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PROOF OF INSURANCE (2022 - 2023) CLOSED_ OP ID: III A� +►" l� DATE (MMIDDIYYYY) CERTIFICATE 4% LIABILITY INSURANCE 02/11/2022 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 he 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 endomementlat. ....._--_"" Alliance filgt. 8r Insurance Sery NAMR.' "Michelle A Nowell 355 Via Vera Crux Ik7_��I� CA A, eTTIlBrokar Li 0737966 ONE 760�71�378 760.471-7716 EwMAlL (-_ r No): Ban arcos, CA 92076 ADORESS-, rnnowel1l Iscorp corn I Michelle A. Nowell PR" UC EiT CU , MgRmIo rile JMKCO 1 INSURED t OaVEnR. AGEB N1A8Marie E Kirk Lmonite INSURER A USnS Company �. . . 47 m AveA #440�06 INSURER eUnited FinancialasualtyCo12523 Mira Loma, CA 91752 INSURER c INSURER D CERTIFICATE INDICATED. NOTWITHSTANDING ANY NUMBER: REVISION NIiIIMB' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCEE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORR THE POLICY PERIOD 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. ».TIT .... TYPE OF RISURANCE _.. N OL USR' ...... ..... 9CY ET(P ,.,_. .......... _.. POLICY NUMBER POLICY & POL , M C MMIDOPYY LIMITS GENERAL LIABILITY ; EACH OCCURRENCE $ 1,000,0 A I X COMMERCIAL GENERAL LIABILITY X PKV0000495 04119/2021 04119/2022 D tlACE'TO RENTED _ PREMISER,iE�t a:pr�rr) $ 100,0 CLAJMOCCUR MED E%P �a� y pinta+ Pusan) � � 5,6 m,,. m ..,. X 8.OmISsiOn PERSONAL $ ADV INJURY S 1,000,E � ..X.. . 4.-.- GENERALAGREGATE S 00000 ..,.e._X N AGGREGATE LIMIT APPLIES PER PRl OUCT'S COMPlOP AGG S 1 000 00 POLICY' PERO L�OC � .a AUTOMOBILE LIABILITY SINGLE LIMIT $ COMBci 2,000,00 B X ANYAUTO 04245990 11/1212021 (Ea accident) 05112/2022 „,,,.. + -.. , ALL OWNED AUTOS � BODILY INJURY (Per person) 4 SCHEDULED AUTOS BODILY INJURY (Per accident) S _ PROPERTY DAMAGE S HIRED AUTOS (PER ACCIDENT) B X NON -OWNED AUTOS 04245990 i 11/12/2021 06/12/2022 S UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 1,000,00 X EXCESSLIAe A ... _ _ CLAIMS MADE UMV0000144 04I1912021 04,19,2022 � AGGREGATE S 1,000,00 DEDUCTIBLE a..$ RETENTION S � $ WORKERS COMPENSATION ''... WC STATU OTH AN D EMPLOYERS' LIABILITY Y f N RY.I fM)ITS ER . ,,, .... ANY PROPMETOMPARTu� ER16XE.C.UTIVE OFFIL.ERo'MEIbESER E:SCLUOED"Y N ! A E L. EACH ACCIDENT $ I axidatoi In Nh1I L. DISEASE EA EMPLOYEE $ VI de: ift ure _ ... _ ..,,......... . A CRI D ION OF OPERATIONS he E.L. DISEASE - POLICY' LIMIT S 17 DESC PTION l T�RATION ! LICATIONS 1 VERICLESMAtaseka ACORD 01„ Additional Ro meclw'a Schedule, if more spacer is required) The ity o e IIno is directgr , o cars, errsI oree' pangeorneec�I�y tie narne� S d a'dd tionaf Insured wlf res ects to tfle Or name nsuredi. Investigations, CA - - 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 El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE 9 1955-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PKV0000495 COMMERCIAL GENERAL LIABILITY CIGL 79 03 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ...... ....... ! 0 ..Ilk FQ 4111M x nil, .. SCHEDULE Name Of Additional Insured Person(s) Or Or anization(s) Location(s) Of Covered Operations Blanket as required by valid written contract. Blanket as required by valid written contract. Additional Information: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your operations for the additional insured at the location shown in the Schedule. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; b. If coverage provided to the additional insured is required by a contract or agreement, the insurance CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2 afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured; and c. Regardless of the date of occurrence or when the injury or damage first occurs or is first discovered, a person's or organizati'on's status as an additional insured under this endorsement ends upon the earliest of:. (1) The completion or termination of the contract or agreement between you and the additional insured for the location shown in the Schedule; (2) The date you cease actively performing operations for the additional insured at the location shown in the Schedule; or (3) The expiration or termination date of the policy or this endorsement. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to liability or damages for "bodily injury", "property damage", or "personal and advertising injury": 1. Caused by, arising from, or included in the "products -completed operations hazard"; 2. Arising out of the additional insured's sole negligence; 3. Arising out of work or operations performed by you that were completed prior to the effective date of this endorsement; or 4. Which continues or progressively deteriorates after you cease actively performing operations for the additional insured at the location shown in the Schedule, even if the injury or damage first occurred, or is alleged to have first occurred, during the course of your operations for the additional injured. C. Solely for purposes of this endorsement, the following definition is deleted in its entirety and replaced by the following: 1. `""Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed; (b) When all of the work to be done at the location shown in the Schedule has been completed if your contract calls for work at more than one location; or (c) When that part of the work done at the location shown in the Schedule has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. D. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: I. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2 ALLIANCE MGMNT & INS PO BOX 849 SAN MARCOS, CA 92079 1-760-471-7116 Policy number: 04245990-0 Underwritten by: United Financial Cas Co February 11, 2022 Pagel of 2 1 Certificate Holder ........ ...,... �.... . ...... ..... .... .............. Additional Insured CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245 Insured nes entl m ...I ....................... A5c .plus l...1-1 Broker 1MK CONSULTANTS, LLC ALUANCE MGMNT & INS 17252 HAWTHORNE BLVD #428 PO BOX 849 TORRANCE, CA 90504 SAN MARCOS, CA 92079 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies. Poli EtiD ......, ........ ....,,. a.. _.... ..... *......... ................... ty..,.ffecve ate. Nov 12, 2021 � Policy Expiration..Date.,, . May..12, 2022 Insurance coverages) Limits Bodily Injury/Property Damage $2,000,000 Combined Sin le Limit ...... ... 4..., ,.. Uninsured/Underinsured Motorist $100,000/$300,000 p..y.................................................. $2,000,000 Combined Sin..,,,. ................. ......... .......... Em to er's Non -Owned Auto BIPD gle Limit Description of Location/Vehicles/Special Items Scheduled autos only ....... ..................... 201.. HONDA.. .. CIVIC $5 000 Medical Payments Comprehensive $500 Ded Collision $500 w/Waiver Ded Corrmr�n Policy number: 04245990.0 Page 2 of 2 Certificate number 04222AI5990 Please be advised that additional insureds and loss Payees will be notified in the event of a mid-term cancellation. CERTIFICATE OF LIABILITY INSURANCE DATE (M WDIYYYY) 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 pollcy(les) 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 rl hts to the certificate holder in lieu of such endorsements .. CONTACT Fairfield 01145018 yH 45018 N 8 5 366 PRODUCER Liberty0 Box 186065 Insurance _,PHONE EeMF. N1io ... I.10^9�62 7132 „„ .. .,. F x No). ' G MRaIt INSURED Jmk Consultants LLC 12523 Urnonite Ave Ste 440-306 Eastvale CA 91752 riae7T 1'r-PT1CIfIAT IVIIU12CD• --- E: NAIC S THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE , . .. ,.,......� .~„ D 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. IF18RA L' R �....... „„„ "PE Of INSURANCE-. J POUCX LIMBER e .., .,...,.. m, ,.., ,._ ...,. .. ,.._..,......... ...... �............ M.ND,Dtl"M„ PF POLICY�A J LIMITS COMNF�CIALGENERA L L LIABILITY CLAIMS N C CCUCE _ IbAi -MADE OCCUR �MISES I�a��as �� S mm I MF-O EXP (Awv one p a saartl S PERSONAL 6 ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER:. S POLCY jiLOC g L.GENERALAGGREGATE w - MP/OP AGG S OTHER, _PRODUCTS I $ ALIT OMOBILE LU161LITY j ANYAUTO 1BODILY COMSINIwD SIN L LIMN r .,(a uarNci+3raAj INJURY (Parperson) S OWNED "SCHEDULED AUTOS ONLY �,,, ,,,,, AUTOS -� m. BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROI�ERtiYDAAUyGE pgl �? $ � � g UMBRELLALU43 OCCUR EACHOCCURRENCE S EXCESS LIAR CLAIMS -MADE AGGREGATE S DED , RETENTIONS I 1 $ A WORKERS COMPENSATION XWS59475520 1/17/2022 1/17/2023 � STATUTE OTH f AND EMPLOYERS' LIABILITY YIN , ANYPROPRIETORIPARTN ERIEXECUTIVE OFFICERIMEMBEREXCLUDED7 E:]!NIAI -- FR E L EACH ACCIDENT - ......... $1,000.000 ^ (Mandatory in and 1 I N under E L DISEASE E:4 EMPLOYEE ' $1 »0,W Dyyes,1IPTI DESCRIPTION OF OPERATIONS below ; E.L. DISEASE-EAEMPLOYEE Y LIMIT S1,000.000 ! ( 1 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be al4ched B more space is requlred) 14 i.1111d1"J_la-4 Cltx of EN Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Qt Main El eg THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ElSegundo CA 90245 AUTHORIZED REPRESENTATIVE Cheyenne Williams ©1988-2015 ACORDCORPORATION. All rights reserved. ACORD 2( 1/ 3) The ACORD name and logo are registered marks of ACORD 171R54F ! 59475520 1 -2.s WC ! Chayr:ne Willi— ' 2/11'2022 10:Su.07 Fva1 (j;ST) 1 Fagg .L