2020-137-E Transportation - Lytz Price software

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DocuSign Envelope ID:82D524E5-C75F-4822-B9EC-BOB503C3F270 LYTXHOLDI V I I G I I G1r.1J I I JJ DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 7/01/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Francesca Captain Marsh&McLennan Agency LLC PHONE g58-242-5763 FAX 858-452-7530 A/C No Ext: A/C,No Marsh&McLennan Ins.Agency LLC E-MAIL francesca.captain@marshmma.com PO Box 85638 INSURER(S)AFFORDING COVERAGE NAIC# San Diego,CA 92122 Atlantic Specialty Insurance Company 27154 INSURER A: p Y P Y INSURED INSURER B: Lytx Holdings, LLC INSURER C Lytx, Inc. INSURER D 9785 Towne Centre Drive San Diego, CA 92121 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY 7110126390008 7/01/2019 07/01/2020 EACH OCCURRENCE $1 000000 CLAIMS-MADE _ OCCUR PREMISES EaoN'u ence $1,000,000 X Int'I WC&Auto MED EXP(Anyone person) $10,000 X Int'I Bus Travel Acc $1,000,000 PERSONAL&ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: $250,000 $1.25M Agg GENERAL AGGREGATE $2,000,000 X POLICY JECOT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 7110126390008 7/01/2019 07/01/202 (CEO,accident $MBINED SINGLE LIMIT 1 I I 000 000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ Owned& Hired Autc PD Comp/Coll $1,000/1,000 A X UMBRELLA LIAB X OCCUR 7110126390008 7/01/2019 07/01/2020 EACH OCCURRENCE $10 OOO OOO EXCESS LIAB CLAIMS-MADE AGGREGATE $1 O 00O 000 DED RETENTION$ $ A WORKERS COMPENSATION 4060374790008 7/01/2019 07/01/2020 X PER OTH- AND EMPLOYERS'LIABILITYSTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? JU N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Coverage. CERTIFICATE HOLDER CANCELLATION Wal-Mart Stores, Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Its Subsidiaries and Affiliates ACCORDANCE WITH THE POLICY PROVISIONS. c/o Vendor Underwriting 1301 SE 10th St, MS#0710-1_06 AUTHORIZED REPRESENTATIVE Bentonville,AR 72716-0000 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S4219992/M4219026 WS G C L