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PROOF OF INSURANCE (2023 - 2024) CLOSEDA1 P ATE (MM/DD/YYYY) A ry.. CERTIFICATE OF LIABILITY INSURANCE 07/27/2023 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 CONTAC NAME;...... PHONE.................................................................................................... Michael Geffre Insurance Agency 949-494-7261 N 949-494-4481 32392 Coast Hwy Ste 260 E-MAILADDRESS: ...................., _.................. Laguna Beach, CA 92651 INSURER(S) AFFORDING COVERAGE NAIC# INSURED URBAN FUTURES, INC. dba ISOM ADVISORS 1100 TOWN AND COUNTRY RD STE 1246 ORANGE, CA 92868 INSURERA: SCOTTSDALE 41297 _._..__....._..... .... ....._ INSURER B : MID-CENTURY INSURANCE COMPANY 21687 INSURER C: STARSTONE NATIONAL INSURANCE CO 25496 INSURERD: WESTCHESTER SURPLUS LINES 10172 INSURER E : NORTH AMERICAN CAPACITY INSURANCE 25038 INSURER F f:0Vr—'RACF CFRTIFICATF NIIMRFR• RFVIRIAN NIIMRFR- 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. ILT R ADDTYPE OF INSURANCE L U POLICY EFF POLICY EdfP LIMITS LTR. POLICYNUMBER MMIDD MMId'IyO °IY.... X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A . CLAIMS -MADE Y^ a OCCUR Y Y CPS7708187 12127/202212/27/2023 %nn" �" occurrence) PREMISES Ea or,GUrrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE'. LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X ' POLICY � JECT PRE- � LOC PRODUCTS - COMP/OP AGG $Not Covered OTHER'; $ B AUTOMOBILE LIABILITY COMBINED SINGLEUMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY X AUTOS .. Y 606900024 03/11/2023103111/2024 BODILY INJURY (Per accident) $ HIRED XNON -OWNED AUTOS ONLY AUTOS ONLY ��- PROI"�'E�.TY DAMAGE r act ,rd $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 C EXCESS LIAB CLAIMS -MADE 7012OR220ALI 12127/202212/2712023 AGGREGATE $ 2,000,000 $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBEREXCLUDED? ,..... NIA PER OTH- STATUTE _,_... , E .... '', E.L. EACH ACCIDENT _............................. .......... __...._........ $ ........................................... (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under ...... .......................... ..................... _ ................. ................. DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A SEXUAL/PHYSICAL ABUSE CPS7708187 12/27/202212/27/2023 LIMIT $25K/$50K D PROFESSIONAL LIABILITY G74382708001 12/231202212/23/2023 PER OCCURRENCE $2,000,000 E CYBER LIABILITY C&PT154335 12/23/202212/23/2023 LIMIT $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED AS RESPECTS GENERAL AND AUTO LIABILITY AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. GENERAL LIABILITY INSURANCE IS PRIMARY/NON-CONTRIBUTORY PER POLICY FORM WORDING. INSURANCE INCLUDES WAIVER OF SUBROGATION PER THE ATTACHED ENDORSEMENT(S). 30 DAY NOTICE OF CANCELLATION. GtK 1 Ir"Ill A 1 Ic. MULULK GANGtLLA I IUN CITY OF EL SEGUNDO 350 MAIN STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245-3895 ACCORDANCE WITH THE POLICY PROVISIONS. go ©1988-1015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD A� SCOTTSDALE INSURANCE COMPANY" ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE DATE FORMING A PART OF (12:01 A.M. STANDARD TIME) NAMED INSURED AGENT NO. POLICY NUMBER 1': V/2G,22 URBAN k'(F]['U11:�hS, ::I::)V(;. DE',A. .C�."."OM ADVISOR, 0 4067 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to this endorsement, SECTION II —WHO IS AN INSURED is amended to include as an additional in- sured any person or organization whom you are required to add as an additional insured on this policy under a written contract, written agreement or written permit which must be: a. Currently in effect or becoming effective during the term of the policy; and b. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury." The insurance provided to these additional insureds is lim- ited as follows: 1. That person or organization is an additional insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations for that additional insured are completed. a. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional insured(s) at the loca- tion of the covered operations has been com- pleted; or portion of "your Jvn" out of VhC1ieuTh k I11ti11 jury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. 3. The limits of insurance applicable to the additional insured are those specified in the written contract, written agreement or written permit or in the Decla- rations for this policy, whichever is less. These lim- its of insurance are inclusive of, and not in addition to, the Limits of Insurance shown in the Declara- tions for this policy. 4. Coverage is not provided for "bodily injury," "property damage," or "personal and advertising injury" arising out of the sole negligence of the additional insured. 2. With respect to the insurance afforded to these 5. The insurance provided to the additional insured additional insureds, the following exclusions are does not apply to "bodily injury," "property damage," added to item 2. Exclusions of SECTION I— or "personal and advertising injury" arising out of COVERAGES: an architect's, engineer's or surveyor's rendering of or failure to render any professional services This insurance does not apply to "bodily injury," including: "property damage" or "personal and advertising injury" occurring after: Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc., 2004 GLS-150s (7-06) Page 1 of 2 a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, re- ports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engi- neering activities. 6. Any coverage provided hereunder will be excess over any other valid and collectible insurance avail- able to the additional insured whether primary, ex- cess, contingent or on any other basis unless a written contract specifically requires that this insur- ance be primary. When this insurance is excess, we will have no du- ty under SECTION I —COVERAGES to defend the Additional insured against any "suit' if any other in- surer has a duty to defend the additional insured against that "suit." If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. WeI � / 12/28/2022 AUTHORIZED 'ATIVE DATE Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc,, 2004 GLSr150s (7-06) Page 2 of 2 COMMERCIAL GENERAL LIABILITY CG 20 01 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. �. 0r This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 24 53 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) ION) - AUTOI'ATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS 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 against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. CG 24 53 12 119 © Insurance Services Office, Inc., 2018 Page 1 of 11 POLICY NUMBER: 605900024 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: Countersigned By: 07/27/2023 Named Insured: URBAN FUTURES, INC. Authorized Re resentative SCHEDULE Name of Person(s) or Organization(s): CITY OF EL SEGUNDO ITS OFFICERS OFFICIALS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 11 CERTIFICATE OF LIABILITY INSURANCE 1 ITDATEIT`MMIDDIWYY) 07/26/2023 _............. _....�....................................................._................................................�._._� .�.. 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 CONTACT Marsh AFfini NAME: ty -NAME: 800-743-8130 FAX ............. Marsh Affinity AIC. No, Exr . APC, No): a division of Marsh USA LLC. E-MAIL ADPTotalSource@marsh.com PO BOX 14404 A.DDRESS:-.®®®®..._m..m..-,-m..m..-,-m..m.... ._._._._._. Des Moines, IA 50306-9686 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: AIU Insurance Company 19399 INSURED tust uzra to - ADP TotalSource DE IV, Inc 5800 Windward Parkway Alpharetta, GA 30005 LIC/F: Urban Futures Inc 1470 MARIA LANE STE 315 Walnut Creek, CA 945960000 COVERAGES CERTIFICATE NUMBER: INSURER E„ INSURER F: 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 ........ ... W.._.�....__._...................................................................... .... _. � ..� ........ INSR ADDL BURR POLICY EFF POLICY EXP LTR TYPEOFINSURANCE INSD ''. WVD POLICY NUMBER (MMIDD/YYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE OCCUR DAMAGE TO RENTED PR,t=MISE.v a Raacuraenaerl S MED EXP (Any one person) ...................................................................................................................................................................... S PERSONAL& ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PELT LOC PRODUCTS - COMP/OP AGG S S OTHER: AUTOMOBILE LIABILITY OOMBIGideNED SINGLE LIMIT Ea aGn t S BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S iPROPERTYOAMAGE Per accidera $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY S UMBRELLA LIA EACH OCCURRENCE S EXCESSLIAB HOCCUR CLAIMS -MADE AGGREGATE S DED RETENTION $ S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN JPER X STATUTE ER E L EACH ACCIDENT S 2,000,000 A ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA (Mandatory, in NH) X WC 0342.84166 CA 07/01/2023 07/01/2024 E.L. DISEASE - EA EMPLOYEE S 2,000,000 ff yes, desiMbe under DESCRIPTION OF OPERATIONS below """ E L. DISEASE - POLICY LIMIT .......... .. W."' S 2,000,000 ( ittonaf Remarks Schedule, may De att,-. hed if more space is required) 0ESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ACORD 101, Add. .. ac m All woakstle employeas wwking for Urban Futures Inc pabd under ADP TOTALSOURCE. INC's ayroll, .are co ared under the above stated palicy. WAIVER OF St1BROGATION IN FAVOR OF CI of El egundow its officers, offi"'41s, empployees and vowntoofs. AS RESPECTS OF JOB PERFORMED SY Urban Futures Inc AS REOUfRE.D B'Y WRI'BTE.N CONTRACT. 1470 Mada Ln CERTIFICATE HOLDER CANCELLATION Cltyyof EI eglando.................................... .... _ ..................... .............._ _..................._....._.�..._M..............................._....._..................................................... ._.... ............................. __ 350 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo,„ CA 90245 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 .f 1' M. ACORD 25 (2016/03) @ 1988-2016 ACORD CORPO IION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY. INSURANCE POLICY WC 43 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be _% of the California workers' compensation premium otherwise due on such remuneration. Schedule WAIVER OF SUBROGATION IN FAVOR OF City of El Segundo, its officers, officials, employees and volunteers. AS RESPECTS OF JOB PERFORMED BY Urban Futures Inc AS REQUIRED BY WRITTEN CONTRACT. Person or Organization City of Ell Segundo 350 Main Street El Segundo, CA 90245 Job Description 1470 Maria Ln Notes: 1. This endorsement may be used to waive the company's right of subrogation against named third parties who may be responsible for an injury.. 2. The sentence in ( ) is optional with the company, It limits the endorsement to apply to specific jobs of the insured, and only to the extent that the insured is required to obtain this waiver,. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 07/01/2023 Policy No. WC 034284166 CA Endorsement No. Insured Insurance Company AIU Insurance Company ADP TotalSource DE IV, Inc. 5800 Windward Parkway Alpharetta, GA 30005 L/C/F: Urban Futures Inc 1470 MARIA LANE STE 315 r Walnut Creek, CA 945960000 Countersigned by ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual ©2001.