Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
PROOF OF INSURANCE (2014) CLOSED
C4 10 /24/2013 3 00" CERTIFICATE OF LIABILITY INSURANCE DIDD/Y 10/24 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 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 1-800-326-6203 CONTACT CERTIFICATES NAME CATE Arthur J. Gallagher Risk Management Services, In Services, Inc. FAX . ... .. ., ---- PHONE 1 800 - 326 -6203 FAX 972-663-6258 (�e/Pr,..E...Fjnk LA s No .. ) . Two Lincoln Centre EMAIL ADDRESS; PESTSURECERTS @AJG.COM Suite 400 - Dallas, TX 75240 INSURERS) AFFORDING COVERAGE NAIC INSURERA: OLD REPUBLIC INS CO 24147 . IN SURED INSURER B: XL INS AMER INC 2455 4 DEWEY SERVICES, INC. BRANCH NO.. 7 ........_... ..... - - - -- DBA DEWEY PEST CONTROL INSURERC: ................ -. ._ ... 939 EAST UNION STREET INSURER D: PASADENA, CA 91106 -7214 INSURERE INSURER F: COVFRAIMFS CFRTIFICATF NIIMRFR• 36543640 RFVICInM NI IMRFI7- 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. i ,..S '..ADD B POLICY NUMBER ..••. �� MMJDDYIXYYY MPIAOII /D•.. ------ . .••••.�. .......__ ,,..... a..e.m. .... ............ .... OLI TYPE OF INSURANCE DIYYYY LIMITS A GENERAL LIABILITY X X MWZY 60332 10 /01 /1 10/01/14 EACH OCCURRENCE $ 2.000,000 X COMMERCIAL GENERAL LIABILITY ,..p 5�� .pracem $ 100 000 X CLAIMS -MADE OCCUR MED EXP (Any one person) $ 10,000 .....................� ............... PERSONAL &ADV INJURY ........GGREGATE $ 2, 000, 000 ............- ...... GENERALAu_.�....... ............ $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIE S P ER. PRODUCTS - COMP/O P AGG $ 4,000,000 X POLICY P1�.C} -, LOC $ A AUTOMOBILE LIABILITY X X MWTB 22068 10 1 COMBINED SINGLE LIMIT -- Eaacclden(), .......... $2,000,000 X ANY AUTO BODILY INJURY (Per person) $ g- e",,,,AUTOS ALL OWNED SCHEDU LED AUTOS BODILY INJURY (Per accident) $ X LX�-" NON -OWNED $ HIRED AUTOS I AUTOS R�OpPERdTerlL7AMAGE )) $ 8 X . -.�.W. UMBRELLA LIAB X OCCUR US00065870LI13A 10 /O1 /l �. 10/01/14 EACH OCCURRENCE ..," $ 1,000,000 EXCESS LIAB CLAIMS -MADE ............._..,. AGGREGATE ..,........,..... ....... ............................... ,............................0 $ 11000.000 .......................... ............................... DED � RETENTION $ $ $ A WORKERS COMPENSATION X MWC 118084 00 O1 /O1 /1 O1/O1/1s1.. X WCSTATU• OTH- ANDEMPLOYERS' LIABILITY Y / N m,....�. , QR.X.LIN�II$.. � ............. .. ........... ...,...,- ,.,..............__.._ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N / A` ....................... (Mandatory In NH 1 E.L. DISEASE • EA E MPLOYE $ 1,000,000 If yes, describe under -- DESCRIPTION OF OPERATIONS below '.. E.L. DISEASE POLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ALL LOCATIONS & OPERATIONS. ADD'L INSURED COVERAGE IS PROVIDED BY FORM # CG 2010 (07/04). SEE ATTACHED. THE CITY OF EL SEGUNDO IS NAMED AS ADDITIONAL INSURED. COMPLETED OPERATIONS IS INCLUDED ON THE GENERAL LIABILITY POLICY. A WAIVER OF SUBROGATION IS PROVIDED IN FAVOR OF THE CITY OF EL SEGUNDO. 30 DAYS NOTICE OF CANCELLATION WILL BE PROVIDED TO CERTIFICATE HOLDER (10 DAYS FOR NON - PAYMENT OF PREMIUM.) VCR I Irfl.m I r rIULLJrK 4,P1,N "UMLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF EL SEGUNDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUBLIC WORKS DEPARTMENT i', ' ACCORDANCE WITH THE POLICY PROVISIONS. GENERAL SERVICES DIVIS'IO Y 150 ILLINOIS STREET AUTHORIZED REPRESENTATIVE ,/" EL SEGUNDO, CA 90245 I USA I © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD marimal 36543640 POLICY NUMBER: mwzY 60332 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations as required by contract or agreement. Information re uired 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 t" Section IV — Conditions: We waive any right of recovery we may have agains the person or organization shown in the Schedul above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ POLICY NUMBER: mwzY 60332 COMMERCIAL GENERAL LIABILITY CG 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 Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations CITY OF EL SEGUNDO PUBLIC WORKS DEPA TMZXT,, 150 ILLINOIS STREET EL SEGUNDO, CA 9024!- USA All Locations. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and de- scribed in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑