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PROOF OF INSURANCE (2024 - 2025) CLOSEDACORD CERTIFICATE OF LIABILITY INSURANCE �,� D03/19/2024 YY) 03/19/2024 PRODUCER Costanza Ins. Agency, Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3010 LBJ Freeway ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 925 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Dallas TX 75234- (972)991-6084 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Summit Specialty - GL 16889 Arroyo Background Investigations ".""" """"""� Eric Arroyo INSURER B: 19510 Van Buren Blvd #F3-192 INSURER C: Riverside CA 92508- INSURER D: ._ .... ------,_-----,., INSURER E:. I"ntl'GR A.iC' w 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ww-----------_ ----- „... _..... .....�.-. INSRD.........................-.-- D' POLICY EFFECTIVE POLICY EXPIRATION I TO POLICY NUMBER LIMITS A GErNERALLIABILITY SCGL005000024402 03/19/2024 03/19/2025 EACH OCCURRENCE _ $ mmmmm 1,000,000 X COMMERCIAL GENERAL. LMiLITY' DAMAGE TO RENTED .kiEat"IISES.4E ":�eecanse)✓...- 100,000 $ .................. CLAIMS MADE E m� OCCUR MEa FXP,tAn„_y one person) $ ._j. ITOOO PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATEITITITITITITITIT, $ 2,000,000 X ERRORS AND OMISSIONS GE:N`L.AGGREGAT _ _ _..ELIMITAIPLIESPER: ... .�... '.PRODUCTS - COMP/OP AGG $ITITITITITITITITIT2,,,000,000 RO- P POLICY' L,OC.. A AUTOMOBILE LIABILITY SCGL005000024402 03/19/2023 03/19/2025 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY X (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ................... ANY AUTO OTHER THAN EA ACC ,,$ AUTO ONLY: AGG $ T iCESWUMBRELLA LIABILITY EACH OCCURRENCE .... OCCUR CLAIMS MADE AGGREGATE ,U, ........................... DEDUCTIBLE $ RE rEN TI ON $ WC STATU- OTH- '.... WORKERS COMPENSATION AND � T.ORy-L g.__.. __„_..____.. EMPLOYERS' LIABILITY .EACH ACCIDENT $ '.. ANY PROPRIETOR/PARTNER/EXECUTIVE ,__„ ''. OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under El. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS &xt:KIIFICAI,E HULLIEFC 6..AN%.LLAIMUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ''.. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN El Segundo Police Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 348 Main St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR El Segundo CA 90245- REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988 POLICY NUMBER: SCGL005000024402 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations As required by written, and properly executed, contract As per written, and properly executed, contract prior to prior to loss, if required by your written contract or written loss, if required by your agreement with such agreement with such Additional Insured. If anyone, other Additional Insured than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV — COMMERICAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. Additional Insureds shown in a written contract, or written agreement that includes primary and non-contributory wording The inclusion of one or more Additional Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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) at the location of the covered operations has been completed; or 2. 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. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 0 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 ❑ CERTHOLDER COPY SIP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 09-01-2023 EL SEGUNDO POLICE DEPARTMENT SP 348 MAIN ST EL SEGUNDO CA 90245-3813 GROUP: POLICY NUMBER: 1863950-2023 CERTIFICATE ID: 44 CERTIFICATE EXPIRES: 09-01-2024 09-01-2023/09-01-2024 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 30 days advance written notice to the employer. We will also give you 30 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 listedherein, 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 subjectto all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 09-01-2022 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER ARROYO, ERIC (AND) ARROYO, TERISIA SP 19510 VAN BUREN F-3-192 RIVERSIDE CA 92508 PRINTED : 08-17-2023 IREV.7-2014) M0408