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PROOF OF INSURANCE (2021 - 2022) CLOSED0 DATE (MMIDD/YYYY) ACC>R" CERTIFICATE OF LIABILITY INSURANCE t 10/19/2021 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 CONTACT Illana Goldfinger NAME:. Professional Risk Solutions, Inc PHONE (410) 486-2400 FAQ (410) 486 2998 37 Walker Ave. EMAIL igoldfingertu?a prsbrokers com ADDRESS; Suite 200 INSURE ..... R(S) AFFORDING COVERAGE NAICIC p Baltimore MD 21208 INSURERA: Twin City Fire _......__,_, 29459 ....................... INSURED INSURER B Zencity Technologies Us Inc / Zencity Technologies LTD INSURER C .. ......................................... ......................... 1313 N. Market Street INSURER D , Suite 5100 INSURER E': Wilmington DE 19801 INSURER F. COVERAGES CERTIFICATE NUMBER: CL2132506199 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 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, TYPE OF INSURANCE -------_ .........._.... LI Y I F POLICY P .....-.mm........... . R INS wVD POLICY NUMBER MMIDD/YYYY) MMIDD/YYYY} LIMITS ............ ........._ ...... .. COMMERCIAL GENERAL LIABILITY 2,000,000 FACH-rW_OC'CURRENCE S m..a_. _renrey S 1,000,000 CLAIMS -MADE OCCUR PREMISES (Ea occur,,,, , A nGEN'LAGGREGATE LIMIT APPLIES PER P(N• f'CPP...I(;Y PR LOC o rHER.: AUTOMOBILE LIABILITY '...... ANY AU TO A OWNE1.) SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AI JrOS ONLY Rx AUTOS ONLY UMBRELLA LAB � OCCUR EXCESS LIAR CLAIMS -MADE LDF.D ,�___J RETENTION S wORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE 0 NIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below MED EXP (Arty one person) .. ......,,_,,,................. $ 10,000 30SBMTY0198 03/07/2021 03/07/2022 PERSO NAL& ADV INJURY S 2,000,000 GFNERALAGGREGATE S 4,000,000 ,,,..,...,w.....�.m.. ....._ ...�........ PRODUCTS-COMP/OP AGO $ 4,000,000 _.........._ .... ...... C 66nEErC sNGLS tIMt1 5 1,000,000 BOIDII...Y INJURY (Per person} S 30SBMTY0198 03/07/2021 03/07/2022 BC DIN Y IN.lI.YIRY (G'erarridenty S PROPERTY DAMAGE $ ..........___ (Per accident} S EACH OCCURRENCE S AGGREGATE ... S S E.L. EACHACCIDENT S YEE E.L DISEASE-EAEMPLOS EL DISEASE -POLICYLIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City, its officials, and employees as additional insureds and to state that such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto. T City of El Segundo City Clerk 350 Main Street ACORD 25 (2016103) 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 CA 90245-3813 6� L1.1 i__i__ ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD F1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated below: Policy Number: 30 SBM TY0198 Named Insured and Mailing Address; ZENCITY TECHNOLOGIES US INC / AND OR ZENCITY TECHNOLOGIES LTD 1313 N MARKET ST STE 5100 WILMINGTON DE 19801 Policy Change Effective Date: 10/19/21 Effective hour is the same as stated in the Declarations Page of the Policy. Policy Change Number: 014 Agent Name: PROFESSIONAL RISK SOLUTIONS LLC Code: 722393 POLICY CHANGES: TWIN CITY FIRE INSURANCE COMPANY ANY CHANGES IN YOUR PREMIUM WILL ■ ■ IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN ■ WILL CHANGE ■ DRAW AMOUNTS. THIS IS NOT A BILL. Installment Payment Premiums Total Additional or Return Premium Dates of Subsequent installments if payable in three installments: Previous Additional Installments Premium $ NO CHANGE Return Premium Revised Installments 2. $ $ $ $ 3. PREMIUM DUE AT EFFECTIVE DATE OF ENDORSEMENT $ $ $ $ $ Total for remainder of policy terrrr: $ $ Form SS 12 11 04 05 Page 1 Process Date: 10/22/21 Policy Effective Date: 03/07/21 Policy Expiration Date: 0 3 / 0 7 / 2 2 POLICY CHANGE (Continued) Policy Number: 30 SBM TY0198 Policy Change Number: 014 FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE. IH12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION Form SS 12 11 04 05 T Page 02 Process Date: 10/22/21 Policy Effective Date: 03/07/21 Policy Expiration Date: 03/07/22 POLICY NUMBER: 30 SBM TY0198 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - VERSON/ORGANIZATION CITY OF EL SEGUNDO, THE CITY, ITS OFFICIALS, AND EMPLOYEES CITY CLERK 350 MAIN ST EL SEGUNDO CA 90245 Form IH 12 00 11 85 Printed in U.S.A. IMPORTANT: This Certificate is issued as a matter of information only and confers no rights upon the holder, It does not amend, extend or alter the coverage afforded by the Policy and it does not constitute a contract of insurance. If an 'additional insured' is stated below, the Policy must have an additional insured provision or be endorsed for this be valid. Should the Policy be cancelled before the expiry of insurance stated below, notice will be delivered in accordance with the Policy provisions. POLICY NUMBER: ESJ0131342507 THE INSURED: ZENCITY LTD 24 Peretz Hayot St Tel Aviv Israel ADDITIONAL INSURED: City of El Segundo the City, its officials, and employees City Clerk 350 Main Street El Segundo CA 90245-3813 BUSINESS ACTIVITIES: Al software for actionable insights for cities and counties THE UNDERWRITERS: Underwritten by certain Underwriters at Lloyd's INCEPTION OF INSURANCE: 00:01 Local Standard Time on 18 May 2021 EXPIRY OF INSURANCE: 00:01 Local Standard Time on 18 May 2022 RETROACTIVE DATE: 09 Feb 2017 LEGAL ACTION: Worldwide INSURING CI...AUSE 1: ERRORS AND OMISSIONS Limit of liability: USD2,000,000 each and every claim, including costs and expenses Aggregate limit of liability: USD2,000,000 including costs and expenses Deductible: USD15,000 each and every claim, including costs and expenses INSURING CI...AUSE 3: MUI..- rIMEDIA I...IABILITY AND ADVERTISING INJURY Limit of liability: USD2,000,000 each and every claim, including costs and expenses Aggregate limit of liability USD2,000,000 including costs and expenses Deductible: USD15,000 each and every claim, including costs and expenses INSURING CI._AUSE F: COURTAT-I ENDANCE COSTS Aggregate limit of liability: USD100,000 sub -limited to USD2,000 per day Deductible: USDO each and every claim or loss INSURING CI...AUSE 7: 1 OSS MI FICA"rION Limit of liability: USD50,000 each and every claim or loss Deductible: USDO each and every claim or loss INSURING CLAUSE 8: REPUTATION AND BRAND PROTECTION Aggregate limit of liability: USD100,000 Deductible: USDO each and every claim or loss Authorised Signatory CFC Underwriting Ltd DATE: 21 October 2021 PLEASE REFER TO YOUR POLICY DOCUMENT FOR FULLTERMS AND CONDITIONS ATTACHING TO POLICY NUMBER: ESJ0131342507 THE INSURED: ZENCITY LTD WITH EFFECT FROM: 18 May 2021 It is understood and agreed that the following amendments are made to this Policy: 1 The following DEFINITION is added: "Additional insured" means: City of El Segundo the City, its officials, and employees (Effective From: 20 Oct 2021) City Clerk 350 Main Street ElSegundo CA 90245-3813 In respect of the "Additional insureds" CONDITION, additional insureds are included as a third party 2 The following paragraph is added to the "Additional insureds" CONDITION: Additional insureds Where we indemnify a third party as an additional insured under this Policy, this Policy will be primary and non-contributory to the third party's own insurance, but only if you and the third party have entered into a contract that contains a provision requiring this. 3 The following CONDITION is added: Notice of cancellation to additional insureds If we give you notice of cancellation in accordance with the "Cancellation" CONDITION, we will endeavour to provide the same notice of cancellation to additional insureds; however, not doing so will not place any additional liability upon us, SUBJECT OTHERWISE TO THE TERMS AND CONDITIONS OF THE POLICY Authorised Signatory Authorised Signatory A-M�iz\,_ 9Vkv- CFC Underwriting Ltd CFC Underwriting Ltd " d! �� CERTIFICATE OF LIABILITY INSURANCE WJ=19 ER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLY ArmtoD Gur hitcroational Urderwrim AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS BS.R Tower4.2Dih Flow. 7 bksak Bnei-Brsk, lase] CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. RIMAW A: Zeneily TwbtokW LTD sndior Zescily Technology US me 040RERIt Nsmr� of Iriwanco Lmkov 2. TO Aviv. Ismd l� rxPI D. Nmm, of lomeooe .-— . . DOMER IL I � - -b �,. "M �X Mi '� A n�. .: a �. . •,. ^•'- TYPEOFBISURANCE A ❑ p°"^E^�NER4L LARLM L-I. OOrrtl mmL OE m& L1,wm M.A. MADE ❑ O=vt 0 I--1 GENL AGGREGATE LOWAPPLIES PER; ❑ POLICY ❑ PRDlECr ❑ LOC B ❑ rA^U^��TOMOSM LM,BLDY ANYAUTO ❑' ALLOwEDAUMS ❑' SCHBOIAI:DAUMS 0 MWOMMAUICS ❑ O�ARAOE LUQm E] AMYAUTO C ❑ EACESSaIMOM L r LIABBrrY OCCUR ❑ mAm s MADE DED =MLE 10 RETOMON s rmrs-1 _ w, POLLMNUM80t Emv Policy A Eincr Policy 0 Edder Policy ■ (if re"irem Ender Policy a (if fewitem Emu Policy ErEfedive I � Evimlion Date EnWE =tm d Due �iiratimz DEnter ow Effective Ea Ex�Ion Eder Effective ErAW Dale Date Sum Date Elfedrve I Erder Dole Exp=tioa 4.a«.4,"+. LAB s —.... 7;- PERSONAL &ADVD ARY s TE S S s COM&NEOSDR"AELONT s SO MY s tlCAptCY IMMYs Aaw MPEWCAMAGE s ArlTOONLY-EAAOCCIDEW s O THAN EAACC s AUTOONLY; AOG S WE s s 's s ❑Y�C STATtitm t�t � TORY umffams L. 1 ER ... LL EACHACCOM s LL -EA Ewwms LLOLSME-POULYLWR s 3A00X0 USD AcdAgg /� 9"O=ANY OF THE ABWH ossCFU= FOLraIEs sE CAIKELLEC Bum THE a AA WY s EZPMUMRAN "MOF. MMUMAMAMeCOYEAAOEpMLtDJgWMTO � �,(� / C NAd,�DAYUYrR1TTENNO=TOTIECERTWATEHOUMWA=TOYNELEFS. � ` � ` � t, �\I g l�� .0 L t BW FALURETO DO ZO 8NNL FOSS HO OBL1UA7gH OR LYIBLDY OFANY IOIO UpOH MrSU11"'ORAEPMWAYNI& njot_( ( AU A oft 25 0II4f I r _ DATE (MM/DD/YYYY) " CERTIFICATE OF LIABILITY INSURANCE 10/21 d2021 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). CONTAG PRODUCER SUNZ Insurance Solutions, LLC ID: (Rippling PEO 1 In )4RE,_ RippG'imdt Support Team c/o RipplingPEO 1 I nc t/CI PHONE, Exj), 321-319-4852 IA' N49 2443 Flllmore Street, Ste #380-16714 D•MAIL San Francisco, CA 94115 +aDpEs , jenrnlPr lauh.r�bllator.com IM�gS4IRER�SJ AFFORDING COVERAGE NAIC # A: United Wisconsin Insurance Comoanv 29157 INSURED INSURER B : RI ling PE,O 1 Inc LU Zencity Technologies US INSURER C : _ 2443 Fillmore Street INSURER D: Ste #380-16714 INSURER E San Francisco CA 94115 INSURER F COVFRAGFS CERTIFICATE NUMBER: rdFr& IRA 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. .., , .D .....,.,.,., ." IC INSR bCSUBR .....TYPE ..... OF INSURANCE..,.. LTR POLICY NUMBER / MMDC /YEYYY MM/ /YYYX LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 .. _. •._1 NIwCNOAL"r�t'(,'�E��.kwl l`�I',k e.. .... .._.. CLAIMS -MADE OCCUR'. ,,,,,,I�fiIL Iv15$;x,.(q'.a o�mCurrarcx!1„ . MED EXP 4Any one porsum S .. ......... ,,, _PERSONAL BADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S n PIhtC}• POLICY JE:CT LOC .. .,e„ ..._.., PRODUCTS COMP/GP AGG S , . ______, ... _ .w O'V HE'R 5 AUTOMOBILE LIABILITY ... R 0106UNED SINGLE 77 5 ...iE w,aacC'o Ta tl ... ............... ., , ........ ... _ , , ANY AUTO BODILY INJURY (Per person) S . OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS ONLY AUTOS ,. ,,,,,,., HIRED .., NON -OWNED i"ROrsEI^CT1'OAM,AGE 5 AUTOS ONLY AUTOS ONLY , ................ UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS -MADE. AGGREGATE DED RETENTIONS S A WORKERS COMPENSATION WC572-00127-020-SZ 3/4/2021 12/1/2021 PER OTH- AND EMPLOYERS' LIABILITY Yjr"/ N STATUTE ER -- — '- ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT S 1,OOQ000 OFFICE RIM EMBER EXCLUDED? i I N / A -- --- "--- " (Mandatory in NH) "-"""' E L DISEASE - EA F.MPLOYEEe S 1 09Q 000. If es, describe under ­- ''.... DESCRIPTION OF OPERATIONS below EA DISEASE POLlCY 1.04W 1 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Coverage Provided for all leased employees but not subcontractors of: Zencity Technologies US Client Effective: 3/4/2021 Waiver of Subrogation in favor of certificate holder, as per written contract, while work is performed at or in: CA.. CERTIFICATE HOLDER CANCELLATION 824547182 (CA) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of El Segundo, its officials, and THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN en )Ioyee ACCORDANCE WITH THE POLICY PROVISIONS. 3P Main, Street El Segundo CA 90245 AUTHORIZED REPRESENTATIVE I., Rick Leonard O 1988-2015 ACORD CORPORATION. All rights reserved. ACO D 25 (201/3) The ACORD name and logo are registered marks of ACORD 6464918E I Zencity Technologies US (CA) MCP 00127 WOS I Kandi Smith 1 10/21/2021 11:42:27 AM. (EDT) I Page 1 of 2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 03 13 Ed. 7-09 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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 $ 100 Schedule Person or Organization Job Description The City of El Segundo, its officials, and employees Covem��g�a Provided for aleased employees but not subcontractors of: Zencity Technologies US Client Effective: 314/2021 Waiver of Subrogaflon in favor of certificate holder, as per written contract, white work Gs performedat or in. CA. 350 Main Street ElSegundo 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 03/04/2021 Insured Rippling PEO 1 Inc 2443 Fillmore Street Insurance Company United Wisconsin Insurance Company WC 99 03 13 (Ed. 7-09) Policy No.WC572-00127-020-SZ LCF Zencity Technologies US Countersigned by Endorsement No. 64649188 W11,11 I I l ;1 I ='1 _ V:: , .7 n.Id„I. P'i (`d'A i V T ' ,p, i I ''Id i to 1 .h I 7 0 / I / ` 7 R : I I n ' 1' / IMF �1-:1) 1") 1 r 0^,' 1 114 :$