ANY PROPRIETORPARTNEREXECUTIVE
OFFICERMEMBER EXCLUDED"
INSR ADDL SUBR LTR INSD WVD
PRODUCER CONTACT
NAME:
P+ONE )A; (AC, No, E[t): (AC, No):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER ) :
POLICY NUMBER POLICY E)) POLICY E;P TYPE O) INSURANCE (MMDDYYYY) (MMDDYYYY) LIMITS
AUTOMOBILE LIABILITY
UMBRELLA LIAB
E;CESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS
LIABILITY
DESCRIPTION O) OPERATIONS LOCATIONS VE+ICLES (ACORD 101, Additional RemarNs Schedule, may be attached if more sSace is required) AUT+ORI=ED 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 - COMPOP 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) A))ORDING COVERAGE NAIC
COMMERCIAL GENERAL LIABILITY
Y N
N A (Mandatory in N+)
S+OULD ANY O) T+E ABOVE DESCRIBED POLICIES BE CANCELLED BE)ORE T+E E;PIRATION DATE T+EREO), NOTICE WILL BE DELIVERED IN ACCORDANCE WIT+ T+E 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 RE4UIREMENT, 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.
T+IS CERTI)ICATE IS ISSUED AS A MATTER O) IN)ORMATION ONLY AND CON)ERS NO RIG+TS UPON T+E CERTI)ICATE +OLDER. T+IS CERTI)ICATE DOES NOT A))IRMATIVELY OR NEGATIVELY AMEND, E;TEND OR ALTER T+E COVERAGE A))ORDED BY T+E POLICIES BELOW. T+IS CERTI)ICATE O) INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN T+E ISSUING INSURER(S), AUT+ORI=ED REPRESENTATIVE OR PRODUCER, AND T+E CERTI)ICATE +OLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the Solicy(ies) must haYe ADDITIONAL INSURED SroYisions or be endorsed.
If SUBROGATION IS WAIVED, subMect to the terms and conditions of the Solicy, certain Solicies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTI)ICATE NUMBER: REVISION NUMBER:
CERTI)ICATE +OLDER CANCELLATION
ACORD 25 (201603) 1
88-2015 ACORD CORPORATION. All rights reserYed.
CERTI)ICATE O) LIABILITY INSURANCE DATE (MMDDYYYY)
The ACORD name and logo are registered marNs of ACORD
1222024
License 0M63276
(
51) 368-0700 (
51) 368-0707
22306
GMV Syncromatics CorSoration dba: Syncromatics
CorSoration
700 South )loZer St., Suite 470
Los Angeles, CA
0017
222
2 41840
A 1,000,000
; =D3-28
33801 1202024 1202025 100,000
10,000
1,000,000
2,000,000
2,000,000
A 1,000,000
=D3-28
33801 1202024 1202025
B 6,000,000
U+3-28
34201 1202024 1202025 6,000,000
0 C
W23-38337600 5152023 5152024 1,000,000 N 1,000,000
1,000,000
B Cyber Liability L+3-28
44801 1202024 Aggregate 2,000,000
Certificate +older is included as Additional Insured Zith regards to General Liability Ser attached comSany forms.
City of Redondo Beach
451 Diamond St.
Redondo Beach, CA
0277
SYNCCOR-01 AS+UNN
Gallant RisN and Insurance SerYices, LLC
4160 Temescal Canyon Rd. Suite 214
Corona, CA
2883
Massachusetts Bay Ins Co
The +anoYer Insurance ComSany
Allmerica )inancial Benefit Insurance ComSany
;
1202025
;
;
;
; ;
;
;
;
421-2
15 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY O) COVERAGES
1. Additional Insured by Contract, Agreement or Permit Included
2. Additional Insured ± Primary and Non-Contributory Included
3. Blanket Waiver of Subrogation Included
4. Bodily InMury Redefined Included
5. Broad Form Property Damage ± Borrowed Equipment, Customers Goods Use of Elevators Included
6. .nowledge of Occurrence Included
7. Liberalization Clause lncluded
8. Medical Payments ± Extended Reporting Period Included
. Newly Acquired or Formed Organizations - Covered until end of policy period Included
10. Non-owned Watercraft 1 ft.
11. Supplementary Payments Increased Limits
- Bail Bonds 2,00
- Loss of Earnings 1000
12. Unintentional Failure to Disclose Hazards Included
13. Unintentional Failure to Notify Included
This endorsement amends coverages provided under the Commercial General Liability Coverage Part through new coverages, higher limits and broader coverage grants.
1. Additional Insured by Contract, Agreement or
Permit
The following is added to SECTION II – W+O IS
AN INSURED:
Additional Insured by Contract, Agreement or
Permit
a. Any person or organization with whom you
agreed in a written contract, written agreement
or permit that such person or organization to
add an additional insured on your policy is an
additional insured only with respect to liability
for “bodily inMury”, “property damage”, or
“personal and advertising inMury” caused, in
whole or in part, by your acts or omissions, or
the acts or omissions of those acting on your
behalf, but only with respect to:
(1) "Your work" for the additional insured
s
designated in the contract, agreement or
permit;
(2) Premises you own, rent, lease or occupy;
or
(3) Your maintenance, operation or use of
equipment leased to you.
b. The insurance afforded to such additional
insured described above:
(1) Only applies to the extent permitted by
law; and
(2) Will not be broader than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
Policy Number: ZD3-J289338-01
421-2
15 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4 (3) Applies on a primary basis if that is
required by the written contract, written
agreement or permit.
(4) Will not be broader than coverage
provided to any other insured.
(5) Does not apply if the “bodily inMury”,
“property damage” or “personal and
advertising inMury” is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
c. This provision does not apply:
(1) Unless the written contract or written
agreement was executed or permit was
issued prior to the "bodily inMury”, “property
damage", or "personal inMury and
advertising inMury".
(2) To any person or organization included as
an insured by another endorsement
issued by us and made part of this
Coverage Part.
(3) To any lessor of equipment:
(a) After the equipment lease expires; or
(b) If the “bodily inMury”, “property
damage”, “personal and advertising
inMury” arises out of sole negligence of
the lessor
(4) To any:
(a) Owners or other interests from. whom
land has been leased which takes
place after the lease for the land expires; or
(b) Managers or lessors of premises if:
(i) The occurrence takes place after
you cease to be a tenant in that
premises; or
(ii) The "bodily inMury", "property
damage", "personal inMury" or
"advertising inMury" arises out of
structural alterations, new construction or demolition operations performed by or on behalf of the
manager or lessor.
(5) To “bodily inMury”, “property damage” or
“personal and advertising inMury” arising
out of the rendering of or the failure to
render any professional services.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision,
hiring, employment, training or monitoring
of others by that insured, if the
“occurrence” which caused the “bodily
inMury” or “property damage” or the offense
which caused the “personal and
advertising inMury” involved the rendering
of or failure to render any professional
services by or for you.
d. With respect to the insurance afforded to
these additional insureds, the following is
added to SECTION III – LIMITS O)
INSURANCE:
The most we will pay on behalf of the
additional insured for a covered claim is the
lesser of the amount of insurance:
1. Required by the contract, agreement or
permit described in Paragraph a.
or
2. Available under the applicable Limits of
Insurance shown in the Declarations.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
2. Additional Insured – Primary and NonContributory
The following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 4. Other insurance:
Additional Insured – Primary and NonContributory
If you agree in a written contract, written
agreement or permit that the insurance provided to
any person or organization included as an
Additional Insured under SECTION II – W+O IS
AN INSURED, is primary and non-contributory,
the following applies:
If other valid and collectible insurance is available
to the Additional Insured for a loss covered under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary to other insurance
that is available to the Additional Insured
which covers the
Additional Insured as a Named Insured. We
will not seek contribution from any other
insurance available to the Additional Insured
except:
(1) For the sole negligence of the Additional
Insured;
(2) When the Additional Insured is an
Additional Insured under another primary
liability policy; or
(3) when b. below applies.
If this insurance is primary, our obligations are
not affected unless any of the other insurance
is also primary. Then, we will share with all
that other insurance by the method described
in c. below.
Policy Number: ZD3-J289338-0
421-2
15 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4 b. E[cess Insurance
(1) This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(a) That is Fire, Extended Coverage,
Builder
s Risk, Installation Risk or
similar coverage for "your work";
(b) That is Fire insurance for premises
rented to the Additional Insured or
temporarily occupied by the Additional
Insured with permission of the owner;
(c) That is insurance purchased by the
Additional Insured to cover the
Additional Insured¶s liability as a
tenant for "property damage" to
premises rented to the Additional
Insured or temporarily occupied by the
Additional with permission of the
owner; or
(d) If the loss arises out of the
maintenance or use of aircraft, "autos"
or watercraft to the extent not subMect
to Exclusion g. of SECTION I ±
COVERAGE A ± BODILY INURY
AND PROPERTY DAMAGE
LIABILITY.
(2) When this insurance is excess, we will
have no duty under Coverages A or B to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured
s
rights against all those other insurers.
(3) When this insurance is excess over other
Insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and self
insured amounts under all that other
insurance.
We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically
to apply in excess of the Limits of
Insurance shown in the Declarations of
this Coverage Part.
c. Method Of Sharing
If all of the other insurance permits
contribution by equal shares, we will follow this
method also. Under this approach each
insurer contributes equal amounts until it has
paid its applicable limit of insurance or none of
the loss remains, whichever comes first. If any
of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer
s
share is based on the ratio of its applicable
limit of insurance to the total applicable limits
of insurance of all insurers
3. BlanNet WaiYer of Subrogation
The following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 8. Transfer Of Rights
Of RecoYery Against Others To Us:
We waive any right of recovery we may have
against any person or organization with whom you
have a written contract that requires such waiver
because of payments we make for damage under
this coverage form. The damage must arise out of
your activities under a written contract with that
person or organization. This waiver applies only to
the extent that subrogation is waived under a
written contract executed prior to the “occurrence”
or offense giving rise to such payments.
4. Bodily InMury Redefined
SECTION V – DE)INITIONS, Definition 3. “bodily
inMury” is replaced by the following:
3. “Bodily inMury” means bodily inMury, sickness or
disease sustained by a person including death
resulting from any of these at any time. “Bodily
inMury” includes mental anguish or other
mental inMury resulting from “bodily inMury”.
5. Broad )orm ProSerty Damage – BorroZed
EquiSment, Customers Goods, Use of
EleYators
a. SECTION I – COVERAGES, COVERAGE A –
BODILIY IN-URY AND PROPERTY
DAMAGE LIABILITY, Paragraph 2.
E[clusions subparagraph M. is amended as
follows:
Paragraph (4) does not apply to "property
damage" to borrowed equipment while at a
Mobsite and not being used to perform
operations.
Paragraphs (3), (4) and (6) do not apply to
"property damage" to "customers goods" while
on your premises nor do they apply to the use
of elevators at premises you own, rent, lease
or occupy.
b. The following is added to SECTION V –
DE)INTIONS:
24. "Customers goods" means property of
your customer on your premises for the
purpose of being:
Policy Number: ZD3-J289338-0
421-2
15 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4 a. worked on; or
b. used in your manufacturing process.
c. The insurance afforded under this provision is
excess over any other valid and collectible
property insurance
including deductible
available to the insured whether primary,
excess, contingent
6. KnoZledge of Occurrence
The following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 2. Duties in the EYent
of Occurrence, Offense, Claim or Suit:
e. Notice of an "occurrence", offense, claim or
"suit" will be considered knowledge of the
insured if reported to an individual named
insured, partner, executive officer or an
"employee" designated by you to give us such
a notice.
7. Liberali]ation Clause
The following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
Liberali]ation Clause
If we adopt any revision that would broaden the
coverage under this Coverage Form without
additional premium, within days prior to or
during the policy period, the broadened coverage
will immediately apply to this Coverage Part.
8. Medical Payments – E[tended ReSorting
Period
a. SECTION I – COVERAGES, COVERAGE C –
MEDICAL PAYMENTS, Paragraph 1.
Insuring Agreement, subparagraph a.(3)(b)
is replaced by the following:
(b) The expenses are incurred and reported
to us within three years of the date of the
accident; and
b. This coverage does not apply if COVERAGE
C – MEDICAL PAYMENTS is excluded either
by the provisions of the Coverage Part or by
endorsement.
. NeZly Acquired Or )ormed Organi]ations
SECTION II – W+O IS AN INSURED, Paragraph
3.a. is replaced by the following:
a. Coverage under this provision is afforded until
the end of the policy period.
10. Non-OZned Watercraft
SECTION I – COVERAGES, COVERAGE A
BODILY IN-URY AND PROPERTY DAMAGE
LIABILITY, Paragraph 2. E[clusions,
subparagraph g.(2) is replaced by the following:
g. Aircraft, Auto Or Watercraft
(2) A watercraft you do not own that is:
(a) Less than 1 feet long; and
(b) Not being used to carry persons or
property for a charge;
This provision applies to any person who,
with your consent, either uses or is
responsible for the use of a watercraft.
11. SuSSlementary Payments Increased Limits
SECTION I – SUPPLEMENTARY PAYMENTS
COVERAGES A AND B, Paragraphs 1.b. and
1.d. are replaced by the following:
1.b. Up to 2,00 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily InMury Liability Coverage applies.
We do not have to furnish these bonds.
1.d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or “suit",
including actual loss of earnings up to 1000 a
day because of time off from work.
12. Unintentional )ailure to Disclose +a]ards
The following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 6. ReSresentations:
We will not disclaim coverage under this Coverage
Part if you fail to disclose all hazards existing as of the inception date of the policy provided such
failure is not intentional.
13. Unintentional )ailure to Notify
The following is added to SECTION IV –
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 2. Duties in the EYent
of Occurrence, Offense, Claim or Suit:
Your rights afforded under this policy shall not be
preMudiced if you fail to give us notice of an
"occurrence", offense, claim or "suit", solely due to
your reasonable and documented belief that the
"bodily inMury" or "property damage" is not covered
under this policy.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.
Policy Number: ZD3-J289338-0
461-0478 12 12 Includes copyrighted material of ISO Insurance Services Office, Inc., with its permission Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED – PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
A. The following is added to SECTION II –
LIABILITY COVERAGE, Paragraph A.1. Who Is
An Insured:
Additional Insured if Required by Contract
If you agree in a written contract, written
agreement or written permit that a person or
organization be added as an additional “insured”
under this Coverage Part, such person or
organization is an “insured”; but only to the extent
that such person or organization qualifies as an
“insured” under paragraph A.1.c. of this Section.
If you agree in a written contract, written
agreement or written permit that a person or
organization be added as an additional “insured”
under this Coverage Part, the most we will pay on
behalf of such additional “insured” is the lesser of:
(1) The Limits of Insurance for liability coverage
specified in the written contract, written
agreement or written permit; or
(2) The Limits of Insurance for Liability Coverage
shown in the Declarations applicable to this
Coverage Part.
Such amount shall be part of and not in addition to
the Limits of Insurance shown in the Declarations
applicable to this Coverage Part. Regardless of
the number of covered "autos", "insureds",
premiums paid, claims made or vehicles involved
in the "accident", the most we will pay for the total
of all damages and "covered pollution cost or
expense" combined resulting from any one
"accident" is the Limit of Insurance for Liability
Coverage shown in the Declarations.
B. The following is added to SECTION IV –
BUSINESS AUTO CONDITIONS, Paragraph B.
General Conditions, subparagraph 5. Other
Insurance:
Primary and Non-Contributory
If you agree in a written contract, written
agreement or written permit that the insurance
provided to a person or organization who qualifies
as an additional “insured” under SECTION II –
LIABILITY COVERAGE, Paragraph A.1. Who Is
An Insured, subparagraph Additional Insured if
Required by Contract is primary and noncontributory, the following applies:
The liability coverage provided by this Coverage
Part is primary to any other insurance available to
the additional “insured” as a Named Insured. We
will not seek contribution from any other insurance
available to the additional “insured” except:
(1) For the sole negligence of the additional
“insured”; or
(2) For negligence arising out of the ownership,
maintenance or use of any “auto” not owned
by the additional “insured” or by you, unless
that “auto” is a “trailer” connected to an “auto”
owned by the additional “insured” or by you; or
(3) When the additional “insured” is also an
additional “insured” under another liability
policy.
C. This endorsement will apply only if the “accident”
occurs:
1. During the policy period;
2. Subsequent to the execution of the written
contract or written agreement or the issuance
of the written permit; and
3. Prior to the expiration of the period of time that
the written contract, written agreement or
written permit requires such insurance to be
provided to the additional “insured”.
D. Coverage provided to an additional “insured” will
not be broader than coverage provided to any
other “insured” under this Coverage Part.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.
Policy Number: ZD3-J289338-01