Loading...
PROOF OF INSURANCE (2018) CLOSED AC R 0112612016 CERTIFICATE OF LIABILITY INSURANCE I DATE/2018 � IYYYY) - 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 poll'c;y(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 MARSH USA INC. NXIMEI 1050 CONNECTICUT AVENUE,SUITE 700 ( FAX Alco.N+a.F,xtl;. „ ..... .. 4 Ic,,Nol!',,,,,, WASHINGTON,DC 20036-5386 E-MAIL Attn:CSS,TELEPHONE 202-263-7600 APPRESSS, INSURERS AFFORDING COVERAGE NAIC# 115014-NAV-GLS-17-18 INSURER A:Federal Insurance Company 20281 INSURED DUNCAN SOLUTIONS,INC. INSURER B:Vigilant Insurance Company 633 W.WISCONSIN AVE. INSURER c:American Guarantee and Liability Insurance Company MILWAUKEE,WI 53203 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-006253882-01 REVISION NUMBER: 1 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 II ANDD SMUT „ POLICY EFF ibLI�CY EXP .... .. . LTR TYPE OF INSURANCE V POLICYNUMBER IMMIDD/YYYY) I'MMYD0IY"YY'Yt LIMITS A X COMMERCIAL GENERAL LIABILITY 35970827 04/30/2017 04/30/2018 EACHOCCURRENCE $ 1,000,000 ( DAMAGE TO RENTED X nce $ 00 CLAIMS-MADE ( OCCUR PREMS.ES(a occurre, ) 1 000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 OT ICY JECT V $� .. . . X LOC PRODUCTS-COMP/OP AGG 2,000,000,.'11 A AUTOMOBILE LIABILITY 73588740 04/30017 04130/2018 C011MBINEDSINGLE LIWT $ 1,000,000 .(E21,aaPr,imtali91 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ , AUTOS ONLY IPPI AUTOSHIRED NON-OWNED PROPERT AUTOS ONLY J AUTOS ONLY (Per ac denlDAM.AGB $ ..... .. X UMBRELLA LIAB C X OCCUR AUC 9820020-03 04/30/2017 04/30/2018 EACH ORENCE $ 5000, 00 EXCESS LIAB CLAIMS MADE AGGREGATE 000 QED RETENTION$ $ WORKERS COMPENSA71ON 07H- AND AND EM LOYERRLIA UD DXECUTIVE hd /1740633 0413012017 04030/2016 EL EACHUTE p ER 00,000 Y I N X �STAY NIA ACCIDENT $ 10 (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000,00° If yes,descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101 Additional Remarks Schedule may be attached if mores ace is re ufred 1 Y P Q ) CERTIFICATE HOLDER,ITS OFFICERS AND EMPLOYEES IS/ARE INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT WITH RESPECTS TO GENERAL AND AUTO LIABILITY. WAIVER OF SUBROGATION IS APPLICABLE WHERE REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS WITH RESPECT TO WORKER'S COMPENSATION. CERTIFICATE HOLDER CANCELLATION CITY CLERK'S OFFICE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF EL SEGUNDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 MAIN ST, ACCORDANCE WITH THE POLICY PROVISIONS. EL SEGUNDO,CA 90245 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD C H U B B° Liability Insurance Endorsement Policy Period APRIL 30,2017 TO APRIL 30,2018 Effective Date APRIL 30,2017 Policy Number 3597-08-27 DTO Insured NAVIENP CORPORATION Name of Company FEDERAL INSURANCE COMPANY Date Issued MAY 30,2017 This Endorsement applies to the following forms: GENERAL LIABILITY 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. Liability Insurance Additlonal Insured-Scheduled Person Or Organization continued Form 60-02-2367(Rev.5-07) Endorsement Page 1 CHUBB' Liability 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. 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 80-02-2387(Rev.5-07) Endorsement Page 2