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PROOF OF INSURANCE (2024 - 2024) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 10/18/2023 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). COVERAGES CERTIFICATE NUMBER: 1698375624 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, BY PAID CLAIMS. TYPE ofCONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN 111111­111--­ EXCLUSIONS AND CODI AtdL151JFt POLIC f CFI i�czi:tcrTxw R I TR - INSURANCE 6 POUCYNUMBL.R �MMIDDIY'v"Y"a'' MMIDD LIMITS L A X COMMERCIAL GENERAL LIABILITY Y Y GL0549603 9/25/2023 9/25/2024 EACH OCCURRENCE $1 000,000 — — CLAIMS MADE X OCCUR PF(�VSI tCaoccu�erreemcp _.... $500,000 .... _MED ErIAn1 one Person) 15 000 PERSONAL INJURY $1,000,000 00 $ 200 GEN L AGGREGATE LIMIT APPLIES PER : 0„000 I GENERA,LAGGREGATE ,.,",,,,— """__....... POLICY E JEC,T . LOC P/OP AGG $ 2u000,000 PI�CY- _ . _PRODUCTS CO... ,...., OTHER: A AUTOMOBILE LIABILITY Y 7100396780003 9/25/2023 9/25/2024 CCIM8MED SINGLE UMIT $ 1 000 000 ... 4E�can _ . y ANY AUTO BODILY INJURY (Per person) $ OWNED X SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PPROPPr{T!YtDAM4Gt XHIRED X NON -OWNED � AUTOS ONLY AUTOS ONLY ___ HkedAutoPhs coal Dave $ Included AGGREGATE $1 OOt3 000 A - X UMBRELLA LIAB X"l Y Y EX0394103 9/25/2023 9/25/2024 O CU RENC `$1 000 000 OCCUR E CLAIMS -MADE 1 _ •_0 ----- -EXCESS LU1B ,. .. ..,..� ..--- DED RETEN"T'ION B WORKERS COMPENSATION Y CWWCP10009405201 5/25/2023 5/25/2024 X PER OTH AND EMPLOYERS' LIABILITY Y I N AINYPROPRIETORMARTNER'�dEXC•.CU'T''IVE j�""'' NIA _ ACCIDENT S1,000,000 ... I �... E.L.Sc...-- OFFICE:RIMwIEMBEREXCLUDED? EASE EA EMPLOYEE, $ 1 000m000 (Mandatory in NH).. .... �- OI ea, describe under DESCRIPTION OF OPERATIONSbolow E.L. DISEASE -POLICY t.IMIT $ 1,000, 00 A ' Misc. E ui ment 710-04-10-50-0002 9/25/2023 9/25/2024 Limit $310,000 9 P Rented/Owned Deductible $2,500 DESCRIPTION OF OPERA71ONS / LOCATION'S I VEHICLES (ACQRD 101, Additional Remarks Sohedulo, may be attacNd it more space is required) Certificate I•Iolder is included as Addillonal Insured on the general Liability, on a Primary, & Contributory basis, as required by a written contract or agreement. Waiver of Subrogation in favor of the Additional Insureds applies to the General Liability, Auto Liability and Workers Compensation policies, as required by a written contract or agreement. Certificate Holder is included as Additional Insured and/or Loss Payee on the Auto Liability as required by a written contract or agreement and as their interest may appear. Hired Auto Physical Damage Included, subject to $1,000 Comprehensive and Collision Deductibles. Umbrella is follow form. CERTIFICATE HOLDER _ . CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of El Segundo its officers, Officials, employees, ACCORDANCE WITH THE POLICY PROVISIONS. agents, and Volunteers AU-T�HOORIZEED REPRESENTATIVE 3501 Main St El Segundo CA 90425 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO5496-02 COMMERCIAL GENERAL LIABILITY CG 20 12 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL. INSURED - STATE OR GOVERNMENTAL TAL. AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: All States or Political Subdivisions -issuing such permits to the insured Information re aired to com lete this Schedule„ if not shown above„ will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury"" "properly damage" or "'personal and advertising injury" arising out. of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: GL05496-02 COMMERCIAL GENERAL LIABILITY ECG 24 520 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - OTHER INSURANCE (PRIMARY NOI' CONTRIBUTORY) UTORY) This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph a. Primary Insurance of 4. Other Insurance of SECTION IV COMMERCIAL. GENERAL LIABILITY CONDITIONS is replaced by the following: a. Primary Insurance This insurance is primary except when b. be- low applies. If this insurance is primary, our ob- ligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below, except that we will not seek contribution from any party with whom you have agreed in a written contract or agreement that this insurance will be primary and noncontributory, if the written contractor agreement was made prior to the subject "oc- currence" or offense. ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 O with its permission. POLICY NUMBER:GL05496-02 COMMERCIAL GENERAL LIABILITY CG 24 0412 19 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 ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS Name Of Person(s) Or Organization(s): as re uired' contract SCHEDULE to the date of an "Occurrence" this Schedule, if not shown above, will be shown in the The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: e waive any right of recovery against the persona(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. CG 24 0412 19 © Insurance Services Office, Inc., 2018 Page 1 of 1