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PROOF OF INSURANCE (2022) CLOSED.•*• OP ID: MN CERTIFICATE OF LIABILITY INSURANCE DA07114/2021TE Y) 07/14/2021 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 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 CONTACTNAME. Michelle A Nowell Alliance Mgt. & Insurance SerV PHONE � TFAX 355 Via Vera Cruz #7 (�CAIL Mp. Er1) 760-471-7116 l(AIC No)9-471 9378 A entlBroker Lic# 0737966 E M CA San arcos, CA 92078 ADDRESS mnowell@amiscorp.com ____ -----.-_ Pffiy Michelle A. Nowell a° In g. TRAUB-2 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. ANRR � DDLSUER , POLIOY EFF POLICY LTR TYPE OF INSURANCE POLICY NUMBER I MMIDDiYYYY MMIOD/YYYY LIMITS GENERAL LIABILITY i EACH OCCURRENCE S 1,000,00 A X X PKV0000417 04/07/2021 04/07/2022 DAMAGE TO RENTEDIIABILITY 100,00 COMMERCIAL GENERAL L PREMISES (Ea occurrence) X OCCUR MED EXP (Any one person) S 5,00 X Errors &Omissio n � $ 1 000,000 GENERALAGGREGNJURY ATE 5,000,00 - LIMIT APPLIES PRODUCTS COM P/oP AGG � � 1.000.00 PROV, X POLICY LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000,00 (Ea acadent) A ANY AUTO PKV0000417 04/07/2021 04/07/2022 f BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS------. 1 s - -.- BODILY INJURY (Per accident) �S m.. PROPERTY DAMAGE S HIRED AUTOS PER ACCIDENT) X NON -OWNED AUTOS $ i UMBRELLA LIAB I OCCUR US I 'EACH OCCURRENCE$ $ EXCESS LIAR E CLAIMS -MADE MAD AGGREGATE � DEDUCTIBLE ..�.... ._ --- S RETENTION $ I $ WORKERS COMPENSATION WC STATU RH- TQRY_LlKTS AND EMPLOYERS' LIABILITY Y / N ®"• ANY PROPRIETOR/PARTNER/EXECUTIVE E L. EACH ACCIDENT S OFFICER/MEMBER EXCLUDED?, / A` """"' """" (Mandatory In NH) ,N E.L. DISEASE EA EMPLOYEE $ If yes, describe under I DESCRIPTION OF OPERATIONS below E L DISEASE POLICY LIMIT S A Professional Liab yPKV0000417 04/0712021 04/07/2022 Prof Liab 1,000,00 A 'Cyber iPKV0000417 04/07/2021 04/07/2022 Cyber 300,00 DESCRIPTION OF OPERATVONS I LOCATIONS / VEHICLES Mach ACORD 101 Additional Remarks Schedule, if more space is required) City El Segundo is insured to the of reamed as an ad'dit4onal with respect work performed by the Inamed insured.. Investigation, CA — e^�'CTTICtP"A7 M1.�P"4I Tit=aa:.. reMrl=l I ATlnM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Human Resources AUTHORIZED REPRESENTATIVE Rebecca Redyk 350 S Main Street El Segundo, CA 90245-3895 U 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PKV0000417 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Automatic Status Included Where Required by Written Contract. All Where Required by Written Contract. Section II - Who Is An Insured is amended to in- clude 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 your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 202607 04 © ISO Properties, Inc., 2004 Page 1 of 1 11 Workplace Investigation Specialists License PI 188615 2625 Townsgate Road Suite 330, Westlake Village, CA. 91361 714-693-3428 Email: ba.normtraub@gniaii.com EXEMPTION FROM AUTOMOBILE LIBILITY INSURANCE Norman A. Traub & Associates does not own vehicles. Accordingly, I certify that Norman A. Traub & Associates shall not utilize company -owned vehicles in the performance of the work under this agreement. All independent contractor investigators that provide investigation services use their vehicles. Investigators can provide a city representative proof of automobile insurance. T. Brock Avery General Manager Norman A. Traub & Associates LLC SignatureDATE: 6-17-21 : Workplace Investigation Specialists License PI 188615 2625 Townsgate Road Suite 330, Westlake village, CA 91361 714-69.3-3428 805-207-9216 www,norxmtraubassociates.com F.rnail: ba,normtraub@gmail.com July 8, 2021 Ms. Rebecca Redykl Human Resources Director City of El Segundo I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for workers' compensation or to undertake self- insurance in accordance with the provision of that Code, and I will comply with such provision before commencing the performance of the work of his agreement. I certify that in the performance of the work under the permit, license agreement, purchase order, or contract with the City of El Segundo, which is the subject matter of this certification, I shall not, in any manner, employ any person or contract with any person so that any worker on said work would become subject to the workers' compensation laws of the State of California. By my signature below, I affirm under penalty of perjury, I am authorized to bind my company, agency/agents, partnership and I am not required to comply with Section 3700 of the Labor Code, or any workers' compensation laws of the State of California, and further, I agree to hold harmless, indemnify, and defend the City against any claim or damage included by not limited to any subrogation demand arising from performance under my contract with the City. I waive any right of subrogation against the City. Norman A. Traub Associates does not have employees. All Associates are independent contractors. July 8, 2021 Authorized signature / Date T. Brock Avery General Manager/Principal Norman A. Traub Associates (714) 693-3428