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PROOF OF INSURANCE (2016) CLOSED
Client #: 22449 GRANIINC DATE (MMIDD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 5/02/2016 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. gIPORTANT: If the certificate holder Is an AD � _. _. ADDITIONAL gNSUIRED, the pogicy(ges) must be endorsed, If SUBROGATION! IS WAIVED, subject tom 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). NAME: Linda Bogardus PRODUCER NFP Property & Casualty PHONE 802 658 -1100 �Ak 802 658 9419 iAP ,,,No, Ext) � IAfC. Nun): 620 Hinesburg Road E-MAIL of P. O. Box 2127 ADDRESS. Imda.bo g ardus @_nf com INSURER(S) AFFORDING COVERAGE NAIC # So Burlington, VT 05407 -2127 _ ".......µµµ.......µµFederal Insurance p ............... ..... ........... INSURER A • y 20281 Com an _ . � ... . .... ..................................... .. ..�.........,.. INSURE Integrated Practices Solutions, Inc.dba Granicus, Inc. 70717th Street, Suite 4000 Denver, CO 80202 ,�. ..." ...,.,,,,.,.., , , , , , , ,.,.., . , . , ..... ............................... INSURER B : Chubb Ind emnity Insurance Compa ER INSURERC: Darwin National Assurance Compa _ ................................... _ ................... --... ...... .. ............................................................ ---- .......... . INSURER D ........... ............................ . INSURER E: INSURER F: ----- ------ - - 12777 16624 ................ ............................... COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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 ADDL SUB P TR TYPE OF INSURANCE wvn POLICY NUMBER ............. _ _ m ........... POLICY EFF POLICY EXP (MMI D IVYVYI ( M!DD/vvVYl LIMITS ...... '.. A GENERAL LIABILITY 36032895BOS 12/31/2015 12131/201 EACHOCCURRENcE $1,000,000 CO LIABILITY ,�( COMMERCIAL GENERAL IIE'%p rr . . , „ �aa`.auFrrencel $11,000.000 CLAIMS -MADE OCCUR ENP.x.L.a (Any one person) $10,000 _ PERSONAL & ADV INJURY $ „1,000,000 _ _____ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY..] ..... PRO .... .... LOC .. ................. _ , _._. „& AFi b .... .... .. ._ _, ..,.......- .....,........ _ $. .:r......... ......- ....Y. A AUTOMOBILE LIABILITY 1573592235 12/31/2015 12131/201 (EOM BINE—D(sINGLE LIMIT 1.000,000 ANY AUTO BODILY INJURY (Per person) $ ” ALLOWNED SCHEDULED AUTOS AUTOS .. ......... ......-- -- -- -------- -- BODILY INJURY (Per accident) $ X X NON -OWNED PROPERp' DAMAGC" Y $ HIRED AUTOS ..._. AUTOS (p ,�kW6Gtl) $ ......... ._._._._. A X UMBRELLA LIAB X OCCUR 78180755 —� .. ... 12/3112015 12/311201 EACH OCCURRENCE $10 000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 �.0 �. $ B 1671 754109... °rs�n�lasE�naiurr WC STATU OTH- 12/31/2015 12/ 31 /201 X T(1RY IMITS �FR ANY PROPRVETORIPARTNER/EXECUTIVE� EL, EACH ACCIDENT $1,000,0 . ...... $1,00 under DESCRIPTION OF OPERATIONS below ..._... - - -------------- - -.... __.... EL. DISEASE- POLICY LIMIT $1.000.,000 0.000 .... .. . .... ..-.. " ...... . C Crime 03091033 7/02/2015 07/02/2016 $500K.." Limit; $7,500 Ded A Property - Blanket 36032895BOS 12/31/2015 12131/201 $588K Limit; $2,500 Ded Valuable Papers 36032895BOS 12/31/2015 12/31/201 $75K Limit: $2.500 Ded DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Errors & Omissions /Professional Liability: Information & Network Technology Combination Insurer A - Federal Insurance Company Effective Date: 12/31/15 Expiration Date: 12/31/16 $4,000,000 Limit $25,000 Deductible City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Ad'min Services, Finance Alp ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St El Segundo, CA 90245 ,� AUTHORIZED REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S245198/M243474 LSB Kh��Ue Liability Insurance Endorsement Policy Period DECEMBER 31, 2015 TO DECEMBER 31, 2016 Effective Date DECEMBER 31, 2015 Policy Number 3603 -28 -95 BOS U v Insured GRANICUS INC Name of Company hEDERAL INSURANCE COMPANY Date Issued JANUARY 15, 2016 :'; FED"' Yk�" mY�^ �s,„. r�Kr��...;"f >Sda�a:✓,,.�o-..�"�. �erv4'�^C;:�"�S".d�Y �rair. ��; �r; �Sb�.% 4;/;++ a" a ''u3`a ✓,r,�;".n,s'a^tirT•�ai�.,7 da�.. areui. r4ax" �w' S,44�'d.Pa+�Ah�afYrr»�F�%..�... ^",�? Fran^. �' eris, rr+; b; �S: 7✓'? �" l'' d: i, Nd�w.. vaa. aa> �. �`, Y, �d�T�and�6� ;�.%'u�,dr�."Yi�tK;dl7k This Endorsement applies to the following forms: GENERAL LIABILITY INFORMATION AND NETWORK TECHNOLOGY BLENDED LIABILITY INSURANCE . b.+ J�J" ?S:�'r+Ek✓X.,.Gtk'7!",,G; + ?.'�� ..,..i5'+E,>,✓b,:rr�7:,,Y»r�; �.?5+� !, gaV�M�!`r,Y�f c.�,.�»E�:��kti ^ ?,�nv�' �^,`ritidx:Gd, e.�;"Y,t7h. r eh�.✓ ., k^.c�Y�:�k4. ✓dJ'..�SiAe:�' /rrv7" .. X57 .,., ,: , a9a. 4nn' �d+, �.. �Pr 'rT��i..,nu'^�rYi''.,.c,ar 5rv.way..nY, k.,��. �', }+S.R�Fx77.rrr✓kY�ta'd/::#i: Under Who Is An Insured, the following provision is added. Who Is An Insured Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto). • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. mw. Liability Insurance Additional Insured - Scheduled Person Or Organization continued Form 80.02 -2367 (Rev. 5 -07) Endorsement Page i Liab111ty Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance, Conditions Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. kt"" MM2 V*Z'W""✓. 4�4' a""' 4�i�" ✓e!%M".fY.9i,1 �G:;..N ia'iZ.Lw iU �w"'VM�a�"+.%N iY �:�'r$NT .f r'�",h�"tivw5",R�", ie'! n,y/c' ',17a { Nti� $.%7ii'Jhl.ti;l' ✓. ^.vkrrvrrnN, rai"wGG'f � >fa.v.S.N i;Y,: i n:rC. ,+ s"""Wai 1rw, 'V: gas "sN;i1�l.Y/'. sN45"✓�,' Schedule Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with such insurance as is afforded by this policy. All other terms and conditions remain unchanged. Authorized Representative Liability Insurance Additional Insured - Scheduled Person Or Organization last page Form 80-02-2267 (Rev. 5 -07)mm Endorsement — Page 2