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PROOF OF INSURANCE (2023) CLOSED.. ..... .. ...........�.. DATE (MMIDDIYYYYI ,acoRo° CERTIFICATE OF LIABILITY INSURANCE 06/21/2022 ....................... .............. _ ...... 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). PRODUCER CON"4`AW'C'T I NAME. The Camp Team, LLC PHONE - FAX Nag ray ,)800 747-95731w" 303-422-1276 9035 Wadsworth Parkway, E•AI"C Suite 3820, AAODRES.5: info@campteam,com Westminster. CO, 80021 pl ••••••••••• ....... INSURERS) AFFORDING COVERAGE NAIC p INSURED SSEI Program Management Inc. INSURER A : HDI Global Specialty SE AA1340041 City of El Segundo INSURER B „ INSURER C : 350 Main Street INSURER D G El Segundo, CA, 90245 •••• ----- INSURER E : INSURER F COVERAGES CERTIFICATE NLIMRER- A- P» tJ-22-O6S-21-25'5 80 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. '.. TYPE OF INSURANCE ADOL POLICY NUM10 POL ICYEFF FOUCY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000,00 AN N HDGL003700608 06/21/2022 06/21/2023 ------ COMMERICAL GENERAL LIABILITY DAMAGE TO PREMISES $ 300,000.00 X RENTED An one remises) CLAIMS -MADE OCCUR X MED EXP (any one person) $ 5 000.0Q X 1 INCI UDES A'T'HL,ETfC PhRTICIPANTS PERSONAL & ADV INJURY $ 1.000 000.00 GENERAL AGGREGATE s 3,00,00Q.00, GENERAL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ X POLICY PROJECT LOCIF AUTOMOBILE LIABILITY N COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO HIRED AUTOS ---- H BODILY INJURY (Per person) $ ALL OWNED NON -OWNED AUTOS AUTOS BODILY INJURY (Per accident) $ ......... PROPERTY DAMAGE SCHEDULED AUTOS Per aeeident ,,,,-," UMBRELLA LIAB T OCCUR EACH OCCURRENCE _ $ �. AGGREGATE $ ...... EXCESS LIAB CLAIMS -MADE $ DEDUCTIBLE RETENTION $ WORKERSCONPENSATION WC STATU-OTH A DEMPLOYERSLIABLITY YIN TOR....... ANY PROPRIETOWPARTN:REXECUTNE OFFICERMEMBER EXCLUDED? ... EACH ACCIDENT EL $ '. plandatoryinh" NIA If yes, describe under E.L- DISEASE -EA EMPLOYEE $ SPECIAL PROVISIONS below E.L. DISEASE POLICY LIMIT $ OTHER A Abuse/Molestation N HDGL003700608 06/21/2022 06/21/2023 Each Occurrence: $ 100,000.00 Aggregate: $ 500,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Liability Policy Deductible: $0.00 Deductible for Bodily Injury and $ 1000.00 per Property Damage Claim. ISO Occurrence form CG 00 01 0413 and company's specific forms, Coverage for Participant Legal Liability requires that every participant signs a waiver/release, RE: Registered Theatre participants: 06/21/2022 - 06/2112023; CERTIFICATE HOLDER UAIVL.tLLA I IUN City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo, CA, 90245 Mark Di Perno ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ©1988- 2009 ACORD CORPORATION. All rights reserved. AGENCY CUSTOMER ID: A-SP-SU-22-06-21-255680 LOC# ADDITIONAL REMARKS SCHEDULE Page 1 of 1 ._ ....._.....�..... .......... _ ........ ._.� AGENCY NAMED INSURED The Camp Team, LLC City of El Segundo _. ........ .......... ..__..._..... POLICY NUMBER HDGL003700608 350 Main Street CARRIER NAIC CODE El Segundo, CA, 90245 HDI Global Specialty SE AA1340041 EFFECTIVE DATE: 06/21/2022 ©2008 ACORD CORPORATION. All rights reserved. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD