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PROOF OF INSURANCE (2024 - 2025)CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDrYYYY) I� ._. 04/11 /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 pollcy(les) must be endorsed. If SUBROGATIONIS 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 CONTACT SPECIALTY PROGRAM GROUP LLC/PHS NAME: HONE (866)467-8730 Fa x 46505301 ''........ (A/C, No, Ext): (AIC, No): The Hartford Business Service Center E-MAIL 3600 Wiseman Blvd San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Underwriters Insurance Company 30104 PROGRESSIVE SOLUTIONS INSURER B ; 525 W WHITTIER BLVD INSURER C : LA HABRA CA 90631-3737 ..................... INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: .pWWW 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS TR I.NSR WVD IMMfi DDi Y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADEOCCUR DAMAGE TO RENT Eaooc.urrence. $1,000,000 ,PREMAISES MED EXP (Any one person) $10,000 X 'General Liability A _W_ WWWWW_ X X 46 SBA BA4CXE 04/10/2024 04/10/2025 PERSONAL &ADV INJURY $2,010,000 I GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY x PRO-LOC PRODUCTS - COMP/OP AGG $4,000,000 JECT ............. OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000 BODILY INJURY (Per person) ANY AUTO A ALL OWNED SCHEDULED 46 SBA BA4CXE 04/10/2024 04/10/2025 BODILY INJURY (Per accident) AUTOS AUTOS HIRED NON -OWNED PROPERTY DAMAGE X AUTOS X AUTOS (Per accident) - I .... ......... UMBRELLA OCCUR LIAB EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS- MADE ED I RETENTION $ WORKERS COMPENSATION .... j PER OTH- AND EMPLOYERS' LIABILITY _ S TUT w_ ANY Y/N E.L. EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE N/ A . OFFICER/MEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) - If yes, describe under E.L. DISEASE- POLICY LIMIT . LISr,RIPTIQN C„,•F�PERATIONS tael w�_. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Those usual to Insured's operations. CERTIFICATE HOLDER CANCELLATION Office of The City Clerk OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Patti Adlen 7BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 350 MAIN ST ACCORDANCE WITH THE POLICY PROVISIONS. EL SEGUNDO CA 90245-3895 AUTHORIZED REPRESENTATIVE ld'l� 1-41" © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD A%jr.N .II 1.UO I UIVICK IU: LOC# : ADDITIONAL REMARKS SCHEDULE Page 2..,_ of 2 AGENCY NAMED INSURED SPECIALTY PROGRAM GROUP LLC/PHS PROGRESSIVE SOLUTIONS POLICY NUMBER 525 W WHITTIER BLVD SEE ACORD 25 LA HABRA CA 90631-3737 ..................................... CARRIER NAIC CODE SEE ACORD 25 EFFECTIVE DATE: SEE ACORD 25 AUUI I IUNAL THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SL 00 00, attached to this policy. The Business Liability Coverage Part includes a Blanket Additional Insured By Contract Endorsement, Form SL 30 32. Certificate holder is an additional insured per the Additional Insured - Designated Person Or Organization Form SL3042 attached to this policy. Certificate holder is an additional insured per the Additional Insured - Owners, Lessees, Or Contractors - Completed Operations Form SL3036 attached to this policy. ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/05/2023 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(ies) must be endorsed. If SUBROGATIONIS 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 CONTACT NUTMEG INS AGENCY INC/PHS 76210781 - PHONE (888)925M313'7 FAX (A/C, No, Ext);. (ANC, No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# '.. INSURED INSURERA.: Hartford Fire and Its P&C Affiliates 00914 PROGRESSIVE SOLUTIONS INSURER B 525 W WHITTIER BLVD LA HABRA CA 90631-3737 INSURER C ; INSURER D '.. INSURER E : INSURER F c 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 IND ICATED.NOTWITHSTAND ING 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 LT TYPE OF INSURANCE ADDLSUBR INSR I WVD ', POLICY NUMBER POLICY EFF / POLICY E XP MM Pff YYY LIMITS ''... COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED PREM.gr;,,rk1rTer1reL MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY E] PRO- � LOC PRODUCTS - COMP/OP ASS JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS IBODILY INJURY (Per accident) HIRED NON -OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS - MADE Ed:7 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER STATUTE OTH- Q E,L. EACH ACCIDENT $1,000,000 ANY YIN A PROP RIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA 76 WEG AL8BA1 06/16/2023 06/16/2024 E.L.DISEASE -FA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to Insured's operations. Certificate holder is named as Additional Insured. Office of The City Clerk Patti Adlen 350 Main Street El Segundo CA 90245-3895 ACORD 25 (2016/03) 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 © 1988-2015 ACORD CORPORATION. All rights reserved.. The ACORD name and logo are registered marks of ACORD