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PROOF OF INSURANCE (2018) CLOSED O' DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 111612017 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 palicy(les)must have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Julee Haqer Diversified Insurance Industries, Inc. PHONE .410-433-3000 iac.flnl:410-433-3440 Suite 155 Vilest, 2 Hamill Road plc_No.Exr, Baltimore MD 21210-1873 E'MAIMAIL iulee.haaerCWdii-ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Great Northern Insurance Co* 20343 INSURED ENVIS-2 INSURER s-Federal Insurance Co.* 20281 Envisionware Inc INSURERC:Chubb Indemnity Ins Co.* 12777 2855 Premiere Parkway, Suite A INSURER D,. Duluth GA 30097 {INSURER E t INSURER F COVERAGES CERTIFICATE NUMBER:2117058559 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 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 AUDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE _ _ _INSR wyn POLICY NUMBER fMM10D1YYYY1 rMM""YYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y 35943516EUC 118!2017 11812018 (EACH OCCURRENCE $1,000,000 IDA CLAIMS-MADE X❑OCCUR PREMISES�aEoccurrence) $1,000,000 j I MED EXP(Any one person) S10,000 { I PERSONAL BADVINJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE 32,000,000 POLICY❑ PRO-JECT D LOG PRODUCTS-I - - CDMPIOP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 118!2017 1/812018 OMBI EDtSINGLELIMIC S1,000,000 _ 73565308 X ANY AUTO I BODILY INJURY(Per person) $ OWNED SCHEDULED I BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) $ $ B X UMBRELLA LIAB X OCCUR 79876897 JIMO17 1/8/2018 EACH OCCURRENCE $2,000,000 EXCESS LIAS CLAIMS-MADE AGGREGATE 52,000,000 I D£D I X RET€NTtON$0 S C WORKERS COMPENSATION 71741378 1/812017 118/2016 X I PER f OTH- AND EMPLOYERS'LIABILITY STATUTE E ER ANY PROPRIETORIPARTNERIEXECUTNE Y N 1A E.L.EACH ACCIDENT $500,000 OFFICERIMEMeER EXCLUDED? { ---- - - - ---- -- (Mandatory in NH) € E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe udder DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,090 B Errors&Omission $2577145 1/812017 118/2016 Per Claim $1,000,000 Aggregate $1,000,000 Deductible $25,900 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 401,Additional Remarks Schedule,may be attached if more space Is required) Regarding Bodily Injury&Property Damage under the General Liability,Certificate Folder is listed as Additional Insured for ongoing operations of Named Insured if required by written contract. - ---- ---- ------------- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo Attm City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo CA 90245-0989 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD + Liability Insurance Endorsement Policy Period JANUARY 8,201E TO JANUARY 8,2017 Effective Date JANUARY 8,2016 Policy Number 3594-35-16 EUC Insured ENVISIONWARE,INC, Name of Company GREAT NORTHERN INSURANCE COMPANY ssszsu.�,�.,fi~s�z;�tz�s�:,�cs��.:.�;a^��,,,,rc:..v.,-.,�.wyN_,•,.���:cw��.sax�z�;sxNSw..t��sa�a��r!�sx:�.ays>.4�� ;�.x�a.E�a^�s��•;s. �sss�t��r��t,��.���;c�x,� c�s�a:�sta��s,�;F�: i. This Endorsement applies to the following forms, GENERAL LIABILM INFORMATION AND NMWORK TECHNOLOGY BLENDED LIAI3II.ITY INSURANCE f,1.�`^v�,rS.'+�5.'L:� �•:d::7.f3-,tS:4Y.'t�G:v Nk'55.�3.'?1?,t.„WV.v,.>,,:i..wna.,,,i�Y7`�:te;Ev".'f�>i{�;�fiYtGRS�2G'�'XtY+�?7,s's:�w'�'�f.17'.'o`.cX”�.Ll�.'iN.'�Y!�%�?.cYdi�22�»Sv`�`Xff4:%r�;'.ry`�C,`�«v.S't4:?�ibk,",Gfi'.+G'�'�Gii�"�Y3a�A.ta,�;d� Under Who Is An Insured,the following provision is added. Who is An Insured Additional Insured- Persons or organizations shown in the Schedule are is seireds;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 whale 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 darnages,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 contractor agreement. fi?�'1,:5'�Y:aE:S�1,a�c7:1 5fi13�..C,'F,�fi'�"i'L`ki`.�`r'M'�SYa�x,vks:&SSF��?.b`.1';.iv.'YciC`YFGS,'�7kGYfi�1"^4Y�i.Y§l`»?3YsfiZbY�YddL�f'.d�.'C�L..w�=?�kk�irl��:4��ti:�S�N�2;a3{,n:.N.kibXS'.�I�aA�`.rk'2ert"'.4'C3;Ri��.Yh.Hi1:�2"a3RYa�fY:..^,:"�?. t.iabiilty Insurance Additfanat tnsursd-Schedolod Parson or Orgenization continued Form WwW-2367(nay.5-07) Endorsement Page I Liability Endorsement (continued) Under Conditions,the following provision is added to the condition titled tither Inswance. Conditions Other Insurance-- if you are obligated,pursuant to a contract or agreement,to provide the person or organization Primary, Moncontributory 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, 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 unchan4ed. AuthorizedAapresentativa Liakiiity insurance Additional Insured-Seheduled Parson Ot organization fast page — 9 Forrn 8D-D2-2367'(Rev.5-07) Endorsarnenl pn a 2