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PROOF OF INSURANCE (2021 - 2021) CLOSEDA�®T,- GATE (MMIDD/YYYY) R� CERTIFICATE OF LIABILITY INSURANCE 12/23/2020 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 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), CONTACT PRODUCER NAMC`e Aubrie Kemp Shank &Associates P�oNE (702) 878-2820 rAX 'Not (102)970 1263 A7C. ....... 10091 Park Run Drive E-MAIM$ aubrie@swartsmanning.com Spite 200 INSURER(S) AFFORDING COVERAGE NAIC # Las Vegas NV 89145 INSURER Arch Insurance Compan _._.�._.......... wawa_. ......... y INSURED INSURER B: State Compensation Insurance Fund RAS Consulting& Investigations, LLC g INSURER C: Philadelphia Indemnity Ins Co RAS Inc. DBA RAS Watch INSURERD:LLOYDS OF LONDON 550 Continental Blvd #150 INSURERE:United Financial Cas Co. EL Segundo CA 90245 INSURER F t rnurpAr:GC rFRTIFIrOTF N11MIRFR-20-21 MAster 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. ADDL SIIBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDNYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � ] CLAIMS -MADE Fx-],, OCCUR rA DAMAGFTo RENTED PREMISES Ea 0rru'rrenc $ 100,000 X BIPKG0179301 9/21/2020 9/21/2021 MED EXP (Any one personj $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 5,000,000 7{ PP10- POLICY IECT ❑ LOC PRO®UCTS - COMP/OP AGG $ 5,000,000 $ OyrHERi E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aandid41nl $ 1,000,000 R BODILY INJURY (Per person) $ _...... ANYAUTO 03037958-0 12/22/2020 6/22/2021 BODILY INJURY (Per accident} $ ALL OWNED SCHEDULED '.. AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ % '.. HIRED AUTOS AUTOS "Per arcidenl. $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,00 0000 A EXCESS LIAB CLAIMS -MADE AGGREGATE JI 2,000 000 DED RETENTION S BIFXSO059301 4/21/2020 4/21/2021 $ WORKERS COMPENSATION X PER OTH- STATUTE AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORWARTNERIEXECUTIVE �d EL.. EACH ACCIDENT $ 1,000,000 B OFFICERIMEMBER EXCLUDED? FYI (Mandatory in NH) NIA 920923720 4/21/2020 4/21/2021 E,L.. DISEASE EA EMPLOYEE $ 1,000,000 E,L, DISEASE- POLICY LIMIT S 1,000,000 If yes, do5rnbe under DESCRIPBIORN OF OPERATIONS below C Errors & Omissions PHPK2200029 10/31/2020 10/31/2021 LIMIT OF LIA011...11Y $2,000,000 D CYBER LIABILITY ESH011151778 4/21/2020 4/21/2021 L.IMIIOFLABIL.ITY $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations. Certificate Holder is named as Additional Insured with regards to the General Liability coverage where required by contract per form GL033400 04/08, subject to policy terms and conditions. Coverage is Primary/Non-Contributory. I i��_ A \ CERTIFICATE HOLDER CANCELLATION City of E1 Segundo 350 Main Street E1 Segundo, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE im Shank/SH 4 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) POLICY NUMBER: BIPKGO179301 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSONS OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s Locations Of Covered Operations CITY OF EL SEGUNDO LOCATIONS REQUIRED BY WRITTEN CONTRACT 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, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 broader 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. 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 behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: BIPKGO179301 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES O CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations CITY OF EL SEGUNDO LOCATIONS REQUIRED BY WRITTEN CONTRACT ALL CLASSIFICATIONS LISTED IN THE DECLARATIONS. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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 broader 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 behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES POLICY CHANGE NUMBER 1 POLICY NUMBER POLICY CHANGES EFFECTIVE COMPANY BIPKGO179301 11/19/2020 ARCH INSURANCE COMPANY NAMED INSURED AUTHORIZED REPRESENTATIVE RAS CONSULTING & INVESTIGATIONS, LLC W. H. BROWNYARD CORPORATION COVERAGE PARTS AFFECTED COMMERCIAL GENERAL LIABILITY COVERAGE PART CHANGES IT IS HEREBY UNDERSTOOD AND AGREED THAT THE FOLLOWING FORMS ARE MADE PART OF THE POLICY AS PER THE ATTACHED: CG20100413 ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS- SCHEDULED PERSON OR ORGANIZATION CG20370413 ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS NO PREMIUM CHANGE 11 /19/2020 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION 9209237-20 RENEWAL SP 8-76-25-53 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE JANUARY 8, 2021 AT 12.01 A.M. AND EXPIRING APRIL 21, 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 RAS CONSULTING & INVESTIGATIONS LL 550 CONTINENTAL BLVD STE 150 EL SEGUNDO, CA 90245 Jam' 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, RAS CONSULTING & INVESTIGATIONS LL 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: AI.Ni'f�'C�RI,T.EO REPRESFf�T IhJE SCIF FORM 10217 (REV.4-2018) JANUARY 12, 2021 PRESIDENT AND CEO, 2570