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PROOF OF INSURANCE (2023 - 2023) CLOSEDPRESMED-01 AANAYA �►co�ro,,, CERTIFICATE OF LIABILITY INSURANCE `.�•-- DATE(MM/DD/YYYY) 8/16/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (323) 400-6705 (A/C, No): PIASC Insurance Services, Inc. 5800 S. Eastern Avenue Suite 400 ADDRIESS: info@piascins.com Los Angeles, CA 90040 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Travelers Insurance Co. 25674 INSURED INSURER B: Travelers Casualty& Surety of America 19046 Presentation Media, Inc. c/o Nate Nielson INSURERC:Clear Blue Specialty Ins Co 37745 1916 W 144th St INSURER D : INSURER E : Gardena, CA 90249 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 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 6806J20566442 6/17/2022 6/17/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 300,000 $ MED EXP (Any oneperson) $ 5,000 X GL BROAD FORM END PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY El jECT El LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Emp. Ben. $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BA1N16960442 6/17/2022 6/17/2023 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP 6J348780 6/17/2022 6/17/2023 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DED X RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE [Y] OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A ZAWC19987200 8/1/2022 8/1/2023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYEE $ 1,000'OOO E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Profesional Liab. :E7 0566442 6/17/2022 6/17/2023 DED: $1,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named ADDITIONAL INSURED with respects to services performed and/or provided by the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo Police Department 9 P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 348 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE /4 J• ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PRESMED-01 LOC #: 1 AANAYA ACOR©" `...-✓ ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED PIASC Insurance Services Inc. Presentation Media, Inc. c/o Nate Nielson POLICY NUMBER 1916 W 144th St SEE PAGE 1 Gardena, CA 90249 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance APPLICABLE COVERAGE FORMS APPLICABLE COVERAGE FORMS: -GENERAL LIABILITY Additional Insured When Required by Written Contract, Written Agreement or permit per Coverage Form CG D1 05 04 94 -GENERAL LIABILITY Primary & Non Contributory When Required by Contract per Coverage Form CG T1 00 02 19 -GENERAL LIABILITY Waiver of Subrogation per Coverage Form MP T1 02 02 05 AND CG D8 42 02 19 -GENERAL LIABILITY BLANKET ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISE Coverage Form CG 20 11 01 96 APPLICABLE AUTO COVERAGE FORMS: -AUTO Additional Insured if Required by Contract per coverage form CA T4 20 02 15 -Auto Primary & Non Contributory if Required by Contract per Coverage Form CA 00 01 10 13 -AUTO BLANKET Waiver of Subrogation if required by written contract per Coverage form CA T4 20 02 15 INSURED LOCATIONS SCHEDULE INSURED LOCATIONS SCHEDULE: 1846 W. Sequoia Avenue, Orange, CA 92868 1910-1920 144th Street, Gardena CA 90249 TRAVELERS PRPERTY CASUALTY COMPANY OF AMERICA AM BEST RATING A++ APPLICABLE COVERAGE FORM WORKERS COMPENSATION: ---------------------------------------------- ---------------------------------------------- BLANKET WAIVER OF SUBROGATION - CA FORM WC ON 04 WS A First Named Insured and Other Named Insureds Presentation Media, Inc. dba Classic Letters dba Colortek Digital dba Extraordinary Show Productions dba ESP Exhibits dba Tandem Exhibits dba Adage Graphics Page 1 of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD