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PROOF OF INSURANCE (2025 - 2025)+a DATE (MM/DDNYYY) A4CC R" CERTIFICATE OF LIABILITY INSURANCE 2/26/2024 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). PRooucER, CONTACT Michael Somoles Baldwin Krystyn Sherman PHONE _ FAX 4211 W. Boy Scout Blvd. qq (,, 813-984 3236 �_ c, N813 '384 3236 E-MAIL Suite 800 DREss BRP rttfrcatBs� f3aldW!9RI§Wartners cons Tampa FL 33607 INSURERJS)AFFORDINGCOVERAGE NAIC# INSURED Burnham Benefits Insurance Services, LLC 4211 W. Boy Scout Blvd., Suite 800 Tampa FL 33607 rnvCDAr_ca P=DTICIrATC RJInJII:IF;P ,A.`AAACiIf) INSURER A Great Northern Insurance Compa _ 20303 INS,URERB, Federal Insurance Company, __2,0281 INSURER C INSURER D INSURER E : PFVI ICIN NIIMRFP, 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 --- ILTR .......... ...... ..TYPE OF INSURANCE � �.�....._ A011L tJl l � ........., POLICY NUMBER..._— l ,(MWDDfYYYY MWDD ~EXP �---- ... LIMITS A X COMMERCIAL GENERAL LIABILITY Y 36069302 3/1/2024 311/2025 EACH OCCURRENCE $1 000.000 N„— %�,� $ 1 000,000 _.... CLAIMS -MADE OCCUR PREM SES, a oocurr J_, ......... ................. ...... ............ MED EXP (Any one person) $ 15.000 ---...--------- .............. ...,...._ .....µ. PERSONAL & ADV INJURY $ 1,000,000 GEN'L m..m� AGGREGATE LIMIT APES PER: G GREGATE $ 2 000 000 ,P,ENERAL AG PIMI POLICY X LOG JEC^p` PRODUCTS COMP/OP AGG $ Included .. � $ OTHER:: A AUTOMOBILE LIABILITY 73620127 3/1/2024 311/2025 VLa COMBBINEDINED SINGLE LIMV1 a $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ... .....__. ...... ---� OWNED SCHEDULED BODIL..�....�. ____. Y INJURY (Per accident) - $ AUTOS ONLY AUTOS HIRED NON -OWNED t'71 ER'FYOAMAGU $ _ AUTOS ONLY , ONLY t'p B X,.. UMBRELLA LIAB X 78188562 311/2024 3l1/2025 OCCURRENCE $25,000000 .. EXCESS LIAB CLAIMSMADE..., j LL G AGGREGATE,.... _ - $25,000000 ,.,....I ---�I 4 DE D X [RETENTION $ ..T $ WORKERS COMPENSATION PER OTH- LSTATU7E AND EMPLOYERS' LIABILITY YIN ,,FAR w, „ _ __ ------- ANYPROPRIER F�(EC E OFFICERIMEMBER EXCLUDED? E m N I i4 ACCIDENT $ ..... (Mandatory NH)PART ,L DS EASE EA EMPLOYEE E.., ._....- ..... ._ $ ..... .. ....... If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of El Segundo, its officials, and employees are included as Additional Insured with respect to General Liability -if required b Written contract and subject to if by terms, conditions, and exclusions of the policy. Coverage is provided on a Primary &feton-Contributory basis on the General Liability requiredWritten contract and subject to terms, conditions, and exclusions of the policy. Umbrella Liability pOicy fallouts form over General Liability- subject to terms„ conditions, and exclusions. 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 350 Main Street El Segundo CA 90245 ©1988-2015 ACORD CORPORATION. All rights reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CH U B Bm Liability Insurance Endorsement Policy Period MARCH 1, 2023 TO MARCH 1, 2024 Effective Date MARCH 1, 2023 Policy Number 3606-93-02 BHM Insured BRP GROUP, INC. Name of Company GREAT NORTHERN INSURANCE COMPANY Date Issued APRIL 26, 2023 This Endorsement applies to the following forms: GENERAL LIABILITY Under Who Is An Insured, the following provision is added Who Is An Insured Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto). • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Liability Insurance Add banal Insured - Scheduled Peraw Or OWnLtabon conEnued Form 80-02-2367 (Rev. 5-07) Endorsement Page 1 CHUBB® Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Conditions Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT TO A CONTRACT OR AGRESVIENT, TO PROVIDE WTTH SUCH INSURANCE AS IS AFFORDED BY THIS POLICY. All other terms and conditions remain unchanged. Authorized Representative#' Liability Insurance Additional Insured - scheduled Person Or Organiza &on last page Form 80-02-2367 (Rev. 5-07) Endorsernent Page 2 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 2/28/2024 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 riqhts to the certificate holder in lieu of such endorsement(s). PRODUCER IeS Baldwin K st n Sherman µ PHONE FAX d�lc Na 813 3236 Svc rto1; 813-984 3236 4211 W. Bo Scout Blvd. y .Eask�l „984 EMAIL Suite 800 B Pcerli i t s M afidwarlRlskd'artner cQ_ ,RDDR(�! _..... ........ ----- Tama FL 33607 p AF DING OVE _....... INSURER s.......F.4.R............. � -- ---..............................��. ............................ . ---------...t I .................RAGE ...................�.�.� NAIL it -- ,INSURER „A: Pacific Indemnity.Company INSURED INS BRP Colleague Inc. BRP Colleague II Inc. EIB "rtxuR Rc 4211 W. Boy Scout Blvd., Suite 800 NSUR ER D �.1._,..---......................... .............................................______ ..-�.��.....�.... Tampa FL 33607 INSURERE o INSURER F i CAVFRAGF-R CERTIFICATE NUMBER 207431479 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 ............ ..............._ DOL:64BR� ...POLICY EF .. POLT—C— P— TMPEOFINSURANCE D ---LIMITS N LTR INjollWvn POLICYNUMBER MMOWYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ...--- ----.� CLAIMS -MADE OCCUR „PREMtlSLS - -------.... .........._...................................................._ MED EXP (Any..one„p,e„rsopl..........� $..........__.... ..... PERSONAL & ADV INJURY $ S PER: GENLAGGREGATE LIMIT APPLIEA GGREGATE $ � GENERAL A.......,,.. .. -- ...,.... - __ ------- �PRO- POLICY JECT LOC PRODUCTS-COMPIOP y__ ......TS AGG $ OT1JER AUTOMOBILE LIABILITY COMBINED S INUIN11Min YY _xLS _-Wens $ ......... ANY AUTO BODILY INJURY (Per person) $ SCHEDULED BODILY INJURY (Per accident) $ '. AOWNED UTOS ONLY HIRED NON -OWNED AUTOS pRO��RTeYnDAMAGE $ - AUTOS ONLY AUTOS ONLY -....-_._�1_ _ ..... ....,.,--. .. ...... $ UMBRELLA LIAB .... OCCUR EACH OCCURRENCE ..,...... ,-, $ ............ ..... EXCESS�LI(AB II CLAIMS -MADE AGGREGATE --- .....,.,... ........ .,...,..:.--- $ ...........� DED 11 RET.......... ..... ............. .. ENTION $ $ A WORKERS COMPENSATION 71740952 1/1/2024 1/1/2025 X PER OTH STATUTE ER ER, AND EMPLOYERS' LIABILITY Y d N ANYPROPRIETOR/PARTNER/EXECUTIVE L EACH ACCIDENT $ 1 Ew„ _., .000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) NIA E.L. DISEASE EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of El Segundo 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. © 1988-2015 ACORD CORPORATION. All rights reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 2/28/2024 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), INSURER F : A CAVERAt±ES CERTIFICATE NUM13ER:11R92S2993 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. .. ... ,..__m . .�.. __.... ...,...-....._ ._— Y E ,...__......... __ ..... .... ...,....... ........., POLIC YY INSrt AD L �UBR�. POLICY YEXP TYPE OF INSURANCE POLIC...,.�.� LT LIMITS NUMBER MMPDOdY Mh1'fDDIYYYY V ''. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ......� ". .... ... CLAIMS -MADE �I---- OCCUR`I1� REMISES,cu ., Ea acmence) _ $... „....--. MED EXP (Any one erso) _ $ PERSONAL 8 ADV INJURY ...,. $ GEN'L ... AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ .........� RO POUCY LOC ❑ 1ECi ❑ ,.RODUCTS.-COMP/OPAGG ? $ ............. .�_. _ --- _ 0o'k1�L-:R.0 -- AUTOMOBILE LIABILITY---- C'OMA9BIdEDSINIGLELIMIT a accbutza�t). — $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS---' HIRED NON -OWNED PROPERTY-��--�� DAMAGE. $ _, ............. AUTOS ONLY .......�'.� AUTOS ONLY (('..a-rr's!GrI'pnl�,..,.�.,._._,_ ...�...,... -. Is UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ .___........,_EXCESS LIAB CLAIMS -MAD AGGREGATE $ ..... DED FI'; RETENTION $ + $ WORKERS COMPENSATION PER 01"'H ER AND EMPLOYERS' LIABILITY YINE,L. ANYPROPRIETOR/PARTNER/EXECUTIVE EACH ACCIDENT_ $ OFFICER/MEMBEREXCLUE NIA (Mandatory ) L. DISEASE EA EMPLOYEE' E����..----.— ,.. $ -. .. ...... _ ...... If yes, describe under DESCRIPTION OF OPERATIONS below E .L. DISEASE POLICY LIMIT $ A Errors &Omissions SPL004221113 3/1/2024 3/1/2025 Each claim limit $5,000,000 Aggregate limit $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of El Segundo 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. ©1988-2015 ACORD CORPORATION. All rights reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD