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PROOF OF INSURANCE (2015) CLOSEDAcbj l DATE (MMIDD/YYYY) �". CERTIFICATE OF LIABILITY INSURANCE 16/1/2015 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 `" ' "`"� Vlktona Cordes 'ST Insurance Brokers PHONE FAX 446 W. Napa Street lair.- Kl F .� 707 -996 1232 ,A,c No,, 707-996-6655 -.,. .._ ­1111 ionoma CA 95476 ' D'RIESSavcord'es @sstins.com a INSURERA:Hartford Fire Insurance INSURED SURVE INSURER B: Mercury Insurance Groi g INSURER C: Essex Insura nce Comp SurveillanceGrid Integration, Inc. 18434 Technology Morgan Hill CA 95037 INSURER D INSURER E: r rr; tl m n r I- CCa^rIMI A rC wll lillaD,C0. 99AAg;R1 Q9 rsr r are rr.r� .rn �.n rP.. 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, INSR.. .......__ ..... -..- .............. "A1701: SUt ,,,,,,....... "`--_ ............................. ..._POLICY EFF" . POLICY EXP - ------- ...,,,,,.,...... .... ... ............... ----- ._._.. LTR TYPE OF INSURANCE INcn wyn POLICY NUMBER IMMIDDIYYYYI IMM /DDIYYYYI LIMITS C X COMMERCIAL GENERAL LIABILITY 3DW2729 12/3/2014 12/3/2015 EACH OCCURRENCE $1,0'OOo000i 'PPFMGE.S!Ea')=I1"I�(,o . -.- ' ,,.,.. _.. CLAIMS -MADE X OCCUR _PRFMICFSlF,aheC'AIpFB.ff'AYI $SOOOO MED EXP (Any one person) $1,000 PERSONAL &ADV INJURY $1.000.000 AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X PRO - POLICY .... JECT LOC ry I• RODUCTS' COMP /OP AG-G... $'2,000,000 OTHER: $ B AUTOMOBILE LIABILITY (Ea accident) ..... L ......... $1,000 000 X ANY AUTO.. BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ - -. -.., NON -OWNED X HIRED AUTOS X AUTOS C�ROPER'T'y'r71.W,%ACI: ,.. (Per accldev) UMBRELLA LIAB OCCUR --- - -- , .......,. EACH OCCURRENCE .,..... ,..._. ....... $ EXCESS LIAB .CLAIMS -MADE, ... ... AGGREGATE .......... ...... .... .- ------........ .......... $ ............. - -----._._ ,..,..........,. DED RETENTION $ $ A WORKERS COMPENSATION 57WECDX4436 /19/2015 3/19/2016 PER OTH- AND EMPLOYERS' LIABILITY Y I N , STATI ITF FR ANY PROPRIETOR/PARTNER /EXECUTIVE EL EACH ACCIDENT $1,000,000 OFFICER /MEMBER EXCLUDED? N/A .... _ ...E.L _. y , Mandato In NH (Mandatory ) DISEASE E - EA EMPLOYE $1.000.000 If yes, describe under .. .. ................ -,. -----.._ .,. ..., ,DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as Additional Insured for all California Operations. Waiver of Subrogation to follow. CERTIFICATE HOLDER CANCELLATION JU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo, City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Brian Evanski 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY III POLICY NUMBER: 3DW2729 MARKEr ESSEX INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. WAIVER OF SUBROGATION Th is endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Additional Premium: $ 150.00 Name of Person or Organization: city of El Segundo, CIty Clerk 350 Main Street E1 Segundo, CA 90245 The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above as respects written contracts that exist between you and such person or entity, provided you have agreed in writing to furnish this waiver. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain unchanged. MEGL 024104 11 Includes copyrighted material of Insurance Services Office, Inc. with Page 1 of 1 its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY.. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. City of El Segundo, City Clerk 350 Main Street El Segundo, CA 90245 Effective 6/02/15 -16 SurveillanceGrid Intergration, Inc. Policy #57WECDX4436 AP5004US 11 -06 Page 1 of 1