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PROOF OF INSURANCE (2023 - 2024) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 09/15/23 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 WANED, 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 endrsrsarrianarmt_ PRODUCER '� Greg Bornstein or ,Andrea. Tr e o Eddin ;s Bornstein Insurance PHONE22850 W, Fat 310 32 -4343 I3tiI 325-7037 Torrance, Ca 90505 Crenshaw Blvd., Ste. 203 l ,greg0bornins,com or andrea@bornins.com Torr IN&URVER S AFFCNFttYaNG C:OVNeRA NAIOri' 1N Arch In CompanV 11150 INSURED EAGLE PROTECTION SERVICE, INC. INSURERS: Integon National Insurance Company 29742 DBA: EAGLE PROTECTION OF CALIFORNIA INS RER C. PO BOX 1428 INSURER D Torrance, CA 90505 INSLIRERE 310 320-9100 INSURER F: r""nA)r.0AIT'::..r`'.C" nraxrw7 warn s— i__ R r1" ... _. .... _...URANCE .,.» ,,,,,.,......,, I'KICVax`SVN NNLBVbLIK: Vvr THIS IS TO CERTIFY THAT THE POLICIES OF INSLISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. INSA L7R TYPE OF INSURANCE X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Iffso WVn... POt ICY' Ft'7t, CY LIMITS EACH OCCURRENCE e+w any $ 1 000 000 d. .. r �..,�.......C.,�+t '$' 100 000 00 A Y BAPKG0002714 ea is/ ray a,}aa zcaa MED EXP Aau awns ezr,„dNt PERSONAL SAOVIN.laYl$Y 1 000 000 GEN"L. AGGHC'GATE. LIMIT APPLIES PER: X 11 PCSI ICY JECOT LOC GENEWtAfr. AGGREGATE 5,000,000 $� ✓ p 000 , 000 PRODUCTS• COM WOP AsaGG 5,0004000 $ AUTOMOBILE LIABILITY 24MMISINGLrLIMIT B ANYAUTO AUTOS AUTOS ALLOWNED NCHEDULED ON OWNED X HIRED AUTOS X AUTOS II 2003901412 OG/'dlti,Ae'1 EI47id,Zp',4 BODILYI NJURY (Per person) $ BODILY INJURY (Per accident) $ P I $ $ A` UMBRELLA LAB X OCCUR EXCESS LIAB CA-AIMS-MADEAOOREGATE' '� 6T N, 0 BAFXS0066400 EACH OCCURRENCE 11000,000 r WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ,a, ANY PROPRIETORIPARTNERIE%ECUTWE (MandatorOFFI y n NH) EXCLUDED? Mandel m NH If W �, descr bQ aundef N IA ::. TAI T R E 1. EACH ACCADENT El. U(B fySE• EA EMPI,OYE,E Is �XLTMIT Holder LOCATIONS I VEHICLES ACORD 101, Addut Remaoks Schedule, may awatladXKtlf more space is required) DESCRIPTION OF OPERATIONS lers named as Additional Insured with respect to Commercial Certificate Hold General Liability for services performed by the Named Insured, per Blanket Additional Insured Endorsement Form 00 GL0334 00 04 08 City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE its officials, and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street, Room 5 AUTHORIZED REPRESENTATIVE El Segundo, CA 90245-3813 L)1988-2014 ACORD CORPORATION. All rights reserved„ ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BAPKG0002714 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: Section II, WHO IS AN INSURED, is amended by adding Any person, organization, trustee or estate: a. to whom "you" are obligated by written contract to provide insurance such as that afforded by this policy, or b. specifically designated as an additional insured on an authorized Certificate of Insurance received by "us" prior to any "occurrence"; Coverage afforded under (a) or (b) is limited to liability arising out of "your work'' for such additional insured(s) and is caused by the negligent acts of the named insured. This endorsement shall be excess of any other insurance available except coverage afforded by this endorsement will be primary and non-contributory, but only if and to the extent required by written contract.. All other terms and conditions of the Policy remain the same. 00 GL0334 00 04 08 Page 1 of 1 DATE (MMIDDIYYYY) AR" CERTIFICATE OF LIABILITY INSURANCE 05/19/2022 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 endorsement(s). PRODUCER CONTACT Automatic Data Processing Insurance Agency, Inc. Automatic Data ProcessingInsurance Agency, Inc. ( ) 1 7011 24 FAX PHONE ,.N�� Ex4 : 800-524-...,. .. _ . 1_pArce.„ Nral - 1 Adp Boulevard INSURER(s) AFFORDING COVERAGE NAIC 0 Roseland NJ 07068 INSURER A: Eagle Protection S nce Fund � 35076 9 Services Inc. INSURER B INSURED Stale Compensation nsura INSURER C : 2700 W 182ND ST STE 201 INSURER D : INSURER E Torrance CA 90504 INSURER F I'nvCDAr_CC RFRTIFICATF N11MRFR• 2461498 REVISION NLIMRFR: 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. ADDL Sl6Sp ..- - 9$1TR POLICY OFPCP(.lCY AzXfa 7 TYPE OF INSURANCE POLL,... INSD CYNUMBER MM6oDaYY'+'Y MMiDDIYYYY' LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ I , CLAIMSMADE OCCUR • . DAMArjrW(TENTED r PREM1�6v�S (F� crr�;audrerr(;e�. I $ ''.. I. 77 (Any Ipei sonr J b09 one _ -- ! PERSONAL & ADV INJURY 7 $ I` GEN'L AGGREGATE LIMIT APPLIES PER: I ATE AGGREGATE a GENERAL v $ ` 1 r(Y II I � Y � PRODUCTS COMPIOP AGG$(JL2t „, .. I Vk I AUTOMOBILE �... r. LE LIABILITY COMBINED SINGLE 9 MI $ f ti�a a,ilgfyryt ANY AUTO BODILY INJURY (Per person) � $ " OWNED SCHEDULED AUTOS ONLY AUTOS ESODILY pNJLNRY (Per aocYdentl) ; $ HIRED NON -OWNED ? i _.., PROPPRT*bAMAGt ! $ AUTOS ONLY 1. AUTOS ONLY 3 I r I(Permcu"I'denll r P f I � .. UMBRELLALIABOCCUR I -i EACH OCCURRENCE ., ,. ..,.,, $ i EXCESS LIAB CLAIMS -MADE ,, , AGGREGATE $ DIED ION $ ! RETEN �Y � WORKERS COMPENSATION` AND EMPLOYERS' LIABITY IL ( [ � I STATUTE FHH m. YIN ANY PROPRIETOR/PARTNER/EXECUTIVE A Y NIA Y 9274922-2022 r I EACH ACCIDENT 1t�t)6 000 05/01/2022-05/01/2023 - Am i'OFFICERIMEMBEREXCLUDED) 1,000,000 Mandatory in NH If describe j _ y es, under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,0010,000 I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This certificate has a blanket Waiver of Subrogation for the following state(s) :CA CFRTIFICATF 14OLDFP CANCELLATION 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. 315 Main Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245•-� V -1115tf-LUID AI,UKU L,VKrUKAIlUrv. mii ngnts reserveu. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE MAY 1, 2022 AT 12.01 A.M. AND EXPIRING MAY 1, 2023 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME EAGLE PROTECTION OF CALIFORNIA 2700 W 182ND ST TORRANCE, CA 90504 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION 9274922-22 RENEWAL SC 1-84-37-50 PAGE 1 OF NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: MAY 3, 2022 2572 Al lTun017Cn DCDDCCMUT Z". DDMCInCRJT Arvin 1