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PROOF OF INSURANCE (2019 - 2019) CLOSED DA't E(IM MIDD/YYYY) A CERTIFICATE OF LIABILITY INSURANCE I189izl/ 0 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 •„..;.•.,......,,•• •.••...••, .... , , • °, ..,, Bornstein Insurance PHONE F», (310) 325-4343 „M (A/C No,( C.1) 325-7037 22850 Crenshaw Blvd. , Ste. 203 Torrance, Ca 90505 INSURER(S) AFFORDING COVERAGE NAIC# INSURER Arch Specialty Insurance Company 21199 IIINSURrn EAGLE PROTECTION SERVICE, INC. INSURER Integon National Insurance Company 29742 DBA: EAGLE PROTECTION OF CALIFORNIA IWIV IRFR 4C PO Box 1428 N6J;,UKY.K 0 Torrance, CA 90505 (310) 320-9100 FGdd COVERAGES CERTIFICATE, NUMBER REVISION t~,k0.JMBER. I HIS,19 YC?Cr R CII-Y FIIIA r -Hl=4Y11LIC;11.-,01- IPRSUFiNrrd(:PT V I'i'r=Y}6NV V C7ttYr ILn\(Y.--.Iq i rd IF:i'ui r3 It:1"I IIF ftSulklI II NAIM I:l A\VBf7VV Foo'0.1 Ir Poi lcy i'[FRioi.t VM1➢IK'AIII I) NC''T'itV/I"I'ISIANDING,Arlw 11'11 OIIII?I-IW INV, 11-RNA OR t,C¢;)Nni i'ICH CN ANY C;CINIRAC'I oi,,,orm:�R r'aC}Cuivld I,H VVIIiI Rr.-,,PFC:V TO WHICH ­HW::' I::Ir I�.I Y ?':.Alk-YvYA"f 131- I1_i 1, D OR MAr Pr-RIAIN, IML INF.URANC'E AEY"ORp I-D HY Hill I't"%I.ICI&.S Di F N:1RF0 IIIFRI-IN IS SURNEC.I iii AH lliY 'I'FRIB,_ II_''6o;„II,,I;gICINi+P�Nlr? C;0N11l"II0NSC,ISUCH POILICIY S VlrAT'%+C:;IIC7WN YrAA"i 4!P�Vr IIal=11 YJ A?LLxl,ll4'I-I.?N3"f I'�AIlY t;I ACUrYIi INSI< wuur_ auure a{„yl.IC"„'C;,1�Y:" PCM li�::'e%".m, LTR TYPE:OF INSURANCE „S1 VJVG1 I"41.1? dKAWEiC)r'v"r'M'M'1 MI I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CI Alrr s hmr)II:" � C:O00,01-; br P d{Aji IG',(iEAI wH,Ir1V'fR"�<,;rrt -$ 100 r 000 BAPKG0002709 044/13/20L(4 M/1:3/20:19 IMI o r AF'41,nvone peisol,0 $ 51000 A Y PERSONAI.&ADVIIVJUrrd s 1,000,000 MV'TAPPI Ir; I'Fk' r,I.NILHAL AO RFGATE a, 5,000,000 �R'iYM+ICK ra II I0C %rluOI.UCis ComnvlupAcc S 5,000,000 S AluPr:tiM1lt.YU+lIF11ltkltlll"U'N YC&SPP HINeI'r.rirvP ill dd!ILE iLIoWY^, $�.��.1"V6V' 060. I l4 rJ'r')yVIrC? E.i(1Y,711."(IYJ.!u_iIRY(E�'ru rrourc»t) :L I -- 2003901412 0r;/m/Nula ,6/01/2e R .All I('ANNI-1"r ':6111E_1?l7V LD RCt1"Ii I."i IIN.IrPVs'H B ., AV.i'US AU OS NOM1Y 0VVNII 1) Il MAG X II YIll II Al IIOF, x AY.YIOS llrA f)PIF I.kA I IAR OC't'IIU", - EACH o)C'wlji"Rl UrICE 1$ I..IIAI3 H;C.LdAlM'"S-MAUI., - AC¢ I Y tiA"I"%::' �. G1FC71 )RI(I.l'd'V 11",'di'4"w. �..... i „ AND EMPLOYERS I IABILITY � � �•�i'�f'. ��` TATUTEP WORKER'SC"C,YIUI F4F YJSAIIOIV YIN 15ER C .. .... ... A19Y PROPRIETOR(PARfNERIEXEGLINVFI..-V. EACH AC'i 111.11E N'➢ 8 OFFICEI'AMENGF3F_R EXCLUDED? I I�NIA " (Mandatory in NH) I��Irr E L DISE:A SE: FA EMPI..GYE:,F ,6 (ryes,descnbe under DFSC°RIPTI(7N 1F C)PF;RA ilt?N, ltPlOyu I l"I. 11V5,4 G`>Y- !'6")I lt"'Y WJ1V( i; DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attachedlf more space is required) Coverage afforded by this policy is Primary and Non-Contributory - Certificate Holder is named as Additional Insured with respect to Commercial General Liability for services performed by the Named Insured, per Blanket Additional Insured Endorsement Form 00 GL0486 00 07 08 - 30 day notice of cancellation - 10 day notice of cancellation for non-payment CERTIFICATE HO'LDE'R CAN ". AT ON City of El Segundo SHO oLD ANY OF I Hd AHOW-r?r SCRIPFI" "DI..ICrk...S IIE C.ANrr a I.rlrr m.-u su- its officials, and employees "rllF 7XlrIr?Jk NON IDAII. hHIFIF',FDr, NOTICP WIII 1-YF I'I=Irn-uCh-I:4 IN )'irCC:OIRa)6NC::1-WI I I t IIH I.:II:10LIICY G ROVIE¢WNS City Clerk I 350 Main Street Room 5 � Ak,1lPcrWII-r; ua1=11uc11.;:IFNrAIuv% E1 Segundo, CA 90245-3813 I ©1988-2014 ACORD CORPORATION. All rights reserved ACORD 25(2014/01) The Al name and logo are registered marks of ACORD POLICY NO . BAPK00002709 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II—Who Is An Insured is amended by adding the following: Any person(s)or organization(s)whose liability you have assumed under a valid written contract but only for that person(s) or organization(s) liability arising solely out of your operations. In no event, shall coverage afforded to any additional person(s)or organization(s)be broader than coverage for the Named Insured. Section I—Coverages,Coverage A Bodily Injury and Property Damage Liability,Paragraph 2.,Exclusions is amended by adding the following: This insurance does not apply to: 1. Any customer or a user of your goods or services who does not have a"standard contract". 2. Person(s) or organization(s)who are contractors for whom you are a subcontractor or for whom you are otherwise providing services unless a"standard contract"has been effected, Services include but are not limited to leasing,maintaining,servicing,or monitoring of alarm systems. 3, Person(s)or organization(s)who is a manager,owner or lessor of premises leased to you for: (a) "bodily Injury"or"property damage"occurring after you cease to be a tenant; or (b) "bodily Injury"or"property damage"of those acting on your behalf. 4. Person(s)or organization(s)who is an owner or lessor of leased equipment for: (a) "bodily injury"or"property damage"occurring after the equipment lease expires;or (b) "bodily injury"or"property damage"arising out of the sole negligence of the owner or lessor. 5. "Bodily injury" or "property damage" the person(s) or organization(s) has assumed from another person(s)or organization(s)other than liability the person(s)or organization(s)would have had if it had not been assumed. All other terms and conditions of the Policy remain unchanged. 00 GL0486 00 07 08 Page 1 of 1 DATEMIDD/YYYY) 7"- R,[= CERTIFICATE OF LIABILITY INSURANCE 10(/125/2018 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 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 ICUNPACI NAME. PHONE FAX Automatic Data Processing Insurance Agency,Inc. tlAfC,Nei,Ext): IAIC,Noy E-MAIL 1 Adp Boulevard ADDRESS; Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC p INSURER A: NorGUARD Insurance Company 31470 INSURED INSURER B EAGLE PROTECTION SERVICE INC INSURER C 2700 W 182ND ST STE 201 Torrance,CA 90504 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 1009399 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 TYPE OF INSURANCE ADDL'SIUSR POLICY EFF POLICY EXP' LIMITS LTR INSD wVD POLICY NUMBER (MMlDOIYYYYI (M7w�I=YYYYI COMMERCIAL GENERAL LIABILITY "A,:;l f Ok:a:.l.UP PI"Ir,91 S 'DAMAOF''Cl Rr'N'1.7, 0 A.INI:S'fv,MDi C]f,CU lk: PREMISES(Ea occurrence) IMF i i FFP tAii,rrnr-hr,rr>r,mj (b' C,F('IAtt(:RrC;AIIIlr«Iil;4F1L11 -,; PILI4a C31:.1`•IIIRRU, At"ICPPrt,r'('dP" :& ''RI:a 1`01Ic:,"i I I"; CD 14 ku.F' ti AUTOMOBILE LIABILITY C'l(?MRillll':P:a:).'�II•dd',;L"I' L"Pr71'I ,,t APP(AUIi? U"7t'�L!IL'r'IIJJIJIP"rc(vor I>r.rson) 45 Al.d (DWN1 >t;�IliF"171u1I I) uoI:,R IIDIA.)Ri{I'era�:LVdo.nt} a ,tIJ I^:;':; rtlJ o(J::.v I k('jl"�I°;:R lL A'I�:DAMAr4(I: Plr.:� �'aL'Vf(°dF") I,p i3C,CAlk'lnIl Y( ISIIA"-Y.("i"1,x,4!"Ii't> rW..l"C.'att Rfa °k• UMBRELLA LIAB iii;CUFd ".A'H!i,•e C:LFile:£'PA.:I ;$ EXCESS LIAB t;l AIM;',MADI AGGREGATE $ WORKERS COMPENSATION x ',I'A aF k I AND EMPLOYERS'LIABILITY srAll.!rl. 1=F" A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E L EACH ACCIDENT �$ 1,000,000 OFFICER/MEMBER EXCLUDED? �u Y NIA Y EAWC903426 05/01/2018 05/01/2019 1,000,000 (Mandatory In NH) 11 L i_ E,:,',I-A r [-A I iAAPI.("�1fV E '�I If yes,describe under1,000,000 DESCRIPTION OF OPERATIONS below IL L. L,eYfiF A4-,�E [:,OV I,I:Y I IMIT �._......� _w......._........._........ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) This certificate has a blanket Waiver of Subrogation for the following state(s):CA 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 ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street,Room 5 _ EI Segundo,CA 90245 AUTHORIZED REPRESENTATIVE A@ 1988.2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 1•0.2...,...% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver-Any person or organization for whore the All CA Operations Named Insured has agreed by written contract to furnish this waiver. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. EAWC403426 Endorsement No, Insured Insurance Company Countersigned By 01998 by the Workers'Compensation Insurance Rating Bureau of California.All rights reserved.