PROOF OF INSURANCE (2021 - 2021) CLOSEDCERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
01/14/2021
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
Michael Geffre Insurance Agency
32392 Coast Hwy Ste 260
Laguna Beach, CA 92661
INSURED
URBAN FUTURES, INC.
dba ISOM ADVISORS
17821 E. 17TH ST. STE 245-265
TUSTIN, CA 92780
COVERAGES
CERTIFICATE NUMBER:
949-494-7261
SCOTTSDALE
INSURER B :
TRUCK IN.11
INSURERc
MID-CENTURY INSURANCE COMPANY
INSURERD:
EVANSTON INSURANCE COMPANY^
INSURER E:
FEDERAL INS URANCE COMPANY
INSURER F :
LLOYDS OF L ONDON
REVISION NUMBER:
949-494-4481
41297
21709
........ .........
21687
35378
20281
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.... ..... �x(Sa �IIM.a; . ................... ......... ..............._ POLICY EFF POLICY EXP
LTR. Wvn POLICY NUMBER iM_wOP MMIDDlYYYY LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
A
. .....
X
CPS7282108
12/27/202012/27/2021,,
100,000
CLAIMS -MADE OCCUR
- .�,
y
y
PRFMIses E courrenne
a q.
$
--..
._ w.......�
MED EXP (Any one person)
$ 6,000
PERSONAL& ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'LAGGREGATE
LIMIT APPLIES PER:
X �..
...........
I _....._1
PRO-
POLICY L------ 1 JEC'T I LOC
._.._....... _... _..............�....... ...,............__............_.._—_______.
...PRODUCTS .-..C.G.M.P(G.P..AGG.......$.....Not...
Covered ..............
OTHER:
$
C AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$ 1,000,000
ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
)(
AUTOS ONLY AUTOS
Y
605900024
03/11/2020
03/11/2021
B... .. .... accident)
ODILY INJURY (Per accident)
$
x
HIRED NON -OWNED
P�C1PERi-"p'V7AM1AGEf
$
AUTOS ONLY '.,,,. AUTOS ONLY
(,Pq�',3�pit�,gr11,),
I
$
X UMBRELLA LIAB OCCUR
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
s 2,000,000
D
EXCESS LIAB CLAIMS -MADE
1_d
EBU016390618
12/27/202012/27/2021
$
DED C RETENTION $
WORKERS COMPENSATION
X PER O'TH-
UT ER�
B
YIN ILITY
AN PROPRIETOR/PARTBNERIEXECUTIVE
'y
N0915 67 09
03/11/202003/11/2021,
E.L.EACH ACCIDENT
.........._..
$ 1,000,000OFFICE
WMEMBE
IManda ory in NHy EX�C:LUOE07'
N / A
E.L. DISEASE EA EMPLOYEE
$ 1.,000,00.. ...., 0
ul , deswilhe under
DESCRIPTION OF OPERATIONS haknm
E.L. DISEASE POLICY LIMIT
,000,,000
$� 1X
A
SEXUAL/PHYSICAL ABUSE
CPS7282108
12/27/202012127/202,
LIMIT
$25K/$50K
E
PROFESSIONAL LIABILITY
8255-6017
12/23/202012/23/202,
112/23/2020
AGGREGATE
$2,000,000
F
CYBER LIABILITY
CY2000080
12/23/2021
LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
THE CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED AS
RESPECTS GENERAL AND AUTO LIABILITY AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. GENERAL LIABILITY
INSURANCE IS PRIMARY/NON-CONTRIBUTORY PER POLICY FORM WORDING. INSURANCE INCLUDES WAIVER OF SUBROGATION
PER THE ATTACHED ENDORSEMENT(S). 30 DAY NOTICE OF CANCELLATION.
CITY OF EL SEGUNDO
350 MAIN STREET
EL SEGUNDO, CA 90245-3895
GANI:tLL.A I IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
171988-20115 ACORD CORPORATION_ All rights reserved
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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COVERAGES:
ajr� atrc(f�+y{�#`�1 +t�tFQ{�iy� �srl ► ��� fy'a�� re}��
yet
f yyry�
T'iIi, 11 #1rY li I,M�1i�nk#T?E fff •r J. ^ ,
,
"property. da '" ,,or " l ,er�d
a. The preparing, approving or failing to prepare
or approve maps, shop drawings, opinions, re-
ports, surveys, fleld orders, change orders ot
drawings and specifications; and
b. Supervisory, inspection, architectural or engi-
neering activities,
S. Any coverage provided hereunder Wit be excess
over any other valid and collectible insurance avail-
able to the additional insured whether primary, ex-
cess, contingent or on any other basis unless a
BRIM
Oil-B N
. . . . . . . . . . .
additional insured's rights against all those other
Insurers.
Includas coIl matelal of ISO PiWmes, Inc., mth b pem� $Mcn-
CoMqK 160 Propertles, Inc., 2004
OLSM509 (7-08) Pwo 2 of 2
14 Al
I
'.us F'K
This endorsement modifies insurance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is aWed to the Other Insurance
Condition and supersedes any provision to the
contrary'.
Primary And Noncontribuft" Insurance
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 01 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER: CPS7282108
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY
Co 24 04 05 09
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or lean:
ANY PERSON OR OR2MATION WITH WHOM THE 11481MED HAS AGREED TO WAIVE RIGMS OF
RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS.
The following Is added to Paragraph S. Transftr Of
Rights Of Recovery Against Others To Us of
Secdon IV — Conditions:
We waive any right of recovery we may have against
the person or organization shown 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 In the
Schedule above.
CO 24 04 05 09 a insurance Services Office, Ina., 2008 Page 1 of I a
POLICY NUMBER: 605900024
COMMERCIAL AUTO
CA 20 48 02 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement Identifies person(s) or organization(s) who are "Insureds" under the Who Is An Insured Provi-
sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form,
This endorsement changes the policy effective on the Inception date of the policy unless another date Is Indi-
cated below.
Endorsement Effective:
01114J2021
Named Insured:
URBAN FUTURES, INC.
Countersigned By:
SCHEDULE
Name of Person(s) or Organization(:): CITY OF EL SEGUNDO ITS OFFICERS OFFICIALS
(if no entry appears above, Information required to complete this endorsement will be shown in the Declarations
as applicable to the endorsement,)
Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent
that person or organization qualifies as an *insured" under the Who Is An Insured Provision contained
in Sectlon 11 of the Coverage Form.
CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 a
41A� .t
FARMERS
INSURANCE
WORKERS' COMPENSATION AND EMPLOYERS'
LIABILITY INSURANCE POLICY
Named URBAN FUTURES, INC.
Insured
WC 99 06 19
17821 E 17THST#245
TUSTIN CA 92780
Agent
Effective 03/11/20 97-55- N091 "7-09 2020
Date
Policy Number Policy
of the Company Year
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET
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 for which you perform work under a written contract that
requires you to obtain this agreement from us.
The additional premium for this endorsement shall be 3.0 %of the Workers' Compensation premium otherwise
due for the state(s) listed below on such remuneration, subject to a minimum charge of
All written contracts in the state(s) of CA.
This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise
subject to all the terms of the policy.
Countersigned.,
13$P
WC 99 06 19 9-07 Page I of 1
93.6369 J6369101