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PROOF OF INSURANCE (2024 - 2025)Policy Number: cpsBO41949 Date Entered: 08,/14/2024 A+ ORV CERTIFICATE OF LIABILITY INSURANCE DATE(MWDWrfYY) 8/14/2024 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 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). PRODUCER CONTACT Kevin Gowey Insurance Agency N .,7...m............ .. PHONE 030 AXNCI (310) 641 7378 (310) 641 6060 W. Manchester Ave. Suite 201 E,LESS; ADPARDR kgoweyinswrence gmaal . com Los Angeles, CA 90045 _ INSU l ..,� .._,_...... _.——....._. INSURER A.' Scottsdale InsuranceE any/Nation ido INSURED Molina DBA Diligent Group Daniel INSURERS : INSURER C 3050 Field Ave IxsuRER o Los Angeles, CA 90016 E..._ mINSURER ........ .. INSURER F 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 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. TYPE of IxsuR�wcE ._ . POLICY NUMSE'.R .� ..( e .w. ._.� _�.. ....�........ —. _ P47L1CY EFF IYYYYI �... ITS COMMERCIAL GENERAL LIABILITY / IWIDI EACH OCCURRENCE $ 1 , 000 , 000 , ENII"b. CLAIMS MADE ®OCCUR /� CPS8041949 D6/1/2024 e/1/2025 f"5RE $ 100,000 PI3wP.'.E,.w„6kfi',�'.?'M!u??�'. ..........-- MED ane �'stlanl $5, 000 Y $1,000,000 GENERAL _._. AGGREGATE V $ 2, 000, 000 CEiNPOLICYEATELIMITAPPLIESPER: 17 ❑ LOC I 0wm M+OPAC PRODUCTS - G T1, 000 , 000 JJECT Deductible $ 500 OT IE'R, AUTOMOBILE LIABILITY COTOVBWNED StNGLE LIMIT$ ''...... ANY AUTO BODILY INJURY (Per person) $ .... �. OWNED - -r SCHEDULED BODILY INJUR.. . __ .... ., INJURY $ AUTOSONLY ;..,a!!AUTOS HIRED NON -OWNED -pR�' RT"' _ 5 AUTOS ONLY ..�..--_-- .....- . $ UMBRELLA B OCCUR � C H OCCURRENCE EACH �. � $ .._. .- 'EXCESS LIAR . �.I AICI9i5•MAT1E 1 REGATE $ sw DED RETENTION '$ ",KERS COMPENSATION STAiUT ER AND EMPLOYERS'LIASILITY ( Y I N .y ANY PROPRIETORlPARTNERIEXECUTIVE .NIA EACH ACCIDENT $ {R}¢TpCERpMEIJWk3EREXCLUDED? (Mandatory In NH) E L MSEASE - EA EMPLOYEE E. .....�.— $ ----- ...._....� . II .describe under (YESCRiPTkOhpOFOPERAlIONS Ea EL DISFASE-POLICYLIMIT $ 1 i I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached it more apace Is mqulred) CERTIFICATE HOLDER CANCELLATION City of El Segundo 350 Main St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN El Segundo, CA 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOREZED REPRESE ATNE 4 f 6 A D CORP RATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC40RD CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUEDAS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE 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 he endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies m ay require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endGmement(s). ............ . - — --- ------ PRODUCER CONTACT NAME: . . ... ..... Kevin Gowey(2950307) PHONE FAX . — 6060 W Manchester Ave Ste 201 (A/C, NO, EXT): 310-641-2279 (A/c, No): 310-641-7378 ..... .... ---- ---- E-MAIL ADDRESS: kgowey@farmersagent.rom Los Angeles CA 90045-4266 , _ -.— INSURER(S) AFFORDING COVERAGE NAIC# . ............. . . . . ....... . .. . ....... INSURED INSURERA_ Truck Insurance Exchange 21709 _INSURERB- Farmers Insurance Exchange 21652 ITITITITmmmm . . 21687.......... . DILIGENT GROUP INSURERC: Mid Century Insurance Company 3050 FIELD AVE INSURER D: .......... . . . ...... . . . ....... ...... INSURER E: LOS ANGELES CA 90016 INSURER F: COVERAGES CERTIFICATE NUMBER! REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICYPERICID INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM ORCONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITI I RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE LOLILICIES DESCRIBED HEREIN tSSUBIECTTOALLTHETERMS. EXCLUSIONS AND CONDITIONS OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . ...... ..... ADDT TYPEOFINSUWICE INSC LIMITS SUBIR POLICYNUMBIR I (MM/t/Y . YY7Y) . N I COMMERCIAL GENERAL LIABILITY —1 CLAMS -MADE R OCCUR GFN'L AGGREGATE LIMIT APPLIES PER: 3 Poucy El PROJECT D Loc OTHER: . . . . . ........ AUTOMOBILE LIABIL117Y ANYAUTO OWNEDAUT01 .1 SCHEDULED B ONIY AUTOS N y HIREDALITOS NON -OWNED ONLY AUTOSONLY UMBRELLAUAB OCCUR EXCESS LIAB CLAIMS -MADE L — - BED REI EN NON $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROP RI ETOR/PARTN ER/ Y/N EXECUTIVE OFFICER/ MEMBER N/A EXCLUDED? (Mandatory in NH) E: lives, describe under DESCRIPTION OF OPERATIONS below L; 0910112023 1 0910112024 Remarks schedule, maybe attached if more space is required) EACH OCCURRENCE is DAMAGE TO RENTED PREMISES (Ea Occurrence)) MED EXP (Any unc Person) PERSONAL &ADV INJURY 2!IlEtLAGGR GATE PRODUCTS- COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILYINJURY (Per person) S BODILY INJURY (Per accidem) S PROPERTY DAMAGE (Per accident) EACH OCCURRENCE PER HER 51 STATUTE ............. . S ,E.�LCHACCIDENT E-L DISEASE- EA EMPLOYEE E,L DISEASE- POLICY LIMIT . .. . ....... ......... . . . . . . .. CERTIFICATE HOLDER CANCELLATION . . .. ..... .... . . .... . CELLED BEFORE THE EXPIRATION City of El Segundo SHOULD ANY OF THE ABOVE DE R�SEDPOUCIESBECAN DATE THEREOF, NOr"CIEWILLBEI SLIVERED IN ACCORDANCE W 4 HEPOUCY PROVISIONS- 350 Main St .... ....... .. FJ Segundo, Ca 90245 AUTHORIZED REPR T"_ ESENTATIVE CD . . ... .... . ACORD 25 (2016/03) @1988-2015ACORD CORPORATI;4I fights Reserved 31-1769 11-15 The ACORD name and logo are registered marks of ACORD CC I ''�. DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/14/2023 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). PRODUCER CONTACT NAMc ...., .., AP INTEGO, A SUBSIDIARY OF NEXT PHONE FA:X 375 Woodcliff Drive WP.AP.Enth w_..,,_... __ q�ro N:(aL...,.. __ Suite103 Asap n ,_.- _------------------- .................... _, Fairport, NY 14450 INSURER(S)AFFORDINGCOVERAG.. ...._NAIC.# ............ INSURERA: NorGUARD Insurance Company 31470 INSURED Diligent Group 3050 Field Ave Los Angeles, CA 90016-4035 INSURER B INSURER C INSURER D:. INSURER E: INSURER F s 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 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 ..... .m......__ ....._ - ADDL,SUBR.....,... P.. -- M0audyM .... ,���.., � w_.. w..........._,-_ ----._._...... LIMITS LTR TYPE OFINSURANCE§12 .... .... ----................ POLICY /DD/YYFF MMIDOIYY P COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 0 1 CLAIMS -MADE OCCUR g„ PREMIS.F§(gm Tmc .1grin l ... ., ..0 ... GEN'L AGGREGATE LIMIT APPLIES PER: POLICY „.ILORw;, ., JPROECT OTdaEF AUTOMOBILE LIABILITY ANY AUTO ---------- OWNED SCHEDULED ....... AUTOS ONLY , .... , : AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR 1 EXCESS LIAR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y FN ANYPROPRIETOR/PARTNER/EXECUTIVE N I A A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If ves. describe under '... MED EXP (Any one person) S PERSONAL & ADV INJURY S GENERAL AGGREGATE S PRpDUCTS-COMPlOPAGG S S COMBINED SIN„ ILS,. LINUT, S BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PR0PCR`tCw6A4AdE S gPer r.r<k 900... ....... ....... S EACH OCCURRENCE S AGGREGATE S ..,. - .......... ..... ...3 I X - STATWT .. _ -ER ._ DIWC494441 I1011212023 ,10/12/2024 mEL EACHACCIDENT $ E L DISEASE EA EMPLOYEE S E L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Employees: Full Time: 1; Part Time: 0 Governing Class Description: BURG/SECURTY SYS ALARM INST,SVC,REP Exclusions: Daniel Molina, President; 000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CSLB U ACCORDANCE WITH THE POLICY PROVISIONS. �,982'pliusjness Park Drive S8t t"'amento, CA 95826 AUTHORIZED REPRESENTATIVE � � � l C/ -�-----ate ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD