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PROOF OF INSURANCE (2024 - 2024) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/ 11 /17/202323 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 SUBROGATIONIS 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 GROSSLIGHT INSURANCE/PHS PHONE (866) 467 730 FAx 72250765 (A/c, No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED PSYCHOLOGICAL CONSULTING ASSOCIATES INC. 10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024-3910 INSURER A: Sentinel Insurance Company Ltd. 11 INSURER B INSURER C : INSURER D : INSURER E : INSURER F'.r. r:OVFRAnPA rr-RTIFIr:ATE 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS L. R IN R '... WVD M/DD/YYYY MM/DD/Y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMSIiAtaEl 71 pOCCUR I,,...�....0 DAMAGE T°RENTED PR ,Atl4. .rurr ,nre $1,000,000 MED EXP (Any one person) $10,000 X 'General Liability A X 72SBA BE0717 04/01/2023 04/01/2024 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY [ _] PRO- 1 X LOC JECT Fx] PRODUCTS - COMP/OP AGG $4,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Iza3arldmil- $2,000,000 ANY AUTO BODILY INJURY (Per person) A ALL OWNED SCHEDULED AUTOS AUTOS X 72 SBA BE0717 04/01/2023 04/01/2024 BODILY INJURY (Peraccident) PROPERTY DAMAGE (Per accident) X HIRED FNON-OWNED AUTOS AUTOS UMBRELLA LIAB OCt.UR EACH OCCURRENCE AGGREGATE LIAB 1-1 CLAIMS - MADE iEXISCES ED RETENTION $ WORKERS COMPENSATION PER ISTATUTER OTH-'. AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT ANY Y/N PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/ A E.L. DISEASE -EA EMPLOYEE (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT DES2RIP112N OF,C7PERATIONSb-&& A DATA BREACH - DEFENSE & 72 SBA BE0717 04/01/2023 04/01/2024 Limit $100,000 LIAB COVG DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. r'IFRTIFIr_AT5= wnt nr-p r"..A.Nr P1 II A'TIf)M CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. '...... AAU(�T'HORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE TE DA11/17/2023Y) 11 /17/2023 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 SUBROGATIONIS 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 NUTMEG INSURANCE AGENCY INC/PHS 02025657 PHONE (866')467.8730 FAX (A/C, No, Ext): (AIC„ No): The Hartford Business Service Center E-MAIL 3600 Wiseman Blvd San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAICII INSURED Casualty Insurance Compan A: y 29424 PSYCHOLOGICAL CONSULTING ASSOCIATES INC. SURER B10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024-3910 [INSURERHartford SURER C: SURER D SURER E,. INSURER F : r_nvi:aer:FA rFPTIFI'..rATF' NIIMPtIPPI 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. INS LTR TYPED INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM POLICY EXP (MMIORN YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED M1SFS IEa or ,11Ltnr MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRODUCTS - COMPIOP AGG POLICY El PRO- LOC JECT OTHER: AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED AUTOS AUTOS ''.. BODILY INJURY (Per accident) PROPERTY DAMAGE HIRED NON -OWNED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS - MADE AGGREGATE I 'Ek7' RETENTION $ III WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER A T IT OTIY- E.L. EACH ACCIDENT. I $1 000,000 ANY YIN A OFFICER/MEMBER M MBER EXCLUDED?UTIVE NIA X 02 WEG AR6RC3 03/11/2023 03/11/2024 E.LDISEASE -EA EMPLOYEE .000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT '.. $1 ,000,000 '.. DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, AddItlonal Remarks Schedule, may be attached If more space Is required) Those usual to the Insured's Operations. Waiver of Subrogation applies in favor of the Certificate Holder per the Broad Form Endorsement -Extended Option WC990301, attached to this policy r ■ r713rr#:owl%Itrr711 CITY OF EL SEGUIND0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �1160L,1 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Account Number: CA PSYC 1870 Date: 10/17/23 Initials: JA ALLIED WORLD INSURANCE COMPANY C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 800-421-6694 This is to certif, that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the :Darned Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. 10940 WILSHIRE BLVD SUITE 1600 LOS ANGELES CA 90025 Type of Work Covered: PROFESSIONAL PSYCHOLOGIST Location of Operations: N/A (If different than address listed above) Claim History: Retroactive date is 04/1.5/2002 Additional Named Insureds: GINA L. GALLIVAN, PH.D Coverages Policy Number Effective Date Expiration Date Limits of Liability PROFESSIONAL/ LIABILITY 5011-2743 4/15/2023 4/15/2024 1,000,000 1 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: THIS POLICY HAS BEEN ENDORSED WITH CYBER LIABILITY COVERAGE. THE DEFENSE REIMBURSEMENT LIMIT FOR PROCEEDING ON THIS POLICY IS $75,000. ADDITIONAL INSUREDS: SEE ATTACHED This Certificate Issued to: Name: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. Address: 10940 WILSHIRE BLVD SUITE 1600 LOS ANGELES CA 90025 APA 00138 00 (06/2014) Authorized Representative PAGE 1 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY ITEM 2: ADDITIONAL INSUREDS 01. CITY OF LONG BEACH POLICE DEPARTMENT 400 W BROADWAY LONGBEACH, CA 90802 02. CITY OF SANTA MONICA POLICE DEPT. 333 OLYMPIC DR. SANTA MONICA, CA 90401 03. CITY OF GARDEN GROVE POLICE DEPT P.O. BOX 3070 GARDEN GROVE, CA 92842 04. CITY OF BURBANK ATTN:PURCHASING DIVISION 275 E OLIVE AVE BURBANK, CA 91502 05. CITY OF ANAHEIM 425 S HARBOR BLVD ANAHEIM, CA 92805 06. CITY OF OXNARD FIRE DEPT RISK MGMNT-REF #705715FI 300 W THIRD ST, STE 302 OXNARD, CA 93030 07. SEE ATTACHED LONG BEACH, CA 90801 08. CITY OF CULVER CITY POLICE DEPT. 4040 DUQUESNE AVE CULVER CITY, CA 90232 09. CITY OF HUNTINGTON BEACH POLICE DEPT/FIRE DEPT 200 MAIN ST., PO BOX 70 HUNTINGTON BCH, CA 92648 10. COUNTY OF LOS ANGELES CA SHERIFF'S DEPT. 211 W. TEMPLE ST LOS ANGELES, CA 90012 *** CONTINUED ON NEXT PAGE *** REPRESENTATIVE PAGE 2 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY ITEM 2: ADDITIONAL INSUREDS 11. CITY OF BEVERLY HILLS HUMAN RESOURCE ANALYST DEPT. 455 N. REXFORD DR. BEVERLY HILLS, CA 90210 12. BEVERLY HILLS POLICE DEPT. 464 N. REXFORD DR. BEVERLY HILLS, CA 90210 13. CITY OF EL SEGUNDO 350 MAIN ST. EL SEGUNDO, CA 90245 14. COUNTY OF ORANGE SHERIFF CORONER DEPT PURCH UNIT 320 N FLOWER ST SANTA ANA, 00000 15. CITY OF PASADENA 100 N GARFIELD AVE PASADENA, CA 91101 16. CITY OF RIVERSIDE RISK MNAGEMENT 3900 MAIN ST RIVERSIDE, CA 92522 17. STATE OF CALIFORNIA CDCR OFFICE OF BUSINESS 9838 OLD PLACERVILLE B-2 SACRAMENTO, CA 95827 18. THE CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BCH, CA 92647 19. MONTEBELLO UNIFIED SCHOOL DISTRICT 123 SOUTH MONTEBELLO MONTEBELLO, CA 90640 20. CITY OF MANHATTAN BEACH 420 15TH STREET MANHATTAN BEACH, CA 90266 *** CONTINUED ON NEXT PAGE *** AUTH REPRESENTATIVE PAGE 3 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY ITEM 2: ADDITIONAL INSUREDS 21. CITY OF TORRANCE 3300 CIVIC CENTER DRIVE TORRANCE, CA 90503 22. COUNTY OF LOS ANGELES DEPT OF CHILDREN & FAMILY SERVICES LOS ANGELES, CA 90020