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PROOF OF INSURANCE (2024 - 2024) CLOSEDCERTIFICATE OF LIABILITY INSURANCE F DATE (MM/DDlYYYY) 12/5/2023 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). PRODUCER CON I NAME: Yd>dClrgan Ldwson Robert Bell Insurance Brokers Inc. PHarNNE' Ex, (760)451-8556 Aci Nov (T6oI4si-8613 605 East Alvarado Street EMAIL morgan@robertbellinsurance.com ADDRESS: Suite 200 INSURERS AFFORDING COVERAGE NAIC # Fallbrook CA 92028 INSURERA:ARA - Axis Insurance Company 37273 INSURED INSURER B : Pico Rents Inc., DBA: Pico Party Rents & Sells INSURERC: 4646 E Los Angeles Ave INSURER D: -- INSURER E : Simi Valley CA 93063 INSURERF: rnVFRAnPR rFRTIFICATF NIIMRFR-23-24 MASTER 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 TYPE OF INSURANCE pDDL SUB POLICY NUMBER MM/DDPOLICYEFF POLICYNYYY MM/DD EXP L7R LIMITS '.. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � AMA E"fOR N D 100,000 A CLAIMS -MADE u..:..OCCUR PREMI S Fa a rre unce $ X AlPICA001-036513-05 5/1/2023 5/1/2024 MED EXP (Any one person $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY JEC ��ILOCPRODUCTS-COMP/OPAGG ®_ $ 2,000,000 $ OTHER' AUTOMOBILE LIABILITY COMBINED SINGLE UNIT 0 awidont $ 1,000,000 BODILY INJURY (Per person) $ X A ANYAUTO ALL OWNED SCHEDULED AIPICA001-036513-05 5/1/2023 5/1/2024 BODILY INJURY (Per accident) $ AUTOS AUTOS WNED X X M,�r et'Uac6 PROPERTY DAMAGE dPCCIgffi rill $ HIREDAUTOS AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE - AGGREGATE $ 1,000,000 $ DED RETENTION $ A5PICA001-036514-05 5/1/2023 5/1/2029 WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED?r---. ❑ �NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ A ....EQUIPMENT FLOATER AIPICA001-036513-05 5/1/2023 5/1/2024 LIMIT UNLIMITED DEDUCTIBLE $5 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD101, Additional Remarks Schedule, maybe attached if more space is required) The City, its officers, officials, employees, agents, and volunteers are included as Additional Insured with regard to General Liability. Such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto per forms that apply: ARAX 30 01 08 12, CG 20 01 12 19. CERTIFICATE HOLDER L4f_1 � Lh a 1qW_U L0M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn : City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St Room 5 El Segundo, CA 90245-3813 AUTHORIZED REPRESENTATIVE Michael Bell/MOR ©1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) Policy Number: A1F'IC:AUU1-U bb13-Ub GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. N ON • 1 0 1-,A a • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II — Who Is An Insured is amended to include as an additional insured any person, organization, state or governmental agency or subdivision, or political subdivision when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) is to be named as an additional insured on your policy, subject to the following provisions: A. The contract, agreement or permit must be in effect during the policy period shown in the Declarations, and must have been executed prior to the "bodily injury," property damage" or "personal and advertising injury." B. The person, organization, state or governmental agency or subdivision or political subdivision is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. The ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: (a) This insurance does not apply to any "occurrence" which takes place after you cease to be a tenant in that premises. (b) This insurance does not apply to any structural alterations, new construction or demolition operations performed by or on behalf of the person or organization added as an insured. 2. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s), subject to the following additional exclusions: (a) This insurance does not apply to "bodily injury" or "property damage" occurring after all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) has been completed. (b) This insurance does not apply to "bodily injury" or "property damage" occurring after that portion of "your work' out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. (c) This insurance does not apply to "bodily Injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (i) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (ii) Supervisory, inspection, architectural or engineering activities. 3. The maintenance, operation or use of equipment leased to you by such person(s) or organization(s). This insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 4. 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, subject to the following provisions: ARAX 30 01 08 12 Includes copyrighted material of the Insurance Services Office, Inc. used with its permission Page 1 of 2 (a) This insurance does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of the operations performed for the federal government, state or municipality. (b) This insurance does not apply to "bodily injury" or "property damage" included within the "products - completed operations hazard." 5. Their liability as a grantor of a franchise to you. 6. Their liability as a grantor of a license to you. A person(s) or organization(s) status as an additional insured under this provision ends when: (a) The license granted to you by such person(s) or organizations(s) expires; or (b) Your license is terminated or revoked by such person(s) or organizations(s) prior to expiration of the license as stipulated by the contract or agreement. ARAX 30 01 08 12 Includes copyrighted material of the Insurance Services Office, Inc. used with its permission Page 2 of 2 r-oncy ivumDer: H-W1L AUu-i-usn5-is-u5 COMMERCIAL GENERAL LIABILITY CG20011219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. i RONZEN "" • • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 A CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/05/2023 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(ics) 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 Arthur J. Gallagher Risk Services for CoAdvantage Jeffrey Rendel 250 Tequesta Drive Tequesta, FL 33418 925-2990 INSURER A: American AFFORDING lnsuraNAIc Insurance CO DanV.............................................._-V 40142 INSURED INSURER B : CoAdvantage Corporation Labor Contractor, for co -employees of: Pico Rents, Inc. dba: Pico Party Rents ,INSURER C : 101 Riverfront Blvd Suite 300 INSURER D _........ .... ......... Bradenton, FL 34205 INSURER E _........�..........�-n... ... .....rrr._----�... ... .............-- __ - .....,...,—� INSURERF. COVERAGES CERTIFICATE NUMBER:23FL0901137143 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. ........ .................... ... -..�.w -- —..... .......,.....,., ,...... ._.__— .,,,,.. .....LIMIT"..,r-- -- . .... .... ILTR „ .. TYPE OF INSURANCE , ..,... ADt7L SO 96.#t§' C' .,--,-.. ".m-� POLICY NUMBER MM/DDNYYY MMIDDIYYYY ....... S COMMERCIAL GENERAL LIABILITY EACH CLAIMS -MADE OCCUR PREAA SIESO�ocNur er?ctm) $ -- _.._ MED EXP (Any one person) .— ............. $ �uo„ PERSONAL & ADV INJURY _ GEN• AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ _ JECT PRODUCTS -COMP/OP AGG $ OTHER:LOC AUTOMOBILE LIABILITY — YrtflG'r C Oe 121r 113 INGLI k... $ ANY AUTO BODILY INJURY (Per person) $ — OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY — PftOPEt�TYOAMAGF 4�r accldengt ,.. e- $ ... .. ..... _. $ CCUR EACH OCCURRENCE � EXCESS LIAB EXCESSUMBRELLAB .�... : ��IMS MADE AGGREGATE � .. $ � RETENTION $ � $ DED WORKERS COMPENSATION ''...X..STAPER. UTE A AND EMPLOYERS' LIABILITY N EXC UDEID ECUTIVE N N I A i WC 14-14-991-01 04/01/2023 04/01/2024 .....[�EO,R,H,,,-,�,,,-_.... ACCIDENT 2 000 (Mandatory NH) E L DISEASE EA EMPLOYEE $ 2,000,000 IF yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 2,000,000 Edwards, William included. Edwards III, William included. Edwards, Darren - included. Location Coverage Period: 04/01/2023 04/01/2024 Client# 611980-CA DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Pico Rents, Inc" dba: Pico Party Rents R Joy Ar� and the World Event 2023 Cove rage is proVudad for 4646 E Los Angeles Ave g only Ihose co -employ s of, but rot subcontractors Simi 'Valley, CA 93063 The City of El Segundo, its officers, officials, employees, agents, and volunteers. to: CERTIFICATE The City of El Segundo, its officers, officials, employees, agents & volunteers Attn: Aly Mancini 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