ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDAYYY) 1/20/2022
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
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), 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 this cerate des or rules to reader ten is may require a endorsement. A statement ov CONTACT The Certificate Team NAME:
Assured Partners Design Professionals Insurance Services, LLC PHONE 3697 Mt. Diablo Blvd Suite 230 (A/C, No, Ext):
Lafayette CA 94549 ADDRESS: [email protected]
INSURERS) AFFORDING COVERAGE NAIC N
License#: 6003745 INSURER A : HARTFORD INSURANCE COMPANY 38288 INSURED LUCC&AS-01
INSURER B: Travelers Property Casualty Company of America 25674 Lucci & Associates, Inc.
3251 Corte Malpaso, #511 INSURERC: The Travelers Indemnity Company of Connecticut 25682 Camarillo CA 93012 INSURER D: Travelers Casualty and Surety Co of America 31194 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 959513306
THISIS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
TYPE OF INSURANCE POLICY NUMBER
X COMMERCIAL GENERAL LIABILITY 6806H320610 1/11/2022 1/11/2023 EACH OCCURRENCI | $2,000,000 1X OcCUR DAMAGE TO RENTEL
CLAIMS-MADE PREMISES (Ea occurrence).. $ 1.000.000
Contractual Liab MED EXP (Any one person) - $ 10,000
Included PERSONAL & ADV INJURY $2.000,000
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 PRO-
POLICY LOC
PRODUCTS- COMPOD AGG $4.000.000
OTHER.
AUTOMOBILE LIABILITY BA3R587874 1/11/2022 1/11/2023 $1,000,000 ANY AUTO BODILY INJURY (Per person)
OWNED SCHEDULED BODILY INJURY (Per accident) s
AUTOS ONLY AUTOS
HIRED NON-OWNED ROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY er acciden
B UMBRELLA LIAB CUP9K023174 1/11/2022 1/11/2023
OCCUR EACH OCCURRENCE $4,000,000
EXCESS LIAB
CLAIMS MADE AGGREGATE $4,000,000
X
DED, RETENTIONS n
A WORKERS COMPENSATION 57WEGAB8WKG 1/31/2022 1/31/2023 STATUTE TOR"
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N/ A
(Handatory in NH) EL DISEASE - EA EMPLOYEE $ 1,000.000
EL DISEASE - POLICY LIMIT | $ 1,000,000
D Professional Liability 107569705 1/31/2022 1/31/2023 Per Claim 52.000000 Aggregate Limi
CERTIFICATE HOLDER CANCELLATION 30 Day Notice of 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
City of Redondo Beach
Recond been C 30277 AUTHORIZED REPRESENTATIVE
Mo. Harter
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:680-6H320610 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
Location And Description Of Completed Operations
Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section II - Who Is An Insured is amended to in- location designated and described in the schedule of clude as an additional insured the person(s) or or- this endorsement performed for that additional in- ganization(s) shown in the Schedule, but only with sured and included in the "products-completed opera- respect to liability for "bodily injury" or "property dam- tions hazard". age" caused, in whole or in part, by "your work" at the CG 20 37 07 04
CG T8 01 01 22 © ISO Properties, Inc., 2004
DATE OF ISSUE: 11/24/2021 Page 1 of 1
POLICY NUMBER:680-6H320610 COMMERCIAL GENERAL LIABILITY 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
SCHEDULE
Names of Additional Insured Person(s) or Organization(s):
Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed by you before, and is in effect when, the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed.
Location of Covered Operations:
Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies.
(Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II - Who Is An Insured is amended to in- This insurance does not apply to "bodily injury" or clude as an additional insured the person(s) or "property damage" occurring, or "personal injury" organization(s) shown in the Schedule, but only or "advertising injury" arising out of an offense committed, after:
damage", "personal injury" or "advertising injury" 1. All work, including materials, parts or equip- caused, in whole or in part, by
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf; tion of the covered operations has been com-
in the performance of your ongoing operations for pleted; or the additional insured(s) at the location(s) desig-
nated above 2. That portion of "your work" out of which the B. With respect to the insurance afforded to these
additional insureds, the following additional exclu-
sions apply: tor engaged in performing operations for a principal as a part of the same project.
CG D3 61 03 05
Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved.
CG T8 03 01 22ncludes copyrighted material of Insurance Services Office, Inc. with its permission.
DATE OF ISSUE: 11/24/2021 Page 1 of 1
Policy # 6806H320610
COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares, we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable c. We have issued this policy in reliance upon limit of insurance or none of the loss remains, your representations. whichever comes first.
The unintentional omission of, or unintentional error
If any of the other insurance does not permit in, any information provided by you which we relied contribution by equal shares, we will contribute upon in issuing this policy will not prejudice your by limits. Under this method, each insurer's rights under this insurance. However, this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of
premium or to exercise our rights of cancellation or
insurance of all insurers
nonrenewal in accordance with applicable insurance
Primary And Non-Contributory Insurance If laws or regulations.
Required By Written Contract 7. Separation Of Insureds
If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an
any rights or duties specifically assigned in this
insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies:
contributory basis, this insurance is primary to
other insurance that is available to such insured a. As if each Named Insured were the only which covers such insured as a named insured, Named Insured; and and we will not share with that other insurance, b. Separately to each insured against whom claim provided that: is made or "suit" is brought.
(1) The "bodily injury" or "property damage" for Transfer Of Rights Of Recovery Against Others which coverage is sought occurs; and To Us
(2) The "personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us. The insured must subsequent to the signing of that contract or do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights
agreement by you.
to us and help us enforce them.
5. Premium Audit
9. When We Do Not Renew
a. We will compute all premiums for this Coverage
Part in accordance with our rules and rates. If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in
b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only. At not less than 30 days before the expiration date. the close of each audit period we will compute
the earned premium for that period and send If notice is mailed, proof of mailing will be sufficient notice to the first Named Insured. The due date proof of notice. for audit and retrospective premiums is the date SECTION V - DEFINITIONS shown as the due date on the bill. If the sum of 1. "Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured supporters. For the purposes of this definition:
c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request
b. Regarding websites, only that part of a website
6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # 6806H320610 COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your "employees" therapy assistant, physical therapist or for "bodily injury" that arises out of providing speech-language pathologist; or or failing to provide "incidental medical (b) First aid or "Good Samaritan services" services" to any person to the extent not by any of your "employees" or "volunteer subject to Paragraph 2.a.(1) of Section II - workers", other than an employed or Who Is An Insured.
volunteer doctor. Any such "employees" K. MEDICAL PAYMENTS - INCREASED LIMIT or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan The following replaces Paragraph 7. of services" during their work hours for you SECTION III - LIMITS OF INSURANCE:
will be deemed to be acting within the 7. Subject to Paragraph 5. above, the Medical scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of "bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III - LIMITS OF a. $10,000; or
INSURANCE:
For the purposes of determining the b. The amount shown in the Declarations of applicable Each Occurrence Limit, all related this Coverage Part for Medical Expense acts or omissions committed in providing Ог Limit.
failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services" , first aid or "Good Samaritan
CONDITION - PROFESSIONAL LIABILITY
services" to any one person will be deemea
to be one "occurrence" The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV -
4. The following exclusion is added to
COMMERCIAL GENERAL LIABILITY
Paragraph 2., Exclusions, of SECTION I - CONDITIONS:
COVERAGES - COVERAGE A - BODILY
INJURY AND PROPERTY DAMAGE This insurance is excess over any of the other LIABILITY: insurance, whether primary, excess, contingent or on any other basis, that is Professional
Sale Of Pharmaceuticals
Liability or similar coverage, to the extent the
"Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION -
pharmaceuticals committed by, or with the
knowledge or consent of the insured. WHEN REQUIRED BY WRITTEN CONTRACT
OR AGREEMENT
5. The following is added to the DEFINITIONS
Section: The following is added to Paragraph 8., Transfer "Incidental medical services" means: Of Rights Of Recovery Against Others To Us, of SECTION IV - COMMERCIAL GENERAL
a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment, If the insured has agreed in a written contract or advice or instruction, or the related
furnishing of food or beverages; or agreement to waive that insured's right of recovery against any person or organization, we
. The fumishing or dispensing of drugs ol
medical, dental, or surgical supplies o or ore aur riot, but only for paye sue make appliances. because of:
6. The following is added to Paragraph 4.b., a. "Bodily injury" or "property damage" that Excess Insurance, of SECTION IV GENERAL LIABILITY occurs; or
COMMERCIAL
CONDITIONS: b. "Personal and advertising injury" caused by This insurance is excess over any valid and an offense that is committed; collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement.
CG D3 79 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy: BA3R587874 COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
HABITY COVERAGE TO BONES AUTO
COVERAGE FORM and Paragraph e. in A.1., Who Is
An Insured, of SECTION II - COVERED AUTOS Autos Liability Coverage, but only for damages to LIABILITY COVERAGE in the MOTOR CARRIER which this insurance applies and only to the extent of COVERAGE FORM, whichever Coverage Form is
part of your policy:
This includes any person or organization who you are
required under a written contract or agreement
CA T4 37 02 16 © 2016 The Travelers Indemnity Company. All rights reserved Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # BA3R587874 COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.5., Transfer of
Rights Of Recovery Against Others To Us, of the
CONDITIONS Section:
5. Transfer Of Rights Of Recovery Against Oth-
ers To Us
We waive any right of recovery we may have
against any person or organization to the extent
CA T3 40 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: 57WEGAB8WKG Endorsement Number:
Effective Date: 01/31/2022
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 2% of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights Mo Hontor
Countersigned by
Authorized Representative
Form WC 04 03 06 (1) Printed in U.S.A.
Policy Expiration Date: 01/31/2023