Holder Identifier : 7777777707070700077761616045571110777707006315547207453126763506200072651466047221130772415113077011207527405222271113075732724625777210705023744607777307040003572325520076727242035772000777777707000707007 7777777707070700073525677115456000722011406036013107022337342072010071223372430631100703332635206311007122337352063001070223373521720100713223635317301107133236253173011077756163351765540777777707000707007 Certificate No : 570091621865
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
02/15/2022
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).
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. PRODUCER Aon Risk Services Northeast, Inc.
New York NY Office
One Liberty Plaza
165 Broadway, Suite 3201
New York NY 10006 USA
PHONE
(A/C. No. Ext): E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122
INSURED INSURER A: AIU Insurance Company 19399
INSURER B: National Union Fire Ins Co of Pittsburgh 19445 INSURER C:
INSURER D:
INSURER E:
INSURER F:
FAX
(A/C. No.): (800) 363-0105
CONTACT NAME: Verizon Communications Inc.
1095 Avenue of the Americas
New York NY 10036 USA
COVERAGES CERTIFICATE NUMBER: 570091621865 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. Limits shown are as requested
POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVDINSR LTRADDL
INSD TYPE OF INSURANCE POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR
POLICY LOC
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
X
X
X
X
XGEN'L AGGREGATE LIMIT APPLIES PER:
$2,000,000
$2,000,000
$10,000
$2,000,000
$2,000,000
$2,000,000
Standard Contractual Liability
XCU Coverage is Included
B 1728890 06/30/2021 06/30/2022
PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO
OWNED AUTOS ONLY
SCHEDULED
AUTOS
HIRED AUTOS ONLY NON-OWNED AUTOS ONLY
BODILY INJURY ( Per person) PROPERTY DAMAGE
(Per accident) X
BODILY INJURY (Per accident)
$2,000,000 B 06/30/2021 06/30/2022
AOS
B 4594299 06/30/2021 06/30/2022 MA
B 4594300 06/30/2021 06/30/2022
B 06/30/2021 06/30/2022 VA
See Next Page
COMBINED SINGLE LIMIT
(Ea accident)
4594298
EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE
EACH OCCURRENCE DED UMBRELLA LIAB RETENTION
E.L. DISEASE-EA EMPLOYEE
E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $2,000,000 X
OTH
- A 06/30/2021 06/30/2022 PER STATUTE AOS
A 16393206 06/30/2021 06/30/2022
$2,000,000
Y / N
(Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A N CA WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $2,000,000 16393209
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Redondo Beach is included as Additional Insured with respect to the General Liability and Automobile Liability policies. The General Liability policy shall apply as Primary and Non-Contributory Insurance to each Additional Insured listed herein. Where permitted by law, the Named Insured parties listed herein waive all rights against City of Redondo Beach listed herein for recovery of damages to the extent these damages are covered by the above-referenced General Liability, Automobile Liability and Workers' Compensation policies and as further limited by written contract between the parties.
CERTIFICATE HOLDER CANCELLATION
City of Redondo Beach AUTHORIZED REPRESENTATIVE 415 Diamond Street Redondo Beach CA 90277 USA
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE
LOC #:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance EFFECTIVE DATE: CARRIER NAIC CODE
POLICY NUMBER
AGENCY NAMED INSURED See Certificate Number:
See Certificate Number:
570091621865
570091621865
Aon Risk Services Northeast, Inc.
570000027366
ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits.
INSURER
INSURER
INSURER
INSURER
INSURER(S) AFFORDING COVERAGE
Page _ of _
NAIC #
Verizon Communications Inc.
TYPE OF INSURANCE
POLICY NUMBER LIMITS AUTOMOBILE LIABILITY
B 4594301 06/30/2021 06/30/2022
B 4594302 06/30/2021 06/30/2022
WORKERS COMPENSATION
A 16393207 06/30/2021 06/30/2022
A 16393208 06/30/2021 06/30/2022
A 16393205 06/30/2021 06/30/2022
NH - Primary
NH - Excess
NY
MA,ND,OH,WI,WY
NJ,TX,VA
N/A
N/A
N/A
ADDL INSD
INSR LTR
SUBR WVD
POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD