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PROOF OF INSURANCE (2025 - 2025) CLOSEDUKINTER-01 LHEMMERE DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE F21712024 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(les) 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). HUB University AvenueN,4a9CIg) 379 13 s.,Hett1 „ y �909 533 22fi6 PRODUCER License 6757776 PANT -Hemmers 0 rtlers B International Insurance Services Inc. PHONE 33 FAX X Ne 339 tMA I sands plerTilTiers fllwlainterriat)Inal Qom Suite 300 ADD ,, s y Iri u m RtslArw R�Dww coy RA _. _. Riverside, CA 92501 .._NA11c ......-- ..k,iN$uRAr.-ri,A PI"IMkawslelpwhlianl�rir�t InscJart,+rp�an'.....g8 .._ , .. ... �... _........_ _ ..... i;g, .. 1 ., ... ,. . INSURED uRERa_Cer°tain UndelWOVM Ahhay sm _ U.K. International Soccer Camps Inc. INSURER W , P. O. Box 1838 INsuREp,fs m, Redlands, CA 92373 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSiON6 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l X COMMERC AL GENERAL LIABILITY I F INSURANCEDOL SURR' POLICY NUMBER n POLkCY EFP II POLICN ESP DAMAGE TO RENTED UMIVru 00 cLArMs•MADE X . OCCUR X j ,PHPK2625875 11112024 1/1/2025 ,,PREMISES (6a Mcurrenpol Exolud. _ , . _ ...... P eNt AGGREGATE.LI " LIRRMaaITAPPL�ES PER: j � . u G'LNFRAL AFSdaffLEGATE � S .. ... 3,000 POLICY .. JECT _. LOC -� _. fFtQrUT 0."',pO;Plt%d�'ACC« �',, . . .,...000 3,000,000 __. { f r.OTHER'. I '. ....�.......... y 8 ,..�.......... s A AUTOMOBILE LIABILm a q I COMBINED SINGLE LIMIT �.tEa.a4ido df .. $ 1,000,000 # �ANYAUTO "PHPK2625875 IIIJ2024 1/1/2025 AU OS ONLY q AUTOS SCHEDULED s '. Uq�RY(PPar,amdoMf� PERTYAMAwDE �_..i AHUIR ONLY A Nt: - '^ X } r5k?err.. A X UMBRELLA LIAR X OCCUR EACH OCCl3FEMC .. 5,000,000 EXCESS LIAR CLAIMS MADE PHUB890518 1/112024 1/112025 V `REGAT'E 5 000 000 DED E X v RETENTIONS 10,000 I E u I S WORKERS COMPENSATION a i� 'AND EMPLOYERS' UABILrrY Y rnN' _ i 9 PER Y OTH- _ _.�_STAT,IITE ..I I ER_ .. _ ... µ.. ,- ..... ANY ECLII'IVE ' N I A E.L CV ( M7 FlIEFUME NH EXCLUDED? It es. describe under V u I FA _.. EMPLd7'11' '� ........__ OpSF.ASE y..a.. . ,.._-a,_.. DESCRIPTION OF P RATIONS below P - I POLICY LLWI I t E, . B (Misconduct l Abuse TBD B0621PUKINODO123 214/(2024 21412025 Each Person 1,000,000 B Misconduct I Abuse ITBD B0621 PUKINODO123 2/4/2024 2/4/2025 (Aggregate ( 2,000,000 DESCRWTION OF OPERATIONS MLOOATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be araaehod It more sPaco is required) Le: Programs, Camps field during the policy term :ity of El Segundo, its officers, officials, employees, agents and volunteers are includedas Additional Irmured on General Liability as required by written :ontract for sponseredlsupervlsed activites of the named insured per attached. 'Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc (Hub), independent of any rights which may be afforded vithin the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thl'rty (30) days of the :ancellation date, except in the event the cancellation is due to non-payment of premium, In which case Hub will provide to such certificate holders notice of ;uch cancellation within ten (10) days of the cancellation date." SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXP City of El Segundo ACCORDA NE ION DATE WITH THE POLICY PROVISIONS. 7CE WILL BE DELIVERED IN 350 Main Street El Segundo, CA 90425 AUTHORIZED REPRESENTATIVE ACORD 2512016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PI-GL-005 (07/12) ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 05/19/2023 Name of Person or Organization (Additional Insured): City of El Segundo, its officers, officials, employees, agents, and volunteers SECTION 11— WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement. Schedule, but only with respect to liability for "bodily injury," "`property damage"car "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work"' for .such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 14 of 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 001 of 002 CERTHOLDER COPY SP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 04-01-2024 CITY OF EL SEGUNDO SIP 350 MAIN ST EL SEGUNDO CA 90245-3813 GROUP: POLICY NUMBER: 1890817-2024 CERTIFICATE ID: 38 CERTIFICATE EXPIRES: 04-01-2025 04-01-2024/04-01-2025 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer,. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. �!/GI✓!/ham .j(�Jtl/1Z�[/`� Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1651 - NIK ALSOP, P,S - EXCLUDED. ENDORSEMENT #1651 - GARY GAMBLE, VP - EXCLUDED. ENDORSEMENT #1651 - NIK ALSOP, P - EXCLUDED. ENDORSEMENT #1651 - GARY GAMBLE, VP - EXCLUDED. ENDORSEMENT #1651 - NIK ALSOP, P - EXCLUDED. ENDORSEMENT #1651 - GARY GAMBLE, VP - EXCLUDED. ENDORSEMENT #1651 - NIK ALSOP, P,S - EXCLUDED. ENDORSEMENT #1651 - GARY GAMBLE, VP - EXCLUDED. ENDORSEMENT #1651 - NIK ALSOP, P - EXCLUDED. ENDORSEMENT #1651 - GARY GAMBLE, VP - EXCLUDED. EMPLOYER SOCCER CAMPS INC UK INTERNATIONAL SOCCER CAMPS INC PO BOX 1838 REDLANDS CA 92373 M0998 PRINTED : 03-18-2024 (REV.7-2014) Page 002 of 002 CERTHOLDER COPY SIP • - P.O. BOX 8192, PLEASANTON, CA 94588 ADDENDUM TO PAGE 1 ISSUE DATE: 04-01-2024 GROUP: POLICY NUMBER: 1890817-2024 CERTIFICATE ID: 38 CERTIFICATE EXPIRES: 04-01-2025 04-01-2024/04-01-2025 CITY OF EL SEGUNDO SP 350 MAIN ST EL SEGUNDO CA 90245-3813 ENDORSEMENT #1651 - NIK ALSOP, P - EXCLUDED. ENDORSEMENT #1651 - GARY GAMBLE, VP - EXCLUDED. EMPLOYER SOCCER CAMPS INC UK ENTERNATIONAL SOCCER CAMPS INC PO BOX 1838 REDLANDS CA 92373 M0998 PRINTED : 03-18-2024 (REV.2-05)