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PROOF OF INSURANCE (2022) CLOSEDClient#: 1635640 MATRICON2 DATE (MM/DDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 7/18/2022 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Christine Torrance NAME: 2375 E. Camelback Road Suite 250 I No Ex 602 666-4830 118tq' p):. 610 537 USI Insurance Services, LLC PHONE d h 83 c ns lw� a .... ! one � ......_ .. ADDRESs._ tlne.torrance@usl.com Phoenix, AZ 85016 WWWW`W`WW`WW`W`W`W`W— INSURER(S) AFFORDINGCOVERAGENAIC # 877 468-6516 Sentinel Insurance Com an Ltd _ 11000 INSURED Matrix Consulting Group, Ltd 1650 S Amphlett Blvd, Ste 213 San Mateo, CA 94402-1234 INSURER A: P Y INSURER B : Hartford - WC Multiple Issuing Cos 00914 INSURER C : Twin City Fire Insurance WCompany 29459 INSURER D : INSURER E INSURER F : 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 CONTRACTOR 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, IN R TYPE OF INSURANCE �DDL U POLICY NUMBER MM/RCY EFF m POLICY EXP LIMITS---- ........ m�... ..m _....... .......... gIYYYY 'AG,IDPYW1"")"„a, �.............-. ...._. .... A X COMMERCIAL GENERAL LIABILITY 59SBAR00849 0 8/08/2021 08/08/2022 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED CLAIMS -MADE X. OCCUR PREM.ISES,;Ea occurrence $1 000 000 (_ $10a000 MED EXP Any one person) PERSONAL & ADV INJURY .... ... _ $2,000 000.......... AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 �....PRO LOCPOLICYX __............_....._Ty.Pw..CR..?.O.M....D.B....UI..fl..C....T..D.S.._S.IC.N..Od.C.S.MV..'.EP.m./..OiEPAf GG..$4a,0.-0-.-.0,.,. 000 JOHER $..... A AUTOMOBILE 59SBAR00849 8/08/2021 08/08/202 Ea a AdaI -„.. 2 000,000 ANY AUTO BODILY INJURY (Per person) $.-------..- OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY �: AUTOS DAMAGE $ X AUTOS ONLY X_. AUUTOS ONLY AUTOPROPERTY !^4��I................. A .._--....--.... X occuR .�.....mmm .�............._...... �_... ..... ....._... A X UMBRELLA LIAB 59SBAR00849 8/08/2021 08/08/2022 EACH OCCURRENCE $3,000 OOO EXCESS LIAB GGREGATE $3,000 000 CLAIMS -MADE A .......__...........,,....._........ a ....... B WORKERS COMPENSATION A TION 59WECAB6SO4 8/08/ - _ $ DED X RETENTI_ON $10 OOO AND ANY PRd.7F"RIEERS' LIABILITY IABI dER/EXECUTIVE YY /2021 O8/O8/2O2 XL. EACH ACCID �T�� H $1ymm000 O0 WORKERS COMPENSATION rY 1 ❑ L U a dFatoMEn NHR i:Xti:;.I..IVDED? NIA E.L DISEASE - EA EMPLOYEE. $1,,000 OOOmmmmmIT .IT If yes, describe under DESCRIPTION_OF OPERATIONS below ..................................... . E.L. DISEASE POLICY LIMIT $1,000,000 C Professional Liab 59PGO297372 8/08/2021 08/08/202 $2,000,000/$3,000,000 $5,000/Ded/Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Liability, including ongoing and completed operations, and Auto Liability include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder, only when there is a written contract or written agreement between the named insured and the certificate holder and with regard to work performed by or on behalf of the named insured. General Liability, Auto Liability and Workers Compensation provide a blanket Waiver of Subrogation in favor of same, when required by written (See Attached Descriptions) City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE V ©, 6.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S36757599/M35396345 JZCZP SAGITTA 25.3 (2016/03) 2 of 2 #S36757599IM35396345