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PROOF OF INSURANCE (2021 - 2021) CLOSEDI DATE (MM/DDIYYYY) A'C'RE" CERTIFICATE OF LIABILITY INSURANCE 10/8/2020 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 riqhts to the certificate holder in lieu of such endorsements). CONTA PRODUCER cA„cT Mark Schneiderman FAQ — MARK SCHNEIDERMAN INSURANCE PHONE (818) 340-0078 A1C Naj (818) 340-7123 ....ancenet Woodland Hills, CA 91364IL 22201 Ventura Blvd #206 "'ADDRESS, m ark SUrINSURER(S) AORDING COVERAGE NAIC # ........... .NB..7....8.. I„SURERA: Sen nCompany, p . Ltd, 212106060 INS REDINSURER B: Hartford Acidt and nea it 22357 LanairGroupLLC INSURER C. ACE AmerI an Insurance 7 - p, 330 N Brand Blvd Ste 600 LINSURER D: Glendale, CA 91203 - 2331 INSURER E: CA 91203 - 2331 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 .+........... �. - JAD15L S-6801 ...... .. POLICY EFF POLDIC rgP LIMITS LTR TYPE OF INSURANCE IN9I1 POLICY NUMBER IMMIDILYYYYI IMMI .. .., X MMERCIAL LIABILITY EACH OCCURRENCE 00 $ "... bAMAGE Tb R U 00, 00 rre— IMS-MADEGENERAL ® OCCUR PR_ MLSES�haFN'Y 9eou.....nre, $ ) — --.00000.00 ............................. M.E.D..EXP-(An one person) $ 10'0 — I A Y Y 84SBATY7914 8/6/2020 8/6/2021 PERSONAL & ADV INJURY $......2.,,000,000 00 .......................... GEN'L AGGREGATE LIMIT APPLIES PER: GEN GTE $ 0.00 ERALAGREGA 4,000,00 —-- X POLICY JPRDCTO I LOC PRODUCTS - COMP/OP AGG $ 4,000,000.00 — �_�! OTHER AUTOMOBILE LIABILITY COMBINED' SINGLE ILIWT ,000,000,00 2 ((e„ly,;irap)y ...,, ANY BODILY (Per A OWNEDTO SCHEDULED 8/612020 816/2021 Y Y 84 BA aperson) R BODILY INJURY (Per accident) $ *✓ auros ONLY HIRED Auros NON -OWNED X .,NYU,,, FROPFR ° OADfid GE $ — AUTOS ONLY AUTOS ONLY LFgI p X OCCUR EACH OCCURRENCE 1,000 000 00 A 1 EXCESS ARAB E 84SBATY7914 8/612020 816/2021 AGGREGAT $ 1 000,000 .00 � DED nd $ 10,1000 00 i $ WORKERS COMPENSATION PER 0TH- X �. AND EMPLOYERS' LIABILITY YIN /E ECUTIVE EACHR $ 1,000,000.00 -- E L EACH1,000,000-00 ,�,N B OFFICER/MEMBER ER/EXCLUD �. NIA Y 84WECRE1519 7/1/2020 7/1/2021 .... ..... EMPLOYEE! $ E L DISEASE EA EM„ (Mandatory in NH) If yes, describe under DESCRIPTION,OF OPERATIONS below DESCRIPTION E L DISEASE - POLICY LIMIT $ Professional Liability C G2151911A010 7/1/2020 7/1/2021 $5.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Liability policy excludes claims arising out of the performance of professional services. Those usual to the Insured's Operations. City of EI Segundo, its officers, officials, employees, and volunteers, are additional insureds per the Business Liability Coverage Form SS0008 attached to the business owners policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Waiver of subrogation applies to workers compensation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of EI Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245-3895 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD KIM POLICY NUMBER: 84 SBA TY7914 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR CITY OF CAMARILLO AND ITS OFFICIALS, OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS THE CITY, ITS ELECTED OR APPOINTED OFFICERS, OFFICIALS, EMPLOYEES AGENTS, AND VOLUNTEERS ARE TO BE COVERED AS ADDITIONAL INSUREDS WITH CITY OF SANTA CLARITA 23920 VALENCIA BLVD SANTA CLARITA, CA 91355 CITY OF EL SEGUNDO LOC 002 BLDG 001 350 MAIN STREET EL SEGUNDO,CA 90245 Form IH 12 00 11 85 T SEQ. NO. 001 Printed in U.S.A. Page 001 Process Date: 05/21/20 Expiration Date: 08/06/21 POLICY NUMBER: 84 SBA TY7914 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION THE CITY, ITS ELECTED OR APPOINTED OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE TO BE COVERED AS ADDITIONAL INSUREDS WITH RESPECT TO LIABILITY ARISING OUT OF WORK PERFORMED BY OR ON BEHALF REG LOC 002 BLDG 001 330 BRAND BLVD STE 600, GLENDALE, CA 91203 TRANSWESTERN PROPERTY COMPANY WEST, L.L.C. DBATRANSWESTERN 330 NORTH BRAND INC. AS OWNERS UBS REALITY INVESTORS, LLC PROPERTY MANAGER 330 N. BRAND BOULEVARD, SUITE 675 GLENDALE, CA 91203 Form IH 12 00 11 85 T SEQ. NO. 002 Printed in U.S.A. Page 001 Process Date: 05/21/20 Expiration Date: 08/06/21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 84 WEC RE1519 Endorsement Number: Effective Date: 07/01/20 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: LANAIR GROUP, LLC 330 N BRAND BLVD STE 600 GILENDALE CA 91203 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description CITY OF ELSEGUNDO 350 MAIN ST, EL SEGUNDO, CA 006 90245 Countersigned by Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 05/21/20 Authorized Representative Policy Expiration Date: 07/01/21