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PROOF OF INSURANCE (2022 - 2022) CLOSEDA V CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) ,..- 03/31/2021 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 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 License0751768 N. T BOB HADZOR NAM'r.: 'Robert Hadzor Insurance Services PHONE (925) 372-9000 FAX tig). (925) 372-9003 3755 Alhambra Ave. Suite 7 E-MAIL .bob@hadzorinsurance.com INSURERISI AFFORDING COVERAGE NAIC Martinez, CA 94553- INSURERA:NO. Tofits Insurance All INSURED The El Segundo Nursery School Group INSURERB: P.O. Box 73 INSURER C Markel Insurance Com pan 300 E . Pine Avenue. INSURER D : E1 Se Undo CA 90245- INSURERF: COVFRAr.FS 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 LTR TYPE OF INSURANCEAVOLSUSR POLICY NUMBER POLICY EFF MMIDD/YYYY -1POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY 021-20766-NPO 4/01/2021 4/01/2022 EACH OCCURRENCE $ 1, 000, 000 DAMAGE - ISE.SlEa�ccarrencel ... - - $ 100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR / / / / _E, MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS - COMP/OP AGG $ 3,000,000 PRC). X P4,�LtC'1P' LOC / / / / LIQUOR $ 1,000,000 A AUTOMOBILE LIABILITY 021-20766-NPO �4 /01/2021 4/01/2022 COMBINED SINGLE EaeccdenI) (, re 1 000,000 ANY AUTO / / / / BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS / / / / BODILY INJURY (Per accident) $,- X PROPERTY DAMAGE ........-.- $ X NON -OWNED / / J J HIRED AUTOS AUTOS 0�trr r� ,fd 'A $ UMBRELLA LIAB OCCUR / / EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS MADE / / / / _ DED RETENTION $ / / / / _ ^$- C WORKERS COMPENSATION C0023768-10 2/01/2021 2/01/2022 X WC STATU- OTH- -1 AND EMPLOYERS' LIABILITY Y / N / / / / E ANY PROMEMBER/EXCLUDRIEXECUTIVE � N / A E L, EACH ACCIDENT E L $ _ , oao ,000 -, OFFICER/MEMBER EXCLUDED? / / (Mandatory n NH) . , DISEASE - EA EMPLOYE $ 1'000, 000. If yes, describe under / / / DESCRIPTION OF OPERATIONS below v4/01/2022 E L. DISEASE - POLICY LIMIT $ 1 000 000. A PERSONAL PROPERTY 021-20766-Prop 4/01/2021 SPECIAL FORM RC 5,000'' A D&O INSURANCE 021-20766-NPO-D&O 4/01/2021 4/01/2022 SPECIAL FORM RC 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of El Segundo its Officers, Officials, Directors, Employees and Voluteers to be named as additional insured and Also attached is the Waiver of Subrogation for Work Comp policy through Markel Insurance company. Re: Landlord of The E1 Segundo Nursery School Group City of E1 Segundo its Official and Employees c/o City Clerk 350 Main Street RM 5 El Segundo CA 90245-3813 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 ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005),01 The ACORD name and logo are registered marks of ACORD NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Hodfor 14507m Ameartfal r ftnptofft. POLICY NUMBER: 2021.20766.NPO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE A. Section 11 — WHO IS AN INSURED is amended to include: r on W1 espe I *personal and advertising Injury" caused, in whole or In part by. a. Your negligent acts or omissions, or b. The negligent acts or omissions of those acting on your behO. in the performance of your ongoing operations. No such public entity or individual is an additional insured for !lability arising out of the sole negligence by that public entity or its designated individuals. The additional Insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III — LIMITS OF INSURANCE is amended to include: C. With respect to the insurance provided to the additional insured(s). ConditJon 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDMONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is Primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary, If other insurance is also primary, we will share with all that other insurance as described in c. below-, or NIAC-E61 0219 Page 1 of 2 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A,He,ad' for 1nsutv,Pce.A =eartf sonwomr. POLICY NUMBER: 2021-20766-NPO (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over. 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That Is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for 'your woW; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner, (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with pennission of the owner, or (d) If the loss arises: out of the maintenance or use, of aircraft, "autos" or watercraft to the extent not subject to Exclusion 9. of SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE. (a) Any other insurance available to an additional insured(s) under this Endorsement coveting liability for damages which are subject to this, endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suir. If no other insurer defends, we will undertake to do so, but we will be entitled to the additional Insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of th,p loss, if any, that exceeds the sum of (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self4nsured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing WAR% 411111agmil I- I - #I I- I I -- -' 6 . # I 10 . . 1 0 - 0 1 * Wi 11-1 01 ItimaiiWAIN I UZI V-7 NIAC-E61 02 19 1 Page 2 of 2 POLICY NUMBER: 2021-20766-Prop COMMERCIAL GENERAL LIABILITY CG 2012 07 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Political Subdivision: Any State or Political Subdivision that issues a permit to the named insured. (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section 11 — Who Is An Insured is amended to 2. This insurance does not apply to: include as an insured any state or political subdivi- a. "Bodily injury," "property damage" or "personal sion shown in the Schedule, subject to, the following and advertising injury" arising out of opera- provisions.- tions performed for the state or municipality; 1. This insurance applies only with respect to opera. or tions performed by you or on your behalf for b. ""Bodily injury" or "property damage" included which the state or political subdivision has issued within the "products -completed operations a permit. hazard". CG 20 12 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 13 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) 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. Work performed by EL SEGUNDO CO-OP NURSERY SCHOOL(NONPROFIT) at: PO Box 73 El Segundo, CA 90245-0073 Schedule Subrogant Information Class Code Description City of El Segundo its officials & Employees c/o City Clerk 8868 Colleges/Schools–private–professionals 350 Main Street Room 5 El Segundo, CA 90245 This endorsement changes the policy to which 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 02/01/2021 Policy No. MWC0023768-10 Endorsement No. Insured: EL SEGUNDO CO-OP Premium (See Attached) NURSERY SCHOOL(NONPROFIT) Insurance Company: Markel Insurance Company Countersigned by WC040306 (Ed. 04-84) O 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation insurance Fortes Manual 0 2001 18 of 34 Payroll $0.00