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PROOF OF INSURANCE (2024 - 2024) CLOSEDa DATE (MMIDDNYYY) ACCWE CERTIFICATE OF LIABILITY INSURANCE L 11/15/2023 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 ONTACT Ulan a Goldfinger NAME;: Professional Risk Solutions, Inc. PHONE F'f4X A+C No. Est • A!C No). 37 Walker Ave. AIL igoldfinger@prsbrokers.com Suite 200 INSURER(S) AFFORDING COVERAGE NAIC # Baltimore MD 21208 INsuRERA.. Twin City Fire 29459 INSURED I INSURER B : Zencity Technologies US Inc, DBA: PHS Corporate Services, Inc INSURER C 1313 N. Market Street INSURER D Suite 5100 INSURER E s Wilmington DE 19801 INSURER F a COVERAGES CERTIFICATE NUMBER: CL2321807976 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. INSR LTR. ........ ......... _'AMWUOR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POL CY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE is 2,000,000 FX_1 1,000,000 CLAIMS -MADE OCCUR PREMISES tEa pccurrerre $ MED EXP (Any one person) ',, $ 10,000 A 30SBMTY0198 03/07/2023 03/07/2024 PERSONAL BADV INJURY $ 2,000,000 GENLAGGREOATE.. LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 C ti POLICY JF T ❑ LOC ECI" PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHER -- AUTOMOBILE LIABILITY COMBINED SINGtX- UMT'r *vnidenty. $ 1,000000,000 ANYAUTO BODILY INJURY (Per person) $ A OWNED 30SBMTY0198 03/07I2023 03/07/2024 BODILY INJURY (Per accident) $ AUTOS ONLY HIRED AUSCHTOSEDULED NON- P'ROPERI'Y Pat - $ +� AUTOS ONLY XI AUTOS ONLY -OWNED P eYpDAMAGE . UMBRELLA LIAR ''. X OCCUR _ .._... EACH OCCURRENCE _..... $ 2,000,000 A 1 EXCESS LIAB CI AIMS -MADE 30SBMTY0198 03/07/2023 03/07/2024 AGGREGATE $ 2,000,000 DED RETENTION $ $ WORKERS COMPENSATION srATUTE EERH AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE [:::] NIA E.L. EACHACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL. . DISEASE -POLICY LIMIT $ ......._ ........... ..�.. .... .. ....... DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City, its officials, and employees as additional insureds and to state that such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto. CERTIFICATE HOLDER LoAPIL:tLL.A1 tvly 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. City Clerk 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245-3813 &X !� @ 1988-2015 ACORD CORPORATION. All rights reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DATE (MMIDD/YYYY) i - CERTIFICATE OF LIABILITY INSURANCE 11 /15/2023 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 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). "il'(: I,..C` INSURED Zencity Technologies US Inc. and/or Zencity Technologies LTD 1313 N Market St Suite 5100 Wilmington, DE 19801 i 1m i'::M INSURERA: Coalition Insurance Solutions, Inc INSURER B : ......,.,,�m.,,.,----------- :......................................................................,.,..,,.�. INSURER C : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 524210 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. ....... ................. INSY2.,,..... .. ,.�,.�,�. .- .-.-.-. ......... ...A' 6L 61lii lk' ........ .........,...... ,.__ -.........POLICY EFF ...i'OLIOY EXP ..._ ..........,, LTR TYPE OF INSURANCE I POLICY NUMBER MM/DDf1i YYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY P„REMES Ea urre , CLAIMS -MADE OCCUR MED EXP (Any onepersonj $ mo,A,.,...qq$ - ............. .... PERSONAL & ADV INJURY $ -J I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRODUCTS - COMP/OP%••••., $ $ ... PtD(,.ICY I C FRO- I+i .., LOC ,AGG ------------- AUTOMOBILE LIABILITY COMBINED1NGL.E L.tMn .LlOMBI ,rXlS .... Li `�-....... _.., ANY AUTO BODILY INJURY (Per person) $ ,...._ ALL OWNED SCHEDULED BODILY INJURY (Per accident) T $ AUTOS NON -OWNED r PROPb,R 1 Y 0AA1AGE. . $ ...,......_ HIRED AUTOS __.. AUTOS Ipa1w tar�.lat9w9.) _. ...... , .............. .. Is ..._ LA LIAB OCCUR EACH OCCURRENCE is ...... --E - EXCESS LIAB (( CLAIMS -MADE AGGREGAT $ .. .., .. ...J .,......�......_ Fs - DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH I TQRYtL.IIM11S ER I.. l AND EMPLOYERS' LIABILITY Y / N I ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ ... ...... .. OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A` E.L.. DISEA ,LOYEE� $ SE If yes, describe under $ ''. DESCRIPTION OF OPERATIONS below EL, DISEASE -POLICY LIMIT A Cyber and Technologies C-4MSK-130542-CYBER-2023 05/04/2023 05/04/2024 Each Claim Limit- $3,000,000 Errors and Omissions Aggregate Limit- $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD101, Additional Remarks Schedule, if more space is required) The City, its officials, and employees as additional insureds and to state that such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto. City of El Segundo City Clerk 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 � ACORD 25 (2010/05) V TBSS-2U7U AL.UKU GVKVUKAI IVIV. All rlgnis reserVeu. The ACORD name and logo are registered marks of ACORD >r ACC 16PK DATE � ' tFr WDWYYYYI CERTIFICATE OF LIABILITY INSURANCE 11/15/2023 �� 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 endorsements . PRODUCER AON RISK SERVICES SOUTH INC 3550 LENOX ROAD NORTHEAST SUITE 1700 SUIT ATLANTA GA 30326 CONTACT Risk Services, Inc of Florida NAME;.: Aon R FAX C N r ExtG; 833 506-1544 C No. E AIL. ADDRESS: wor'k,COm. trinet,.COm INSURERISJ AFFORDING COVERAGE NAM INSURER A: Indemnity Insurance Company of North America 43575 INSURED TnNet Group, Inc. L/C/F Zencity Technologies US, Inc,. INSURER B 1 Park Place, Suite 600 INSURER C. '. INSURER D Dublin, CA 94568-7983 INSURER E : INSURER F .. COVERAGES CERTIFICATE NUMBER: 15691498 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. INSR TYPE OF INSURANCE ADDL SUBRI POLICY NUMBER POLICY EFF POLICY EXPID LIMITS LTR INSR WVD MMD/YYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO CLAIMS -MADE ❑ OCCUR 7-1 '. EEMSE66a000u..®nre $ ''. MED EXP An one erson $ _............-------------_-- PERSONAL $ ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PROJECT 1-1 LOC PRODUCTS - COMP/O.P AGG $ OTHER $ ................ L M � NED , IN t.E1Cn4NIT AUTOMOBILE LIABILITY 'Ea accident $ BODILY INJURY Per erson $ ANYAUTO BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Per accident. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAtMS-MADE DEC RETENTION $ - W WORKERS COMPENSATION PER ETH- X STATUTE ER AND EMPLOYERS' LIABILITY Y P N EL. EACH ACCIDENT $ 2,OOQ000 A ANY PROPRIETOR/PARTNERIEXECUTIVE WLR C5314763A OFFICER/MEMBER EXCLUDED? � N / A X � 07/01I2023 07101/2024 E_L DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) "� E.L. DISEASE - POLICY LIMIT $ 2,000,000 IF yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of subrogation in favor of City of El Segundo as required by written contract. Workers Compensation coverage is limited to worksile employees of Zencity Technologies US, Inc. through a co -employment agreement with ThNet HR XI, Inc.. CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE d"Fon ask 6etvice6 South Qac 31988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy y..........g.. — . Named N.�,.... Insur11 ed ndorscmcnt Number et Group,Inc. L/C/F Zencit Technologies US, Inc. - 1 Park Place, Suite 600 Policy Number Dublin, CA 94568-7993 Symbol: WLR Number: C5314763A Policy Period 07/01/2023 TO 07/01/2024 ......... Issued By (Name of Insurance Company) Indemnity Insurance Company of North America Effective Date of Endorsement 07/01/2023 Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy, This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule City of El Segundo City Clerk 350 Main Street El Segundo, CA 90245 For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Agent WC 00 03 13 (1 1/05) © Copyright 1983-2017 National Council on Compensation Insurance, Inc. All Rights Reserved.