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PROOF OF INSURANCE (2024 - 2024) CLOSEDA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°D/YYYY) 5/25/2023 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 aCONTACT WS Certificates Woodruff Sawyer PHONE FAX .. 2 Park Plaza, Suite 500 WCIN2")• 844-872-6329 (Wt, Nip; Irvine CA 92614 ADDRESS certificates@wog odruff awy r.com „ INSURERS AFFORDING COVERAGE NAIC INSURERA: Berkle National Insurance Com an .----________-----------------�.y.._._.__..�.m___ 3891 -- IHinderliter HOLcoMP-01 INSURER B: Hudson Excess Company 144E de Llamas & Associates - --Insurance —.. HdL Software, LLC. INSURER C r 120 S. State College Blvd, Suite 200 INSURER ------ Brea, CA 92821 INSURER E . INSURER F : CCIVFRAnFR CFRTIFICATF Nl1MRFR, 1RR7QAQFiFF RFVISIAN 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,. INSR' .................. L. " .k -.. .-n-....POLICY EFF ���_.—.......,.., .--.n.n.n.-..,.n.n.--n.--.w..,..,-. n..._..___ POLICY EXP LTR '... TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD LIMITS A X C 0 MMERCIAL GENERAL LIABILITY '' Y TCP702275410 5/26/2023 5/26/2024 EACH OCCURRENCE $1.000,000 CLAIMS 1 OCCUR t%Afi�/a0FTd F1gTE0 .. ---- $ 1,000,000 -MADE PREMISES LEa oprurrence) MED EXP (Any one person) $ 15,000 PERSONAL 8 ADV INJURY -----.n.n----------��-- - $ 1,000,000 -- GEN'L AGGREGATE LIMIT APPLIES PER: G GENERA L AL AGGREGATE $ 2,000,000 X PI'cor. POLICY ❑ JEC•r. 0 LOC PRODUCTS - COMP/OP AGG $2,000000 OTHER: A AUTO MOBILELIABILITY TCP702275410 5/26/2023 4 5/26/2024 .:F.. O a, adasdenl. OSINGLE LtM'PT '.cc $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOSHIRED NON -OWNED L---' ^PROPERTY DA MAGE$ AUTOS ONLY AUTOS ONLY Per awdenl —$ ..... A X UMBRELLA LIAB X OCCUR TCP702275410 5/26/2023 5/26/2024 EACH OCCURRENCE $ 5„000,000 11111111 EXCESS LIAB CLAIMS -MADE AGGRE GATE $ 5,000,000 0FD X RETENTION $ N,on P$ WORKERS COMPENSATION PER 01'"H- ' AND EMPLOYERS' LIABILITY Y / N ......,,... S,TATUTE 'm........_ .E............ ........ .............. .....-- ANYPROPRIETORIPARTNERJE O ICERIM MBEREXCLU ED?ECUTIVE NIA $ -- in NH) E.L.andatory DISEASE - EA EMPLOYEE If Y ...E.L. ...$.,.,n_.-....----- DESCRIPTION OF OPERATIONS below DISEASE- POLICY LIMIT. B Professional Liability EET 14167 01 5/26/2023 5/26/2024 Prof Liab Agg $2,000,000 B Cw Cyber Umit $2.000,000 teL e_O 11B EET 467 01 5/26/2023 5/26/2024 Tech E80 Limit $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Retroactive Date for Professional Liability- 2/15/2013. Line Of Coverage: Crime Policy # 82556901 Effective Date 5/25/2023 - 5/26/2024 Carrier: Federal Insurance Company NAIC # 20281 Crime Limit: $1,000,000 See Attached... CERTIFICATE HOLDER CANCELLATION City of El Segundo, its officials, and employees 350 Main Street El Segundo CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 15 r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: HDLCOMP-01 LOC #: ACC ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Woodruff Sawyer Hinderliter de Llamas & Associates HdL Software, LLC. 120 S. State College Blvd, Suite 200 POLICY NUMBER Brea, CA 92821 CARRIER CODE 7]NAIC ....... ......... '.. EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE City of El Segundo, its officials, and employees are included as additional insured as respects General Liability to the extent provided in the attached form. Notice of Cancellation applies with respects General Liability to the extent provided in the attached form. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TCP702275410 COMMERCIAL GENERAL LIABILITY CG 20 26 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability 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 operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 C Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: TCP702275410 COMMERCIAL GENERAL LIABILITY CG 02 2410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 30 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. City of El Segundo, its officials, and employees 350 Main Street ElSegundo CA 90245 CG 02 2410 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 0 A+C " CERTIFICATE OF LIABILITY INSURANCE ]ED�AJTTE(MMIDD/YYYY) P0 MTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ................................. 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 olic les must have ADDITIONAL ..d...If ....... p y( ) 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 Affinity Marsh Affinity NAME, PHONE APtC y Ext 800-743 8130 F' .......... ....,.,,.... (NC No) a division of Marsh USA LLC. E-MAIL ADDRESS: ADPTo[alSource@marsh.com PO BOX 14404 _ ..........E Des Moines, IA 50306-9686 ..............�.._, NAIC# RAG INSURER(S)AFFORDINGCOVE..���..........................�..�������������� ,...e.,.....d.. ............................... INSURER A: ..........�,.,._. AIU Insurance Company.. 19399 ...,.,......................_... INSURED INSURERS: ADP TotalSource DE IV, Inc. INSURERC: 5800 Windward Parkway INSURER D: Alpharetta, GA 30005 �...,....__.. .................................. _. UC/F: INSURER E: Hinderliter de Llamas & Associates '. INSURER F : 120 S State College Blvd Suite 200 Brea, CA 92821 COVERAGES CERTIFICATE NUMBER: 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 SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS .................... TN­ LTR mCONDITIONS mOF TYPEOFINSURANCE �............_.._� ADDL INSD UBR.... WVD .�"ITITITITITITITITITITITITITITITmm.m�mm� POLICY NUMBER ... ,.POLICYEFF (MM/DD/YYYY) _...�... POLICYEXP (MM/DDIYYYY) LIMITS . .............. ............ _�.. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR 444 ...AAJ DAMAGE TO RENTED _. PREMISES Eaourr�mcc„� ITIT _ . $ ...-.-...i MED EXP (Any one person) $ PERSONAL & A D V INJURY $ GENERAL AGGREGATE $ ................., GEN'L AGGREGATE".LOMIT APPLIES PER: �.„ POILtlC::1" ,JECT LOC .........................................�.. PRODUCTS -COMP/OP AGG .,. _.... __ $ ....... OTHER: $ W ... ........_..__._ AUTOMOBILE LIABILITY ........__ .COMBINEDIdJGI.EI V.IMpr Ela ecND S M'emdEg ,) $ . ............. ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) ...._ $ ..................... ............. NON- PROPERTY AMAGE g AUTOS ONLY AUT®NLD ......._ UMBRELLA LIAR­`J� OCCUR ............... ...._..... EACH OCCURRENCE $ AGGREGATE ................. $ EXCESSLIAB CLAIMS -MADE .. ................... DED I RETENTION $ $ WORKERS COMPENSATION X STATUTE FR - ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA X WC 034279274 CA 07/01/2023 0710112024 ---°---- E,L. EACH ACCIDENT """" """"""""" $ 2,000,000 ......"" AMandatory in NH) E.L DISEASE EA EMPLOYEE $ 2,000,000 l yes, describe under DESCRIPTION OF OPERATIONS belowI'll _ IE.L DISEASE- POLICY LIMIT """"' $ 2.000,000 DESCRIPTION ....... OF OPERATIONS r LOCATION'S I VEHICLES (ACORD 101„ Additional Remarks Schedule„ may be attached ....... .. if more space is required) ......... All wWks4e employees workwn�g fore HGnoerlmar da Llamas "s S Ass um2es pa6d under ADP TOTALSOURCE, IN FAVOR OF CfCyy INO payroll are covered u n ier the above sealed oI GIs AS RESPLCTT�OF WANNER JOB PERFORMED Or St9BROGATION pf BY PiBndergatar da Llamas EM Ser Assocmias. undo, oSfr¢aal5, and eer�a&ogees AS REOUIR.EO BY WRd'ITEN Cs3NiThCT. CERTIFICATE HOLDER CANCELLATION Cityy of El Segundo, its officials, and employees 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. ..IZE ...-....E ENTATIV _... ... ....w_....................... AUTHORIZED REPRES LAV ACORD 6 (2016103i_..... Q 1988-2015 ACORD CO PO ION. All rights reserve The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 43 03 06 . 4-4) 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 officials, and employees AS RESPECTS OF JOB PERFORMED BY Hinderliter de Llamas & Associates AS REQUIRED BY WRITTEN CONTRACT. Person or Organization City of El Segundo, its officials, and employees 350 Main Street El Segundo, CA 90245 Job Description 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 034279274 CA Endorsement No. Insured Insurance Company AIU Insurance Company ADP TotalSource DE IV, Inc. 5800 Windward Parkway Alpharetta, GA 30005 L/C/F: Hinderliter de Llamas & Associates 120 S State College Blvd Suite 200 e Brea, CA 92821 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.