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PROOF OF INSURANCE (2025)ACOR6 DATE (MW OD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/161'2024 r-TH IS CERPFICAVE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, MEND 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. 11 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 endorse men I( s). PRODUCER CONTACT NAME: MICHAEL EVANS Michael Evans(2921328) PHONE FAX 11706 Artesia Blvd (A/C, NO, EXT): 562-924-8228 (A/C. NO): 562-924-3961 iEMAJI_ _ . ....... ___ __ ... ........... Artesia CA 90701-3804 ADDRESS: mevans@farmersagent corn . . . ..... . INSURER(S) AFFORDING COVERAGE NAIC 11 INSURED INSURERA: Truck Insurance Exchange 21701 . . ......... .. INSURER 8: Farmers Insurance Exchange 21652 FIREFIGHTER SAFETY CENTER INSURERC: Mid Century Insurance Company 21687 14565 VALLEY VIEW AVE STEW INSURER D: SANTA FE SPRINGS, CA. 90670 - - — INSURER E:... INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: _ IQ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME 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 SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDTL ,.�.,,,SUBIR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR I S 0 M?A/DD/YYYY) i (MM/DD/YYYY) XCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE IS' Z00000 _; DAMAGE TO RENYED CLAIMS -MADE OCCUR PREMISES (Ea Occurrence) 15 1,000.000, MEDEXP(Any oneperson) 10,00-0 . . ........ .. A y �606622936 04/0112024 04/0112025 PERSONAL& ADV INJURY IS 2,000,000 . . . . . ............ GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE 1 4,000„000 POLICY PROJECT L LOC f PRODUCTS-COMP/OP AGG 1$ 2,000z( OT�illk Is _1_1 . . ................ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY S 2.000,00C E I aac . c - id I en . 1) ANYAUTO BODILY INJURY (Per pers S A OWNEDAUTOS SCHEDULED ONLY I AUTOS PJ 606622936 04/01/2024 04/01/2025 HIREDAUTOS X NON -OWNED ONLY AVTOSONLY 44 UMBRELLA LIAR OCCUR EXCESS IAAG ...CLAMASIMAEA . ............ ... .......... DED RIJENflONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/ WN EXECUTIVE OFFICER/MEMBER N/A A09239644 0110112021 1410112025 C EXCLUDED) (Mandatory In NH) Y I I yes, describe under DE SCRIPT ION OF OfERATIONS bela- DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached If more space Is required) LOCATION 1) 14565 VALLEY VIEW AVE.STE W. SANTA FE SPGS. CA 90670 CERTIFICATE HOLDER CITY OF EL SEGUNDO 350 MAIN STREET EL.-SEGUNDO. CA 90245 ACORD 25 (2016/03) 31-1769 11.15 BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE �5 AGGREGAT—E"---, CANCELLATION SHOULDANYOF THEAROVE DESC�RISEDPOLI�CIE$SECA04CEILED�BE%CRE THE EXPIRAIIO$4 DATE T14FREOF,140710E WILL at OELIVERED IN ACCORDANCE MTH tHEPOUCY PROVTS*Ns, fi AUTHORIZED REPRESENTATIVE MICHAEL EVANS 0 1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY NUMBER: 606622936 J " 23 7 1 st Edition FARMER$ INSURANCE ADDITIONAL INSURED - VENDORS This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COVERAGE FORM APARTMENTOWNERS LIABILITY COVERAGE FORM CONDOMINIUM LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) (Vendor): CITY OF EL SEGUNDO FIRE DEPT Your Products: PATCHES SEWN ON SHIRTS EMBROIDERED JACKETS Information required to complete this Schedule, if not shown above, will be shown in them Declarations. A. The following is added to Paragraph C. Who Is An Insured of the applicable Coverage Form: Any person(s) or organization(s) (referred to throughout this endorsement as vendor) shown in the Schedule is also an additional insured, but only with respect to "bodily injury" or "property damage." caused„ in whore or in part, by "your products" shown in the Schedule which are distributedor sold in the regular course of the vendor's business.. However: a. The insurance afforded to such vendor only applies to the extent permitted bylaw; and b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will) not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors, the following additional exclusions apply: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contractor agreement. This exclusion does not apply to liability for damages that the vendor wou Id have in the absence of the contractor agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which„ after distribution or sate by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or J7237 02-19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 937237 17237101