PROOF OF INSURANCE (2023 - 2024) CLOSEDPo6cyWjrnbar. PID'O.OR7.007�3 DaIeEntere& 08/08/2023
CERTIFICATE OFLIABILITY INSURANCE DATE WIMIDIDINYVY)
S/ 8/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UIPONI 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 IINISUIRER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER:.
IMPORTAIII If the cerfificate holder is an ADDITIONAL INSURED, the poNcypes) must have ADDITIONAL INSURED Provision$ or be endorsed.
If SUBROIGATION IS WAIVED, subject to the forms and conditions of the polity, cortalin polIcles may require an endorsement A statement on
this certificate does not Confer rights to the Certificate holder in lieu of such andorsernanQs),
PRODUCER COWYAM
Salomon Insurance Agency NAVK�
ON
71
g6a� (310) 414-9I4O�9
R
i32-11-111-
BBC' Apollo street Al',�
Suite 335 ADDRES3z
. ...........
!ngEF S) AFFORDING COVERAGE
NAC 0
El Segundo, CA 910245 MURE R A ti"C'OX insurance Company Inc
...............
INSURED XNB Consulting, LLC MiUMER S
C/0 Kristen Bergavin MUNER C:
1142 S Holt Avg INSURER D
#3 IfNSUI E:
Los Angeles, CA 90,035
MURER P
COVERAGES CERTIFICATE NUMBER.
REVISION NUMBER, -
THIS IS TO CERTIFY THAT THE POLCIES OF INSURANCE LASTED BELCW HAVE BEEN ISSUED, TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED INOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDIRION OF
ANY CONTRACT OR OTHER DOCUMENT VMTIH RESPECT TO W41CHI THIS
CERTIFICATE MAY BE ISSUED OR WY PERTAIN, THE INSURANCE AFFORDED
IBY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND, CONDITIONS OF SUCH POLICIES, LIMITS SHCM MAY HAVE BEEN REDUCED BY PAl1D CLAIMS,
In
--vM1e7-Pr— —Iftavur-
LTR TYPE OF NSVIRAKCE, MID POUCY NUMBER
AA0100,yyvvL—&9;P �Iyyvy L111WIrrS
A COMNIERCIAL GENERAL LIABILITY
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7$ 2 r 0 0 0 , 01 0 0
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E L DISkA-,% POLICY LflaIr
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A
Professional
P100085.370.3
02/015/202!3
02/05/2024
Aggregate
$1,00I0,000
. 1-iab-ility
I
093CRIPTION OF OPERATIONS I LOCAMNS WEII41CLES tACCRID 101, Addifgwwl Remarks ScbedvlC mav be atadied 4 morm %pery I% vvq,Wvedl
CERTIFICATE HOLDER CANCELLATION
City of E,l Segwitio
350 Main St
SHOULD ANY OF THE ABOVE DESC JI POLICIES BE! CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
01 SaI CA 90245
ACCORDANCE WItH THE PO LIICY PNOVISIONS,
AUTHORIZED REPRESMITATWE
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HISCOX.
enCOUrage couragial,
Youcelli, Docuiments
Enclosed you will find the policy documents that retake up your insurance contract with us.
Hilscox Insurance Company hc.
�,se *1111111711nen i , i MIT My t1tesumns or REIM Ir rp &I dinj U"*11T InAliffna
us at 844-35i7-0840 (Mon-Fd7am-10prn ET).
Declarations Page
This contains specific policy information, such as the limits and deductibles, you have selected.
Policy Wording
This details, the terms ands conditions of your coverage, subject to policy endlo,rsements.
Endorsements
These documents modify the Policy Wording or Declarations Page. These include relevant terms and conditions as
reqluiredi by your state and are part of your policy.
Notices
These documents 1provide information that may affect your coverage such as optional terrorism coverage (if
purchased) and other important items required by your state.
Aplplication Suinnimary
This is a summary of the information that you provided to us as part of your application. Rease review this document
and ow lit any of the information is incorrect.
1, 6
L"r, al lag 11-11 a Le gall I A91111HIRZIRI&JI11W.
-4—m
Phone: 866-424-8508
Mail: Hisicox Claims Center
5 Concourse �Pairkway
Suite 2,150
Atlanta, GA 30328
HI I SCOX
Declarations Page
HIS,COX
H1SCOX INSURANCE COMPANY INC. (A Stock Company)
enCOLVa,qP. COUrF391R'
104 South Michigan Avenue, Suite Fr00, Chicago, Illinois 60603
(914)1273-74010
Professional Liability
Errors & Omissions Insurance Declarations
This, is a "Claims Made and Reported" Policy in which Claim Expenses are included within the Limit of Liability
unless otherwise noted. Those words (other than the words in, the captions) which are printed in Boldface are
defined in the Policy.
Declaration Effective Date:
February 0�'
Policy Nlo.:
P10101,0185,3703
Renewalof
P1110085.3702
1. Named insured.-
suiting LLC
Z Address:
1142 S Holt Ave
3
Los Angeles, CA 90035
Email Address:
kristenbergievin@outlook,com
Limit of Liablljty
1,000,000 Each Claim
3.13•
S1,000,000 Aggregate for all Claims
4. Deductilble:
500 Each Claim
5. Notjce:
Phone, 866-424-8508
Email: reportactaim@hiscox.com
Mail: Hiiscox
5 Concourse Parkway, Suite 2150
Attn: Direct Claims
Atlanta GA, 30328
6. Policy period.,
203 ry , 2, 2, 124
From� Februa5I To: February 5
At 12V A,Mi. (Standard Time at the addlress shown above.
7, Retroactive Date,
8, Premluim-.
9. Attachments:.
DPL P001 CW (05/13) - Professionall Liability Coverage Form
DPL E5424 CW (02/115) - Blanket Additional insured Endorsement
DPIL E5026 CW (01'1/110) - Piubiic Relations Services Endorsement
D01/10) - CWifornia Amendatory Endorsement
I:NT N003 GW (01 Ill 9) - Policyholder Notice Electroft Delivery
IN hr N001 CW (01109) - Economic And! Trade Sanons Poficyholder Notice
IDPIL D001 CW (111/1 '9) Page 1
Am
HISCOX HISCOX INSURANCE COMPANY INC. (A Stoick Company)
lancourage cioll mrage, 104 South Michigan Avenue, Suite 6001, Chicago, illinois 60,6013
1(914) 273-74010
IN WITNESS WHEREOF, the Insurer Iindi Wed ahove has caused this Po9q to besigned by Rs President and Secretaq, but this Pdicy shaill not be affedive unlass also
siguedi by the linsurei's dully authicrized representative,
2=
Authorized Representative
Diate., February 5, 2023
D�PIL D0101 CW (11/1�9) Page 2
tAeo
HI'S'COX
encourage ciouralgeo
Policy Wording
•
. . .............. . . . . . .... . . . . ................... . .................. ........ .
------ . . . . . . . . . . ...................... . . .
PROFESSIONAL LIABILITY US DIRECT
ERRORS AND OMISSIONS INSURANCE
C Hi Inc, AJIl tight s reseived. DIPL P001 CW (05113)
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HI�S,COX
VP Rol 111014#11 f-� I Kon (NDM HIM
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DPL IP001 CW (05113) Q Hiscox Inc. All rights reserved!!,
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HISCOX
a . n w +r r r ► ., w 1 .
A. INSURING AGREEMENT
ENT
* �" 1V. is '" ", 1 VA .. • NX M,,, "": �� :VM �.,, ,� M '". M i. .,. Nw � �.:
We shall IN MI. on YourbehalfSupplemental • •
:.:.. covered Claim that is first made You during,. Policy Periodand
right
LORIM*&III 9"T,I#1,k
, We shall not, however, enter into a settlement without Your prior consent„ which,
consent shall not be unreasonably withheld,
If You shall refuse to consent to any settlement recommended by Us„ Our
liability for such Claim shall) not exceed the amount for which, such Claim could
have been settled) Iglus Claim )Expanses incurred up to the data of such refusal.
DPL PU01 GVV (06113), C) Hscox Inc, AN rights reserved,
AM
HISCOX
I . As a condition precedent to any coverage under this Policy,, You shall give
written notice to Us of any Claim as soon as practicable, but in all events no
later than:
a. the lend of the Policy Period (or any purchased Optional Extended
Reporting Period); or
b. 60, days after the end of the Policy Period (oi, any purchased Optional
Extended Reporting Period) so, long as such Claim is made within the last
60, days of such Policy Period (or any purchased Optional Extended
Reporting Period).
2. Such notice shall be sent to Us at the address set forth in Item 5, of the
Declarations.
3. Such notice shall include any and all documents related to such Claim,
inctuding every demandnotice, summons or other applicable information
received by You or by Your representative.
i M Magg
of such potential Claim during the Pollcy Period, Such notice must include to the
fulleist extent possible:
1 � the identity of the potential claimant;
2, the identity of the Ipeirson(s) who aflegeldly committed the Wrongful Act;
3. the date of the alleged Wrongful Act,
4. specific details of the alleged Wrongful Act; and
5. any written notice from the potential claimant, describing the Wrongful Act.
If such notice is accepted as a "potential Claimi," then any actual Claim that is
subsequently made shall be deemed to have been first made on the date such
potential Claim" was first reported to U&
Provided, however, You may not report "potential Claims" during any purchased
Optional Extended Reporting Period,
1. If We or the Named Insured cancel or non -renter this Policy (as described by
Endorsement hereto),, then the Named Insured shall have the: right to purchase
for an additional premium an Optional Extended Reporting Period. Provided,
DPL P1001 CW (06113) 4 0 Hscox Inc. All rights fes,ervedl:.
VAM
HI SO
)owever, the right to purchase an Optional Extended Reporting Period shO
,iot aipp�y
a. this Policy is canceiled by Us for nonpayment of premium (as described by
Endorsement hereto); or
b. the total premium for this Policy has not bleen fufly paid,
a. are first made against You and reported to Us during, such Optional
Extended Reporting Period; and
b. are for Wrongful Acts committed on oir after the Retroactive Date but prior
to the effective date, of cancellation or non -renewal (as describled by
Endorsement hereto),
3. The additional premium for such Optional Extended Reporting Period $hall
not exceed 200% of the annualized expiring premium for an Optional
Extended Reporting Period of 3 years.
The additional premium for such Optional Extended Reportingi Period shall
be fully earned at the inception of such Optional Extended Reporting Period,
........... . . . . . . . . .
0 di 1 0
the Declarations.
lIN I plill
MFTrj-11j=.=O millim 1111,131111-1-111
& based upon or arising out of any actual or alleged fraud, dishonesty, crirrI
conduct, or any knowingly wrongful, malicious, or intentional acts or Omissions;
provided, however that:
I We *111 pay Claim Expenses uintil there is a final adjudication establishing such
coniduict, at which, time' alu shall ireimbuIirse Us fair such Claim Expenses" and
2. this exclusion shall not apply to otherwise covered intentional acts or omissions,
resulting in a Personal Injury,
DPL P0101 CW (05113) 5 0 Ifticlax Inc. M rights rewrved.
•
B, based upon or arising out of any actual air alilege!d gaining of any profit or advantage
to which You were not legally entitled,
C. based upon or arising out of any actual or alleged wrongful termination, retaliation or
discrimination against or harasismient of any past, presie�nt, future or potential
Employee, Including but not limited to any violations of federal, state or local
statutory or common
iiiii;lllllil iiiiiiiiiiii FERMI 1!11!11!1!!Il I I I I
I was committed prior to the Retroactive Date;
2, has been the subject of any notice given under any other policy of which this
�Pioor replacement, or
I You had knowledge of prior to the Policy Period and had a reasonable basis to
believe, that such W'ronigful Aict could give rise to a Claim, provided, however,
that if this Policy is a renewal or replacement of a previous policy issued by Us
providing materially identical coverage, the Policy Period referred to in this
paragraph will be deemed to refer to, the inception date of the first such policy
issued by Us.
E, brought by or on behalf of any federal, state or local govemment agency or
professional or trade licensing organization; provided, however, this exclus,ion shall
not apply to claims brought in their capacity as a client receiving Your, Professional
Seallces.
1-11,111 1111,711171111
G. brought by or on behalf of any persoor entity, maintaining Effective Control of
You.
H. based upon or arising out of any actual or alleged violation of the following laws,
including any s,iimilar provisions of any federall, state or local statutory or common
law.
1the Securities Act of 1933 (as amended)l,
2. the Securities Exchange Act oded�)�
3. any state blue sky or securities laws (as a;lmeinded)�,
4 the Racketeer Influenced and Corrupt Organizations Act, 18 US.C6 § 19131 k4
seq. (as amenided)�
5the Emplqyee Retirement Income Security Act of 1974 (as amended);
w w'N wiated thereund.r,
I. based upon or arising out of any actual or alleigied obligation under any Workers'
Compensation, Unemployment Compensation, Employers Liability or Disability
Benefit Law, including any similar provisions of any federal, state or local statutory
or con-itot law.
I based upon or arising out of any actual or alleged liability of others that You assume
under any contract or agreement unless such, liability would have attached in the
absence of such contract or aigreement,
OPL PQQI CW (05/13), 6 0 Hisduox Inc. Ail rights reservedi,
Vito
HISCOX
based upon or ariisingi out of any actual or alleged Bodil�y Injury or Property
Damage.
�L. based upon or arisiing out of any actual, Meged or threatened discharge, dlis,persal,
release or escape of Pollutants, including any direction or request to test for,
monitor, clean up,, remove, contain, treat, detoxify or ineutralize Pollutants.
�M. based upon or arising out of any actual) or alleged infringement of any copyright,
trademark, trade dress, trade name, service mark, service name, title, 8Aogiain or
patent or theft of trade secret,
0. based upon or arising out of any actual or alleged breach of contract or breach of
any implied or express warranty or guarantee; provided, however,i this Exclusion
shall not apply to�
1. any oWigation you have to perform your Professional Services, with
reasonable skill air care; or
2. any liability You wouild have had in absence of suich, contract, warranty orr
guiaraintee,
R based upon or arising out of any actual or alleged violation of any federal, state or
local statutes, ordinances or regulationsi regarding or relating to unsolicited
telemarketing, solicitations, eni faxes or any other communications of any type
or nature, including but not linnited to any 4anti-spam" and "do-not-caill' statutes,
ordinances, or regulations.
Q. based upon or arising out of! any actuall or afleged failuire to procure or maintain
aidequate insurance or bonds.
;11!111 - 1 11!1!
W 11, 1 1111 111
S. based upon or arising out of! any actual or alleged actuarial services,, medical or
niuirsing servicesInsurance agent/broker services, legal services or services as an
architect or engineer.
A. LIMIT OF LIABILITY
DPL POO I CW (105113) 7 0 1 Inc. Al rights reserved.
ofifet
HISCOX
Regard1less, of the number of Claims made during the �Policy Peri�od (or applicable
Extended Reporting P,eriold), the maximum t�hat We shall be liable to pay for all
covered Diamagesi, Claim Expenses and Supplemental Paymients shall be as
foillows:
1. The amount set forth in Iltern 3.A. of the Declarations as "Each Claim' shall be
the maximum amount for each covered Claim.
2. The amount set forth in Itern 3.13. of the! Declarations as, "Aggregate for all
Clairris" is the maximum amount for all Claims combined.
IM 0 01 41 0 4171171171111�
2. We may at Our discretion advance paymient Of Damages or Claims, Expenses
within the Deductible amount on Your behalf, but You shall ireimlburse Us for
any such amounts, as soon as We requiest such reimbursement.
rovol-To = 01 IMIN I =U
to 101M. =VP 1 0
i OPfrall 060,11-
i III * -
IIWIIIIIIilillillll INIOA1
OWNtl4wt -
first such Claim was made.
A, ESTATES, HEIRS, LEGAL IREPRESIENTATIIVES, SPOUSES & DOMESTIC
PARTNERS
1, the heirs, executors, administrators, trustees in bankruptcy, assignees and legal
representatives of any Insured in the event of such Insured's death or disability;
or
2, the legal spouse or legal domestic partner of any Insured;
1. for the Wrongful Acts of such Insured o or
DPIL POO 1 CW (M 13) C HIscox Inc, Al dghts reserved.
441V
HISICOX
� I , 1 11 ,
Vi if] agg Im.] ace! 1111,zw I iw
You shall have the duty to cooperate, with U's in the defense, investigation and
settlement of any Claim, including but not limited to-
1. upon requiest, submit to examination and initerrogiatioder oath by Our
representativei
2, attend hearings,, depositions and trials as requested by Us;
3. assist in securing and giving evidence and obtaining the attendance of
witnesses�
4. provide written statements to Our representative and meet wi�th such
representative for the purpose of investigation andilor defense; and
5. provide all documents, We may reasonably require,
You shall not, except at Your own cost, make any payment, incur any expense:,
admit any liability, settle any Claim or assume any obligation without Our prior
consent.
171 M I FrlMtT=-
1. You have complied fully with all the: terms and conditions of this Policy; and
2. the amount of Youir obligation to pay shall have been finally determined either
by juidgmenit against You after actual trial, or by written agreement between
You, Us and the, cl4imant.
t o person or organrztffon S I i RSTF My n3T
to any Claim against You nor shall We be Impleaded by You or Your legai
representatives in any such Claim.
E. OTHIER I:NISURANCS
F. SUBROGATION
1 . lin the event of any payment by U's under this Policy, We, s,hail b=! subrogated to a!'
of You r rig of recovery to su ch payrn e nt
2. You shall do everything that may be necessary to secure and preserve such,
s,ubrogabon rights, including but not limited to the execution, of any documents,
necessary to allow Us to b;rinlg suit in Your name,
DR. P001 CW (OW1 3) 0 Hiscox Inc. Ali dghts resenwd.
44ew
H'ISiCOX
3. You shall do nothing to prejudice such subrogation rights without first obtaining
Our written consent,
4. Any recovery shalI first be paid to 1s upi toi the amount of any Damages, Claim
Expenses or Supplemental Payments that We have paid. Any remaining
amounts shall be paid to You.
J I � I I J ITIFilill I I
I E3MEB2=-
G. ALTERATION AND ASSIGNMENT
No change in, modification of air assignment of interest under this Policy shall be
effective unless made by written endorsement to this, Policy signed by Our
authonizedrepresentative.
condition precedent of Our obijgations under this Policy, You represent that:
I the statements and representations miade by You in the Application are true
and are the basis of the Policy and are to be considered as incorporated into
and constituting a part: of this Policy;
2, the statements and representations made by You in the Application shall be
deemed material to the acceptance: of thie risk assumed by Us under the Policy-,
3, this Policy is issued in reliance upon the truth of the statements and
representat�ons made by You in the Application,: and
4, in the event the Application contains misrepresentations whic�h materially affect
the acceptance of the risk assumed by Us under thiisi Policy, this Policy shall be
voidab initioi.
Your bankruptcy or insolvency shall not relieve Us of any of Our obligations under
this Policy.
K. FALSE OR FRAUDULENT CLAIMS
If any Insured shall commit fraud iin proffering any Claim or regarding the amount or
otherwise, this Insurance shall become void as to such Insured from the date such,
fraudulent claim is proffered.
L. NAMED, INSURED RESPONSIBILITIES
DPL P0101 CW (05113) 10 0 Hi Inc. All rights reserved.
F on
It shall be the responsibililty of the Named Insured to act on behalf of all other
Insured�s with respect to the following,
I giving and receiving notice of cancellation and/or none -renewal (as, described by
Endorsement hiereto);
2. payment of premium
3. receipt of return premiums;
4acceptance of changes to this Policy; and
& payment of Deductibles,.
N. TITLES
Title!s of sections of! and endorsements to this Policy are inserted solely for
convenlience of reference and shall not be deemed to limit, expand or otherwiise
affect the provisions to which they relate.
A. A�pplilcation means the signed application for the Policy, whether submitted on-fil
over the phone or on paper, includling any attachments and other materials or
statements submitted in conjunction therewith, If this Policy is a renewal or
replacement of a previous policy or policies issued by Us, Application shall also
include all signed applications, and other materials that were submitted therewith
and attached thereto,
Bodily Injury means physical injury to or sickness, disease or death of a person, or
mental injiury, mental angil emotional distress, parn or, suffering, or shock
sustained by a persion,
I i 1 9 1 ii I i I i i l! I T I ill I i I I I I 1! 1 � I'll I
EEMEMSEMM
11. Claim �Ex�pienses means the following that are incurred by Us oir by You with Ouir
prior written consent:
reasonable and necessary fel icosts and expenses (including the fees of
attorneys and experts) incurred in the investigation, defenise andi appeal of a
Claim, and
2. premiums on appeal bionds, attachment boinds or similar bonidi, Provided,
hiowever, We shail�l have no obligation to apply for air furnish any such bonds.
i
Claim Expenses shall not mean anid We shall not be obligated to pay�
1. salaries, wages or expenses other than Supplemental Payments; or
DP L P001 QVV (051131) 11 0 1 linia, Alit rights resmed.
•
2, the defense, of any criminal! investigationcriminal grand jury proceeding, or
cHimirial actiioni.
E. Damages means a monetary judgment or monetary award that You are legally
obligated to pay (including pre- or post -judgment interest) or a monetary settlement
negotiated by Us with Your consent.
Damages shall not imean and We shall not be obgateidl to pay:
1. finies, penalties, taxes, sanctionis levied against You;
2, any punifive or exemplary damages or that portion of any multiplied damages
award which exceeds thie daimagie award so multiplied, provided, however, that,
if such damages are otherwise insurable under applicable law and regulation,,
We will pay an award of punitive or exemplary damages in excess of thie
Deductible and up to, a maximum sum of $25,01,000. This limit shall be a, part of
and not in addition to the Limit of Liability set fo�rth In Items 3. of thie
Declairatiom
3. the return, reduction or restitution of Your fees, commissions, profits,, or charges
for goods provided or services rendered, including any over -charges oir cost
over -runs;
4fliquidated damages; or
5. Your cost of complying with Injunctive relief.
F. Effective Control means -
I . ownership of more than 50% of the issued and outstanding voting securities; or
2. having the right pursuant to written contract, by-laws, charter, operating
agreement or similar documents to elect, appoint or designate a majority of the
board of directors, management committee members of a partnership or the
members of the management board of a limited liabiHty coimpany (oequivalent
management structure).
G, Employee rneans any past, present orfuture;
1.
,c i employee (in l�udingi any part-time, seasonal or temporary employee or any
volunteer);
1 partner, director, officer, member or board mlember (or equivalent position);
1 independent contractor;, or
4. leased worker:
of an Organization, but only in their performance of Professional Services an
behalf of or at the dlirection of such Organization,
wa w 7 r « Mo
a 4, '* . 41
i. Optional Extended Reporting Period means any applicable OptionaFExtendidd
Reporting Period contemplated by the OPTION�AL EXTENDED REPORTING
PEIRIIOD Clouse.
OPL P001 CVV (06113) 12 Q Hiscox Inc, Al rights res,erveid.
AM
HISCOX
I k, 1! 1771 T 1171 !!1 � I � I ", � I F I I a" I i � � !! I I
Personal Injury means injury, other than Bodily Injury, arising out of one of more
of the, folloWngi offenses:
1 i false arrest, detention or imprisonment,
2malicious prosecution;
& wrongful eviction fromwrongful entry into, or invasion of the right of private
occupancy of premises;
4, slander, ble!l, defamation or disparagement of gooldsi, products or services; or
5. oral or written publication of material in connection with Youir advertising that
vtolates, a person's right of privacy.
Zlwalo= 1 1 ! I �! I! I i IT I I i I i 1! 1! 1 1 i I 1 1! I . . 1 0
A4 Pollutants means any sio�l�id, liquid, gaseous�, bio�oigical, radiological or thermal
irritant or contarninant, including smoke, vapor, dust, fibers, mold, spores, fungi,
germs, soot, fumes, acidsi, alkalis, chemicals and Waste, "WasW include$, but is
not limited to, materials to be recycled, reconditioned or reclaimed and nuclear
materials.
0. Professional Services means only those services spiecified �in Endorsement to this
1 Policy as performed by or on behalf of an Organization for others for a fee or other
compensation,
PProperty Damage means physical loss of or physical damage to or destruction of
any tangilblie property, including the loss of use thereof, For purposes of this
definition,, "taingible property"" shall not ind:ude electronic data,
Q. Retroactive Date means the date set forth in Itern 7. of the Declarations,
R. Subsidiary mean&
1. any, entity of which the Named Insured has Effective Control ("Controlled
Entity"') on or before the Policy Period, either directly or indirectly through one
or more Controlled Entities;
An entity ceases to be a SubsTdiary once the Aamed insured no longer has,
Effective! Control of such entity, either directly or indirectly through one or more
Controlled Entities, and this Pol�icy will not respond to Claims made against such,
entity thereafter,
DPL P001 CW (05113) 13 0 Hiscox linc,. AM rights resefved,
AM
HISCOX
S. Supplemental Payments means the reasonable expenses i�nicurred by You,
including loss of waiges, it You are reqed by Us to attend arbitration proceedinn
gs
or trial in the defense of a covered Claim,
T. We, Us, Our, or Insurer means the �i�nsurance company set foons.
UWrongful Act means any actual or alleged breach of duty, negligent act, error,
orrission or Personal Injury committed by You in the performance of Your
Professional Services.
V You or Your means any:
I , Organization;
2. Employee;
3. joint venture in which an Organization participates pursuarit to written,
agreement, but only for:
a. Wrongful Acts committed by such Organization; and
b, the parceintage of otherWse covered Damages and Claims Expenses in
proportion to, such, Organization's participation in the jo�nt venture.
DPL P001 GVV (05113) Q ftcox Inc. Al I 691hts, reserved
NA109
HI I S X.
Endorsements
•
Policy Number: P1010.08&3703
Named insured: KNB Consufting LLC
Endorsement Number: ii
Endorsement Effective: 02/05/2023
In consideration of the! piremiumi charged, it is understood anid agreed that the Policy is amended as
follows'.
1, ]in Clause V1. DEFINITIONS, paragraph V., O'You' oir 'Your',"' is amended to include the
following at the end thereof,
RI -A. Addonal Insured meanis any person(s) or organization(s) with whom You have
agreed in a written contract or agreement to add them as an additiona� insured to a
i
poficy providing the type of coverage afforded by this Policy, provided the contract or
agreement!
1, is currentlyin effector becomes effective duriing the Policy Period; and
2. was executed before the Professional Services from which the Clairn arises were
performed.
3. In CWus,e III. EXCLUSIONS, paragraph F. is deleted in its, entirety and replaced with the
following:
li brought by or on behalf of one Insured againstanother Insured; provided, however, t�hiis
Exclusion will not apply to any Claim brought by an Additional Insured in any caipacity
other than that of an Additional Insured.
All other teirmis and conditions remain unchanged,
DPL E5424 CW (02115) Includes copyrighted material of Insurance Services Office, Inc., with its Page 1 of 11
permission.
I = �1�
11111111111111111— 1111111 1.1ro-TIMM, In
Pubfic-Al.p. ons, Servim-Endorse g
Ot
H�IS,COX
encouirage couragia-
In consideration of the premium charged,, it is understood and agreed that the Policy is amended as follows-
OProfessional Services means the below listed services performed for others for compensation:
2. Clause V1. DEFINITIONS is amended to include the following at the end thereof:
DMA Infringement Claim means aniy Claim alleging or arising out of any actual or alleged infringement of
any copyright, trademark, trade dress, trade name, service mark, service name, title or slogain,
I I :I I I 1 11 1 11 !111111111 111M 11111, 111
I - ;I MMEMM=
Claim shall also mean, Infringement Claim,
4. In Clause INN. EXCLUSIONS, paragraphs M, is deleted in, Its enfirety�.
5. Notwithstanding anything in the Policy to the contrary, al I Infringement Cialims shalt be subject to a subfirnit of
liability of 200,000.00, which shall be part of, and not in addition, to, any applicable Limit of Liability,
6. Clause Ill. EXCLUSIONS is amended to include the following at the end thereof,.,
This Policy does not apply to and We shell have no obligation to pay any Damages, Claim Expenses, or
Supplemental Payments for any Claim:
PR A based upon or arising out of any actuall or alleged infringement of any patent or theft of trade secret.
PIR-& based upon, or arising out of any actual or, alleged promotion of media, including but not limited to
music, film, vidleo, books, magazines or other published material on, behalf of any entertainment,,
pubfishing, music (or other recording industry), intemet or media company,
PR-C, based upon or arising out of any actual or alleged promotion of entertainers, including but not limited
to musidains, artists or actors, on behalf of any entertainment, publishing, music (or other recording
industry), Internet or media company.
PR-D. based upon or arising out of any actual or alleged fundraising activities.
IPP- E. based upon or arising out of any actual air alleged price discounts, pinzes, awards, money or valuiabie
consideration given in excess of a total contracted or expected amount.
PR-P based upon or arising out of any actuaill or alleged games of chance or lotteries.
m2m3
EndorsemonU
0 Y-.l ITA
MEMMM=
Endorsement effective: Febnjary 5, 2023
Endorsement No� 2
By Kevin IKeriridgie
(Appointed Representative)
Am
HI COX
oncourage murager
mglmz�r
or
HI'SCOX
enicioumige t,;ot,cragie,
Endomorri 3
This endorsement modifies, insurance provided under the following
:j 11011*1-41-ork T-TRR
In consideration of the premiurn charged, it is understood and agreed thiat the Policy is modified as follows:
1. section V. OTHER MATTERS AFFECTING COVERAGE is amended to Include the following at the end thereof:
I JOLS,"rel
M=1
X The Named Insured may cancel this, PioliIcy Iby giving Us advance written inotice stating when thereafter
such cancellation shalt be effective. If the Named Insured cancels this Policy, the refund may be less
than pro rata,. Provided, however, if this Policy shalt be cancelled by the(Named Insured within 14
days, of the inception of the, Policy Period without having submitted a Claim, We shall return in full any
premium amount actually paid to Us. In such event, the effective date of cancellation shall be deemed to
The the inception date of the Policy Period,
I
If this Policy has been in effect for sixty (60) days or less, and is not a renewal of a Policy We have
previously Issued, We may cancel this Policy by mailing or delivering to the Named Insured at thie
mailing address shown, in the Declarations and to the producer of record, if any, advance written notice of
cancellation stating the reason for cancellation at least �
Ten (10) days before the effective date or cancellation If We cancel for,
(a) (Non-payment of premium; or
(b) Discovery of fraud by:
I. The Insuired or the Jinsured's representative in obtaining this jinsuranceor
H, The Insured or the Insured's representative in pursuing a Claim under the Policy.
Thirty (310) days before the effective date of cancellation if We cancel for any other treason.
C. Policies In Effect For More Than 60 Days.
If this Policy has been in effect for more than sixty (60) days, We may also cancel this Policy by mailing or
delivering to, the Named Insured at the address shown In: the Declarations, the producer of record, if any,
written notice, including the reason for cancellation, stating when not less than thirty (30) days thereafter
(or lien (110), days thereafter when, cancellation is due to non-payment of premium or discovery of fraud),,
the cancellatlon shall be effective.
(a) Nonpayment of premium, lincluding 1paiyment due on, a prior policy issuuedl by Us i and due during the
current policy term covering the same risks,
(b) Discovery of fraud or material misrepresentation by:
The Insured or the Insured's representative In obtalning this insuraince; or
fl, The Insured or the Insured's representative in pursuing a Claim, under the Policy,
40
HISCOX
ell'icouiraige courage,
rn J Califodot My �EAdors.o
mnt
(c) A judgment by a court or an administrative tribunal that the Insured has violated a California or
Federal law, having as oine of its necessary elements an act which materially increases any of the
risks insured against;
(d) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or
regulations establishing safety standards, by the Insured or the Insured's representative, which
materially increase any of the risks insured against
(a) Failure by the linsured or the Insured's representative to implement reasonable loss control
requiirements,, agreed to by the Insured as a condition ofp6cy Issuance, or which were conditions
precedent to Our use of a particular rate or ratirngl plan, If that failure materially Increases any of the
risks insured against;
(f) A determinabon by the Commissioner of Insurance that the
Loss of, or changes in, our reinsurance covering, all or part of the risk would threaten Our
financial integrity or solvency; or
ii. Continuation of the policy coverage wouldi:
a. Place Us in violation of California law or the laws of the state where We are domiciled;
or
b, Threaten Our solvency.
(g) A change by the Insured or the Insured's representative in, the activities or property of the
commercial or industrial enterprise, which results in a materially addecl, increased or changed risk,
is included in the Policy,
0. The mailing of the notice of cancellation shall be sufficient proof of notice and this, Policy shall terminate
at the date and hour specified In such inotice, If We cancel this Policy, any return premium shall be
calculated pro rate. Payment or tender of any unearned premium by Us shalt not be a condition,
precedent to the effectiliveniess of the cancellation, but such payment shalIll be made as soon as
practicable,
17MM17=17
if We eilect not to renew this, PolicyWe will mail or deliver to the Named Insured written notice of
nionreniewal, stating the reason for nonrenewall, not, leas than siXty (60) days, but not more than one
hundred twenty (1 20i) days before the and of the Policy Period.
We wilil mail the notice of nonrenewal to the Named Insured at the last mailing address known Us. If the
notice of nionirenewal is mailed, proof of mailing will be sufficient proar of notlice.
(a) If the transfer or renewal of a policy, without ainy changes in terms, conditions or rates, is between
U's and'a member of Our insurance group.
(bi) If the policy has been extenided for 90; days or less, provided that notice has been given in
accordance with paragraph A above.
Hiscox Insurance Company Inc.
Eadmermird 3
40
HI'SCOX
eini'DiDurage courage,
(c) If the Named Insured has obtained repWcemen:t coveraige, or if the Named Insured has agreed, ir
wrifing, within 60 days of the termination of the Policy, to obtain that coverage,
(d) If the Policy is for a period of no more than 60i days and the Named, Insured is notified at tie! time
of issuance that it will not be renewed.
(e) If the Named Insured requests a change in the terms or conditions or risks covered by the Policy
within 60 days of the ends of the IP,olicy Period,
(f) If We made a written offer to the Namied Insured, in accordance with the timeframes shown, in
Paragraph A above, to renew the Policy under changed terms or conditions or at an increased
premium rate, when the increase exceeds 25%.
Punitive and exemplary dairnages shall not be insurable in cases where California law governs the Claim.
3. The Policy is amended by adding the following Clause at the end thereof:
To the extent any term or condition contained in, the Policy or any Enidorsemient attached thereto conflicts with any
term or condition, contained in this or any other State Amendatory Endorsement attached to the Pollicy, such terms
ands conctitions, most favorable to the Insured shall apply.
All other terms and conditions remain unchanged,
Endorsement effective: February 5, 2023
Endorsement No: 3
Byevin Kerridge
(Appointed) Representative)
DPL E5 1012 CA (01 /101)
111,11
H I SCOX
encourage courage,
Notal
ices
1:3 FTA MOT71MI a M
fill
W- -1
141010011 1 0, P 10 1 1 -IN
Elfir. 11 IZIO lwow�
Tou must notIN us if your email or street address chang�es. To uipidate your email or street address, or to
req�ue,st paper documents, please contact us at 888-202-30107.
P,age I of I
INN N003 CW (01119)
Economic sanctions, prohibit all United States citizens (incluIding corporations, and other entities) and permanent
resident aliens from engaging in transactions with Specially Designated Nationals, Blocked Persons and Sanctioned
Countries. Hiscox may not accept premiium from or issuie, a poficy to insure property of or miake a claim payment to
Specially Designated National or Blocked! Person,, Hiscox may not engage in business transactions with a Sanctioln
I
Country.
"Ur ""IMUT11 "T'I 176 &MUM4 MMI WF17777t7is anj ptrslni TIT 0 Is terminieo as suc y ,, e 'lecretary of
Treasury,
met)
7f—
regulations of the United Statesi,
III Z & 1 0 . I . 1.
MAWRI ilillill[Ilillilloillillillil go] I
11161111i(Mallim W
m-141111111r,11 1 110944
HMO . . . . . .
�"O JO raTaIMMMM
0
Please read your Policy carefully and discuss with your broker/agent or ilnsuirance professional. You miay also visit the
U'S Treasury's website at hjWL11wwwjreas.gov/gff ic ,lent r ntL Ss oLgmq_ qfggl,
IINT N001 CW 01 US Page 1 of I
Report a claim, get coverage and deductible information, request a tow from the accident
scene, schedule an aippiraiisail or reserve a rental c!air using.
. USAA's Mottifle App, or
B0-531-UISAA (8722)1, our mobile phone shortcut number #81722 or
800 - 5 31 - USAA.
'This ID card is evidence of Ihabillity insurance for your vehicle. The card is vapid only as Icing as liability
insurance remains in force. Keep a copy of the IID card in your vehicle at all times.
You may be required to produce your identification card at vehicle registration or inspection, when
applying for a driver's license, foillowing, an: accident, or upon a law enforcement officer's, request.
FCA1 Re.v.6-1l3 50178 1 - 0513 — 02
............ __ ..... ............ ------------------------ ------ I ------------- ............ ........
CALIFORNIA EVIDENCE OF FINANCIAL RESPONSIBILITY
Name and Address of Insured NAIC 25968,
California Evidence of Financiiall Responsibility
KRISTEN BERGEV$N1 Keep, this caird�.
1142 S )VOLT AVE APT 3
LEIS , ANGELES CA 90035-2423 IMPORTANT: The California Financial Responsibility
Act (Section 16020) of the Vehicle Code requires every
owner or operator of a vehicle subject to the
requirements of the Financial Responsibility Act to carry
evidence of financial responsibility in the vehicle at all
times. Under vehicle code (Section 1602,8) every driver
f involved inl an accident must provide evidence of
0 financial responsibility at the scene.Failure to comply is,
an infraction anid shall be punishable by fines,
d inn—intimi—t or fit-nise suespension
Insurance Company
USAA CASUALTY IIINSIURAN CE COMPANY
Policy NurnDer, � Effective DE Irate xpiration 1
010748 27 03C 7101 1 06/0,1123 1210,1123
Vehicle Make/Vehicie Year
LEXLIS A"W"" 2009
This policy provides at least the wilnimurn aii of Habifity Insurance
required by the CA VIEW CODE SECTION 160156 fair the specified vehicle and
named insureds and miay provide coverage for other persons af-WI other
" Odes as pravWeid by the lirsurance policy,
9800 Fredericksburg Road, San Antonio, Texas 7'8,288
W103 X21; I
I NN
oil IF OF IN
. . . . . ....... . ......
I IF i
Oki,
(_) � have and willl maintain a certificate of consent of self4sure for workers' compensation, issued by the Director
of industrial Relations as provided for by Labor Code § 3700 for the performance of the work set forth the agreemient
with the Ciity lot El Segundo-
NEELIM
FRUJIUT -u 471, MUM r -0n n nn
`
of the work for which the agreement with the City of El Segundo is executed, orkers' compensation insuran
carrier and policy niumber are,
Carrier Poficy Nuirriber Expiration Diale
Nanile of Agent Phone#
(_.X_) 1� certify that�, in the performance of the work set forth in the! agreement with the City of El Seguindo, I wifll n ,atio n
jun d 0'
Ci �
employ any person, in any manneir so als to become subject to the workers' compensation laws of California, a:
3 TO
agree! that, if I should becornie si-.zubj' ct to the orkers,' compensation Provisions of Labor Code § 3,7001 1 mu
immediaWy colmplywith those proviso reement automafica1y become void.
Signature of Applicant - :v Date 2/817021
Kristen Bergelith
Print Name 111
111
# I Y
Agreement for -
Dated:
Reviewed by!