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PROOF OF INSURANCE (2021 - 2022) CLOSED,AC<3IlRL> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 02122/2021 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 pollcy(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' ---- !, PHONE I ii.I),.949-...__ -7261.......,_ �..(A', .. _— Michael Geffre Insurance Agency 1,VN-,' 949-494-7261 m.M�� 949-494-4481 X 32392 Coast Hwy Ste 260 AD�rRTs. E-MAIL m RAGE NAIC # m g 4.... La una Beach, CA 92651 _ rNsraER s AFFORDING COVERAGE m^^ INSURED ............. _— !NsuRERA ..SCOTTSDALE 41709 .. 1297 uRED�� INSURERB: TRUCK INSURANCE EXCHANGE URBAN FUTURES, INC. INSURE.c: MID-CENTURY INSURANCE COMPANY 21687 .........— s ....MPANY ISOM ADVISORS INSURER D ; 35378 ANSTON INSURANCE COMPANY N FEDERAL INSURANCE COMPANY 20281 SURER E 17821 E. 17TH ST. STE 245-2 INSURER ........................... — � . ..... ..........� .._. TUSTIN, CA 92780 INSURERF. LLOYDS OF LONDON a^ CMVICWrAYC kl RAMCD. RFVISIAN NUMRFR: 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. _,.. . .._oLICY EiF. . Po%IcYE AOOLSUBR ... ._ .. POUCY NUMBERmmm OF INSU RANCE ... �- MJDDPY"M"YY' MMdDD�"YYY LIMITS ILTR OF INSURANCE COMMERCIALPE AL LIABILITY CE EACH OCCURRENCE 1,000,000 .. ..� - A CLAIMS -MADE OCCUR y 'I( CPS7282108 12/271202012/27/2021 Aol sC I' N PREMIs ( E'a r,�o��e 100,000 MED EXP Any one parson) 5,000 n W._ PERSONA L ADV INJURY $� 1,000,000 ..,.--__ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGAT„ G E $ 2,000,0010 PRO» POLICY NECT I LOC C COlwt PAGG �,...... $ Not Covered -, ... _......_. _ C AUTOMOBILE LIABILITY SBNOLE L COMBINED ,r� E, de,t, LIMIT /..m .. �....... . . $ 1,000,000 � ANY AUTO BODILY INJURY Per person) ( p ) $ .... - __ OWNED SCHEDULED A 605900024 03/11/202103/11/2022 accident) era BODILYINJURYPer $ AUTOS ONLY AUTOS HIRED NON -OWNED pROPEFITb ( 1�er ���.F•@ $ -. AUTOS ONLY AUTOS ONLY .... ......,—...._ .... $ - - OCCUR UMBRELLA LIAR w EACH OCCIJRREPICE',„ .._ ....w,,,,,,.... s2,000,000 . D EXCESS ' ' CLAIMS -MADE ^ EBU016390618 1212712020'12/27/2021 AGGREGATE .„$ _ 2,000,0 0 ... ......... DED __._ RETENTIO N$ $ WORKERS COMPENSATION PER OIH B AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE N/A 'Y ' N0915 67 09 03/11/2021 03/11/2022. ER E.L.0 - _ ^^^ . 1 000 000 ' _1111$1,000,000 OFFICER/MEMBEREXCLUDED? E L DSEASEEAE;IG1'PLOYEE 1 0 1, $ OOO',OOO (Mandeutory in NH — 4 yes. descdbe under DESCRIPTION OF OPERATIONS helow E.L. DISEASE - POLICY LIMIT $ 1,000,000 A SEXUAL/PHYSICAL ABUSE CPS7282108 12/27/202012/27/2021 LIMIT $25K1$50K E PROFESSIONAL LIABILITY 8255-6017 12123/02012/23/2021 AGGREGATE $2,000,000 F CYBER LIABILITY CY2000080 121231202012/23/2021 LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be 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. CERTIFICATE HOLDER UAI Ut:LLA I IUN CITY OF EL SEGUNDO 350 MAIN STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245-3895 ACCORDANCE WITH THE POLICY PROVISIONS. AUT)f0 §I q EPRES TIV ,I ©1'988- 015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SCJ'T'I`SINAo Of S I I TH;S SlrN1E11T Girgli=5 THE P(QLIi✓'( PLEA 1='A`D �T Clwi=tlll,Y, BLANJRED, This,�n�9amerrt;mneN(�,Ir�sta� �rz3+�ld��ttca�r tl�eyf�lir�uu�frtg; GI�FI�AL Li�u�.11jr�ri t ' / ail a. respect to tl indorsement $E+ TiOH II WMO OLR 11 vfr 1#10u Itef � or AN;. IN JRID,t),, amarat�d Ito' Ijicflw@ a an °additieh"'al' in- merit furr t hed,;Prt cost( ct�i n Witi7 such �Kcbri , sur�tl, any pp�o?�9f ,o„rgat��za�ibtr uuhom ,,ynu, anr�e ;rsgtitred to or #�� �p �r than ,rvi�, t�1t�t� a�tld as cin addltt hoj In'su�ed'�n ttass poiscy' under wr4;iten r nce car re it `tt�r t t3 p�r#i�rrneri ' or cari contract wr9ten �ra�ati"Q�f errritt'wii rnt be,sf' a Cti�tr ntfy Ill, L�'0�"bsp rr�ing of ,ectiva, !r> '►i`9 Lion af,the ao erec! ®pemt'onsf-,has„taeen b Executed titer r �r b, Tip p -,t 'of "yo rwat> ` "afahl" ins da'rnagi'" or "Earl ai`glti+ IjIIN ox darn ai 4 C>u } to �f"_ PY ihe I fh U r nt;e ' fcnitdeCl to°thy add +vnal, Insureds is "I�m- other fihan arratth�:r cantrae r or sub�'�t ra y r d a �Taliavas ' � �o " f. That person +�r org�nizai�ri an�additioal tr�sr Pn " pal'�ea a'f t erne „rl . only �rltil rJ'Sj t tL� ltabillxy ufor `pot9iljl "IttJu�ri" 3:, Tht 11tf11 1 pf is 'k n'ce a�S}7i1 die �ditlt3rla! °Property ,c 'mege„ tar °persarmi pant adverb it insured are speclfle ►n tieMi nt ; ,' 1,� r ire patsy by vrtn3terr agreemenf �r,�t n rrnfiao' in ,, Z rarlsrtii',Syii. Te$trrt- �ts,,aff insuran a yii a trP andl not in a,00 tion b. The%acrcc�r +is7ar rlt�se,z�c�frtg��n ur �?,' 1�1 Intf�,e i?�o, I, ?a`. betf�ff:, Nana'°t�rtt�`�s'p�ili4Jf, A, pe"rson's or Qrgarurttan`s,, stetus, a a fecidi- 4 pro�r for ", uerage it �1 � 'did � 4� 1 tian�l Inswed vmc%rth�alendar �rr rrf er�rwton y„ur o'rt�cris farthcttfl iraI ark in}u,s�g c�+a cif Ie rrgeme of f 2 With re�t'to itte insurance affor 'W" to tt�ese , :" Th8 ra uraanyc� pr f�nddc! ;iq �tl l r J if?„ y ''�, cal cnui 9 t? , adtlrtlanl t r . s, tti®f 1 , ,r� ssc�lus�orea; are apple#ar/6polyFirr";gprartydarn, dace nat� /J added to, rtem 41, uXionsr COVErinderir ee Tt%is I b#r fu 1 re`r arty, ;i9r?f sikas " y 4 ndc�yi� �i�� � bAd1►Y �nl�u=Y� Ittelui#�;g. "pnverty 'da nat,�s° w `P ry( rani ` g �rr�ue�s%cC7 syrlghtt f mHtefial,O'JlwPrc ert &, Ir1C Writh tis?,p�tAti �s1Cr�': GLr�'ISt3s (7 ;tie) F?g'1tif 2„ a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, re- ports, surreys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engi- neering activities. 6. Any coverage provided hereunder will 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 written contract speoihcally rewires that this insur- ance be primary. When this insurance is excess, we will have no du- ty under SECTION 11--COVERAGES to defend the additional insured against any 9suir If any other in- surer has a duty to defend the additional insured against that °sulk.' If no other insurer defends, we will undertake to do so, but we Ml be entitlled to the additional Insured's rights against all those other insurers. Includes copyrighted materlsl of 180 Properties, inc., YAM Ns permissim. Copydgtd, 180 Properties, Inc., 2004 COLS-9503 (7-09) Peas, 2 of 2 COMMERCIAL GENERAL UAEIUTY CO 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE MEAD IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory 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 Inured under such other insurance; and (2) You have agreed in writing in a cordract or agreement that this insurance would be primary and would not seek oontribution from any other insurance available to the additional insured. CO 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 LIMILITY CG 24 04 04 09 COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Nam Of Person Or Organization., ANY PERSONOR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MARE IN WRITING AND PRIOR TO THE LOSS. th The following is added to Paragra h 8. Transfer Of Rights Of Recovery Ins 9e s To Us of Section 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 snake for intury 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. mom CG 24 04 05 09 0 Insurance Services Office, Inc, 2008 Page 1 of 1 0 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: 03/11 /2021 Named Insured: URBAN FUTURES, INC.. Countersigned By: SCHEDULE (Authorized Representative Name of Person(s) or Organization(s): CITY OF EL SEGUNDO ITS OFFICERS OFFICIALS EMPLOYEES AND VOLUNTEERS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) t 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 Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. G� FARMER INSURANCE CHANGES IN TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM E3153 1st Edition With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: 03/11 /2021 Named Insured: URBAN FUTURES, INC. (Authorized Representative) SCHEDULE Nance Of Person(s) Or or anization(s): IMTY OF PLY SSAAND VO UN�TCE3EF ISCERS OFFICIALS Additional Premium n $ (If no entryappears above, information required to complete this endorsementwill be shown in the Declarations as applicable to this endorsement.) The Transfer Of Rights Of RecoveryAgainst Others To Us Condition does not applyto the person(s) or organization(s) shown in the Schedule. We will retain the additional premium shown above, regardless of any early termination of this endorsement or the policy. 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. E3153-ED1 6-06 Page 1 of 1 91-3153 E3153101 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 31 (Ed. 6-20) BLANKET WAIVER OF OUR RIGHTTO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our paymentsfrom 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 undera written contractthat requiresyou to obtain this agreementfrom us.) The additional premium for thisendorsementshallbe 3.0°,6o'ftheCaliforniaworkerscompensationpremiumotherwisedue on such remuneration, subject to a minimum charge of 250 All written contracts in thestate(s) of: CA This endorsement changes the policy towhich 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 03/11 /21 Insured 17821 17TH STSTE 245 TUSTIN CA927802173 Policy No. N0915-67-09 Endorsement No. Insurance Company TRUCK INSURANCE EXCHANGE Countersigned By WC 99 0631 (Ed. 6-20) Includes copyright material of the Workers Compensation Insurance Rating Bureau of California. All rights reserved.