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PROOF OF INSURANCE (2020 - 2021) CLOSEDKOPP&GR-01 411...111111CERTIFICATE OF LIABILITY INSURANCE DATE IMMroorrvwl 1112013019 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 pollcy(les) 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 flaw of such endorsement(s). PRODUCER Licensell! ON00529 CT BreBkvrater Strategic Insurance Solutions PNONE Fax 2251 San piago Ave., Ste. B-208 frac„ No', Eel): (619) 780.4600 Ij 317-0019 San Diego, CPk 92.11.0 c MISURER451 AFFORDING COVERAGE NAIC a D9$CAIP'nON OF OPERATIONS I LOCATIONS I VEHICLES IACORD 1,01, Additosl R'emefAe Scltrdule,Ay be ease'hed B more ePece mq Is General Liability Policy excludes claims ari's'ing our of the performance of professional services. All Operations of the Named Insured. City of EI Segundo, its officers, officials, employees, and volunteers ere named additional insured as respects to operations performed by the Named Insured as respects to General Liability per forms CG2026, CG2001 & C2404 attached. • • Drgq a ly migno�C by Jo'wph LullJo Joseph U 11 i o Fimr''i "Milro Llfl6n, o i,09 of o o'9, ndaa, —Director of Finam�:e�, crnmbl wnldlllu�ilwvlMnlvndoo' 9, c" 415 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of E) Segundo ACCORDANRCE WITH THTION E POLICY PROVISIONS. +CE WILL BE DELIVERED IN 360 Main Street EI Segundo, CA 90245-3895 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) ®1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURER A.- Citizens Insurance Company of America 31534 INSURED aGemini Insurance Company 10833 Koppel 6 Gruber Public Finance IINSURER NSURER -, 334 Via Vera Cruz, Ste. 266 jvSUi1ER0; San Marcos, CA 92078 INSURER E r PP I, INSURER F S;,,iC�Vg t3ES CERTIFICATE NUMBER. REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INNSR AD'nL �$USR TYPE OF INSURANCE in N POLICY NUMBER POLICY EFF O POLICY EXP iNMMMDi lMMR1Q0WrA LIMBS A GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 CLAIMS -MADE �X occuR X X OB3p428852-02 DAMA 'E TO RENTED 11f29/2019 11/2912020 �I ! 300,000 TMERCIAL MED EXP $Any one wnoP,1 5,000 -S RSONAL6ADVINJURY S �C;S?JERAL 2,000,000 L AG'GRE TE LIMOIT APP I S PER 7 AGGREGATE S 4,000,000 4,000,000 X�POLICY 1t."T LOC PRODUCTS - COMPIOPAGG S OTHER S — A AUTOMOBILE, LIABILITY Ne I�NdEeD SINGLE LIMIT' s i 9111 2,000,000 ANY AUTO OB3D426852-02 1111 11129/2020 BODILY NJURY IPi S OWNED AUTOS ONLY SCHEDULED AUTOS BQPILY INJURY fPeraccident) S X ARAW scaden S ,4OPERTgAMAGEXAMR ONLY UMBRELLA LIAO OCCUREACH OCCURRENCE ! EXCESS LIAR CLAIMS -MADE A R GATE S .r DEC) Q I RETENTIONS S WORKER'S COMPEN'SA'TION AND E PLOYOU' LIABILITY PER TdE I IN ANY PROp��PMMRCIIMTeDERRqIPEA TNEW ECUTIVE Y7 E L EACH ACCIDENT Ti NIA �i/endetoryl111 1 EL DISEASE -EAEMPLOYEE! 5 II ea, de sertbe under D SgRIPTION OF OPERATIONS below tl E L 0i. POLICY LIMIT' 4 S —d–,Pro fessional Lissy (VNPL006412 11116/2019 1111612020 Claim i. 1,000,000 D9$CAIP'nON OF OPERATIONS I LOCATIONS I VEHICLES IACORD 1,01, Additosl R'emefAe Scltrdule,Ay be ease'hed B more ePece mq Is General Liability Policy excludes claims ari's'ing our of the performance of professional services. All Operations of the Named Insured. City of EI Segundo, its officers, officials, employees, and volunteers ere named additional insured as respects to operations performed by the Named Insured as respects to General Liability per forms CG2026, CG2001 & C2404 attached. • • Drgq a ly migno�C by Jo'wph LullJo Joseph U 11 i o Fimr''i "Milro Llfl6n, o i,09 of o o'9, ndaa, —Director of Finam�:e�, crnmbl wnldlllu�ilwvlMnlvndoo' 9, c" 415 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of E) Segundo ACCORDANRCE WITH THTION E POLICY PROVISIONS. +CE WILL BE DELIVERED IN 360 Main Street EI Segundo, CA 90245-3895 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) ®1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: OB3D426852-02 u7L COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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) City of EI Segundo, its officers, officials, employees & volunteers 350 Main Street E! Segundo CA 90245-3895 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", 'property damage" or "personal and advertising injury" caused; or in part, by your acts or omissions of the of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 or agreement, the insurance afforded to such additional insured will not be boarder than that which you are 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 is added to Section III — Limits of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on whole behalf of the additional insured is the amount of acts or omissions 1. Required by the contract or agreement: or 2. Available under the applicable Limits of Insurance shown in the Declaration: Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 O 150 Properties, Inc., 2012 Page 1 of 1 u7L POLICY NUMBER: OB3D426852-02 COMMERCIAL GENERAL LIABILITY CG 20 010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 0. L 111 01 4 1 s 41 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 (2) You have agreed in writing In a contract or Condition and supersedes any provision to the agreement that this Insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other Insurance available to the additional insured. 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 CG 20 010413 4:1Z) Insurance services Office. Inc., 2012 Paye i of 1 POLICY NUMBER: 013313426852-02 �7L COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 �W Aftj 10 ja I I I I i This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of EI Segundo, its officers, officials, employees and volunteers Information requi red to complete this Schedule, 0 not shown above, will be shown in the Declarations. The following is added to Paragraph a. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovewe may have against st the person or organization own in the Schedule above 'because of payments we make for injury or damage arising out of your ongoing operations or "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 to the Schedule above. 2 i?n' It CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICYHOLDER COPY SP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 04-01-2020 CITY OF EL SEGUNDO SP 350 MAIN ST EL SEGUNDO CA 90245-3813 GROUP: POLICY NUMBER: 1824128-2020 CERTIFICATE ID: 69 CERTIFICATE EXPIRES: 04-01-2021 04-01-2020/04-01-2021 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer, We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms,- exclusions, and conditions, of such policy. a Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-2006 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2020-04-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF EL SEGUNDO ENDORSEMENT #1851 - SCOTT KOPPEL, VICEPRES - EXCLUDED. ENDORSEMENT #1651 - LYNN GRUBER, PRES,SEC - EXCLUDED. EMPLOYER KOPPEL & GRUBER PUBLIC FINANCE (A CORP) SP 334 VIA VERA CRUZ STE 256 SAN MARCOS CA 92078 M0410 PRINTED : 03-17-2020 IREV.7-2014) ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION 1824128-20 RENEWAL SP 7-67-42-43 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE APRIL 1, 2020 AT 12.01 A.M. AND EXPIRING APRIL 1, 2021 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME KGPF 334 VIA VERA CRUZ STE 256 SAN MARCOS, CA 92078 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, KGPF IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: APRIL 6, 2020 J/1 r rea c. AII'i'HORIED REPIES'k NI° IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.4-2018) 2570 OLD DP 217