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PROOF OF INSURANCE (2023 - 2023) CLOSEDS&SLA-1 ge 10, ACOR>D" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)10/12/2022 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 endorsements . PRODUCER 877-242-9600 CO CT Central Insurance Agency NAkR_1'E. Central Insurance Agency, Inc. P87 -HONE 7-2 00 FAX 877-243-8995 93 East Main Street A/O, NO, Exti (A°c N°M------._. P NY 1 es com Smithtown, Ormsby INSURER INSURER F : n IIMMA r' rw nr_0rHZIr ATE *J"fifiAr:0- RI=VlglON NIJM13ER: THIS IS TO CERTIFY THAT THE POLICIES INS _ ,NCE LIST - 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 DDL F UBR POLICY EFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER LIMITS A X '.. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000,000 _.. -' - CLAIMS -MADE [X OCCUR X X GLV0001060 08/30/2022 08/30/2023 DAMAGE TO RENTED d tt [7 S 250 000 s X. ...... ASSBUIt &Battery MED EXP (Arone person) 000 5.----,_.. 5 X ........_ _. Professional Liab PERSQNAL & ADV INJURY S 1,000,000, 3,000,000 GENL AGGREGATE LIMIT APPLIES PER: C,ENALAG ERGREGATE $ POLICY ..�ET LOG PRODUCTS„„ COMP/OP AGG S 3,000,000 OTHER, S COMBINED SINGLE LIMIT S AUTOMOBILE LIABILITY r Jgnll Qgrr......... ..............- ANY AUTO BODILY INJURY. Per,person S OWNED WW SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per ac,,,,_, cident ._, _........ HIRED NON o " P 01.IRT'w`IDAMAGE $ .. AUTOS ONLY . AUTO JDY _...._. - ....... . ......... S A X ELLA LIAB X OCCUR EACH OCCURRENCE %000 5,00 .__. .,�.-.... ..� SS LIAR CLAIMS MADE LDECD UMV0000262 08/30/2022 08/30/2023 AGGREGATE .,--^ m, ........ 5,000„000 ;$ X RETENTION ...-_, $ 10,000 LIABILOITY PE X R T OTH ANDEMPLOYERS'KERS Y /hl ' CPW1000381 01/05/2022 01/05/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE in NH) EXCLUDED? N 1 A E L Fit` ,,,W $,_ „_ 1 000,000 Mandatory E L DI,H„�;,AGGIDENT EASE - EA EMPLOYEE $ . .., , _ If yes, describe under DESCRIPTION OF OPERATIONS below I.LL DISEASE - P OLICY LIMIT 11000,000 $ C BPP 12SBAF0808 04/22/2022 04/22/2023 Contents 200,000 Leas/rent 20,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of El Segundo its officers,officials,employees,agents, & volunteers are incfL ded as additional insured under the general liability with respect to the liability created by the neghgent acts,, errors and omissions of the named insured herein as required by written contract.The General Liability includes a Waiver of subrogation as required by written contract. 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. 3501 Main St. El Segundo, CA 90425 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 AGURD GUKNUKA I IUN. AU rlgnts reserves. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLV0001060 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF' TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any Person or Organization for whom the insured, prior to a claim, occurrence or incident for which the insured could reasonably expect a claim or occurrence to arise, was required via written agreement or contractual obligation, to waive such rights. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work"" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 11