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PROOF OF INSURANCE (2020 - 2021) CLOSEDAt. - CIRLJ" CERTIFICATE OF LIABILITY INSURANCE I IMWDOff VYVI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLAND CONFERS O RJG'HTS THE CERTIFICATE HOLDER. THIS CERTI1FICATIE DOES NOT AFFlRFAATPI OR NEGATIVELY AMEND,Y EXTEND ON R ALTER 'THE C UPON OVERAGE AFFORDED BY THE POLICIES IAELOWe THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE I PRODUCER, AND THE CERTIFICATE HOLD ER, IMPORTANT: If thC'ertifiCatO hold is an ADDITIONAL $NSURED, the pollcy(ler� must have ADDITIONAL INSURED provisions or bg endorsed_ Of SUBROGATION IS WAIVED, SUbjerl to the terms and conditlans of the policy, Conah, policiou may require an endorsement. A statement Grp this - conifiCale does not (,ont(�y rjfj�)h; io the certificate holder In haU Of NIL -Ch I alu„ ��q,ll"IV"ilPf SKAI A IN,5iJRANCL- AGENCYINIC PHONEaC'NIC~i�I�a iIAX GENE SKM A AGENT UG.#0587032 4214N8115 RA'AfAY ......... . NMr; I SAN SE I;! NARIA NO, CA 924q) 7 1 N'dURFR A INSURED "115kPRFR B NANCY K 8CJH1 ING VJqtPR.VR C DBA TI II` COUNSFONG TFAM 1NTF---5"",NAflI INWIRr. R D Stoltp . .................. . . . ...... .. �Aate Farap MLHIJ611 Aujamobik,, Insurance 25 178 ................................°.., ANN) FIRA.TFiE-LORGANZPA"rI()PiAA NIFT)PIORK: INGUIRCR E MAWR F C,OVERAGES CERTIFfICAil E NUMBE L, R , MEIFR� IIII10; IIS TO �:A�NTI,�-YTHAT THF )_EGIFS' IUF 11$1"k0 SELOW F(KVF BFIFIN �!3!�;A"jj jj�:: l�r!, T) F H� INSII.IRED NAMLFD ABOVE (M 111 IF' POLICY PERIOD INDICATFI). NOMAP-ISTANDIN(; ANV kEQUIR"AENT TERM OR r-oNII OF AN't 1[ OR _R J,TIAF_ DOCIIAIFN T'UA 11 IF 11 RFSPECT TO WHICH THIS CFE RTIFICATF K?,M� BE [SWED OR, MAY I.TRTMpo, TlIiF INSURANCE AFFCFIDFr,) FCu IIIHF P011-CIEG DESCFUBEID HERFM IS ,�;110111„JIIFK',7, THE TERP43 EXCIA)SIONS AN11) C(-.)NDI IIIII II SUCH POUCIES, LIMUS� SHOVA MAY W -VE KLN HILDUCLI) BY PAID Adoniiiip r” 01 R4 PM.Iiry II P00,YNOWILK 'A u� jjr,IulFrl�°)Fq�j 1141C.'I 7777, loo.000 PI�$1111P , I IL�� IjI 11 1( -- - — - - — ... A 92LFB14261 92yDr.W221) 07M 2/2020, 07;'1 2f2 (1121 1"" F r 1[ 1 . ......... ...... ........ ............... . . . . . AUDI LIAII51I 4414197F2475 12r2412020 JrMrA:)jjr"n',Ijjr�L Ijrj!I."j jjpj�'t jjp�!11�,:,Vjjj N 10111)k"� �)J(lJ�,,, j­EJ)x­ . . ...... ........... . rMq, III Gf� II ,l:, 11 111141 U 11,I)II J �,Ix jl,�JJI, �!,jIr;jj, $ l'000,im VII I.. IIAB AR 11 1 1 1,; �t:l N11!11!�� .......... . . ....... ANII E0,qFL01(rRSLAA8IIRjn( yru pqqj,jl nre , 1,Q11 'r 111 ']"1 III , 1� In Nj 7 U F A ad U�2, 11 11 A 1! 11,r 1 11 11 l��: R 111 11 q'jMvI I F F, IF" I I IC: IS� 4 mv .. . . . ......... 1::: 11 Y 11110110L 11 111111 1l ()frif,wr J-1gIjc-,y PII LocaIIIOIIysi 41750 Rancho Los PaImas LIw 61.e U ;2, Rancho MjrFx9e, CA 92:2 70 1-881 Bur�qnr.n-,n r;rxnter Dr, Son Bernardino, CA 92.408 347Ei Mwrio,4) FIrtrjOjjrog;., Fid, Ste ICD160, Myrjejj, ( A 92511 1545 Anarapa Rd Ste 7C, VI iGtnr-,,AIIII CA 9.2192 13% S 11`31,ak: CII Blvd Ste 200, Brea, CA 92821 444 rI Del Rick Siv..20 I "',SRv OieqoCA 92108 All Pilornap Air Rd, &3oo, r,,jrj,-,bad, CA 102011 74075 D Pa�eo Sqe AB & A16, ROOM rjCsPrt.. MA 92260 232 Harr -,I '.,ilc 1) (,-Iare"mnv,, ✓ CA 91711 270 E HVT( 2-V1 %in 11 Buelfton, GA 9342/ 4161) Tewnes,al Canyon Rd S1.e 369, Corona, C.,A t42PN3 . . . . . ................. . . . .......... . . ........ CERTIFICATE HOLDFR_ CANCELLAIOTN ---- ---- --- - 11-1 - 11 1-111-1 ..... .. .... - C'ky of El Ekj..jundo, at, urficcr,5, officims, ernp 2oyees. agents and volunteers. 35D Main St R Segundo� CA 90245 ACORD 25 (2016103) SHOULO ANY OF THE ABOVE DE -SCRIBED MLJC[ES BE CANCELLED BEFORE TWE EXPIRATION DATE THEREOr. N0710E WILL BE DELIVERED IN ACCORPANCE WITH THE POLICY PROVISIONS. AU'll UMIPRIIS TATrw*. C- Ty A s- reser'ved. 988-20 ACO" RDC RPORAT�, AAi I+ i The ACORD narne and logo are registered marks of A CORD w 92-YG-0422-0 028378 CM P-4786.1 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY CMP -4786.1 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Policy Number: 92 -YD -0422-0 Named Insured: NANCY K BOHL INC DBA THE COUNSELING TEAM INTERNATIONAL AND DBA THE ORGANIZATIONAL NETWORK PO BOX 10427 SN BERNRDNO CA 92423-0427 01171 s��. - �I ' 11 - 4 CITY OF EL SEGUNDO ITS OFFICERS OFFICIALS EMPLOYEES AGENTS & VOLUNTEERS 350 MAIN ST EL SEGUNDO CA 90245-3895 1. SECTION II — WHO IS AN INSURED of b. If coverage provided to the additional in - SECTION II — LIABILITY is amended to in- sured is required by a contract or agree- clude, as an additional insured, any person or ment, the insurance provided to the organization shown in the Schedule but only additional insured will not be broader than with respect to liability for ""bodily injury', "property damage", or "personal and advertis- that which you are required by the contract ing injury" caused, in whole or in part, by: or agreement to provide for such addition - al insured; and a. Ongoing Operations c. If the contract or agreement between you (1) Your acts or omissions; or and the additional 'insured is governed by (2) The acts or omissions of those acting California Civil Code Section 2782 or on your behalf; 2782.05, the insurance provided to the in the performance of your onoing opera- additional insured is the lesser of that which: tions forthat adnal ditioinsure9 or b. Products – Completed Operations (1) Is allowed for the satisfaction of a de- fense or indemnity obligation by Cali - "Your work" performed for that additional fornia Civil Code Section 2782 or insured and included in the "products- 2782.05 for your sole liability; oir completed operations hazard". (2) You are required by contract or However, Paragraph 1. above is subject to the agreement to provide for such addi- following: tional insured. a. The insurance afforded to the additional We have no duty to defend or indemnify the insured only applies to the extent permit- additional insured under this endorsement un - ted by law; til a claim or "suit" is tendered to us. ©, Copyright, State Farm Mutuar Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CONTINUED 92-YD0422-0 028378 CMP -4786.1 Page 2 of 2 2. Any iivsur,,,,Dnce to the a.,Idditional in- (3) The nature and localj�n of any injury sured shMl only apply with respect to a claim or damage arising 0LI1. of the "occur - made or a "suit' brought for damages for rence" or offense; which you are provided coverage, ® Tender the defense and indemnity of any 3. Wiffi respect to the insurance afforded tote claim or "suit" to us and to all other insur- additional insured, the followilng is added to ers who may have insurance potentially SECTION 11 — LIMITS OF INSURANCE: available to the additional' insured; and If coverage provided to the additional insured c. Agree to li,inke available any other insur- is required by contract or agreement, the niost ace the additional insured has for de - we will on behalf ofthe additional insured fence or darnages for which we would ray will bet"le lesser of ffie,'91TIOLUIt of inSLurWlCe' provide coverage under SECTION III a. Required by the contract or agreement; or LIABILITY, ® Available under the applicable Limits Of ® With respectto the insurarice afforde.�cl the w] - Insurance shown in the Declarations. ditional insured, the following replaces SEC- TION III —LIABILITY of VD air graph 7. Otlier I This endorsement shall not increase the ap- Insurance of SEcTiON I AND SECTION Ill plicable Limits Of Insurance shown in the COMMON POLICY CONDITIONS: Declarations. ® This insurance is primary to and will not ® With respect to the insurance afforded to the seek contribution from any other insurance additional insured, the following is added- to available to the -addifionainsured, provided Paragraph 3. Duties In The Event Of Occur- that the additional, ii%Llied i e a narne(,] iris.. rence, Offense, Claim Or Suit of SECTION sured under such other insurance, 11 — GENERAL CONDITIONS: b. Regardless of any agreerm-'.mit betweerl The additional insured must: YOU 81nd the <',1(Jdj1J0nc1I 411SLVE'd, this irISIAr- ance is excess over any other insurance ® See to it that we are notified as soon as whether prirnary, exce,,,s, contingent or on practicable of an "occurrence" or an of- any otl"ier basis for which the additional in- fense which may result in a claim. To the sure d has been added as an additional in - extent possible, notice should include: sured on other policies. (1) How, when and where the "occur- There will be no refund of premium in the event rence" oraffense took place; this endorsement is cancelled, (2) The names and addresses of any in- jured persons and witnesses; and All other policy provisions apply. CMP -4786,1 0, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc, with its permission, 92 -YD -0422-0 028379 CMP -47861 „> Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. CMP -4786.E ADDITIONAL IN — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM l•*@] 014 11111114 Policyr-r: 92 -YID -0422-1 Named Insured: � 1 Jul kil !• +� 1. SECTION II — WHO IS AN INSURED of b. If coverage provided to the additional in - SECTION II — LIABILITY is amended to in- sured is required by a contract or agree- clrude, as ars additional insured, any person or ment, the insurance provided to the organization shown in the Schedule, but only additional insured will not be broader than with respect to liability for "bodily injury" "property "personal that which you are required by the contract damage", or and advertis- ing injury" caused, in whole or in part, by: or agreement to provide for such addition - al insured; and a. Ongoing O rations c. If the contract or agreement between you (1) Your acts or omissions; or and the additional insured is governed by (2) The acts or omissions of those acting California Civil Code Section 2782 or on your behalf; 2782.05, the insurance provided to the additional insured is the lesser of that in the perforr'nance of your orfioing opera- which: tions for that additional insure , or (1) Is allowed for the satisfaction of a de- b. Products –Com Completed Operations b. P fense or indemnity obligation by Cali - "Your work" performed for that additional fornia Civil Code Section 2782 or insured and included in the "products- 2782.05 for your sole liability; or completed operations hazard". (2) You are required by contract or However, Paragraph 1. above is subject to the agreement to provide for such addi- following: tional insured. a. The insurance afforded to the additional We have no duty to defend or indemnify the insured only applies to the extent permit- additional insured under this endorsement an- ted by law; til a claim or "suit" is tendered to us. d, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CONTINUED 92-y[)04Z2­­0 08«7'9 Z Any insurance provided to the addition --d in- (3) The nature and 1=!ark)n of any Injury SUred only alI with respect to a claim or damage arising out of the "occur- rl"lade Of a "SLlit" broUght fOl' damages for rence" or offense; which you are 1,wovided coverage. lbTender. Uic defense and indernnity of any 3. which 'to 'the insurance afforded to the ClailTI 01* "SUit" to us and to all other insur- addftional InSUred, the followIng Is added to ers who may have insurance potentially SECTION 1:l ­ LIMIT ° INSUIRIANCI available to the additional insured, and If coverage provioJed to the additional inSUred is required by contract or agreement, the n,iosi. we wilV)ay on behalf of the addIflonal insured will be ie lesser of the arnount of insurance, a. Required by the contract or agreement; or ki. Avallal,)Ie under the applicable Urnits Of in tl­ie Declarations, endors6enner,lt sl-,mll not increase the ap- plicable Lin,lits 01' lrisurarice showt,i iril the Declarations, 4. With respect to the in afforded to tl'ie m'.1didonal InSUPEKI, the following is adde(l to 1= at 3. Duties In 1'he Everit Of Occur- rence, Offense, Claim Or Suit of SECTION 11 — GENERAL CONDITIONS: The additional insured must, a. See to it that we an,� notifieci as soon as practicable of an "occurrence" or an of- fense which 1I result in as claim. To the extent possible, notice should include: (1) Flow, when and where the "occur- rence" or offense took place; c. Agre(,,,) to make available any other insur. ance the addKional insured has for de- fense or damages for which we would provide coverage under SE,CTION Ill LIABILITY. & vViti"I respect to the insli-Ji"artce affor(Jed the ad- ditional inSUred, the` following leplaces SEC- TION 11 —IJA13HJTY of Flaragraph 7, other Insurance of SECTION I AN6Sr:C,T*1oN1 COMMON POLICY CONDITIONS: �)0rlrlaly t(,�l arld a® , Y,JJl rml: seek contrlbutiol'a ft0 �n ally o'll"icar insuranoe available, toaeon, ,,°�dclilfional insurlead, provide(l Riat the additional trisull"ed ki a nari-led in- sured under such other insurance, b. Regardless of any agreement between you and the additional insured, this insur- anCe is PXCeSS OWK any 01110' ill$Uranoe wl'tefl,wr primary, excess, col''Ifinglerlit ear oil, any other basis for whicl"a thow-Achtional in- sured has been added as an additional in- sured on other policies. There will be no refund of premium in the event this endorsement is cancelled. (2) The names and ac: dresws of any in- jured l,,)ersons and witnesses; and All other policy provisions apply, ChM P-4786.1 @, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc, with its permission, " 922`-, YD --0422-0 028380 CMP -4787 Page 1 of I 11,10 111 Col AD 104 9 U M CMP -4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US . ... . . .... This endorsement modifies insurance provided under the followin" BUSINESSOWNERS COVERAGE FORM 1 - Policy Number: 92 -YD -0422-0 Named Insured: mriT.- The following is added to Paragraph 10.b. of SECTION I AND SECTION 11 — COMMON POLICY CONDITIONS.' We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP -4787 0, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 92 -.YD -0422-0 028381 CMP -4787 Page I of I C1IP4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BWNERS COVERAGE FORM Policy Number.- 92 -YD -0422-0 Named Insured: VON CITY OF EL SEGUNDO ITS OFFICERS OFFICIALS The following is added to Paragraph IT 10.b. of SECTION I AND SECTION 11 — COMMON POLICY CONDIONS: We waive any right of recovery we may have aga�nst the person or organization shown in the Schedule because of payments we make for injury or damage arising out of.. a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule, All other policy provisions apply. CMP -4787 0, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission "' `N ° 92 -.LB -1426-1 028456 CMP -4786.1 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. CMP -4786.1 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 92 -LB -1426-1 Named Insured: NANCY K BOWL INC DBA THE COUNSELING TEAM INTERNATIONAL AND DBA THE ORGAN'I'ZATIONAL NETWORK PO BOX 1'0427 SN BER'NRDNO CA 92423-0427 Name And Address Of Additional Insured Person Or Organization: CITY OF EL SEGUNDO ITS OFFICERS OFFICIALS EMPLOYEES AGENTS & VOLUNTEERS 350 MAIN ST EL SEGUNDO CA 90245-3895 1. SECTION II — WHO IS AN INSURED of b. If coverage provided to the additional in - SECTION II — LIABILITY is amended to in- sured is required by a contract or agree- clude, as an additional insured, any person or ment, the insurance provided to the organization shown in the Schedule, but only additional insured will not be broader than with respect to liability for bodily injury", "property "personal that which you are required by the contract damage", or and advertis- ing injury caused, in whole or in part, by: or agreement to provide for such addition- al insured; and a. Ongoing Operations c. If the contract or agreement between you (1) Your acts or omissions; or and the additional insured is governed by (2) The acts or omissions of those acting California Civil Code Section 2782 or on your behalf; 2782.05, the insurance provided to the additional insured is the lesser of that in the performance of your onoing opera- tions for that insi which: additional „ or (1) Is allowed for the satisfaction of a de- b. Products – Completed Operations fense or indemnity obligation by Cali - "Your work" performed for that additional fornia Civil Code Section 2782 or Insured and included in the "products- 2782.05 for your sole liability; or completed operations hazard". (2) You are required by contract or However, Paragraph 1. above is subject to the agreement to provide for such addi- following: tional insured. a. The insurance afforded to the additional We have no duty to defend or indeninify the insured only applies to the extent permit- additional insured under ffils endorsement un - ted by law; til a claim or "suit" is tendered to us. ©, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission, CONTINUED 1 028,456 M 28448 CMP -4786 1 Page 2 of 2 2. Any insurance provided to the additional in- (3) The ricIure and of aiy injure sure d shall only apply with respect to a claim or damage arising out of tl°ie "occt.lr_ made or a "sult" biought for damages for rence" ori nse; which you are provided coverage. b. Tender the deferise and in(Jernnity of any 3. With respect to the insurance afforded to the claim or "suit"' to us and to all other incur - additional HISUred, the following is added to ers who may have insurance potentially SECTION It ­ LIMITS OF INSURANCEi available to the additional insured; and If coverage provided to thea itis al insured c. Agree to make available any other insur- is required by contract oragreement, the most ance the additional insured has for de - we will pay on behalf of the aadditionall insured fense or damages for is we would will be the lesser of the arnount of insurance, provide coverage under SECTION III a. Required by the contract oragreement; or LIABILITY. b. Available under the applicable Limits Of 5. With respect to the insurance afforded the ad - Insurance shown in the Declarations, ditional insured, the following replaces SEC- TION 11 —LIABILITY ofParagraph 7, Other This endoir,,,,eri,ient shall not increase the ap- InsuraECTION nce of SI ANd'SECTION 11 plicable Limits Of insurance shown in the COMMON POLICY CONDITIONS: Declarations, a. This is prtyIrid will not 4. With respect to the insurance afforded tote seek cantribution frorn ar)y other insurance additional Insured,- the following is added to available to the additionalinSUred, provided Paragraph 3. Duties In The Event Of Occur- tl­iat the additional, insured is a m)rried in­ rence, Offense, Claim Or Suit of SECTION sured under such other insurance, 11 — GENERAL CONDITIONS: b. Regardless of any agreement between The additional insured must: you and the additional insured, this insur- ® See to it that we are notified as soon as ance is excess, over any other insurance whetl"ier priniary, E)xcess, cor'itirigent Baa.on practicable of an "occurrence" or an of- Uy other basis for whicl"i additional in- fense which may result in a claim. To the sure d has been added as an additional in - extent possible, notice should include: sure d on other policies. (1) How, when and where the "occur- There will be no refund of premium in the event rence" or offense took place; this endorsement is cancelled, (2) The names and addresses of any in- jured pers ons and witnesses; and All other policy provisions apply. CMP -4786.1 - @, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc, with its permission. ail'; ^; Vhr 92 -LB -1426-1 028457 CMP -4786 1 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CMP -4786.1 ADDITIONAL INSURED OWNERS, LESSEES, OR CONTRACTORS ScII I i edule _ ... „ . This endorsement modifies insurance provided under the following; BUSINESSOWNERS COVERAGE FORM I-olicy Number: 92 -LB -1426.1 Named Insured: 1 MAIN ST EL !• CA 90245-3895 1. SECTION II — WHO IS AN INSURED of b. If coverage provided to the additional in - SECTION II — LIABILITY is amended to in- sured is required by a contract or agree - (,Jude, its an additional insured, any person or ment, the insurance provided to the organization shown in the Schedule, but only additional insured will not be broader than with respect to Viability for bodily injury', "property "personal that which you are required by the contract damage", or and advertis- ing injurycaused, in whole or in part, by: or agreement to provide for such addition- al insured; and a. Ongoing Operations c. If the contract or agreement between you (1) Your acts or omissions; or and the additional insured is governed by (2) The acts or omissions of those acting California Civil Code Section 2782 or on your behalf; 2782.05, the insurance provided to the additional insured is the lesser of that in the performance of your on oing opera- which: tions for that additional insured; or (1) Is allowed for the satisfaction of a de- b. Products – Completed Operations fense or indemnity obligation by Cali - "Your work" performed for that additional fornia Civil Code Section 2782 or insured and included in the "products- 2782.05 for your sole liability; or completed operations hazard". (2) You are required by contract or However, Paragraph 1. above is subject to the agreement to provide for such addi- following: tional insured. a. The insurance afforded to the additional We have no duty to defend or indemnify the insured only applies to the extent permit- additional insured under this endorsement un - ted by law; til a claim or "suit" is tendered to us. C, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission CONTINUED 7 92,dl 1111,�,'1 426-1 02645"'1" M 28448 CIVIP-47861 Page 2 of 2 2. Any insurance provided to the additional in- SUred shall only apply with respect to a claim made or a "suit" brOUght for damages for which you are providecl coverage. 3® With 1-61SP�10 to 010 il)SUrance, afforded 'to the additional il-ISUred, tl"W, UIOWil)g is added to SECTION III .-- LIMITS OF INSURANCE� If coverage provided to the additional insured is required by contract or agreement:, the most we will pay on behalf of the additional insured will be the lesser of the arl'1011,111t Of insurance: a. Required by the contract or agreement; or ® Available under the applicable Limits Of Insurance shown in the Declarations. This endorsement shall not increase the ap- plicable Limits Of Insurance shown in the Declarations, 4. With respect to the insurance afforded to the additional. insured, the- following is added to Paragraph 3. Duties In The Event Of Occur- rence, Offense, Claim Or Suit of SECTION 11 — GENERAL CONDITIONS: The additional insured must: a. See to it that we are notified as soon as practicable of an "occurrence" or an of- fense which may result in a claim. To the extent possible, notice should include: (3) The l:Ihire and loc,,,,ilk)n of any injury or darnage arising out of the "occur- rence" or offense; ® Tender the defense and indemnity of any claim or "suit" to us and to all other insur- ers who may have insurance potentially available to the additional insured-, and c. Agree to rnM<e available i,my other insur- ance the additional insured has for de- fense or dalaiages for which we would provide coverage under SECTION III LIABILITY, 5. Wifl-i respect to the insurarice afforded the ad- (Jitional insilred, the following rept aces SEC- TION 11—LIABILITY of Par�,qgapl'li -7 Other Insurance of SECTION I AND'StCT116N 11 COMMON POLICY CONDITIONS: a. This insurance is primary to and will not seek contribution from any other insurance available- to the additkmal iny—ired, provk.,Jed thal: the, additional insured is a m.,iined in_ cured under such other insurance, b. Regardless of any agniernent between You @f1d the additional insured, this insur- ance is excess over any other insurance vvl,iether prin',tary, excess' contingerit or on any otlirler basis, �or whichthe additional in- sured has been added as an additional in- sured on other policies. (1) How, when and where the "occur® There will be no refund of premium in the event rence" or offense took place; this endorsement is cancelled. (2) The names and addresses of any in- jured persons and witnesses; and All other policy provisions apply. CMP -4786,1 0, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc,, with its permission. 92-rLB-1426 1 028458 CMP 4787 Page I of 1 CMP4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the followin BUSINESSOWNERS COVERAGE FORM I Policy Number: 92 -LB -1426-1 VaT-t(-_VMT,sured: • The following is added to Paragraph 10.b. of SECTION I AND SECTION 11 — COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP -4787 0, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 92m11-113-1426-1 028459 CMP -4787 Page I of I 111101[630011111019 Mw CMP -4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST 1THERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Policy Number: 92 -LB -1426 -- Named Insured: M V MIM FT. N r=*3 a M11 I The fallowing is added to Paragraph 10.b. of SECTION I AND SECTION 11 — COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of:Payrnents we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products - completed operations hazard"_ This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP -4787 0, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. C H PHILADELPHIA HINSURANCE CGDMPANfE.S w s a mCIATea Dodi Ilei Certificate of Liability Insurance Date Issued: 07/22/2020 Underwritten by: Philadelphia Indemnity Insurance Company • One Bala Plaza, Suite 100 • Bala Cynwyd, PA 19004 - NAIC #: 18056 Administered by: CPH & Associates 711 S Dearborn St Ste 205 Chicago, IL 60605 P 800 875 1911 F 312 987 0902 info@cphins com DISCLAIMER This certificate is issued as a matter of information only and confers no rights upon the certificate holder The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend, or alter the coverage afforded by the policies listed thereon Insured: Nancy K. BOW Inc. dba The Counseling Policy Number: 025826 Team International Nancy Bohl Policy Term: 08/31/2019 to 08/31/2021 1881 Business Center Drive #11 San Bernardino, CA 92408 Covered Locations Professional Liability: Portable coverage, not location specific Coverage Type Per Incident Aggregate (Occurrence Form) (Per individual claim) (Total amount per year) Professional Liability $ 1,000,000 $ 5,000,000 Supplemental Liability $ 1,000,000 $ 5,000,000 Licensing Board Defense $ 35,000 $ 35,000 Commercial General NIA N/A Liability N/A N/A Fire/Water Legal Liability Business Personal Property N/A N/A Vicarious Sexual Misconduct $ 1,000,000 $ 1,000,000 Cyber Liability (Claims Made Form) $ 25,000 $ 25,000 Retroactive Date: 08/31/2018 Comments/Special Descriptions: Certificate Holder EI Segundo Police Department 348 Main Street EI Segundo, CA 90245 ® Certificate Holder has been added as an additional insured If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) Notice of Cancellation will only be provided to the first named insured in accordance with policy provisions, who shall act on behalf of all additional insureds with respect to giving notice of cancellation Authorized Representative C. Philip Hodson THIS ENDORSEMENT CHANGED THE POI -ICY, PLEASE READ IT CAREFULLY, Additional Insured Endorsement This endorsement modifies insurance provided under the following: w021 1 0.; I *..0 0 §24fla UJ4:jjTjl:XkjjjFAj 010r w' In consideration of the premium paid, this policy is amended as follows: ISI Secundo Police Department is hereby added as an Additional Insured, solely for Damages arising out of a Professional Incident covered under this policy. The Professional Incident must arise out of services provided by the Insured, under contract with EI Segundo Police Department. Additional Insured Name and Mailing Address: EI Segundo Police Department 348 Main Street EI Segundo, CA, 90245 All other terms and conditions of this policy remain unchanged. Policy #: 025826 Endorsement #: PI-PHCP-05 (3 -01) Effective on or after: 08/31/2020 Issued to: Nancy K. Bohl Inc. dba The Counseling Team International Expiration date: 08/31/2021 POLICYHOLDER COPY P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-12-2020 EL SEGUNDO POLICE DEPARTMENT SP 348 MAIN ST EL SEGUNDO CA 90245-3813 GROUP: POLICY NUMBER: 0702761-2020 CERTIFICATE ID: 94 CERTIFICATE EXPIRES: 08-12-2021 08-12-2020/08-12-2021 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. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2019-08-12 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: EL SEGUNDO POLICE DEPARTMENT ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-12-2011 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2020-08-12 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: EL SEGUNDO POLICE DEPARTMENT ENDORSEMENT #1651 - NANCY K BOHL, P,S,T - EXCLUDED. EMPLOYER NANCY K BOHL INC SP 1881 BUS CTR DR STE 11 SAN BERNADINO CA 92408 M0410 (REV.7-2014) PRINTED : 07-16-2020 SP ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION 702761-20 RENEWAL SP HOME OFFICE 2-47-86-99 SAN FRANCISCO PAGE 11 OF 20 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC EFFECTIVE AUGUST 12, 2020 AT 12.01 A.M. STANDARD TIME OR THE TIME INDICATED AT ANDEXPIRING AUGUST 12, 2021 AT 12.01 A.M. PACIFIC STANDARD TIME wAlw4jowa1i =1 =1 �:y A z 0 .114 Ili z FA li I z Vojpmoy�wr4l If ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, 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 RMPLOYEES-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: JULY 21, 2020 2570 AUTHORIZED REPRESENTMV IVE PRESIDENT AND CEO _qmr FnRM 10917 iRFV-4-2019) OLD DP 217