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PROOF OF INSURANCE (2020 - 2020) CLOSEDAC40R CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDfYYYY) 01!2912019 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 I'N'SURED, 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 endorsernent(s). PRODUCER C074TACT NAtLF Deb Groff (A/C rsc l ---- _.,_w ._. .. ................... Community insurance - NH i cid tf354.4551 it sure.com. ..,.A ._..f (A/ ._. (717)355-2154 684 W Main St. m� y P.O Box 367 INSURERtSIAFFORDING COVERAGE NAIC 0 New Holland r . ...._�.-. PA 17551 WrvSURERA Erie Insurance Exch INSURED 2627�1 Ra nasQft, Inc INSURER H ....... 117 S. West End Ave, Ste 12 INSURER D INSURER E Lancaster PA 17603 ,NSUR,£FI F COVERAGES CERTIFICATE NUMBER: 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 CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS 0 .......................F1 LTR ; ....w . ,,.... TYPE OF lt+7SLINSURANCE"' POLICYtcur.lSPR...�.a ...w. EFp ,I I itr oL l,G vvY I i,.,.._.,...,_�, ..u.. .........,,.�.....„ P zi 0MIS JX COMMERCIAL GENERAL LIABILITY EACH AG,3GGURRFEtTNtGFEti . W,t��SS CLAIMS -MADE I OCCUR F_R_EAgES1,i qtenro.s S110O0O00O00 0DOO,, _U -XP RAn one c•en MED D A _. ,......._.... , i Y N 0 1 G" N L AGGREGATE . S I D DDOD �_ r--, Pt �ITAPP-UEisPER: � y 37-Oi567D3 i 0110112019 i 01!01!2020 „ �ENETaA ._..,,� �. T W Ai, S AOV INJURY �✓,r i, AGGREGATE S 20000_00 /4 - POLICY I JECT LOC PRODUCT S - COMAtOP PkGG 5 2000000 .. OTHER _w_r i_ .m ..._..._ .._. eAUTOMOBILE OMOBILE LIABILITY ! .ir fr B�NdEOISINGLE LIMPLIMP..�.._. .. � ANY AUTO 5.... BODILY INJURYPer FsL� .... OVMED SCHEDULED __. �..LPaPiFoOrfaaEPwT•dYP9CJaF.,w,.N.....�..,..-e.r._s.o.n,.�...,, ..S HIRED 7 INJURY a..ident}$AUTOS ONLY NON-ONMED AA'EfAUTOS ONLY AUTOS ONLY S_ ............ ..... ................ ....,,.,._ _.._ S -....._� EXCESS .�.._ _..,..., ..1,...mmm,, GLAtI�tS 7ahA0E� �� l P ....__ .__... -5 _...,,... UMBRELLA LIABOCCUR I, EACH OCCURRENCE SS LIARETEN'r'BOFd'S AGGREGATE DED S ,VVO4KERS COMPENSATION i y- IPER AND �'LIAI Y ANrPFIOPR.EIORTEECWTIVEA IOFFCEROMMBPREXCLUNIAN Q65-0106925 EACH iY17' EDX DN'T ._. Ityary nQ1r t, docrobo t&001101 DESCRIPTION OF OPERATIONS barow E Q DISEASE POLICY LIITw,I .S.S...mS.D.,.O._OOOn ..J.^. , m Limit - each claim $1,000,000 B Professional Liability N N f MPL152586319 '01109/2019t01/09/2020i Limit -Aggregate ( $1,000,00 Retention $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule maybe atiachod If more space is required) City of EI Segundo is named as Additional Insured. City of EI Segundo 350 Main St I EI Sequndo Fax; ACORD 25 (2016103) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE CA 90245 Email: ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ERIE INSURANCE COMMERCIAL GENERAL LIABILITY CG 20 10 (Ed. 4/13) UF -9665 POLICY NUMBER: Q37-0156703 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 Name Of Additional Insured Person(s) Or Organization(s) City of El Segundo 350 Main St El Segundo, CA 90245 SCHEDULE Location(s) Of Covered Operations 350 Main St El Segundo, CA information required to complete this Schedule, if not shown above, ivill be shown in tile Declarations. A. Section 11-- Who Is Ali Insured is amended to include as I. All work, including materials. parts or equipment an addiflonal insured tile person(s) or orginization(s) furnished in connection with such work-, on the project shown in the Schedule, but only with respect to liability (other than service, maintenance or repairs) to be for "bodily ir(jury", "property damage" or "personal and performed by, or on behalf ol'the additional insured(s) advertising injury"' d i whole or in part, by: at the location or the covered operations has been , Jury caused, 1. Your acts or omissions: or completed; 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, However: I. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such, additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 1 That portion of "your work" out or which (lie injury or dainage arises has beef) pul to its intended use by, any person or organization other than another contractor or subcontractor en -aged in performing operations for a principal as a part of the same project. C. With respect to tile insurance afforded to these additional insureds, tile following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we %viil pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; This insurance does not apply to "bodily injury" or whichever is less. "property damage" occurring after: This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. C Insurance Services Office, Inc., 2012