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PROOF OF INSURANCE (2024) CLOSEDA4C"Rf> CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDNYYY) ' 06/30/2023 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 NATEA, NICDIe Klink Merriwether & Williams Insurance Services PHONE (213) 258-3083 Ax (213) 258-3083 AIC No License No.: 0001378 F •M'AIL nicole@imwis.com ADDitSS: 44 Montgomery St., Ste, 940 INSURER(S) AFFORDING COVERAGE NAIC # San Francisco CA 94104 INSURERA: Hiscox Insurance Company Inc, 10200 INSURED INSURER B ; Jeff Cason INSURER C ; 531 Main Street #412 INSURER D : INSURER E: ElSegundo CA 90245 INSURER F : COVERAGES CERTIFICATE NUMBER: UL2363020490 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 MAYBE 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. LLTR TYPE OF INSURANCE INSD l^WVD I. POLICY NUMBER MM2R YYYYj MM DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR ENIEU PREMISES Ea occurrence, 100,000 $ MED EXP (Any one person) ......................� $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y P100.194,024,3 04/06/2023 04/06/2024 GEN LAGGREGATEI LIMITAPPLIES PER: POLICY PRO- JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ S/TGENAGG. $ OTHER AUTOMOBILE LIABILITY COMMUEDSINGLE LIMI.. (Ea accideno $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED ''. AUTOS ONLY AUTOS Y P100.194.024.3 04/06/2023 04/06/2024 BODILY INJURY(Peraccident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY I� AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ .WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOWP,ARTNER'YE':XECUTIVE 'OFFICFRIMEMBER EXCLUDED? ElN /A STATUTE ER E.L. EACH ACCIDENT $ E.L, DISEASE- EA EMPLOYEE $ (Mandatory In, NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L.. DISEASE - POLICY LIMIT $ PROFESSIONAL LIABILITY 4 $500 DED. P100.194.989.3 04/06/2023 04/06/2024 PER CLAIM $1,000,000 AGGREGATE $1,000,000 ''. DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is added as Additional Insured with respects to our Insured's operations only. This insurance is primary and non-contributory as required by written contract. 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. 350 Main Stret AUTHORIZED REPRESENTATIVE ElSegundo CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Aew IJCX Policy Number: P100.194.024.3 Named Insured: Jeff Cason Endorsement Number: 7 Endorsement Effective: 04/06/2023 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any per- son(s) or organization(s) for whom you are performing operations or leasing a premises when you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia- bility for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing opera- tions; or 2. In connection with your premises owned by or rented to you. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. CGL E5421 CW (02/14) Includes copyrighted material of Insurance Services Office, Inc., with its Page 1 of 1 permission. Am HISCO Policy Number: P100.194.024.3 Named Insured: Jeff Cason Endorsement Number: 18 Endorsement Effective: 04/06/2023 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND ONCONTRI�BUTOI' Y - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy, pro- vided: you have agreed in a written contract or agreement to add such additional insured to a policy providing the type of coverage af- forded by this policy; and you have agreed in a written contract or agreement with such additional insured that this insurance would be primary and would not seek contribution from any other insur- ance available to the additional insured. CGL E5581 CW (03/16) Includes copyrighted material of Page 1 of 1 Insurance Services Office, Inc., with its permission