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PROOF OF INSURANCE (2020 - 2020) CLOSED
DATE (MM/DD/YYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE 8/27/2019 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 CONTACT NAMlAl N...Efl _._(..._C...... Risk (AIP 3.3820 prc. Not; 31Chicago, Adams s St Suite 1523 C EMAIL 866 24 AODRESS: ce tS: Obrok'Firs,com......................................... INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Sentinel Insurance Company 11000 . ..................................................................... ........................... ......................,.,., INSURED INSURER B: ACE American Insurance Company 22667 Jail Education Solutions dba Edovo INSURER C : Legacy Inmate Communications dba Legacy Long Distance International, Inc — ----------- 215 W Superior St !.NAuRER R„? .................................. Suite 600 INSURER E Chicago, IL60654 INSURER 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 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INR` ADD-"�'�SR........................................................ JI rP POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN POLICY NUMBER IMMiIDDIYYYYI IMMfODNYYYI LIMITS X ^ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 _p CLAIMS -MADE I,I X OCCURE EXPS(Anp one p ason) $ 1100 0000 ;I .. PERSONAL ...B..ADV „INJURY ...............$ ,.2.o00.Og.0 G�E 0i 'gN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 4y0QUI1 POLICYF—] PRO - LOC PRODUCTS-COMP/OPAGG $ A A—]d PRC 83 SBA AB3534 5/7/2019 5/7/2020 4,000,000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIWT $ 1,000,000 (..pLe�I).......... ANY AUTO BODILY INJURY (Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OX HIREDAUTOS X_ AUUTOS�ED 63 SBA AB3534 5/7/2019 5/7/2020 CRPAC94 0IPROPERTY �AMAGE A � $ UMBRELLA LIAB � �OCCUR CLAIMS -MADE AGGREGATEAuDEXC ss LIRETENTION S 83 SBA AB3534 5/7/2019 517/2020 RRENCE $,5 OQ0 000 jAB ED I E . p WORKERS COMPENSATION " PER II OTH- AND EMPLOYERS' LIABILITY Y / N I STATUTE PER „................................... ANY PROPRIETOR/PARTNER/EXECUTIVEE L, EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? � N / A--- - ----------- °"""""' (MandatoryY ' ) EA EMPLOYEE $ I ESCRIPTION OF OPERATIONS below E.�...DISEASE..:..........L ...,...... O E -POLICY LIMIT $ B Errors & Omissions/Cyber F15081296 001 7/6/2019 7/6/2020 $2,000,000 each claim and aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is an additional insured with a waiver of subrogation where required by written contract. CERTIFICATE HOLDER City of EI Segundo City Clerk's Office 350 Main Street EI Segundo, CA 90245 ACORD 25 (2014/01) 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 P ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed However, no such person or organization is an at the vendor's premises in connection with the sale of the additional insured under this provision if such product; person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F. — Optional Additional Insured Coverages. the vendor; or a. Vendors (h) "Bodily injury" or "property damage" arising out of the sole Any person(s) or organization(s) (referred to negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of "bodily injury" or "property damage" arising its employees or anyone else out of "your products" which are distributed acting on its behalf. However, this or sold in the regular course of the vendor's exclusion does not apply to: business and only if this Coverage Part provides coverage for "bodily injury" or (I) The exceptions contained in "property damage" included within the Subparagraphs (d) or (f); or "products -completed operations hazard". (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual This insurance does not apply to: course of business, in connection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products. vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only with respect to their liability for "bodily (c) Any physical or chemical change injury", "property damage" or in the product made intentionally "personal and advertising injury" by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased to you. or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any 'occurrence" which takes (b) "Bodily injury" or "property damage" place after you cease to lease that included within the "products - land or be a tenant in that completed operations hazard". premises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or (1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or only with respect to liability for "bodily the acts or omissions of those acting injury", "property damage" or "personal on your behalf: and advertising injury" caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with "your work" and or included within the "products - (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (I) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (II) This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products - failure to render any professional completed operations hazard". services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily injury", "property damage" or reports, surveys, field orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. Aggregate Limits The most we will pay for: a. Damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard" is the Products -Completed Operations Aggregate Limit shown in the Declarations. b. Damages because of all other "bodily injury", "property damage" or "personal and advertising injury", including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies separately to each of your 'locations" owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or right-of-way of a railroad. This General Aggregate limit does not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion. 3. Each Occurrence Limit Subject to 2.a. or 2.b above, whichever applies, the most we will pay for the sum of all damages because of all "bodily injury", "property damage" and medical expenses arising out of any one 'occurrence" is the Liability and Medical Expenses Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4. Personal And Advertising Injury Limit Subject to 2.b. above, the most we will pay for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Declarations. 5. Damage To Premises Rented To You Limit The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. 6. How Limits Apply To Additional Insureds The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part is the lesser of: a. The limits of insurance specified in a written contract, written agreement or permit issued by a state or political subdivision; or b. The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. Page 14 of 24 Form SS 00 08 04 05 _ T3-XK1 AC"RV CERTIFICATE OF LIABILITY INSURANCE Ip DATE/25/2°"YYY' 6/25/2019 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 Commercial Lines - (305) 669-6000 PHONE RIs$ 6anagement Department FAX USI Insurance Services LLC W.CA"t�.Qam90) (866)443-8489 (mac mN�)em( t70)tfi8g 002 N ... INSURER S) AFFORDING COm ..ADDRESSs Or Omp rin....t... _................................_....... 2601 S Bayshore Dr INsuRERA: ACE American Insuralnce Com an N7c# Coconut Grove, FL 33133 2266'm""..." INSURED INSURER.D, .............................................,............._.............................. TriNet HR III, Inc. L/C/F Legacy Long Distance Int'I Inc IRE........ DBA Legacy Inmate Communications INSURER E: I 9000 Town Center Parkway, Bradenton, FL 34202 INSURER F: COVERAGES CERTIFICATE 'NUM'BE'R: 14353351 REVISION NUMBER: See below 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. tLTR..�................................ D. wVD POLICY"EFF ..... NSR TYPE OF INSURANCE .........................��,C7. n POLICY NUMBER (MMIDDIYYYY-", '..POLIO. 'E ........... INS L SO ...... I fMMID..... CY XP M'YY1 LIMITS COMMERCIAL GENERAL LIABILITY OCCUR CLAIMS -MADE �...__. GEN'L AGGREGATE LIMIT APPLIES PER: POLICY L..� PRO - LOC JECT O''fHER', �_.._I AUTOMOBILE LIABILITY .. ANY AUTO OWNED SCHEDULED AUTOS ONLY `, AUTOS I HIRED Vp NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED d RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYP ROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N NIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE I S 'GAMXGE"1° `RENT1:15--I PREMISES (Ea occurrence) S MED EXP (Any one person) S PERSONAL &ADV INJURY S GENERAL AGGREGATE PROD UCTS-COMPIOPAGG S ............-............................. S C.ONIBINED SINGLE LIMIT S ?Ea accidernl BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S $ DA NPer GC .,_.-... ERTDAMAGE, .,. ....... m414:g t r t ) EACH OCCURRENCE pN, S AGGREGATE S X WLR 066200279 7/1/2019 7/1/2020 X I PESTATUTER J1 OTH- ER E L EACH ACCIDENT I $ EL DISEASE -EAEMP LOYEEI S I EL DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers' Compensation coverage is limited to worksite employees of Legacy Long Distance Int'I Inc DBA Legacy Inmate Communications through a co -employment agreement with TriNet HR III, Inc. A Waiver of Subrogation applies in favor of certificate holder as required by written contract. CERTIFICATE HOLDER CANCELLATION 2,000,000 2,000,000 2,000,000 City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Clerk's Office ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 11111111111111111110 11111III IN 1111111111111111111111111111111111111111111111111111111111 • cveasazsloozssalozloalolvolo- Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number TriNet HR III, Inc. TriNet HR III, Inc. I Policy Number WLR C66200279 Symbol: Number: Policy Period Effective Date of Endorsement 7/1/2019 TO 7/1/2020 07-01-2019 Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number, The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. (X) Specific Waiver City of EI Segundo Name of person or organization: City Clerk 350 Main Street EI Segundo, CA 90245 ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: Authorized Agent 1 99 03 22 11111111111111111111111111 11 I IN 11111111111111111111111 II 1111111111111 III 1111 •C1B03A251002004/03/03)0(0/0/0"