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PROOF OF INSURANCE (2012) CLOSEDA CERTIFICATE OF LIABILITY INSURANCE 6/30/2012 DA6/28/20111 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 LOCKTON COMPANIES, LLC -1 KANSAS CITY 444 W. 47TH STREET, SUITE 900 (A/C. No. EXt): I Wk No KANSAS CITY MO 64112 -1906 EMAIL (816) 960 -9000 INSURED 1076048 99 CHERRY HILL RD. SUITE #102 PARISIPPANY, NJ 07054 -1102 American Zurich Insurance INSURER B: FEDERAL INSURANCE COMPANY (C INSURER C : National Union Fire Ins Co Pittsbureh PA INRIIRFR in . American Guarantee and Liab. Ins. Co. Zurich American Insurance t_ YJm [ Sy 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 R TYPE OF INSURANCE A'ODL' II4S BS POLICY NUMBER P LILY P POLL Y E,XP LIMITS A GENERAL LIABILITY Y N CP09264393 6/30/2011 6/30/2012 EACH OCCURRENCE R 1.000.000 ,„ co: MMERMA6. GENEiiAt, [..gABI[.JT DAMAGE TO RENTED PREMISES IFa nrcu gnw) 4 1.000.000 CLAIMS -MADE XI OCCUR MED EXP (Anv one Damon) R 5.000 PERSONAL & ADV INJURY $ 1.000.000 GENERAL AGGREGATE 1 $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: '.PRODUCTS - COMP /OP AGG I $ 2.000.000 POLICYM M. X LOC $ D AUTOMOBILE LIABILITY N N CP09264393 (AOS) 6/30/2011 6/30/2012 iFO I rEllntSINGLE LIMIT $ 1.000.000 E ANY AUTO MA 9264395 (MA) 6/30/2011 6/30/2012 X BODILY INJURY (Per person) $ XXXXXXX ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accideni' $ NON-OWNED HIRED AUTOS PROPERTY R DAMAGE $ XXXX��� X $ XXXxxxx CO�NINCOLL $1000 DED, UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXJ�XX EXCESS LIAB CLAIM'S' =MAI }t: NOT APPLICABLE AGGREGATE $ XX=XX DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N WC 9264390 6/30/2011 6/30/2012 WC STAT IMF T c., X Inq IC , YIN 'E.L. EACH ACCIDENT 1 $ 1,000_000 ANY PROPRIETORIPARTNER/EXECUTIVE �7 OFFICER/MEMBER EXCLUDED? 1V NIA A L DISEASE - EA EMPLOYEE 1.000.000 (Mandatory in NH) If yes, describe under D DESCRIPTION OF OPERATIONS below E I DI.5EASF Pnl CY LIM!T � 1.000 -000 e B CRIME N Lv 6800 -5714 6/30/2011 6/30/2012 $1M EMP THEFT $10M 3RD PARTY CRIME C PROF LIAR 02- 406 -05 -19 6/30/2011 6/30/2012 $2M PROF LIAB DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED„ CITY OF EL SEGUNDO ITS OFFICIALS AND EMPLOYEES ARE ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY TERMS AND CONDITIONS. CERTIFICATE HOLDER CANCELLATION 3528678 6 d CITY OF EL SEGUNDO ITS OFFICIALS AND EMPLOYEES 350 MAIN STREET EL SENGUNDO CA 90245 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©T90-2010 The ACORD name and logo are registered marks of ACORD TION. All rights reserved Additional Insured -- Automatic — Owners, Lessees Or ZURIC0 H Contractors Potiev IQo. Exp. Date of Pol. Eff. Date of End. Agency No. hddL Prom. Return Preto. CP09264393 6/30/2012 I 6/30/2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT LLY. Named Insured: York Insurance Acquisition, LLC Address (including ZIP Code): 99 Cherry Hill Road, Suite 102 Parsippany, NJ 07054 This endorsement mo'difies insurance provided under the: Commercial General Liability Coverage Part A. Section II —'Who Is An Insured is amended to- include as an insured anyperson or organization who you are re- quired to add as an additional insured on this policy under a written contract or written agreement. B. The insurance provided to the additional insured person or organization applies only to "bodily injury', "property damage" or ':personal and advertising injury' covered under SECTION I - Coverage A - Bodily Injury And Property Damage Liability and Section I - Coverage .B - Personal And Advertising 'Injure Liability, 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; and resulting directly from: a. Your ongoing operations performed for the additional insured, which is the subject of the written con- tract or written agreement; or b. "Your worle' completed as included in the: "products - completed operations hazai.d ", performed for the additional insured „-,which is the subject of the written contract or written agreement. C. However, regardless of the provisions ofparagraphs A. and B. above: 1. We will not,extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide'to the additional insured person or or- ganization in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contractor written agreement. Includes copyrighted material of Insurance services Office, Inc., with its permission. Agent Copy U- GL- 1175 -B CW (3/2007) Page 1 of A The insurance provided to the additional insured person or organization does not applyto: ":Bodily, injury', "property damage" or "personal and advertising injury, arising out of the rendering or £ailtue to render any-professional architectural, engineering or surveying services including; 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. E. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that rnay ire stilt in a claim; 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires.that this coverage be primary and non - contributory. , ,F. For the boverage provided by this endorsement: 1. The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section TV — Commerdal General Liability Conditions: This insurance is primary insurance as respects our coverage to the additional insured person or organ 4a- tion, where the wiitten contract or written agreement requires that dais insurance be primary and non- contributory. In that event; we will'not seek contribution from any other insurance policy available to the additional insured an which the additional insured person or organization is a Warned insured. 2. The follo,%n paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Sectlon IV — Commervial General Liability Condttions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, *available to an addi- tional insured, in which the additional insured on our policy is also cohered as an additional insured by at- tachment of an endorsement to another policy providing coverage for the same "occurrence", claim or "suit". This provision does not apply to any'policy in which. the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on aprimary and'non- contributory basis. G. This endorsement does not apply. to an additional insured which has been added to this policy by an endoxse- ment showing the additional insured in a Schedule of additional insureds, and which endorsement applies spe. ciiicaliy to that identified additional insured. Any proNisions itx this Coverage Tart not changed by the -term anal conditions of this endorsement continue to apply as written lncludea copyrighted material of Insuranee Services office, lne, with its pex-iuission. U -GL -1175 B CW (3 /2W7) Pago2of2 Agent Copy