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PROOF OF INSURANCE (2021) 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: CA License #0437153 PHONE FAX (A/C, 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 -002381132-13 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-20 INSURER(S) AFFORDING COVERAGE NAIC # CN102956307-STND-GAWU-20-21 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 -002381132-13 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-20 10/01/2020 10/01/2021 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: Fire Damage $ 300,000 B AUTOMOBILE LIABILITY 810-6N38761A-20 10/01/2020 10/01/2021 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 HCLAIMS-MADE EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION UBgK062882-20-51K 10/01/2020 10/01/2021 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. 600..8105A95A..20 Policy Period: 10.1.. 20/21 COMMERCIAL GENERAL LIABILFI Y THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PERSONS OR ORGANIZATIONS FOR BODILY INJURY OR PROPERTY DAMAGE AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION II —WHO IS AN INSURED: Any person or organization that is not otherwise an insured under this Coverage Part and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs subsequent to the signing of that contract or agreement; and b. If the "bodily injury" or "property damage" is caused, in whole or in part, by your ads or omissions in the performance of "your work" to which that contrail or agreement applies or the arts or omissions of any person or organization performing operations on your behalf. The insurance provided to such additional insured is subject to the following provisions: . The limits of insurance provided to such additional insured will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. b. This insurance does not apply to any person or organization for whom you have purchased an Owners and Contractors Protective policy. C. The insurance provided to such additional insured does not apply to: (1) Any "bodily injury" or "property damage" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: [a] The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and [b] Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written coritraact or agreement specifically requires you to provide such coverage for that additional insured during the policy period. d. If the written contract or agreement does not require that the insurance prcrAded under this Coverage Part apply on a primary basis, or a primary and non-contributory basis, then this insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. CG D7 " 02 19 ® 2017 The Travelers IndemnityCompany. All rights reserved. Page 1 of 1 Includes copyrighted materiel from Insurance Services Orrice, Inc. with its permission. A10flik WORKERS COMPENSATION TRAVELERS AND ONE 'TOWER SQUARS EMPLOYERS LIABILITY POLICY HARTFORD, CT 0618,3 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: UB -9K062882 -20-51-K ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not 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, 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-t ­t9 ST ASSIGN: Page 1 of 1