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PROOF OF INSURANCE (2023) CLOSEDa EDATE (MMIDD(YYYY)
AC"R" CERTIFICATE OF LIABILITY INSURANCE
05/16/2022
THIS CERTIFICATE IS ISSUED AS 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 Sherry Mendoza
NAME
The Liberty Company Insurance Brokers PHONE (818) 475-0857 1794 PAX
A lAtC, Noj�
Lic #OD79653 E-MAIL
smendoza@libertycompany com
... . . . . . . . . . . . . . . ........................
47 Discovery, Ste 160 INSURER(S) AFFORDING COVERAGE NAIL
.... . . . . . . . . . . . .........................
Irvine CA 92618 INSURERA: Atlantic Specialty Insurance Co 27154
....
. ............... . . . . . ........... . .......... . . . .......... ............................................ . ..... . . . . . . . . . . .........................................
INSURED OBI National Insurance Co 14190
Morningstar Productions, LLC
41213 Sandalwood Cir
Murriet@ CA 92562
INSURER C
INSURER D
INSURER E'
INSURER F:
............. . . . . . . . ...... .
... . ......................... . . . . . . . . . . . . . . . . . . . .
........ . .......................
..... . ...............................
........
.
. ................................
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COVERAGES CERTIFICATE NUMBER: 22/23 GL/BA/\A/('/Umb
REVISION NUMBER:
THIS IS TO CERTIFY THATTHE 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.
--- --- --- -- -- ....................... ....
SW
LTR TYPE OF INSURANCE %9 77 POLICY NUMBER ...................... . . . .......... _uMIRK=_ snffm
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
9 1,000,000
L9
U7,frA_r,n7)7r.N7r5 .
. . . ........... .
300.000 — — -----------
CLAIMS -MADE OCCUR
..PREMISES (Ea occunenre}
,
MED EXP (Any one person}
s 10,000
A GL0581401 05/06/2022 05/06/2023
PERSONAL& ADV INJURY
. ........ ........................
S 1,000�000
GEN'LAGGREGATE LIMITAPPLIES PER:
AGGREGATE
s 2,000,000
POLICY [g "C' D LOC
JEC'r
.,GENERAL
..t�2�2SIIS -_22ME/OP AGO
S 2,000,000
OTHER
Employee Benefits
s 1,000,000
AUTOMOBILE LIABILITY
CC07BcMide��--
------------------------
—s 1 000,000
Esaxnnb
ANYAUTO
�7100402540001
BODILY INJURY (Pei person)
s
• OWNED _s_e I SCHEDULED 05/06/2022 05/06/2023
BODILY INJURY (Peraccident)
AUTOS ONLY AUTOS
HIRED N-ell NON -OWNED
VD rrf,4FxCrE
s
AUTOS ONLY AUTOS ONLY
gjcizicfrmy
. . ...............
................................ . .................................... .
Uninsured motorist
s 1,000,000
X UMBRELLA LIAB X
� OCCUR
_77777:77=
EACH OCCURRENCE
S 1,000,000
• EXCESS LIAR EX0427201 05/06/2022 05/06/2023
.............. .
AGGREGATE
. . . . . . . ....................... . . ...................................................... .
s 1,000,000
s 0
s
.. ........... . . ..
WORKERS COMPENSATION . ... . . . . . . . . . . ................. . . ....................... . ................. . . ................ . ......................... . . . .....
�
X1 !ERTU=0TH�
AND EMPLOYERS' LIABILITY YIN
STATUTE Ei_
B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA Y 406-0477550001 05/06/2022 05/06/2023
OFFICERIMEMBER EXCLUDED? El
E L EACH ACCIDENT
$ 1,000,000
(Mandatory in NH)
E L DISEASE- EA EMPLOYEE
S 1,000,000
If yes, describe under
. ............ .......................................... . . ....... . . ....... . ... . . ....... . . ......................
El DISEASE POLICYLIW I
$ 1,000,000
Leased/R nted
$910,266
Equipment
A 7100402550001 05106/2022 05/06/2023
............... . . . ..................... . . . . . . . . . ........... . ................................. . ..........................................
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Waiver of Subrogation in favor of The City of El Segundo applies to the Workers Compensation, subject to a written contractor agreement -WCWaiver
Endorsement to follow
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
The City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
AUTHORIZED REPRESENTATIVE
ElSegundo CA 90245
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
INFORMATIONAL NOTICE TO POLICYHOLDERS
OneBeacon Insurance Group has rebranded as Intact Insurance Specialty Solutions. This is the
marketing brand for the insurance company subsidiaries (including Atlantic Specialty Insurance
Company) of Intact Insurance Group USA LLC, a member of Intact Financial Corporation (TSX: IFC), the
largest provider of property and casualty insurance in Canada and a leading specialty insurance carrier in
North America.
Atlantic Specialty Insurance Company will continue to operate under its current name. The marketing
brand change has no impact on policies in force and does not change, amend, or waive any of the
policy's terms.
This notice is for information only and does not become a part or condition of this policy.
NOTICE-IISS ASIC 03 20 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGES
Policy Change 2
Number
POLICY NUMBER POLICY CHANGES COMPANY
GL05814-01 EFFECTIVE Atlantic Specialty Insurance Company
05-06-2022
NAMED INSURED AUTHORIZED REPRESENTATIVE
Morningstar Productions LLC
COVERAGE PARTS AFFECTED
... ........................... ........................................
GeneralLiability Coverage Part
CHANGES
Adding Form II 12 01 11 85,
As follows:
As respects:
City of El Segundo
350 Main street
El Segundo, CA 90245
The following form is added and attached:
Additional Insured — Designated Person or Organization — CG 20 26
Factor: 1
Total Premium for this Endorsement: $100
State Fee Changes: $0
Total Due for this Endorsement: $100
IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1
Copyright, ISO Commercial Risk Services, Inc., 1983
IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 2
Copyright, ISO Commercial Risk Services, Inc., 1983
POLICY NUMBER: GL05814-01
COMMERCIAL GENERAL LIABILITY
CG20261219
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):
City of El Segundo
350 Main street
El Segundo, CA 90245
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(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:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or
rented to you.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance 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.
B. 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:
1. Required by the contract or agreement, or
2. Available under the applicable limits of
insurance, -
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
CG 20 26 12 19 ©insurance Services Office, Inc., 2018 Page 1 of 1