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PROOF OF INSURANCE (2014) CLOSEDOP iD: DATE 'M m IDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 04,16,13 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 Marrs Maddocks & Associates Insurance Svcs, Inc. #0818269 1903 Wright Place, Suite #280 Carlsbad, CA 92008 E. Glenn Ables, CIC INSURED Lightwerks Communication Systems, Inc., dba: CCS Presentation Systems David Riberi 3331 Jack Northrop Ave. Bldg 6 Hawthorne, CA 90250 COVERAGES CERTIFICATE NUMBER: 0 #.CCSPR -1 INSURER(S) AFFORDING COVERAGE Hanover American Ins. Co. . . . . . . . . . . . . . . . . . . . . Allmerica Financial Benefits The Hanover Insurance Group Sec�uoi_a Insurance Com an Llovds of London 36064 ...._._....._._ .41840 22292 22985 • n 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 . .... __. _, INSR ITITITmm Affa SUBR POLICY EFF POLICYEXP LIMITS TYPEOFINSURANCE O tl N MBE.R GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X ZZF 9100960 -02 04115113 04/15/14 � I SO a renceei F''... $ 100,00( - .....- CLAIMS -MADE X OCCUR MED EXP (Anyone person) $ 10,00 X Contractual Liab. PERSONAL & ADV INJURY u$ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP /OP AGG $ 2,000,00 POUC'h F-xl PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 B „X ANY AUTO AWF9101066 -02 04/15/13 04115/14 (Ea accident} ............. .....,........._,. .(Per ---- BODILY INJURY p erson) $ ALL OWNED AUTOS . ................ BODILY INJURY (Per accident) $ SCHEDULED AUTOS mmmmmmmmmmITIT PROPERTY DAMAGE X HIRED AUTOS (Per accident) ... ............... $ X NON -OWNED AUTOS $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,00 C X _�. EXCESS LIAB CLAIMS MADE. mDEDUCTIBLE UHF9100961 -02 04/15/13 04/15114 AGGREGATE - �-- $ 10,000,00 _ - Excludes _.. $ ... X RETENTION $ None Prof Liab $ WORKERS COMPENSATION X WCSTATU- OTH KIDEN D AND EMPLOYERS' LIABILITY YIN! ANY PROPRIETORlPARTNER /EXECUTIVE ggg--- NIA X SWP209240 -3 11/01/12 11/01/13 E L EACH ACC r _ 0 $ -- 1,000,601 OFFICER /MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE EA EMPLOYEE .. $ 1,000,00 If yes, describe under DESCRIPTION OF OP .RATIONS below E L. DISEASE - POLICY LIMIT $ 1,000,00 E 'Prof Liab - Claims 459450 07101112 07/01113 O 1,000,00 Made Policy Form RETRO DATE: 7/1/06 Retention 5,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of E1 Segundo, its officers, officials, employees, agents and insured liability volunteers are named as additional as respects general per forms CG2010 & CG2037 07/04 as required by writte contract; this coverage is primary & non - contributing. Waiver of Subrogation applies to Worker's Compensation as required by written contract. >SEE NOTEPAD> City of El Segundo Attn: City Clerk 350 Main Street El Segundo, CA 90245 ACORD 25 (2009/09) ELSEGUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD M M POLICY NUMBER: ZZF 9100960 -02 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Organlzation,as - n or oraanizatio vei n T oUi-re v vwi this Schedule, if not 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 operation efor the additional insured(s) at the location(s) desig- nated above. Location(s) Of Covered Operations will be shown in the Declarations. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 lips Page 1 of 1 ❑ POLICY NUMBER: ZZF 9100960 -02 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 N ame Of Additional Or O Insured Person(s) � nization s Any person or organization when required by Information rectulred to complete this Schedule, if n 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, dq?_e age" caused, in whole or in part, by "your worm" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and Included in the "products- completed operations hazard ". CG 20 37 07 04 1196 And Description Of Completed Operations will be shown in © ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NO.: ZZF9100960 -02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Other Insurance — Primary and Non - Contributory (Additional Insured) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Section IV — Commercial General Liability Conditions 4. Other Insurance a. Additional Insureds (a) That is Fire, Extended If you agree in a written contract, written Coverage, Builder's agreement or permit that the insurance Risk, Installation Risk or provided to any person or organization similar coverage for "your work "; included as an Additional Insured under Section II — Who is An Insured, is (b) That is Fire insurance primary and non - contributory, the for premises rented to following applies: the Additional Insured or temporarily occupied by the Additional If other valid and collectible insurance is Insured with permission available to the Additional Insured for a of the owner; loss we cover under Coverages A or B (c) That is insurance of this Coverage Part, our obligations are limited as follows: purchased by the Additional Insured to 1. Primary Insurance cover the Additional This insurance is primary to other Insured's liability as a insurance that is available to the tenant for "property Additional Insured which covers the damage" to premises Additional Insured as a Named rented to the Additional Insured. We will not seek Insured or temporarily contribution from any other occupied by the insurance available to the Additional Additional with Insured except: permission of the i. For the sole negligence of the owner; or Additional Insured; (d) If the loss arises out of ii. when the Additional Insured is the maintenance or use an Additional Insured under of aircraft, autos or watercraft to the extent another primary liability policy; not subject to Exclusion or g. of Section I — iii. when 2. below applies. Coverage A — Bodily If this insurance is primary, our Injury And Property obligations are not affected unless Damage Liability. any of the other insurance is also When this insurance is excess, we will have primary. Then, we will share with all no duty under Coverages A or B to defend the that other insurance by the method insured against any "suit" if any other insurer described in 3. below. has a duty to defend the insured against that 2. Excess Insurance "suit ". If no other insurer defends, we will undertake to do so, but we will be entitled to This insurance is excess over: the insured's rights against all those other (1) Any of the other insurance, insurers. whether primary, excess, When this insurance is excess over other contingent or on any other insurance, we will pay only our share of the basis: amount of the loss, if any, that exceeds the sum of: Page 1 of 2 421 -0452 06 07 Includes copyrighted material of Insurance Services Offices, Inc,, with its permission (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. 3. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Page 2 of 2 421 -0452 06 07 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Declaration Number: 001 Effective Date: 11/01/2012 Page 18 Policy Number: SWP209240 -3 LightWerks Communication Systems, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY 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 3 % of the California workers' compensation premium otherwise due on such remuneration. Blanket Schedule Person or Organization Job Description All Written Contracts Various WC 04 03 06 Page 1 of 11