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PROOF OF INSURANCE (2019) CLOSED DATE(MM/DDMIYY) CERTIFICATE OF LIABILITY INSURANCE 512912018 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 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'), 6 PRODUCER CONTACT NAME; Tina Coburn Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX P.O. Box 2925 IAIQ,,N�o,Ertl:253-238-1134 �(A/C No):253-572-1430 E-MAIL Tacoma WA 98401-2925 ADDi TIna_Coburn aJ'g.00m INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Casualty Insurance Co of America 19046 , INSURED ry E Travelers Indemnity Company 25658 File832 Industry WA Drive INSURER S INSURER Tuk 8321ndust Drive Rc. RER D: INSURERE„ V INSURER F COVERAGES CERTIFICATE NUMBER:1374289608 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, NOTVATHSTANDING 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 'OLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS INSR ADDCSUBk'2 POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSO.WVD POLICY NUMBER (MMIDD/YYYY) (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y 6801H079127 6/1/2018 511/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X,i OCCUR PR WSIl SCa occurntncplk $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 XPOLICY J�ECT I I LOC PRODUCTS-COMP/OP AGG $2,000,000 CITHER $ A AUTOMOBILE LIABILITY 8801H079127 6/1/2015 el1/2019 CC.NMWNEDwSGNGI.ELIMI'11 $1,000,000 (Ea acvdent) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS E HIRED NON-OWNED PROP X X R"rY DAMAGE $ AUTOS ONLY AUTOS ONLY ,(,Per 'dent) „ B X UMBRELLA LIAB X I OCCUR CUP11-1879184 6/1/2018 6/1/2019 EACH OCCURRENCE $2,000,000 �f EXCESS LIAB CLAIMS-MADE AGGREGATE S 2 000 000 DED ( X �RETENTION$5 090 A WORKERS COMPENSATION 58011-1879127 e/1/2018 6/1/2019 STATlJTE I'X FRH WA Stop Gap AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $1,000,000 A Property Secilon 6601 HB79127 6/1/2018 611/2019 Contents Ded$500 e17,417 Data Processing Electronic Data 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:EI Segundo Police Department. City In EI Segundo and EI Segundo Police Department has been added an additional insured,as per written contract per forms CG D105 04/94. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF EI Segundo COI ACCORDANCE WITH THE POLICY PROVISIONS. EI Se undo Police Department, Accounting 348 IUNain Street A THORIZ150 REPRESENTCATIVE EI Segundo, CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS b. The "personal injury" or"advertising injury"for COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage is sought arises out of an of- (Section IV), Paragraph 4. (Other Insurance), is fense committed amended as follows: subsequent to the signing and execution of that 1. The following is added to Paragraph a. Primary contract or agreement by you. Insurance: 2. The first Subparagraph (2) of Paragraph b. Ex- However, if you specifically agree in a written con- cess Insurance regarding any other primary in- tract or written agreement that the insurance pro- surance available to you is deleted. vided to an additional insured under this 3. The following is added to Paragraph b. Excess Coverage Part must apply on a primary basis, or Insurance, as an additional subparagraph under a primary and non-contributory basis, this insur- Subparagraph (1): ance is primary to other insurance that is avail- That is available to the insured when the insured DATE(MMIDDIYYYY) ACC)RO CERTIFICATE OF LIABILITY INSURANCE '' f 5/29/2018 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 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; Tina Coburn Arthur J, Gallagher Risk Management Services, Inc. PHONE FAX P,O. Box 2925 /AIC No.Ex'th 253-28.1134 (Arc,Na};253-572-1430 Tacoma WA 98401-2925 ADDRESS: Tina—Cobum(;ajg,com INSURER(S),AFFORDING COVERAGE NAIC# INSURER A:Westchester Fire Insurance Company 10030 INSURED FileOnQ INSURER B: 832 Industry Drive INSURERC: A Tukwila,W 98188 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1964148892 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 ADDUSU11R POLICY EFF POLICY EXP TYPE OF INSURANCE Sp yyyD POLICY NUMBER IMMIDCM!'Y'YYYE IMMIDDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ , „Rd�MA "1 } $ f�}IAGE0RENTED CLAIMS-MADE OCCUR �a SES Ea occurrence, MED EXP(Any one person) $ ,PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICYff�0• LOC „PRODUCTS-COMP/OP AGG $ JEC.T OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea,sccidentl ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE .... ... AUTOS ONLY AUTOS ONLY (Por accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N I STATUTE ER, ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? NIA (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ If yes.describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ A Tech E&O G27604341004 6/1/2018 811/2019 Each clelm 2,000,000 A ppreggete 2,000,000 Re9antlon 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:EI Segundo Police Department. CERTIFICATE (MOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF El Segundo COI ACCORDANCE WITH THE POLICY PROVISIONS. El Se undo Police Department,Accounting 348 ain Street A THORIZED REPRESENTATIVE EI Segundo CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD