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PROOF OF INSURANCE (2015) CLOSED`C"' '' " CERTIFICATE OF LIABILITY INSURANC DATE(29/2YYY4 Page 1 of 1 07/29/2014 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 -1.OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ,... "ORTANT: 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). Willis of New York, Inc. c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230 -5191 Berlitz Corporation 7 Roszel Road Princeton, NJ 08540 (FV.G ..N9_E2iT�_ o 1 1 - ? Y 7 -1 -3 1 c - -- ... ) F -M;Iw° certificatesrillis.com INSURER(S)AFFORDING COVERAGE _ INSURERA Mitsui Sumitomo Insurance Company INSURERS. Mitsui Sumitomo Insurance USA I _ nc INSURER C: INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 21867437 REVISION NUMBER: 888- 467 -2378 _NAIC # of Amex 20362 001 22551 -001 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, Lff TYPEOFINSURANCE LTR A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EVIL AGGREGATE LIMIT APPLIES PER: POLICY P I LOC PRO. JE'C'1 B I AUTOMOBILE LIABILITY ANY AUTO ALLOWNED X X SCHEDULED ULED AUTOS AUTOS HIRED AUTOS (�N4OWNEt A R EXCESS IAB TIONI J CCU10 000 EXCESS LIAR CLAIMS -MADE A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PRO PRI ETOR/PARTN ( Oy^ slldCdER /MbEMBEREXCLUDEDXECUTIVE'N� N/A I DESCRIPTION OF OPERATIONS below POLICY NUMBER PKG3000272 BVR8302170 UMB5500107 WCP9001200 LIMITS 8/1/2014 8/1/2015 EAAo000RRE�CE N 'E TO RE N �ED fJRFMY PR fFa nnro rwnnoti $ /1/2014 8/1/2015 M D EX (Any one person) _E- �_.... P- .,,.._. ,,,,,,,,,,,,,,,,,,,,, PERSONAL & ADV INJURY GENERALAGGREGATE PRODUCTS - COMP/OP AGG BODILY INJURY(Per person) BODILY INJURY(Per accident) /1/2014 8/1/2015 EA_CHOCCURRENCE AGGREGATE /1/2014 18/1/2015 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Additional Remarks Schedule, it more space is required) It is agreed that City of EL Segundo, the officers, officials, employees and volunteers are included as Additional Insureds as respects to General Liability policy. 1 ............1......0, 0,.0.0.0,0 $ 2,000,000 � �. $ lA ®0.0,...0 „00 $ 1,000,000 $ $ 10,000,000 $ 101 000, 000 11000,000 .............. 1,000,000 1,000,000 It is further agreed that such insurance as is afforded shall be primary and non - contributory with any other insurance in force for or which may be purchased by Additional Insureds. CERTIFICATE HOI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of EL Segundo 350 Main Street E1 Segundo, CA 90245 Coll:4476787 Tpl:1845921 Cert:21867437 © 88- 2010ACORDCORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marN of ACORD 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 Organization(s): Location(s) Of Covered Operations City of EL Segundo, the officers, officials, employees and volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11— 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 operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment 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 intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 2010 07 04 © ISO Properties, Inc., 2004