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PROOF OF INSURANCE (2025 - 2025)0 DATE (MMIDDIYYYY) ,4C"R" CERTIFICATE OF LIABILITY INSURANCE .° 07/17/2024 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 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 NA BIBERK ti9l A xrh 844 4720967 is N�} 203-654-3613 P.O. Box 113247 a MAIL ervice bIBERK.com Stamford, CT 06911ARI s ..._customers......._.. _ ................,,. .......... _...._.- _._ .. INSURER A : Berkshire Hathaway Direct Insurance Company 10391 ,Green B...... USA LLC -----........-- INSURER RC 231 E Lomita Blvd INSURER D ...... .. ... ---- Carson, CA 90745 INSURERE m , INSURER F rn�i�onr_�c rt=GTIPIr`ATP KIIIMRPP- 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 .--." ------ '." .. ......-., jADDL S `BRA.' ..,�....µ�� - .,.�...._....------ LIMITS.... ,,......._ ----------- ,.. POLICYF LICY EXP TYPE OFINSURANCE... 1 POLICY NUMBER YY MIDOIYYYY GENERALI �....X LEACH 1000000,---- .. AIMS-MADEOCCUR :50,000 _Q_mu¢_ ,.._ ---- .,.,,....COM I 07/17/2024 07/17/2025 . 5,000 A N9BP207167 MED EXP (Any one person) $ & ADV INJURY r $ Included - �� -----.�..........- PER. G_EN'L AGGREGATE LIMIT APPLIESI „PERSONAL GENERAL AGGREGATE $, ........,. 2,000 000 POLICY LOC PRODUCTS COMPIOP AGG 1 $ 2,000,000 DECO'&: 11 m %� OTHER, $ AUTOMOBILELIABILITY COMB INFD,Ih0G1 E� LIP fIT $.... ..... .....� ........ ANY AUTO .. BODILY INJURY Per arson.. ( P ) OWNED SCHEDULED I^ BODILY INJURY (Per accident)1 $ ...-.-.-.-." AUTOS ONLY „I AUTOS L•- PROI'If RT'Y'DAMAGE HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ spU 4c5TMd3.'I,) `....... ........ ..- ... $ �� UMBRELLA LIAB OCCUR � EACH OCCURRENCE .. � $ �_ ---- ..... EXCESS CLAIMS MADE AGGREGATE _ $ ---- — .... .......... DED RETENTIONS $ WORKERS COMPENSATION I PER OTH STA7t;ITF „FR - AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y� E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA $ I __ (Mandatory in NH) E L DISEASE EA EMPLOYEE, $ If yes. desvibe under L... .,__........... _ LIMIT $ '.. DESCRIPTION OF OPERATIONS below , E L. DISEASE POLICY Professional Liability (Errors & Per Occurrence/ Omissions): Claims -Made I Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) rI=ATIFIrATI= 41111 nFR CANCELLATION EL Segundo Park & Recreation 401 Sheldon St Los Angeles, CA 90024 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 S B (0 19SS-ZUID AGUKU GUKI-UKA I IUN. AR ngms reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DATE (MMIDDIYYYY) ACC" CERTIFICATE OF PROPERTY INSURANCE i 07/17/2024 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. TACT PRODUCER _.. N Crj4A�NM'F1 BIBERK P.O. Box 113247 Stamford, CT 06911 INSURED Green USA LLC 231 E Lomita Blvd Carson, CA 90745 (844)472-0967 salessupport@biberk.com pp @biberk.com 3) 654-3613 INSURERS) AFFORDING COVERAGE NAIC # INSURER_A: Berkshire Hathaway Direct Insurance Compal 1452990 INSURER B ,..,,, - ......... ...�.... ------- ......... ,,, SUR C ....... INSURER INSURER D; INSURERE: ............. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Location: 231 E Lomita BlvdCarson, CA 90745 Bldg #001: General Store - 5999926 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. ..... .,.� .�. ..... EXPIRATION f� COVERED. .. ----. - ..... .... BER TYPE OF INSURANCE POLICY NUM D TE (Y EFFECTIVEPOLICY ILTR1 PROPERTY LIMITS X PROPERTY BUILDING $ 0 �-CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY $ 0 J BASIC BUILDING NSBP207167 07/17/2024 07/17/2025 BuslNEss INCOME $ 250 BROAD --- .....°. EXTRAEXPENSE $ CONTENTS •• -- X SPECIAL RENTAL VALUE $ .,, — .... ...... ........ .. EARTHQUAKE BLANKET BUILDING $ „ ..-. n/a ... ,..- --- ---- -------- BLANKET PERS PROP WIND ... /a $ �✓ ........._ m ........ ....... FLOOD BLANKET BLDG & PP ..... ... $ n/a .., .... .,` $ I .... .,, $ INLAND MARINE TYPE OF POLICY $ .... ,, CA USES OF LOSS ffi NAMED PERILS POLICY NUMBER $ CRIME $ TYPE OF POLICY ............. $ BOILER 8 MACHINERY / $ EQUIPMENT BREAKDOWN::E l --- $ ..... ................. .__ i ....._ $ .._......._. SPECIAL CONDITIONS I OTHER COVERAGES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) * ALS up to 12 months. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL Segundo Park & Recreation ACCORDANCE WITH THE POLICY PROVISIONS. 401 Sheldon St Los Angeles, CA 90024 AUTHORIZED REPRESENTATIVE U IUVO-ZU70 AGUKU k;UKI-UKA I IUN. All rignis re5erveO. ACORD 24 (2016/03) The ACORD name and logo are registered marks of ACORD .ace0 [ CERTIFICATE OF LIABILITY INSURANCE °A�71/2024 Y' 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. I e cent' ate holder Is an AL INSURED, the Po cy(ies) must W endorsed. If SUMMATION is WARO' su iect 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 ;NNAmV.2K�' Certillcate Department Teresa Clutter Insurance Services LLC „wp , 209 836 0719� Nrn 855 879 4374 40D 121h St. Ste 26 s: TeresaC@Clultednsurane.com __. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT `1HE POLICIES OF INSUIRA04CE LISTEO BELOW RAVE 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. .. ..�.�...... ........ .....ee ..__ ...� I'AM ".SUBW- .._._______........ .. ., ... �.'�i" �'FF'....._ M�'d7 'YM1`�� ft i .aPo,,,... .... ........._ ............... ....... .m 11MRS TYPEO,.�... F INSURANCE ,. �. TR IN WVO f POLICY NUMBER MMNOOrYYYY' MM!'DD�YYYY COMMERCIAL GENERAL LIABILITY j , EACH OCCURRENCE s j CMS -MADE OCCUR f CLAIMS -MADE 3�ET, M S aL ns,?^�u�++ln�an ... ,., .... S p t"S MED EXP (Any one person) PERSONAL & ADV INJURY S ............... ...,.,,,E LIMIT ' � GENlAGGREGATE LIMIT APPLIES PER fiAL AGGREGATE S I POLICY PRO- LOG JECT PROD UCTS COMPIOP AGG,,, S� ... OTHEn AUTOMOBILE LIABILrrY qE t c hm n'Ei S S ODO ODO BODILY INJURY (Per person) S ANY AUTO ALL OWNED " SCHEDULED A x'Auras caeD4oa000m-1 �nno24 Tnr2ozs BODILY INJURY (Par accraeMr $ AUTOS NON -OWNED PEAt'a'4 L _� HIRED AUTOS AUTOS a'«"rc"rwf . ..._..�....•........ _.�.� ' UMBRELLA LlAB I OCCUR EACH OCCURRENCE S .......... ... ( CLAIMS-IAADE ,. AGGREGATE I y DED RETENTION S WORKERS COMPENSATION Ulm j AND EMPLOYERS' LU1BILFTY YIN ANY PROPRIETOFLPARTNER(EXECUTIVE S w _�........ OFFICERIMEMBER EXCLUDED? ❑NIA EA EMPLOYEE�� S (Mandstory in NH) E L DISEASE - _ D SCEASECPOLICY yes. descnbe under DESCRIPTION OF OPERATIONS balow r E L LIMIT yV S I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional RwnwM Sdwdula, may bo &McJwd If morn space is ngWnd) Certificate Of Insurance —CERTIFICATE HOLDER CANCELLATION Certificate Of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AMOOR17ED REPRESENTATIVE e ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE,,s„ 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 SUN Insurance Solutions, LLC ID: (DecisionHR) PHONE as$ szs 551.. FAX NAME .... Gortn Horn Y CiO DecisionHR, HOYdin S Inc E-MAIL _ rwI- R.com c" N°1........ AADOREsst! CertDeclslo 5801 Postal road, �'O oX 818020 ....�— . INSURERA: SUNZ Insurance Comoanv 3.. Cleveland OH 44181 IN rS�AFFORDING COVERAGE N 4762762 INSURED INSURER B : __.............. ...,..�,..,..,.m.,�.. _.... DecisionHR Holdings Inc. NSURERC ,........... .............. LCF Green USA LLC I .... ... �............. dba Global Transportation Services .........._. _INSURERD .. ............. 5801 Postal Road', ISO Sox 818020 R E ......... Cleveland OH 44181 INSURER COVERAGES CERTIFICATE NUMBER: 60�02" 440 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. ..... ..... pPAID ." °v,,,, . .�..................__ . ...... ... _.... ...�.., ..._.. IT ` ILTR. ......... dAtSO SUtiR POI.tC11� FF POLICY E°XP „, .. .......,�- .........,,,,. ---...... LIMITS M66C TYPE OF INSURANCE POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ....... ...... --- .....� ...,_. �`C)AM,d1tiL l`CP$F.N iiY ,. ....� CLAIMS -MADE E OCCUR _?R2Mt$E,�^„,/watmo, rnrr,lnT;crs} $.......,... .._..- MED EXP (Any one person) $ RY $ Pm - " — WENLAGGREGATELIMITAPPLIES PER: G GERSONALGGREGATE PRO JE6 LOC �POLICY JECT ... .RODUCTS - $ COMP/OP AGG _ .............. ' OTHER: AUTOMOBILE LIABILITY ) {M:BINEC I�1 MIT sic deDISdN,LE . Wm... ANY AUTO B.r� ( ODILY INJURY (Per person) " .. $ $... OWNED SCHEDULED ' BODILY INJU RY (Per accident) $ �............ AUTOS ONLY AUTOS HIRED NON -OWNED PROPI:R7"YtaANCAfrE • ___. $ I -- AUTOS ONLY AUTOS ONLY (PeaRc.,t¢cn,.l�) ........ ............... .......... .....,,�.....,,..„ --- $ UMBRELLALIAB OCCUR .EACH OCCURRENCE $ -• EXCESS LIAB ,.. .. CLAIMS MADE, GGREGATE ,,, $�.......... ----------- - ....., fJED RETENTION $ --- $ A WORKERS COMPENSATION WC042-00113-024 6/1/2024 6/1/2025 PER OH- TE ER AND EMPLOYERS' LIABILITY YIN W C042-00113-023 6/1 /2023 6!1 /2024 ,,,_ __ ANYPROPRIETORIPARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000 OOO OFFICE REXCLUDED? ❑ NIA (Mandatory in NH) SE EA EMPLOYEE $J.�QQ*jQQ _ .,.,,,, If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of: Green USA LLC dba Global Transportation Services Client Eff Date: 10/1/2022 r".Allu r-t I ATlnu SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo CA 90245 AUTHORIZED REPRESENTATIVE -- •s '"""'� ) Rick Leonard W lvoo'Lu 17/1VVRIJ VWMr-VRM 11V11. M11 I.W.— I........ ACO 5 (16/) The ACORD name and logo are registered marks of AC RD 800294110 1878601 1 Decision DR Holdings I Rosemary Young 1 5/16/2024 12:32:28 PM (EDT) I Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA WC990313 Ed. 7-09) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $ 100 Schedule Person or Organization Job Description PHALANX GROUP INTERNATIONAL 13us'ildita�'" 251 Covera a provided for all lcaased eatapl�oyecs buk not subcontractors of: Gruen USA LLC dbaa Global Transpodat aon,Services d83 N. �k NyIlion Blvd. Clieatk It KSate: 10/1/2022 r� aivv as Subrogation in favor of aeawtkOczte holder as per written contract, aslaaVc ��or&� Is El Segundo CA 90245 performed at or in: CA This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 06/01/2024 Insured. Decision[IR Holdings Inc. LCF Green USA LLC dba Gldbal 4taansortation Services Insurance ', „1 aat9:, PO Box 818020 I l 4-1181 SUNZ Insurance Company WC990313 (Ed. 7-09) Policy No.:WC042-00113-024 Endorsement No.:80029488 Countersigned by 6002r488 1 87C' { [ SlP.6/202t1 Lt..::42u28 Ili Ca'=DT9 1 V�i eye. 2 or 2 . {C'01. IJ ..r.,a =.�;toG C:ii k:o:l. eta nra.r, V E�tcx r+rnzn a::y YnuGre,