SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
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. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
9/17/2025
Arthur J. Gallagher Risk Management Services, LLC
2050 Main Street
Suite 1250
Irvine CA 92614
Elena Ibarra 818.539.8671 818.539.8771 [email protected] License#: 0D69293 Mesa Underwriters Specialty Insurance Co 36838 CLEAPOW-01 Kinsale Insurance Company 38920 Clean Power Alliance
801 S. Grand Avenue, Suite 400
Los Angeles CA 90017
Employers Compensation Insurance Company 11512 1275829160 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X
MP000401510050900 5/1/2025 5/1/2026
B 2,000,000 X
0100348935-1 5/1/2025 5/1/2026
2,000,000
C EIG5238193-02 5/22/2025 5/22/2026
X
1,000,000 1,000,000 1,000,000
Coverage information:
Policy: Crime
Policy#: BDC 1068790 07
Policy term: 5/1/2025 to 5/1/2026
Carrier: Allmerica Financial Benefit Insurance Co
Employee theft: $1,000,000; Deductible: $5,000
See Attached...
City of Redondo Beach
415 Diamond Street
Redondo Beach CA 90277
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
CLEAPOW-01 1 1
Arthur J. Gallagher Risk Management Services, LLC
Clean Power Alliance
801 S. Grand Avenue, Suite 400
Los Angeles CA 90017
25 CERTIFICATE OF LIABILITY INSURANCE
Forgery or Alteration: $500,000; Deductible: $2,500
Theft of money and securities: $500,000; Deductible: $2,500 Robbery or Burglary of other property: $500,000; Deductible: $2,500 Money and securities: $500,000; Deductible: $2,500
Money orders and counterfeit paper currency: $10,000; Deductible: $250 Computer and funds transfer fraud: $500,000; Deductible: $2,500 Policy: Cyber liability
Policy#: PLM-CB-SP4QRPA0P-004
Policy term: 5/1/2025 to 5/1/2026
Carrier: Allmerica Financial Benefit Insurance Co
Limit: $2,000,000; Retention: $50,000
Policy: Directors & Officer liability
Policy#: MLNP2510001526-02
Policy term: 5/1/2025 to 5/1/2026
Carrier: Ascot Specialty Insurance Company
Limit: $2,000,000; Aggregate: $2,000,000; Retention: $50,000 Policy: Employment Practices liability
Policy#: MLNP2510001526-02
Policy term: 5/1/2025 to 5/1/2026
Carrier: Ascot Specialty Insurance Company
Limit: $2,000,000; Aggregate: $2,000,000; Retention: $200,000 Policy: Fiduciary liability
Policy#: MLNP2510001526-02
Policy term: 5/1/2025 to 5/1/2026
Carrier: Ascot Specialty Insurance Company
Limit: $1,000,000; Retention: $200,000
RE:Program Name: Clean Power Alliance Energized Communities Program for Electric Fleet Transition |