYERS'
ANY PROPRIbTORIPARTNERIDCBtXNTNE
08 WS RJ4914
03/01/07
03/01/08
EL. EACH ACCIDENT
$1,000,000
E.L. DISEASE • EA EMPLOYE
$ 1, 000, 000
OFFICERIMEMSER EXCLUDED?
It yep. domes under
SPECIAL PROVISIONS below
E.L. DISEASE• POLICY UNIT
s1 000,000
OTHER
D
Professional Liab
9655581
11/17/06
11/17/07
Agg 10,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate holder is listed as additional insured under the QL policy as
per form CO 2010 and CO 2037 attached. This insurance will be domed
"primary" such that any other insurance that may be carried by the City of
21 Segundo will be excess thereto. This insurance will be on an
"occurrence ", not a "clai.me made," basis or equivalent.
l=mi IPA:AI G,1l umm f= Amr:Fl 1 AY191111
CIT3 59 0
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City Of 81 Segundo
J. Richard 8ogate
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
380 main street
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
8l Seg=do CA 90245
REPRESENTATIVES.
AUTWRUD REPR
#+mowrsw &a law rlwel ® ACORD CORPORATION IV35
POLICY NUMBER: 08 UUN AB1i83
COMMERCIAL GENERAL LIABILITY
CO 20 37 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Person
Or Organization:
THE CITY OF EL SEGUNDO
Location And Description of Completed Operations: ALL
Additional Premium:
(If no entry appears above, information required to complete this endorsement will be shown In the Declarations as
applicable to this endorsement.)
Section II — Who Is An Insured is amended to
Include as an Insured the person or organization
shown in the Schedule, but only with respect to
liability arising out of "your work" at the location
designated and described in the schedule of this
endorsement performed for that insured and included
In the "products- completed operations hazard ".
00 20 37 07 04
0 180 Properties, Inc., 2004
Pape 1 of 1
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ ITCAREFULLY.--'---
POLICY CHANGES
This endorsement forms a part of the Policy numbered below:
Policy Number Named Insured
08 UUN A61553
TYLER TECHNOLOGIES, INC.
Policy Change Effective Date Change No. Agent or Broker
03/01/2007 05 HAYS COMPANIES
CHANGE(S)
IN CONSIDERATION OF NO CHANGE IN PREMIUM, CG20100704 IS AMENDED AS PER THE ATTACHED.,—
Due at Policy Change effective
Installment Premium Schedule
date:
Return
Due Dates
Prior to this change
Result of Change
•Reel $001, -
JnstaU
Additional
Return
$
$
$
$
$
$
Revised Installments, if not shown on this endorsement, will be shown in the Declarations or on Form HM 99 01.
*If Future Annual Installments, this exclude Automobile Premium.
This endorsement does not change the policy except as shown.
This endorsement will not be binding unless countersigned by a duly authorized agent of the company..
Policy Expiration Date
03/01/2007 Countersigned by
AuthorizedjN§ent
Form HIVII 12 01 01 91 Printed in U.S.A.
0 1997, The Har@W�,'.
ZOO/TOO In XVd 'RZ:XZ -LOOZ/qO/VO
POLICY NUMBER: 08 UUN AB1553 COMMERCIAL GENERAL•LLABIU•�'Y,
CG 2010.07, 94
1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY..
ADDITIONAL INSURED - OWNERS, LESSEES OR
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):
THE CITY OF EL SEGUNDO
Location(s) Of Covered Operations,,,
�, or
CG 20 10 07 04
® ISO Properties, Inc„ 2004
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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 additional.
organization(s) shown in the Schedule, but only
exclusions apply:
with respect to liability for "bodily injury', "property
"personal
This insurance does not apply to "bodily injury" or
damage" or and advertising injury"
"property damage" occurring after: ..
caused, in whole or in part, by:
1. Your acts or omissions; or
1. All work, including materials, parts or.
equipment furnished in connection with_ such.._. _ ........
2. The acts or omissions of those acting on your
work, on the project (other than service,
behalf;
maintenance or repairs) to be performed by or
In the performance of your ongoing operations for
on behalf of the additional insured(s)' at{' b
the additional insured(s) at the location(s)
location of the covered operations has been
designated above.
completed; or
2. That portion of "your work" out of which.: ,the r,
injury or damage arises has been put to its
Intended use by any person or organization
other than another contractor or subcontfactor
engaged in performing operations ,fob a
principal as a part of the same project.
CG 20 10 07 04
® ISO Properties, Inc„ 2004
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