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PROOF OF INSURANCE (2022 - 2022) CLOSEDA� �® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 11/16/2021 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 NAME: Terri Shumaker Robert Bell Insurance Brokers Inc. A/c NNo Ext: (760)451-8556 AX NO: (760)951-8613 E-MAIL terri@robertbellinsurance.com ADDRESS: 605 East Alvarado Street Suite 200 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:ARA - Axis Insurance Company 37273 Fallbrook CA 92028 INSURED INSURER B INSURERC: Pico Rents Inc., DBA: Pico Party Rents & Sells INSURER D: 4646 E Los Angeles Ave INSURER E INSURER F: Simi Valley CA 93063 COVERAGES CERTIFICATE NUMBER:2021-2022 Master Cert 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 MAYBE 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 INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 X AlPICA001-0299567-03 5/l/2021 5/l/2022 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 ❑PRO X JECT LOC PRODUCTS-COMP/OPAGG $POLICY 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANYAUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS AIPICA001-0299567-03 5/1/2021 5/1/2022 X PROPERTY DAMAGE Per accident)$ NON -OWNED HIRED AUTOS X AUTOS Medical payments $ 5,000 X UMBRELLA LAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LAB CLAIMS -MADE DED I I RETENTION $ $ A5PICA001-029569-03 5/l/2021 5/l/2022 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE �I Not with Robert Bell Agency PER OTH- STATUTE ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N /A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) I� If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Equipment Floater AIPICA001-0299567-03 5/l/2021 5/l/2022 Limit $1,000,000 Deductible $ 5 , 0 0 0 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City, its officials, and employees are additional insureds. Such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto per forms that apply: ARAX 30 01 08 12, CG 20 01 12 19. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Recreation and Parks Department ACCORDANCE WITH THE POLICY PROVISIONS. 401 Sheldon St AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 Michael Bell/VS -------_...__ ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: AIPICA001-0299567-03 GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS WHEN REQUIRED BY WRITTEN CONTRACT, AGREEMENT OR PERMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II —Who Is An Insured is amended to include as an additional insured any person, organization, state or governmental agency or subdivision, or political subdivision when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) is to be named as an additional insured on your policy, subject to the following provisions: A. The contract, agreement or permit must be in effect during the policy period shown in the Declarations, and must have been executed prior to the "bodily injury," property damage" or "personal and advertising injury." B. The person, organization, state or governmental agency or subdivision or political subdivision is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. The ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: (a) This insurance does not apply to any "occurrence" which takes place after you cease to be a tenant in that premises. (b) This insurance does not apply to any structural alterations, new construction or demolition operations performed by or on behalf of the person or organization added as an insured. 2. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s), subject to the following additional exclusions: (a) This insurance does not apply to "bodily injury" or "property damage" occurring after all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) has been completed. (b) This insurance does not apply to "bodily injury" or "property damage" occurring after that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. (c) This insurance does not apply to "bodily Injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (i) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (ii) Supervisory, inspection, architectural or engineering activities. 3. The maintenance, operation or use of equipment leased to you by such person(s) or organization(s). This insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 4. Operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization, subject to the following provisions: ARAX 30 01 08 12 Includes copyrighted material of the Insurance Services Office, Inc. used with its permission Page 1 of 2 (a) This insurance does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of the operations performed for the federal government, state or municipality. (b) This insurance does not apply to "bodily injury" or "property damage" included within the "products - completed operations hazard." 5. Their liability as a grantor of a franchise to you. 6. Their liability as a grantor of a license to you. A person(s) or organization(s) status as an additional insured under this provision ends when: (a) The license granted to you by such person(s) or organizations(s) expires; or (b) Your license is terminated or revoked by such person(s) or organizations(s) prior to expiration of the license as stipulated by the contract or agreement. ARAX 30 01 08 12 Includes copyrighted material of the Insurance Services Office, Inc. used with its permission Page 2 of 2 Policy Number: AIPICA001-0299567-03 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR 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 Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 ZV9 "'r- .1 4�, ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) F 01/25/21 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 Aon Risk Services, Inc of Florida NAME: Aon Risk Services. Inc of Florida 1001 Rrickell Ray DrIVP., SuilE 0100 _ .._ �� No, Ext : 833.506.1544 AC No): Miami, FL 33131-4937 EMAIL ADDRESS: certs@trinet.com INSURERS) AFFORDING COVERAGE NAIC $I INSURER A; ACE Arnerican Insurance Company 22667 INSURED INSURER B : TriNot HR II -A, Inc. L/CIF Pico Rents Inc DBA Pico Parry Rents INSURER C : INSURER D : 9000 Town Center Parkway Bradenton, FL 34202 INSURER E INSURER F : THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED, CERTIFICATE MAY BF 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 INSURANCE ADDL INSR SUBR WVD POLICY NUMBER FOLIC EFF FOLIC EXP LIMITS _ CONANArPCIA1.. r NIFRAI. I.IARII Iry EACH OCCURRENCE _ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREk115ES(Eaoccurrence) $ MED EXP (Any one person S PERSONAL&ADV INJURY GEN'L AGGREGATE OMIT APPLIES PER. GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ POLICY � PROJECT n LOC OTHER ---------------—_.----- AUTOMOBILE LIABILITY COMBINED SINGLE_ i..I MI7 Fa sccident) BODILY INJURY Per erson 3 ANY AUTO BOOINJURY (Per accident S OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ HIREn NON -OWNED AUTOS ONLY AUTOS ONLY _ S _ UMBRELLA LAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DEC 12E1'EN T IONS WORKERS COMPENSATION X PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY Y / N EL.EACH ACCIDENT S 2,000,000 A ANY PROPRILTOR/PARTNLRJEXLCUTiVL a EXCLUDED'+ N / A WLR "C68971603 ' 3/1/2021 3/1/2022 — E I_ DISEASE - EA EMPLOYEE .....__...._ $ 2,000,00D OFFICERIMEMBER (Mandatory in NH) E.L. DISEASE - POLICY LIMIT I S 2,000,000 If ye'r dr'­a" under DESCRIPTION OF OPFRATIONS halow I.. — DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) WUlkali Gulnpcilsollul� 1511.Ntud to rvVllwllu wnpluyn of r°ico n.nt; Ind du. r+ico Tarty arnnlny—w 1 contr ,t wits. T, NM 4P 11-A. Inn r'.FRTIF!C-ATE HCII_t)FR CANCELLATION Pico Rents Inc dba Pico Party Rents SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Los A s less. rigUC, 9001Street, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Los Angeles. CA .d0061 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE rx n 1988-2015 ACORD CORPORATION. All Hants reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1017479