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PROOF OF INSURANCE (2022) CLOSEDACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/21 /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 Cathy Service VW ke-Stahl NAME: yeryan y Sargeant Insurance Agency, LLC. a/�"N Ext : (818) 561-2600 A/� No): (818) 436-5988 E-MAIL ADDRESS: 7740 Painter Avenue #210 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: The Hartford 29424 Whittier CA 90602 INSURED INSURERB: Indian Harbor Insurance Co 36940 INSURER C : INSURER D 7 BARTEL ASSOCIATES, LLC INSURER E: 411 BOREL AVE STE 620 INSURERF: SAN MATEO CA 94402 COVERAGES 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 INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000.00 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 2 000 000.00 MED EXP (Any one person) $ 15,000.00 PERSONAL & ADV INJURY $ 2,000,000.00 A Y Y 57SBABN8199 09/01/2021 09/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000.00 POLICY ❑ PRO ❑ LOC JECT X PRODUCTS - COMP/OP AGG $ 4,000,000.00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000.00 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS N 57SBABN8199 09/01/2021 09/01/2022 BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ X HIRED IxNON-OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYP ROPRI ETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) NIA Y 72 WEC AH2RPZ 09/01/2021 09/01/2022 X SPER TATUTE OERH- E.L. EACH ACCIDENT $ 1,000,000.00 E.L. DISEASE- EA EMPLOYEE $ 1,000,000.00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 ,000,000.00 B Professional Liability MPP001715217 09/01/2021 09/01/2022 Dam Lim a C aim Dam Lim (Pol Agg) ,000,000.00 5,000,000.00 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF EL SEGUNDO, IT'S OFFICERS, DIRECTORS, EMPLOYEES, AGENTS AND VOLUNTEERS ARE HEREBY NAMED AS AN ADDITIONAL INSURED BY WRITTEN CONTRACTOR WRITTEN AGREEMENT ON POLICY # 57SBABN8199 AS RESPECTS TO OPERATIONS OF THE NAMED INSURED ONLY, COVERAGE IS PRIMARY AND NON-CONTRIBUTORY ABOVE ANY OTHER INSURANCE THE CERTIFICATE HOLDER(S) MAY CARRY. 30 DAY NOTICE OF CANCELLATION. CERTIFICATE HOLDER CANCELLATION 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. 350 Main Street AUTHORIZED REPRESENTATIVE Idew ElSegundo, CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD BARTEL ASSOCIATES LLC POLICY NUMBER: 57 SBA BN8199 ENDORSEMENT NUMBER: 1 THIS ENDORSEMENT SUMMARIZES THE POLICY LANGUAGE, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN CONTRACT COMMERCIAL GENERAL LIABILITY COVERAGE PART. Name of Organization: City of El Segundo, It's Officers, Directors, Employees, Agents and Volunteers (Section C6) WHO IS AN INSURED: The person(s) or organization(s) identified is (are) included as an Additional Insured to the person or organization shown in the Declarations, by written contract or written agreement provided the injury or damage occurs subsequent to the execution of the contract or agreement; but only with respect to liability arising out of "your work" for that additional insured by or for you. A person or organization is an additional insured under this provision only for that period of time required by the contract or agreement. ADDITIONAL PROVISIONS PRIMARY AND NON-CONTRIBUTORY If agreed by written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and the Insurer will not seek contribution from that other insurance. WAIVER OF RIGHTS OF RECOVERY (Waiver of Subrogation) The Insurer named above waives any right of recovery the Insurer may have against the Additional Insured(s) when the Insured has waived their rights of recovery against any such person or organization in a written contract or written agreement that was executed prior to the injury or damage. NOTICE OF CANCELLATION The insurance afforded by this policy shall not be canceled except after thirty (30) days' advance written notice has been given to the Additional Insured(s). (10 days advance written notice for non-payment). Signature -Authorized Representative: [dew Note: Any discrepancy between this certificate addendum and the policy language shall be found in favor of the Insurer policy language. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72 WEC AH2RPZ Endorsement Number: Effective Date: 09/01/21 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: Bartel Associates, LLC. 411 BOREL AVE STE 620 SAN MATEO CA 94402 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 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by due Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 07/22/21 Policy Expiration Date: 09/01/22