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PROOF OF INSURANCE (2024 - 2025) CLOSEDcoRo A °AT071/2"4 ' CERTIFICATE OF LIABILITY INSURANCE /60 ................ 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 SUBROGATION IS WAIVED, , _ . __ D, 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). ..11. .PRODUCE.,..w. .......-...�.� .... .... .. NAME Sportsinsurance.com PRONE 1 866 889-4763 FAX ADDRES& I P.O. Box 1155, ' nsance ...... --11st....ur...m ..__orn Lake Placid, NY, 12946 P�fo N!UR ER INSURED Sports Marketing Program ManagementInc. INSURER A , Accelerant Specia ILy insurance Company pang AGE 16890 NAIC # S A FFORDING COOKSEY'S LIFEGUARD & SWIM ACADEMY, dba HAPPY SWIMMERS INSUREe USA ............... __ - . ..a.. ... ........ ,, _ ... INSURER C : 8025 Redlands St #8 INSURER D Playa Del Rey, CA, 90293 INSURER E INSURERF: ......... ........ ..�............................._m_-_I.. ....... _............... . COVERAGES CERTIFICATE NUMBER: Aµ SP- I 4 Q 2-306915 309120 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 ................. ADDL SL, § ........ .....�YEFF POUYE7tP .....w. ... ___..,.. - ...... ........,_...TYPE OF INSURANCE....,-.... �,......... ......... LIMIT .. .... .... GENERAL LIABILITY $ 1 (�0() 000 0.01 A Y N 50019GL000001-03 07/16I2024 07116/2025 RENTED AURRENCE- ., FIRE DAMAGE TO PRE , X COMMERCIAL GENERAL LIABILITY PREMISES 00 n .. 1 30 -....._.....CLAIMS-MADE X OCCUR MED EXP (?g ADV INJURY $ .. � (any one person) s 5,000.00 _. n one premises X INCLUDES ATHLETICPARTI'.CIrANTS PERSONAL 1 OOQ000 00 ......_ _ ................ ........, ___.�_ .... .,GENERAL AGGREGATE ..............$ Q0Q OQO 00.......... -'..., GENERAL AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ 2 000,OQ0,00 ,, - ---- POLICY PROJECT � LOC $ AUTOMOBILE LIABILITY .......... .... .............-_,......_. ., A Y N S0019GL000D01-03 07/16/2024 07/16/2025 COMBINED SINGLE LIMIT ANY AUTO X HIRED AUTOS (Ea accident) $ 1,000,000. ALL OWNED X NON -OWNED AUTO' BODILY INJ(Per accident) $ URY (Per person) $ ....- AUTOS ... _ .. ..... BODILY INJURY-„— .......... SCHEDULED PROPERTY DAMAGE AUTOS ,y(LPeraccldent �$ ..... -- ,: UMBRELLA LIAR X OCCUR Y N S0019XS000OOJ-03 07/16/2024 07/16/2025 A EACH OCCURRENCE EXCESS LWe E - ..._,___ $ 5 000 000 00 )( AGGREGATE �$ 5,000,000 00 ........... .... ...._.,. CLAIMS MAD. . ...... r �_ .__ .....µ. DEDUCTIBLE $ RETENTION $ .m.......... ......... .....�,..,. ......... ....._... ... ..... .. .....—----------- ........ WORKERSCO�LSATION WC A U M[ A DEMPLOYERS'LWBLITY ..E L E T�ORY.-LIMITS �. ... ,...,.EEt .7,.�.m,- .... ......- ANYPRC ARrNERID�CUINE OFRCEWMEIvBER EXCLUDED? (Mardal inNH) N / A EACH ACCIDENT If yes, describe under .... SPECIAL PROVISIONS below E L DISEASE - EA EMPLOYEE � � ..._ E L DISEASE- POLICY LIMIT I's OTHER A Abuse/Molestation Y N S0019GL000001-03 07/16/2024 07/16/2025 Each Occurrence:$ 1,000,000 00 Aggregate $ 1,000,000.00 L. .. . . . . ........ . ........... . . ............ --------- DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate Issue Date .... ..._. :Aug 9 2024 10:34AM EST Liability Policy Deductible: $0.00 Deductible for Bodily Injury and $ 1000.00 per Property Damage Claim. ISO Occurrence form CG 00 01 04 13 and company's specific farms. Coverage for Participant Legal Liability requires that every participant signs a waiver/release,. The certificate holder is named as Additional Insured with respect to (continued on next page) City of El Segundo 2240 E Grand Ave 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. Mark Di Perno ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 01988- 2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ©1988- 2009 ACORD CORPORATION. All rights reserved. POLICY NUMBER: S0019GL000001-03 COMMERCIAL GENERAL LIABILITY CERTIFICATE#: A-SP-SI-24-05-22-306915 CG 20 26 04 13 NAMED INSURED: COOKSEY'S LIFEGUARD & SWIM'ACADEMY, LLC dba HAPPY SWIMMERS USA 0n1 lry nCoJnn. I.A.. 4c onoe 4- I.A.. -4c onoc THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): Any person or organization that you have agreed to include as an additional insured under an insured contract provided such contract was executed prior to the date of loss. of EI Segundo 40 E Grand Ave Segundo, CA, 90245 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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. CG 20 26 04 13 B. 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 n 111`� a F ' DATE (MM/DD/YYYY) C"" CERTIFICATE OF LIABILITY INSURANCE 7/31 /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 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). 18201 Von Karman Ave .....- CONTACT Arthur J. Gallagher Risk Management Services, LLC 56 6g8693 Nay 562 698 1379 PRODUCER Peter Sessl eI/ __ Suite 200 atTDREss"elr Sess1 I Irvine CA 92612 License# OD6,9293 INsuRERA: Technology ntsuranceDCompanylnc 4AIcu 2376 INSURED COOKLIF-01 INSURER B _ Cooksey's Lifeguard & Swim Academy, LLC INSURER 1519 6th St #209 R c INSURE. ........... ....... Santa Monica CA 90401 INSURER D ................ E � ........., .... ----- ......., __ ... . INSURER F : COVERAGES CERTIFICATE NUMBER:589490821 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 CLAIMS. (PAID ..,..,.... ............ ..------- ....... .... ......... ......... A1LG'G'..��� ..-�� ---- - _.-..._._ r ....,MMIDD EFF INSR LIMITS 41 IWPIWOtl1D...-__ TYPE OF INSURANCE.,.,. LTR I POLICYNUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ... CLAIMS -MADE C f OCCUR _PREMISES...(,4..44currence, ,.. W $...,.... ..... ,. MED EXP ( A _ (Any one person) $ ERSONAL & ADV INJURY $ ....,.... .......,m.. GEN ............... ...... ......... R: AGGREGATE APPLIES PER: $ PO❑ O . ,......., __. PG RODUCTS- COMP IOP„ AGG .. . W.... t j J:ERCT' r$www, m. ___„ .,. OTHER: COMBINFDSINGLE LIMIT AUTOMOBILE LIABILITY $ ANY AUTO BODILY INJURY (Per person) $ OWNED ULED ..'..... c BODILY INJURY (Per accident) cidenl)� .. ..� _.. $ AUTOS ONLY w AUTOS HIRED NON -OWNED FRChPR-RTYa]AhIAGE .. ,........... AUTOS ONLY ._ _ AUTOS ONLY .......,... UMBRELLA LIAR 4..--- H OCCURRENCE AC $ _. ............ .. .......... EXCESS LIAB OLAIMS MADE �.. .--- .. E $ DED I RETENTION $ 1 $ A WORKERS COMPENSATION TWC4278599 7/29/2023 7/29/2024 X PER OTH AND EMPLOYERS' LIABILITY Y / N PRIET R/PARTNERIEXECUTIVE E L. EACH ,000 000 OFFICEANYPR/MEMB EREXCLUDED? OFFICE N / A (Mandatory in NH) E L. DIISEASECEDENT A EMPLOYEE. �E ,000 000 $ 1T Il'yes, describe under '.. DESCRIPTION OF OPERATIONS below Y LIMIT L DISEASE POLIO $ 1.000,000 7 yy I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of coverage. Evidence of coverage. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AAUTTHOR67.E:D R.E. 11 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD