ACORD® DATE (MM/DDAY
CERTIFICATE OF LIABILITY INSURANCE 08/29/2023
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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
T 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 endorsements).
PHONE
Two Alliance Center
Attn: [email protected] / Fax: 212-948-4321 INSURERS) AFFORDING COVERAGE INSURER A: Evanston insurance Company
INSURER B : Continental Casualty Company
Robertson Industries, Inc.
Attention: Maria Townson INSURER C : American Casualty Company Of Reading, Pa 20427 2140 E. Cedar Street 20494
INSURER D: Transportation Insurance Co
Tempe, AZ 85281
INSURER E: National Union Fire Ins Co. of Pittsburgh PA 19445 INSURER F: The Continental insurance Company 35289
COVERAGES CERTIFICATE NUMBER: ATL-005639505-00 REVISION NUMBER: 0
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.
INSR ADDL SUBR
TYPE OF INSURANCE POLICY NUMBER LIMITS
LTR INSP WVD.
X COMMERCIAL GENERAL LIABILITY MKLV2PBC002028 08/01/2023 08/01/2024 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) 100,000
X SIR $250,000 Per Occ. MED EXP (Any one person) 10,000 PERSONAL & ADV INJURY 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000 PRO- 4,000,000
POLICY X | LOC PRODUCTS - COMP/OP AGG $
POLICY AGGREGATE 10,000,000
OTHER:
BUA 7039895527 08/01/2023 08/01/2024 COMBINED SINGLE LIMI 1,000,000
AUTOMOBILE LIABILITY
ca accident
X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED
AUTOS ONLY AUTOS ONLY
Comp/Coll Ded: $1,000
F X UMBRELLA LIAB 7039984806 08/01/2023 08/01/2024 10,000,000
X OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE RETENTION Umb Catastrophe $25,000 AGGREGATE 10,000,000 DED X RETENTIONSO $
WORKERS COMPENSATION WC 7 39895530 08701/2023 08/01/2024 X STATUTE OTH- ER
AND EMPLOYERS' LIABILITY
WC 7 39895544 08/01/2023 08/01/2024 $ 1,000,000
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? N/ A
(Mandatory in NH) WC 7 39919971 08/01/2023 08/01/2024 E.L. DISEASE - EA EMPLOYEE S 1,000,000 DYSCRIPTION OF OPERATIONS below WC 7 39929062 08/01/2023 08/01/2024 E.L. DISEASE - POLICY LIMIT S 1,000,000 E Excess Umbrella 019356229 08/01/2023 08/01/2024 Each Occurrence 15,000,000 SIR: $25,000 Per Project Aggregate 15,000,000
RE: Anderson Park: 56 720-38670 CATIONS VEHICLES (ACOR (ACORO dional Romarie Schedul, maybe stached more space requires) avor of the additionall insureds on the Workers Compensation policy, when required by written contrac
CERTIFICATE HOLDER CANCELLATION
City of Redondo Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 531 N. Gertruda Avenue EXPIRATION DATE NOTICE WILL BE DELIVERED IN Redondo Beach, CA 90277 ACCORDANCE WITH THE POLICY PROVISIONS.
UTHORIZED REPRESENTATIV
Marsh USA LL
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© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:_CN102326389
LOC#: Atlanta
ACORD® ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY
MARSH USA, LLC.
POLICY NUMBER
Tempe,AZ 85281
CARRIER | NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers' Compensation (Continued):
Carrier: Transportation Insurance Company
Policy Number: WC 7 39918885
Dales: 08/01/2023 - 08/01/2024
WC 7 39895530 - AL,AZ,CA,CO,FL,GA,IL, N,KY,MI,MN,MO,NV,NY,OK,OR,PA,SC, TN, TX,UT, VA WC 7 39895544 - CA,CO,FL,GA,IL, IN,MI,MN,MO,M,NC,NM,NV,NY,OK,OR,PA,SC, TN,T WC 7 39919971 - AZ, OR, WI
WC 7 39918885 - OH, ND, WY, WA
Workers Compensation SIR of $150,000
ACORD 101(2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: MKLV2PBC002028
EFFECTIVE: AUGUST 1, 2023
EXPIRES: AUGUST 1, 2024
COMMERCIAL GENERAL LIABILITY
CG 20 10 04 13
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
Name Of Additional Insured Person(s)
Or Organization(s) Locations) Of Covered Operations
As required by written contract executed by both parties All locations prior to loss
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
1. All work, including materials, parts or
A. Section II - Who Is An Insured is amended to equipment furnished in connection with such include as an additional insured the person(s) or
work, on the project (other than service,
organization(s) shown in the Schedule, but only maintenance or repairs) to be performed by or with respect to liability for "bodily injury", "property on behalf of the additional insured(s) at the damage" or "personal and advertising injury"
location of the covered operations has been
caused, in whole or in part, by:
completed; or
1. Your acts or omissions; or 2. That portion of "your work" out of which the
2. The acts or omissions of those acting on your injury or damage arises has been put to its behalf; intended use by any person or organization
in the performance of your ongoing operations for other than another contractor or subcontractor the additional insured(s) at the locations) engaged in performing operations for a designated above. principal as a part of the same project.
However:
1. 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
insurance afforded to such additional insured
will not be broader than that which you are 1. Required by the contract or agreement; or 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:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
© Insurance Services Office, Inc., 2012 Page 1 of 2
CG 20 10 04 13
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase
applicable Limits of Insurance shown in
Declarations.
© Insurance Services Office, Inc., 2012 Page 2 of 2
CG 20 10 04 13
POLICY NUMBER: MKLV2PBC002028
EFFECTIVE: AUGUST 1, 2023
EXPIRES: AUGUST 1, 2024
COMMERCIAL GENERAL LIABILITY
CG 20 37 04 13
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
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations As required by written contract executed by both All locations parties prior to loss
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
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part, by
"your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and 1. Required by the contract or agreement; or ncluded in the "products-completed operations
hazard". 2. Available under the applicable Limits of
Insurance shown in the Declarations;
However:
1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations.
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 an
required by the contract or agreement t
provide for such additional insured.
© Insurance Services Office, Inc., 2012 Page 1 of 1
CG 20 37 04 13
EFFECTIVE: AUGUST 1, 2023
EXPIRES: AUGUST 1, 2024
POLICY NUMBER: MKLV2PBC002028 OMMERCIAL GENERAL LIABILIT G 20 01 04 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available
to an additional insured under your policy
provided that:
(1) The additional insured is a Named Insured
under such other insurance; and
© Insurance Services Office, Inc., 2012 Page 1 of 1
CG 20 01 04 13
POLICY NUMBER: MKLV2PBC002028
EFFECTIVE: AUGUST 1, 2023
EXPIRES: AUGUST 1, 2024
COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
As required by written contract executed by both parties prior to loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV - Conditions:
We waive any right of recovery we may have against
the person or organization shown in the Schedule
bove because of payments we make for injury o
amade arising out of vour ongoing operations o
"your work" done under a contract with that person
or organization and included in the "products-
completed operations hazard". This waiver applies
only to the person or organization shown in the
Schedule above.
© Insurance Services Office, Inc., 2008 Page 1 of 1
CG 24 04 05 09