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PROOF OF INSURANCE (2020) CLOSEDA� ® CERTIFICATE OF LIABILITY INSURANCE I DATE CERTIFICATE 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). PRODUCER (CONTACT Marsh Risk & Insurance Services NAME: PHONE FAX CA License #0437153 WC, No, Ext): (A/C, No): 633 W Fifth Street, Suite 1200 I EMAIL Los Angeles, CA 90071 ADDRESS: I INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: LOS -002381132-10 REVISION NUMBER: 11 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 INSD WVD POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY 660-8105A95A-19 INSURER(S) AFFORDING COVERAGE NAIC # CN102956307-STND-GAWU-19-20 FileK GLALWINSURER A: Travelers Property Casualty Co. of America 25674 INSURED INSURER B: Travelers Indemnity Company of Connecticut 25682 File Keepers, LLC PREM SESO(Ea occur $ Raleigh Enterprises, LLC I INSURER C : 6277 East Slauson Avenue I INSURER D: Los Angeles, CA 90040 PERSONAL & ADV INJURY $ I INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: LOS -002381132-10 REVISION NUMBER: 11 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 INSD WVD POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY 660-8105A95A-19 10/01/2019 10/01/2020 EACH OCCURRENCE $ 1,000,000 IX I DAMAGE RETE ence) 100,000 CLAIMS -MADE OCCUR PREM SESO(Ea occur $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 810-6N38761A-19 10/01/2019 10/01/2020 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY (Per person) $ OWNEDSCHEDULED BODILY INJURY $ AUTOS ONLY AUTOS (Per accident) HIRED NON -OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY HComp./Coll (Per accident) Ded $ 1,000/1,000 UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION UBgK062882-19-51K 10/01/2019 10/01/2020 X I PER OTH- AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N STATUTE ER I E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) With the exception of Workers' Compensation & Employer's Liability, the City of EI Segundo, its officials, and employees are included as an additional insured, but only with respect to liability arising out of the operations performed for them by the named insured as required by written contract This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions. Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of EI Segundo Police Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Mr. Vincent Martinez THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 348 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services James L. Vogel © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Raleigh Enterprises, LLC. Policy No. sso-81oaAeaA'1e Policy Period: 10-1 -19/20 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ ITCAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS 3. This insurance in oxoamo over any valid and col - 1. WHO IS AN INSURED (SECTION U) is amended \echb|e insurance unless you have agreed in a to include as an insured any person ororganiza- written contract for this insurance to apply on a hon (called hereafter "additional insured") with primary orcontributory basis. whom you have agreed in a written contract, 4. This insurance does not apply onany basis: executed prior to loss, to name as an additional a. To any person or organization for whom you insured, but: � heve purchased mnOwners and Contractors a. Only with respect to liability because of Protective policy. "bodily injury" or "property damage" arising b. To any person or organization who dim- out of "your work" for that additional insured tributes orsells "your products" inthe regular performed by you or for you; and course of its business. b. Subject to any limitations in the written non- c. To any person or organization from whom tract regarding the scope o/ the additional you have acquired any products, orany in - insured status. grndient, part or container, entering into, ac - This insurance does not apply to "bodily injury" oompmnyingurcontaining such products, or"property damage" arising out of "your work" d. To any manager or lessor of premises with included in the "prod ucto-oompla0od operations respect to liability arising out of the owner - hazard" unless you are required to provide such ship, maintenance, oruse ofthat part of any coverage by written contract and then only for premises leased Nyou. the period of time required by the ntmct, but innmevent beyond the expiration date of the e. Toany lessor ofleased equipment. policy. f. To any amhiteot, engineer or surveyor for 2. The Limits of Insurance provided to such addi- injury ordamage arising out of: donm|insured shall be: (1) The proparing, approving or failing to m. The limits which you have agreed to provide; prepare or approve mapo, dmwings, or opiniunu, mpono, aurveyo, change or- p de dem. designs or specifications; and b. TheUmitoahmmnon�hoDodanahnno whichever ialess. (2) Supervisory, inspection or engineering CG DI 44 0196 Copyright, The Travelers Indemnity Company, 1996. Page 1 of 1 A WORKERS COMPENSATION TRAVELERS AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: UB-9KO62882-19-51-K WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this p.licy, We will no) enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 0 . 0 % of the California workers' compensation pre- mium. R N TTO M Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 10-1-19 ST ASSIGN: Page 1 of 1