ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT NAME: PHONE FAX
(A/C, No, Ext): (A/C, No): E-MAIL ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG OTHER: $ COMBINED SINGLE LIMIT
(Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $
$ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $
If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
6/27/2023
(213) 634-2500 (213) 640-5000
Sky Elements, LLC.
3819 Ruffe Snow Drive #203
North Richland Hills, TX 76180
A 1,000,000
X ODYH687307 7/15/2022 7/15/2023 300,000
5,000
1,000,000
2,000,000
2,000,000
A 1,000,000
ODYH687307 7/15/2022 7/15/2023
Physical Damage 50,000
A 10,000,000
ODYH687307 7/15/2022 7/15/2023 10,000,000
B
WCP9117029 7/15/2022 7/15/2023 1,000,000
1,000,000
1,000,000
The certificate holder is included as an additional insured solely in respect to claims arising from the operations of the named insured per written contract.
City of Redondo Beach
415 Diamond Street
Redondo Beach, CA 90277
SKYELEM-01 MIBAVEN
MFE Insurance Brokerage
1019 E. 4th Pl.
Los Angeles, CA 90013 [email protected]
Massachusetts Bay Insurance Company
Mitsui Sumitomo Insurance USA, Inc.
X
X
X
X
X X
X
ACZ001 (September 1, 2009) Page 1 of 2 Certificate No. ACZ0100102501
CERTIFICATE OF INSURANCE
This certificate is given as a matter of information only and confers no rights upon the certificate addressee.
Date: June 27, 2023
This is to certify to: That the following policy has been issued to:
City of Redondo Beach
415 Diamond Street
Redondo Beach, CA 90277
SKY ELEMENTS, LLC
3819 Ruffe Snow Drive, Unit 203
North Richland Hills, TX 76180
Policy No. 9028564 issued by one or more member companies of Global Aerospace Pool through Global Aerospace, Inc.
Policy Period: from October 10, 2022 to October 10, 2023 Policy Territory: Worldwide
AIRCRAFT AND COMMERCIAL GENERAL AVIATION LIABILITY
Single Limit Bodily Injury and Property Damage
(All expressed limits are "Each Occurrence" unless otherwise indicated) Serial No / Reg. No Year, Make & Model Liability Limit Third Party War Liability on file UP TO 900 UVIFY IFO DRONES $5,000,000 $5,000,000 Aggregate
AIRCRAFT PHYSICAL DAMAGE
Serial No / Reg. No Year, Make & Model Risk Basis Hull War on file UP TO 900 UVIFY IFO DRONES Not Covered None Excluded Policy includes Commercial General Aviation Liability coverages, with limits as shown in the policy.
Solely as respects an occurrence arising out of the ownership, maintenance or use of an unmanned aircraft insured under this policy and solely to the extent required in an agreement with the Named Insured, the following provisions shall apply:
The WHO IS AN INSURED section of the policy is amended to include the certificate addressee as an insured, but only as respects the Named Insured’s use of the aircraft and only with respect to the certificate addressee’s liability because of acts or omissions of the Named Insured. However, no such person or organization is an Insured if he, she, or it, or any of his, her, or its agents or employees is engaged in the manufacture, maintenance, repair, or sale of aircraft, aircraft engines, components or accessories, or in the operation of any airport, hangar, flying school, flight service, or aircraft or piloting service, as respects any occurrence arising out of such activity.
The insurance, as to the interest of the certificate addressee, shall be primary without right of contribution by any other valid and collectible insurance available to the certificate addressee.
We waive any right of recovery we may have against the certificate addressee because of payments it makes for physical damage to aircraft described in this certificate, but only to the same extent that the Named Insured has waived its right for recovery for such physical damage against the certificate addressee.
If the certificate addressee information shown on this certificate includes a valid mailing address, we agree to give 30 days (10 if cancelled for nonpayment of premium) notice to the certificate addressee in the event the policy is cancelled or materially changed by us.
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. This certificate does not amend, extend or otherwise alter the coverages afforded by the policies described herein. Limits may have been reduced by paid claims.
GLOBAL AEROSPACE, INC.
BY:
ACZ001 (September 1, 2009) Page 2 of 2 Certificate No. ACZ0100102501