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PROOF OF INSURANCE (2023 - 2023) CLOSED0 - DATE(MMIDDIYYYY) ACC>R " CERTIFICATE OF LIABILITY INSURANCE 03IO2I2022 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 Goldflnger NAME: PH( 410 486-2400 FAx (410)486-2998 Professional Risk Solutions, Inc. C No Ext . ( ) Arc NC 37 Walker Ave. E-MAIL igoldfinger@prsbrokers.com ADDRESS. Suite 200 INSURER(S) AFFORDING COVERAGE NAIC # Baltimore MD 21208 INSURER A: 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: r*ew�tc M+cre reoTrerr ATo uneeQeo• (L223206901 RFVISIr1N NIIMRFR- 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 ADDLSUBR TYPE OF INSURANCE POLICY NUMBER MMDDY/YYYY MM DDfYYYY LTR INSD WVD _ �, LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 OAMAGETbRENT 1) 1000000 CLAIMS -MADE � OCCUR PREMISES.. Ea rurrence $ ,, '.. MEP EXP (An one person s 10,000 A 30SBMTY0198 03/07/2022 03/07/2023 ''' PERSONAL &ADV INJURY $ 2,000,000 GEN LAGGREGATE LIMIT -APPLIES PER: GENERALAGGREGATE $ 4,000,000 X POLICY ❑ PRO- LOC JEPT PRODUCTS-COMP/pPAGG $ 4,000,000 OTHER I $ AUTOMOBILE LIABILITY .. COMBINED SINGLE LIMIT Ea accident) $ 1,000,000 ANYAUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OWNED SCHEDULED 30SBMTY0198 03/07/2022 03/07/2023 AUTOS ONLY AUTOS HIRED NON -OWNED I PROPERTY DAMAGE $ AUTOS ONLY *'. AUTOS ONLY P u aoo"de'nl XI UMBRELLA LIAB X. OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE S 2,000,000 A EXCESS LIAB CLAIMS -MADE 30SBMTY0198 03/07/2022 03/07/2023 $ -- DED X RETENTION 5 10,000 WORKERS COMPENSATION - PER OTH- STATUTE ER. AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ''.. E.L.. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L, DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below I EL, DISEASE - POLICY LIMIT $ I- L-L DESCRIPTION OF OPERATIONS / LOCATIONS / 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. 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. City Clerk 350 Main Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245-3813 6le @ 1988-2015 ACORD CORPORATION. All rights reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1 DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 06/02/2022� 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 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)._ Sela Group LLC CONTACT Tamir Zuckerman NAME ._ 1636 Dover Rd, PHONE SAX R�±178�� Tamir c se�ro�lta.,� kI�.E IRI 620-757-0785 Emporia KS, 66801 MAIL om ........, —. INSURED Zencity Technologies US Inc. and/or Zencity Technologies LTD„ 1313 N Market St Suite 5100 VVlmington, DE 19801 INSURER A : Clear Blue Specialty Insurance INSURER B : _^ —nA^00 r=0r1C1rAT= ruIseDOD• RFVICION NIIIMRPR• 37745 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. ..- ....�..... ..„ ..m., .--- ADOL SUBA POLICY °'FF POLICY EXP ILTR '...... TYPE OF INSURANCE POLICY NUMBER DD /YYYY MM/DDIYYYY LIMITS GENERAL LIABILITY EACHCH OCCURRENCE� �., . P C RENTELI...... , ....... $ COMMERCIAL GENERAL L LIABILITY CLAIMS -MADE OCCUR ..� I „PR�MIE`j(Eaorpurrence) MEDEXP S_ y $, � PERSONALINJURY PERSONAL&ADV NJUn) „ -......„...... GENERALAGGREGATE $,,,,,,,,,„„„ ......„„„,� ..... E LIMIT APPLIES PER: GEN'L AGGREGATE _PRODUCTS COMP/OP AGG $ .-.-.....,,, _ j L�NC POI. -ICY ` $ AUTOMOBILE LIABILITY COMBINED SYItiIC,p.E'LkRvll'F ANY AUTO Per personBODILY INJURY ( ) - $ ALL OWNED ............ SCHEDULED BODILY INJURY (Per accident) $ .. AUTOS AUTOS AUTO NON -OWNED P5 oP E RTY' CroT`. - — •- $ AUTOS LlAUTOS : Y adc9lVeu� IV �,__I_DEO UMBRELLA 00CUREXCESS EACH OCCURRENCE E $ CLAIMS MADE LIABAB . E EGA AGGREGAT $.... U RETENTION $ $ WORKERS COMPENSATION WC STATU- -OTH- ',..-....-. AND EMPLOYERS' LIABILITY YIN _dS.1RY_l.li�'1�ITS.........., ... ,..--_.-. ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E„L DISEASE EA EMPLOYEE $ .. ... If yes, describe under DESCRIPTION OF OPERATIONS below E.L- DISEASE- POLICY LIMIT $ A Tech E&O / AX01-4491-01 04/04/2022 04/04/2023 Each Claim Limit- $3,000,000 Cyber Liability Coverage Part Aggregate Limit- $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 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. El Segundo City Clerk 350 Main Street El Segundo, CA 90245 - 3813 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 ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 16PK A it CERTIFICATE OF LIABILITY INSURANCE A06/0620 2YYI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S 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(es) 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 endorsements . PRODUCER AON RISK SERVICES SOUTH INC 3550 LENOX ROAD NORTHEAST SUITE 1700 ATLANTA GA 30326 CONTACT A NAME: on Risk Services, Inc of Florida a EXt „ $33.506_1544 1 IAIC, No): PNo, EKAtL ADDRESS: CertS 'tri.,net.com INSURERISI AFFORDING COVERAGE NAIC # INSURER A: Indemnity Insurance Company of North America 43575 INSURED TriNet HR II Holdings, Inc L/C/F Zencity Technologies US, Inc INSURER B s. INSURER C s, 1 Park Place, Suite 600 INSURER D Dublin, CA 94568-7983 INSURER E : INSURER F : rr)V9PAnPA rPIPTIPW A'TF tdll!MRFR- IR1,7 icvA 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. PNS'R LTR. TYPE OF INSURANCE ADDL. INSR SUaR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED C kIMS-MADE D OCCUR PREMI&ES Ea occu encel $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ G'ENL AGGREGATE LIMIT APPLIES PER: POLICY "PR0JECT LOC PRODUCTS- COMP/OP AGG $ $ OTHEiR INE E� L I M I AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY JPer erson S ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE . Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEC I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X IPER T'H- STATUTE ER $ 2,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? NIA X WLR C71145748 03/01/2022 03/01/2023 F.L��DISEASE�IDENT EAEMPLOYEE 2,000.000 (Mandatory in If yes, descdbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation coverage is limited to worksite employees of Zencity Technologies US, Inc. through a co -employment agreement with TriNet HR XI, Inc Waiver of subrogation in favor of City of El Segundo as required by written contract CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE d"10A ci,k 8etviceb (10"th 42AC ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy . ..... ...... . . . . . . ............... .... . Named Insured Endorsement Number TriNet HR 11 Holdings, Inc. L/C/F Zencity Technologies US, Inc I Park Place, Suite 600 Policy Number Dublin, CA 94568-7983 Symbol: WLR Number: C71145748 Policy Period 03/01/2022 TO 03/01/2023 -- --------- -- -------------- - ........ Issued By (Name of Insurance Company) Indemnity Insurance Company of North America Effective Date of Endorsement 03/01/2022 Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy, WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule City of El Segundo City Clerk 350 Main Street El Segundo, CA 90245 For the state of CA, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. Authorized Agent WC 00 03 13 (11/05)Ptd; USA Copyright 1982-83, National Council on Compensation Insurance