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PROOF OF INSURANCE (2024 - 2024) CLOSED.. DAT 06/ 3 20 3YYY) CERTIFICATE OF LIABILITY INSURANCE 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 T) certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT 'O Aon Risk Insurance Services West, Inc. •...... (g66) 283 7122 FAX (800) 363 0105 d San Francisco CA Office fA{C. Nrn. E•'xpp. ITITIT------ ---- (AdC,.N9p } •••••••• _•_• •-•-•••• 32 425 Market Street E-MAIL -M L 0 suite 2800 ' C 94105 USA San Francisco A INSURER(S) AFFORDING COVERAGE NAIC # INSURED ''.INSURERA:� Old Republic Union Insurance Company 31143 Lyft, Inc. 'INSURER B: Safety National Casualty Corp 15105 185 Berry Street, Suite 400 San Francisco CA 94107-2503 USA INSURERC: INSURER D: ............... ......_....._. ................_..... . ........ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570100228281 REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM 08 CONDITION OF ANY CONTRACT CAR OTHER DOCUMENT WITH RESPECT" TO WHICH THIS CERTIFICATE MAY BE ISSUED OAR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE IE'IRMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LiM,ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTFR TYPE OF INSURANCE iNSO WVD POLICY NUMBER IMMID ffYY IgpM,DVIYYY'Y LIMBS X COMMERCIAL GENERAL LIABILITY MWZY EACHOCCURRENCE $1,000,000'. - p q CLAIMS -MADE II X R OCCUR SIR applies per policy ter s & condi ions FI """"""'" PREMeSES Ea occurrence $100 , 000 IVIED EXP (Any one person) ...... PERSONAL 8 ADV INJURY $1, 000 , 000 GEN'LAG GREGATEj APPLIES PER: GEN E RAL ATE ._..� $ 2 000 , 000 ..._... .... N X PRO POLICY LOC CT _..... ............. PRODUCTS - COMP/OP AGG $2 000 , 000 0 OTHER: AUTOMOBILE LIABILITYa.,.Sr.°W. COMBINED SINGLE LIMIT UD Qtt!I.............. �..........._. .. '.. ANYAUTO BODILY INJURY (Per person) Z OWNED SCHEDULED BODILY INJURY (Per accident) .2 AUTOSIp AUTOS PROPERTYDAMAGE m v HIREDA®03 NON -OWNED We accidenll— ONLY ......... AUTOS ONLY N UMBRELLALUIB OCCUR EACH OCCURRENCE ................ ... ........... V EXCESS LIAB� CLAIMS -MADE AGGREGATE DEC RETENTIOFU B WORKERS COMPENSATION AND PRA4068277 07/01/2023 07/01f 4 XPER STATUTE OTH- EMPLOYERS' LIABILITY Y y N,. ANY PROPRIETOR / PARTNER / EXECUTIVE t•J -• - -•• E.L. EACH ACCIDENT -•• -- •••••••••••••• $1 000, 000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE EA EMPLOYEE $1, 000, 000 It yes, describe under y DESCRIPTION OF OPERATIONS helaw ....... E.L. DISEASE POLICY LIMIT _ $1 000._.__ r 000 LL DESCRIPTIOOF OPERATIONS i LOCATIONS / CLES CORD 101, ditional Remarks Schedule. my be attached If more ce Is El such by� heservice inAsuuredGeneral covProers eNextend d toinsurance thetionlalRE: General9 liabilieementtyepolicyTwillSapplfaasrP)riimary and No and on -contributory, to the 9 y extent of liability assumed under contract. waiver of subrogation applies for General Liability and workers' Compensation t coverages where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of El Segundo AUTHORIZED REPRESENTATIVE 350 Main Street El Segundo CA 90245 USA -------------------- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IL 10 (04/18) OLD REPUBLIC UNION INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - SCHEDULED PERSON OR ORGANIZATION - PRIMARY AND NON-CONTRIBUTORY BASIS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART/FORM SCHEDULE Name Of Person Or Organization: Where required by written contract A. SECTION II — WHO IS AN INSURED is amended to include as an Additional Insured, the person or organization (referred to throughout this endorsement as Additional Insured) shown in the above Schedule but only with respect to liability for `bodily injury", "property damage" or "personal and advertising injury" arising out of, 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. The insurance provided under this policy to the Additional Insured is primary insurance and we will not seek contribution from any other insurance available to the Additional Insured provided that: 1. The Additional Insured is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. GL 799 008 0721 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MWZY 316409 23 Lyft, Inc. 07/01/23 - 07/01/24 However: 1. If the Additional Insured is solely liable for the loss, this insurance shall be excess and shall contribute to the loss as set forth in the policy; 2. The insurance afforded to such Additional Insured only applies to the extent permitted by law; and 3. 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 shown in the Declarations; Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. The coverage provided by this endorsement shall be subject to all the terms, conditions and exclusions of the policy and all endorsements attached thereto. GL 799 008 0721 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 MWZY 316409 23 LA Inc. 07/01/23 - 07/01/24 IL 10 (04/18) OLD REPUBLIC UNION INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY„ WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART/FORM Name of Person(s) Or Organization(s): In the event of payment under this policy, we waive our right of subrogation against any person or organization where the insured has waived liability of such person or organization as part of a written contractual agreement between the insured and such person or organization entered into prior to the "occurrence" or offense. The following is added to Paragraph 8. Transfer Of Rights of Recovery Against Others To Us of SECTION V — CONDITIONS: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. GL 799 007 0721 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MWZY 316409 23 Lyft, Inc. 07/01/23 - 07/01/24 LYFT-XL-01 BLIE DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9125/2023 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 lant surance Metairie LA Causeway Blvd SServices, Inc. t1EJ11P1fR6r,!yft*alrant Com 3850 N Causewa Blvd Suite 1150 INSURED Lyft Inc. !Nsl/RJR C 185 Berry St #400 INSURER.D_ San Francisco, CA 94107 �_,INSURER E : Mobilitas I 16599 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 CONDITIONS OF SUCH POLICIES. LIMITS_ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 5. m.... TYPE OF INSURANCE I S y ,r ..m, m..... ...POLICY NUMBER .. .....^^^^ .......F O 0EXP — LIMITS INSR ADDL SUMR POLICY EFF POLICY COMMERCIAL GENERAL LIABILITY EACH OCGURRFN,QE. . CLAIMS -MADE OCCUR $ OAhdAGE Try EtENTFD � MED EXP Any was PeTp!2) .....,,,,------- .......... ...m.,,...__ PERSONAL &,ADVINJURY ___ CEN L AGGREGATE LIMIT APPLIES --- .....— ... PER: GENERAL„AGGREGATE $_ [PRODUCTS - ._........._ ,. JCT LOC FGI.ICYF , .. ..� MNED SINGLE IM L Iir AUTOMOBILE LIABILITY COMI .... ItpplCpt.. „....... ..... ...•...... ANY AUTO BODILY INJURY Perperson), $ OWNED SCHEDULED AUTOS ONLY — AUTOS _BODILY INJURY {Per accidents $ .,UtlR11117 AMAZE _. HIRED ONLY A7W . _ $...... .. .., . .._.........._._. .._.._.._� .. UMBREL ......... �..OGGIJRLA LIAB CUR AIMS -MADE EXCESS LIAFl� --- RENGE $ _--- __ .._. DED ( RETENTION $ _ $ ... ....._. _....................._ PER TM.d. GIDENT TH STA OFFDICER/M M ER EXCWDED?ECUTIVWORKERS COMPENSAT10N E .ITY YIN„ NIA ............�.�..-.......__ I..,.._ -ESL FJ�GH AC�._ .,EE%—.�t— ....... .. ......_. (Mandatoryin NH .... ...E,.L. DISEASE EMPLOYE.$......,......... ., If ibe under DESCRIPION OF OPERATIONS below ••••••• •••••• ..•. 0/1/2023 10/1/2024 ',PerlOd 2/CSL A Symbol 10/Primary CABA2T6624548270 10/ Llcv LIMIT y _ _.__ .... A _� 1,000,000' A Symbol 10/Primary ICABA3T6624548270 10/1/2023 10/1/2024 Period 3/CSL 1,000,000 .... ..... ........... DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space is required) The Auto Physical Damage limits are provided under Period 2 and Period 3 policies and will be ACV or the Cost of Repair, whichever is less, less the $2,500 deductible. Policy for Period 3 includes UMIUIM $1,000,000 CSL Proof of insurance for Lyft, Inc. re: General Service Agreement between The City of El Sungundo and Lyft, Inc. Any such coverage extended to the additional insured will apply as primary and non-contributory, to the extent of liability assumed under contract. Waiver of subrogation applies for Automobile Liability coverage where required by written contract. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE NOTI City of El Segundo ACCORDANCE WITH THE POLICY PROTION DATE VISIONSCE WILL BE DELIVERED IN 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CABA3T6624548270 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF FIGHTS OF RECOVERY" AGAINST OTHERS TO US (WAIVER OF SUBROGATION) ) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Lyft, Inc. Endorsement Effective Date: 10/01/2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization where required by regulation, statute, ordinance, or to the extent required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization. CA 04 44 10 13 Includes copyrighted material of Insurance Service Office Inc., Page 1 of 1 with its permission. POLICY NUMBER: CABA2T6624548270 EFFECTIVE DATE: 10/01/2022 COMMERCIAL AUTO MCA A 011 0622 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name Of Additional Insured Persons Or Or anization s : any person or organization where required by regulation, statute, ordinance, or to the extent required by contract or greement. As required to provide additional insured status on a primary, noncontributory basis, in a written contract r written agreement executed prior to loss, except where such contract or agreement is prohibited by law. complete this Schedule, if not shown above, will be shown S. A. SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, when you and such person or organization have agreed in writing, in a contract or agreement, that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to their liability for "bodily injury" or "property damage" to which this insurance applies, caused in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; and caused by an "accident" resulting from the ownership, maintenance or use of a covered "auto". However, the insurance afforded to such additional insured: 1. 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 contract or agreement to provide such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your written contract or agreement for the additional insured shown in the Schedule has been fulfilled or expires or this Policy expires, whichever date is earlier. B. Primary And Noncontributory Insurance This insurance is primary and will not seek contribution from any other insurance available to the additional insured shown in the Schedule, provided that: 1. The additional insured is a Named Insured under such other insurance; and 2. You have agreed in writing, in a contract or agreement, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. MCA A 011 0622 Includes copyrighted material of Insurance Service Office, Inc., Page 1 of 2 with its permission. C. The following condition is added to Paragraph B. General Conditions: Waiver Of Subrogation We waive any right of recovery we may have against the additional insured shown in the Schedule because of payments we make for "bodily injury" or "property damage": a. As a result of your written contract or written agreement with the additional insured; and b. Arising out of an "accident' resulting from the ownership, maintenance or use of a covered "auto". This Waiver of Subrogation applies only to the additional insured shown in the Schedule. D. SECTION II — COVERED AUTOS LIABILITY COVERAGE, C. Limit Of Insurance is amended to add the following: With respect to the insurance afforded to the additional insured shown in the Schedule, the most we will pay on behalf of the additional insured shown in the Schedule is the amount of insurance: a. Required by the contract or agreement you have entered into with the additional insured; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. E. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Includes copyrighted material of Insurance Service Office, Inc., MCA A 011 0622 with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 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 obtai n this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE WHERE A WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS IS REQUIRED BY WRITTEN CONTRACT, SUCH ADDITIONAL ENTITIES SHALL BE CONSIDERED AUTOMATICALLY SCHEDULED BY THE COMPANY. INDIVIDUALLY SCHEDULED WAIVERS SHALL NOT BE CONSTRUED TO OVERRIDE NOR NEGATE THIS BLANKET WAIVER. THIS FORM APPLIES ONLY TO THE FOLLOWING STATE(S) IF COVERED BY YOUR POLICY. IF A STATE IS NOT LISTED BELOW, THIS FORM DOES NOT APPLY IN THAT STATE. AL, AZ, CO, CT, DC, FL, GA, HI, IL, IN, IA, LA, ME, MD, MA, MI, MN, MO, MT, NV, NM, NY, OK, OR, PA, RI, SC, TN, VA, WI This endorsement changes the policyto 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 subsequentto preparation of the policy.) Endorsement Effective 07/01/2023 Policy No. PRA4068277 Endorsement No. Insured LYFT, INC. Premium $ Included Insurance Company Safety National Casualty Corporation Countersigned By WC 00 0313 (04 84) Page 1 of 1 ©1983 National Council on Compensation Insurance.