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PROOF OF INSURANCE (2024 - 2025)Client#: 882656 VERSATERUS DATE (MMIDD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE v17/zo24 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 any rights to the certificate holder in lieu of such endorsement(s). ONTA Marsh & McLennan Agency PHONE _ nion g y LLC NC, No, Ext ," C__ 0 m PRODUCER 11330 Lakefield Drive AIpD , Ranee.Mannl on@Marsh'MMA.com Suite 100 INSURER(5) AFFORDING COVERAGE NAIC # Johns Creek, GA 30097-1508 ..... INSURER A: Hartford Casualty Insurance Company 129424 mmmmm W.ITITITITITITITITITITITmm.mm INSUREDINSURER B : Sompo International Holdings Ltd. 55555_ 5 Versaterm Public Safet U.S. Inc. INSURERC : Hartford Accident_&1 in ........... ..._ Safety U.S.'�'��� demnity 22357 1 N MacDonald, Suite 500 INSURER D Scottsdale Indemnity Company� 15580 Mesa, AZ 85201 . Lloyds of London 555555 INSURER E ; Y ........................... _ INSURER F . Hartford Fire Insurance Co. 19682 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR .... ADDL SUER _-.. ..._ .. POLICY EFF POLICY EXP ITITITITITITITITIT.. ..._ TYPE OF INSURANCE LIMITS _....__. ..._...._ .... CNS Wei%...... .......... _POLICY NUMBER....,.,.,. w�,AAM/DD/YYYY) (MM/DDfYYYY).. —_ COMMERCIAL A"O � Re v once 83 OUO,ODU A X 2000NBB6A2E 1101/2024�011011202 g�Eryy CLAIMS -MADE X OCCUR 6� OO OOO MED EXP (Any one person) $1 O 000__ PERSONAL & ADV INJU.RY... $1,000 000 ........ 'GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000 PRODUCTS- COMP/OP AGG PRO $2,000 000 � LOC POLICY JECT OTHER: _ $ F.... AUTOMOBILE LIABILITY 20UENBA3VHD 1/01/20�(1/202 (Ea occidanlStlNGLELtr�Vr $1000000- AUTOMOBILE LIABILRY 24 O1/O � C('IMBdNL4�' ANY AUTO BODILY INJURY (Per person) $ ..........._._.. OWNED SCHEDULED BODILY INJURY (Per aecident} $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE $ X. AUTOS ONLY X AUTOS ONLY t f emlgl a6,) .. B XCCU , UMBRELLA LIAB X OR ELD30051448100 1/01/2024 01/01/202 EACH OCCURRENCE s5,000000 ..®........ __......... ..�t EXCESS LIAB CLAIMS -MADE AGGREGATE s5 OOO OOO ............................_.. __..... C WORKERS COMPENSATION 20WEBA3VHJ _ 10/01/2023 10/01/202 AND EMPLOYERS' I51RTu7,..�FFOTH PARTNrrY -... ACCIDENT DED RETENTION $ IDENT $1 000000 OFFICER/MEMBERANY /EXCLUDED XECUTIVE N N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1 OOOIOOO If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 D C ber/Professnal EK13508520 1/01/2024 01/01/202 $10,000,000 per Occ E Cyber/Professnal TRCX247XVF �1/01/2024�01101/2021 $10,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as additional insured with regards to General Liability, when required by written contact, agreement or permit and subject to the provisions and limitations of the policy City of EI Segundo 350 Main Street El Segundo, CA 90245-0000 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 ..IR Z" �K ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S13684109/M13675332 JJBXR Client#: 882656 VERSATERUS ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 DATE10/512025/20/Y3 23 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 any rights to the certificate holder in lieu of such endorsement(s)w PRODUCER YE Ranee K Mannion Marsh & McLennan Agency LLC PHO le - ILN C. No, Ext): (AIC 11330 Lakefield Drive E Ia t s: Ranee.Mannlon ar'shMMA.com Suite 100 ........m INSUR£R(SI AFFORDING COVERAGE V NAIC # Johns Creek, GA 30097-1508 INSURER A. Hartford Accident & Indemnlry 22357 INSURED ".. INSURER B : SPIDR Tech, Inc. INSURER C : 1 N MacDonald Drive INSURER D Mesa, AZ 85201 INSURER E w w..r-w�wrr• f MOTICIPATC IJI IIUDCD- 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 CONTRACTOR 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, L R AUU W U r. b ..i LIMIT TYPE OF INSURANCE ITmm POLICY NUMBER IMMIDDRCYYY MM�IDDrYYYY) '�....„„„„��.,.,,,,,_ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE'. '$ CLAIMS -MADE R OCCUR Z4. 't`4T a $ MED EXP QAny. ona ptscrr nn) '$ _.. �..............�r... PERSON _ .,_.. .W AL & AD'V INJURY $ ..... GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ppp PRO- 5 POLICY JECT 0 LOCPRODUCTS COMP/OP AGGH ••••• OTHER; .... .... ...-........,- .. m.m...-�., ..._ $ AUTOMOBILE LIABILITY 'IO Ign ..d.. ISiNC.vL, t„IIAIT BODILY INJURY (Pe ANY AUTO (Per person) $ m OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PPROePRdTY(^ F'--- -— AUTOS ONLY AUTOS NLY - $ - $ ....... ...._.�. - .......... UMBRELLA LIAB OCCUR EACH OCCURREINCE. � 5 EXCESS LIAB CI AIMS.MAOE AGGREGATE ,.$. A AND EMPLOYERS' LIABILITY YIN 20WEBA3VHJ 0/0112023 _ _ �— $ OFD .., RE'TEN ION .......... ............. �'' WORKERS COMPENSATION 1 O/O1I202 X P.T�Tt1'�F�..,.... OTii� ANY PROPRIETOR/PARTNER/EXECUTIVE S.L. EACH ACCII MIA A IENT $1 OFFICER/MEMBER EXCLUDED? .. W (Mandatory In NH) E.L., DISEASE - EA EMPLOYEE 51 ur yes doacrtdlal ands 1 TM.-�,..�.d....-. ,-.M,.N.,��.•nn.ic. �...p.,,..., E.L. DISEASE -POL90Y LIMtl'I $'. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached If more space Is required) (WC)Waiver of Subrogation per form: WC000313 Waiver of Right to Recover From Others (per written contract or agreement) City of El Segundo 350 Main Street EI 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. AUTHORIZED REPRESENTATIVE 4U045� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S13373959/M13344865 JJBXR (Policy Provisions: WCOOOOOOC) INFORMATION PAGE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INSURER: SEE ATTACHED ENDORSEMENT THE NCCI Company Number: 21261 T ORD Company Code: 9 Twin City Fire Insurance Company Is required by law to provide its policyholders with certain accident prevention services at no additional cost as required by ARK. Code Ann. §11-9-409(D) and Rule 32. If you would like more information, call The Hartford's Risk Engineering Department, One Hartford Plaza, T-7, Hartford„ CT 06155 at 1- 866-586-0467. If you have any questions about this requirement, call the Health and Safety Division, Arkansas Workers' Compensation Commission at 1-800-622-4472. Suffix LARS RENEWAL POLICY NUMBER: 20 WE BA3VHJ�� Previous Policy Number: New 1. Named Insured and Mailing Address: JUSTICETRAX, INC. (No., Street, Town, State, Zip Code) 1 W MAIN ST MESA AZ 85201 FEIN Number: 86-0960454 State Identification Number(s): UIN : OR 36000000 Refer to the EXTENSION OF THE INFORMATION PAGE — WC990365. The Named Insured is: Corporation Business of Named Insured: Data Processing, Hosting, and Related Services Other workplaces not shown above: See Endorsement - WC990366 2. Policy Period: From 10/01/23 To 10/01/24 ANNUAL 12:01 a.m., Standard time at the insured's mailing address. Producer's Name: MARSH & MCLENNAN AGENCY LLC PO BOX 70 WEST POINT GA 31833 Producer's Code: 20260251 Issuing Office: THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 (877) 853-2582 Total Estimated Annual Premium: Deposit Premium: Policy Minimum Premium: Audit Period: ANNUAL Installment Term: Four Pay (50%Down+3@16.6%) The policy is not binding unless countersigned by our authorized representative. Countersigned by e`.1R" -If Caves 10/12/23 Authorized Representative Date Form WC 00 00 01 A (1) Printed in U.S.A. Page 1 (Continued on next page) Process Date: 10/12/23 Policy Expiration Date: 10/01/24 INFORMATION PAGE (Continued) Policy Number: 20 WE BA3VHJ 3. A. Workers Compensation Insurance: Part one of the policy applies to the Workers Compensation Law of the states listed here: FL SEE ENDORSEMENT - WC 99 03 67 B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily injury by Accident $1,000,000 each accident Bodily injury by Disease $1,000,000 policy limit Bodily injury by Disease $1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any , listed here: ALL STATES EXCEPT NORTH DAKOTA, OHIO, WASHINGTON, WYOMING, U.S.TERRITORIES AND STATES DESIGNATED IN ITEM 3.A. OF THE INFORMATION PAGE. D. This policy includes these endorsements and schedule: SEE ENDORSEMENT -WC 99 03 68 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Classifications Total Estimated Rates Per Estimated Code Number and Annual $100 of Annual Description Remuneration Remuneration Premium Total Standard Premium Premium Discount Expense Constant Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement Catastrophe (Other Than Certified Acts Of Terrorism) Other Miscellaneous State Premiums Estimated Annual Premium (before Surcharges) Total Estimated Surcharges "See the attached Schedule(s) of Operations for Location and State Level Premium Information Total Estimated Annual Premium: Deposit Premium: Policy Minimum Premium: InterstatelIntrastate Identification Number: Refer to Schedule of Operations NAICS: 518210 Labor Contractors Policy Number: SIC: 7374 Form WC 00 00 01 A (1) Printed in U.S.A. Page 2 Process Date: 10/12/23 Policy Expiration Date: 10/01/24