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PROOF OF INSURANCE (2024 - 2025)" "R CERTIFICATE OF LIABILITY INSURANCE DATE IMM!DD YYYY) sizzizoz4 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 -_- A Gaspar Insurance Services - WH PHUNE i l uWv060 23161 Ventura Blvd.. Ste 100 Woodland Hills CA 91364 r f rc . _ INSURERt$)AFFOROINGCOVERAGE NAIC# Lceq e 1004QQmINSURERA Citizens Insurance Company of America 31534 INSURED STRPJNC-0 INSURER BAllmenca Financial Benefit Insurance ompany 41840 Stratiscope, Inc. - 10945 Burbank Boulevard INsuRER c - North Hollywood CA 91601 INSURER D INS,URE,R...i..............................................._..,._.... ............ ..... ._..... ...... .......... INSURER F., COVERAGES CERTIFICATE NUMBER:1990183148 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 „_,,, ........._- INS t ------ — ADD . SUB POLICY EFF _ .. ................ PfYLYCY i=9( '�" LIMITS TYPE OF INSURANCE POLICY LTR NUMBER MMl fYY,YY MMIIDDIYYYX.. A X COMMER IAL GENERAL LIABILITY Y OB3D429971 12/22/2023 12/22/2024J EACH OCCURRENCE $ 1,000 000 .. A _._ OCCUR X J P �d E E h._ $300000 .�........ u...rk MED EXP (Anv one person) 1,10090 000 PERSONAL & ADV INJURY $ 1.000 000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE I $ 2.000 000 X POLICY ❑ PRO- LOC PRODUCTS COMPIOP AGG ... I,w$ Z.000 000 A AUTOMOBILE LIABILITY OB3D429971 12/22/2023 12.i22/2024 A �'' S Included 4 ANY AUTO BODILY INJURY (Per person) $ O VVNED __ _- BODILY INJURY URY (Per accident) $ X AUTOS ONLY X AUTOS HIRED I NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMSMADE AGGREGATE $ DED f7RE7ENTIONS 5 B WORKERS COMPENSATION W23D429975 5i29i2024 5/2912025 X EPN YIN ANYPROPRIETORIPARTNEPiEXECUTIVE OFFDICERIMOEMBER EXCBUDED� NlA. E CCI EN 51,000.000 L EACH — „ (Mandatory m NH ( ry ) E L DISEASE E4 EMPLOYEE $ 1,000 000 If yes. describe under DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT 51,000000 A Employment Practices Liability OB3D429971 12/22/2023 1212212024 Limit! Deductible S250,000/ $25,000 DESCRIPTION OF OPERATIONS; LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Location : 10945 BURBANK BOULEVARD, NORTH HOLLYWOOD. CA 91601 ANY ALTERATIONS WILL VOID THIS CERTIFICATE City of El Segundo is afforded additional insured status as per the embedded coverages found in the coverage forms when required by written contract, agreement or permit but only as respects to the liability of the insured, pursuant to the terms; conditions, limitations and exclusions of the listed policies CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2ACCOof El Segundo RDANCE WITH THE POLICY PROVISIONS. Main Street El Segundo CA 90245 RIZREPRESENTATIVE United States 'U�T'HO AUTHORIZED � r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SUMMARY OF COVERAGES Limits 1. Additional Insured by Contract, Agreement or Permit Included 2. Additional Insured - Broad Form Vendors Included 3. Alienated Premises Included 4. Broad Form Property Damage - Borrowed Equipment, Customers Goods and Use of Elevators 5. Incidental Malpractice (Employed Nurses, EMT's and Paramedics) 6. Personal and Advertising Injury -Broad Form 7. Product Recall Expense Product Recall Expense Each Occurrence Limit Product Recall Expense Aggregate Limit Product Recall Deductible 8. Unintentional Failure to Disclose Hazards 9. Unintentional Failure to Notify Included Included Included Included $25,000 Occurrence Page $50,000 5 Aggregate $500 5 Included 6 Included 6 This endorsement amends coverages provided under the Businessowners Coverage Form through new coverages and broader coverage grants. This coverage is subject to the provisions applicable to the Businessowners Coverage Form, except as provided below. The following changes are made to SECTION II - LIABILITY: 1. Additional Insured by Contract, Agreement or Permit The following is added to SECTION II - LIABILITY, C. Who Is An Insured: Additional Insured by Contract, Agreement or Permit a. Any person or organization with whom you agreed in a written contract, written agreement or permit to add such person or organization as an additionalinsured on your policy is an additional insured 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, but only with respect to: (1) "Your work" for the additional insured(s) designated in the contract, agreement or permit; (2) Premises you own, rent, lease or occupy; or (3) Your maintenance, operation or use of equipment leased to you, b. The insurance afforded to such additional insured described above: (1) Only applies to the extent permitted by law; and (2) Will not be broader than the insurance which you are required by the contract, agreement or permit to provide for such additional insured. (3) Applies on a primary basis if that is required by the written contract, written agreement or permit. (4) Will not be broader than coverage provided to any other insured. (5) Does not apply if the "bodily injury" "property damage"' or "personal and advertising injury"is otherwise excluded from coverage under this Coverage Part, including any endorsements thereto. 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc . with its permission Page 1 of 6 Nbu^ le' mjrarbc,fx t;rt dtt,'a.. 083 D429971 1001567 18. "Suit" means a civil proceeding in which (2) The providing of or failure to damages because of "bodily injury", provide warnings or instructions. "property damage", "personal and c. Does not include vending machines advertising injury" to which this insurance or other property rented to or located applies are alleged. "Suit" includes: for the use of others but not sold. a. An arbitration proceeding in which 23. "Your work": such damages are claimed and to which the insured must submit or a. Means: does submit with our consent; or (1) Work or operations performed by b. Any other alternative dispute you or on your behalf; and resolution proceeding in which such (2) Materials, parts or equipment damages are claimed and to which furnished in connection with such the insured submits with our consent. work or operations. 19. "Temporary worker" means a person who b. Includes: is furnished to you to substitute for a "employee" (1) Warranties or representations permanent on leave or to made at any time with respect to meet seasonal or short-term workload the fitness, quality, durability, conditions. performance or use of "your 20. "Unmanned aircraft" means an aircraft work"; and that is not: (2) The providing of or failure to a. Designed; provide warnings or instructions. b. Manufactured; or SECTION III - COMMON POLICY CONDITIONS c. Modified after manufacture; (APPLICABLE TO SECTION I - PROPERTY AND SECTION II - LIABILITY) to be controlled directly by a person from within or on the aircraft. A. Cancellation 21. "Volunteer worker" means a person who 1. The first Named Insured shown in the is not your "employee", and who donates Declarations may cancel this policy by his or her work and acts at the direction mailing or delivering to us advance of and within the scope of duties written notice of cancellation. determined by you, and is not paid a fee, 2. We may cancel this policy by marling or salary or other compensation by you or deirvering to the first Named Insured anyone else for their work performed for written notice of canceilation at least: you. a. 5 days before the effective date of 22. "Your product": cancellation if any one of the a. Means: following conditions exists at any building that is Covered Property in (1) Any goods or products, other than this policy: real property, manufactured, sold, handled, distributed or disposed (1) The building has been vacant or of by: unoccupied 60 or more consecutive days. This does not (a) You; apply to: (b) Others trading under your (a) Seasonal unoccupancy; or name; or (b) Buildings the course of c A Person or organization tructlon, renovation or whose business or assets you addition. have acquired; and Buildings with 65 o more of 2 Containers other than vehicles), () � ) o floor the rental units or floor area materials, parts or equipment vacant or unoccupied are furnished in connection with such considered unoccupied under goods or products. this provision. b. Includes: (2) After damage by a covered (1) Warranties or representations cause of loss, permanent repairs made at any time with respect to to the building: the fitness, quality, durability, (a) Have not started, and performance or use of "your product", and (b) Have not been contracted for, within 30 days of initial payment of loss. 391-1003 08 16 Includes copyrighted material of insurance Services Office Inc, with its permission_ Page 77 of 8 4 Insa�r ttr� C;r � p, 0133 D429971 100:1567 1. SECTION I - PROPERTY, if two or more of However, if you agree in a written this coverage part's coverages apply to contract, written agreement, or the same Goss or damage, we will not pay written permit that the insurance more than the actual amount of the loss or provided to any person or damage. organization included as an 2. SECTION II - LIABILITY, it is our stated Additional Insured under this Coverage Part is primary and intent that the various Coverage Parts, non-contributory, we will not seek forms, endorsements or policies issued to contribution from any other the named insured by us, or any company insurance available to that Additional affiliated with us, do not provide any Insured which covers the Additional duplication or overlap of coverage for the "occurrence", Insured as a Named Insured except: same claim, "suit", offense, accident, "wrongfulact" or loss. We will (1) For the sole negligence of the not pay more than the actual amount of Additional Insured; or the loss or damage. (2) When the Additional Insured is If this Coverage Part and any other an Additional Insured under Coverage Part, farm, endorsement or another liability Policy. Policy issued to the named insured by us, b. Excess Insurance or any company affiliated with us. apply to the same claim, "suit", occurrence, This insurance is excess over: offense, accident, "wrongful act" or loss, (1) Any of the other insurance, the maximum Limit of Insurance under all whether primary, excess, such Coverage Parts, forms, contingent or on any other basis: endorsements or policies combined shall (a) That is Fire, Extended not exceed the highest applicable Limit of Coverage, Builder's Risk. Insurance under any one Coverage Pact, Installation Risk or similar form, endorsement or policy. coverage for "your work"; This condition does not apply to any (b) That is Property Insurance for Excess or Umbrella Policy issued by us premises rented to you or specifically to apply as excess insurance temporarily occupied by you over this policy. with permission of the owner; G. Liberalization (c) That is insurance purchased If we adopt any revision that would broaden by you to cover your liability the coverage under this policy without as a tenant for "property additional premium within 45 days prior to or damage" to premises rented during the policy Period, the broadened to you or temporarily coverage will immediately apply to this policy. occupied by you with H. Other Insurance permission of the owner; or 1. SECTION I - PROPERTY' (d) If the loss arises out of the If there is other insurance covering the maintenance or use of aircraft, 'autos" or watercraft same loss or damage, we will a only for g pay Y to the extent not subject to the amount of covered loss or damage in SECTION II - LIABILITY, excess of the amount due from that other Exclusion g. Aircraft, Auto or insurance, whether you can collect on it or Watercraft; and not. But, we will not pay more than the applicable Limit of Insurance of SECTION 1 (2) Any other primary insurance - PROPERTY. available to you covering liability for damages arising out of the 2. SECTION II - LIABILITY premises or operations, or the If other valid and collectible insurance is products and completed available to the insured' for a loss we operations, for which you have cover under SECTION II - LIABILITY, our been added as an additional obligations are limited as follows: insured by attachment of an a. Primary Insurance endorsement. This insurance is primary except when When this insurance is excess, we will have no duty under SECTION II - paragraph b. below applies. If this LIABILITY to defend the insured insurance is primary, our obligations against any "suit' if any other are not affected unless any of the insurer has a duty to defend the other insurance is also primary. Then, insured against that "suit". If no other we will share with all that other insurer defends, we will undertake to insurance by the method described in i do so, but we will be entitled to the paragraph c. below. 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc with its permission Page 79 of 81 insured's rights against all those other premium in accordance with our rates and insurers. rules then in effect. c. When this insurance is excess over other 3. With our consent, you may continue this insurance, we will pay only our share of policy in force by paying a continuation the amount of the loss, if any, that premium for each successive one-year exceeds the sum of: period. The premium must be: (1) The total ,amount that all such other a. Paid to us prior to the anniversary insurance would pay for the loss in date; and the absence of this insurance; and b. Determined in accordance with (2) The total of all deductible and paragraph 2. above. self -insured amounts under all that Our forms then in effect will apply. If you other insurance. do not pay the continuation premium, this d. We will share the remaining loss, if any, policy will expire on the first anniversary with any other insurance that is not date that we have not received the described in this provision and was not premium. bought specificaily to apply in excess of 4. Undeclared exposures or change in your the Limits of Insurance shown in the business operation, acquisition or use of Declarations for this Coverage. locations may occur during the policy e. Method of Sharing period that is not shown in the If all of the other insurance permits Declarations, If so, we may require an additional premiurn, That premium will be contribution by equal shares, we will determined in accordance with our rates follow this method also. Under this and rules then in effect. approach each insurer contributes equal amounts until it has paid its applicable J. Premium Audit Limit of Insurance or none of the loss 1. This policy is subject to audit if a premium remains, whichever comes first. designated as an advance premium Is If any of the other insurance does not shown in the Deciarations. We will permit contribution by equal shares, we compute the final premium due when we will contribute by limits. Underthis determine your actual exposures. method, each insurer's share is based on 2. Premium shown in this policy as advance the ratio of its applicable Limit of premium is a deposit premium only. At the Insurance to the total applicable limits of close of each audit period, we will insurance of all insurers. compute the earned premium for that f. When this insurance is excess, we will period arid send notice to the first Named have no duty under Business Liability Insured. The due date for audit premiums Coverage to defend any claim or "suit" is the date shown as the due date on the that any other insurer has a duty to bill. If the sum of the advance and audit defend. If no other insurer defends, we premiums paid for the policy period is will undertake to do so; but we will be greater than the earned premium, we will entitled to the insured's rights against all return 'the excess to the first Named those other insurers. Insured. I. Premiums 1. The first Named Insured shown in the Declarations: a. Is responsible for the payment of all premiums; and b. Will be the payee for any return premiums we pay. 2. The premium shown in the Declarations was computed based on rates in effect at the time the policy was issued. On each renewal, continuation or anniversary of the effective date of this policy, we will compute the 3. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. K. Transfer of Rights of Recovery Against Others to Us 1. Applicable to SECTION I - PROPERTY Coverage: If any person or organization to or for whom we make payment under this policy has rights to recover damages from another, those rights are transferred to us to the extent of our payment. That person or organization must do, everything, necessary to secure our rights and must. do nothing after toss to impair them, But you may waive your rights against another party in writing: 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc , with its permission Page 80 of 81 a. Prior to a loss to your Covered Property. b. After a loss to your Covered Property only if, at time of loss, that party is one of the following: (1) Someone insured by this insurance; (2) A business firm: (a) Owned or controlled by you; or (b) That owns or controls you; or (3) Your tenant. You may also accept the usual bills of lading or shipping receipts limiting the liability of carriers. This will not restrict your insurance. 2. Applicable to SECTION II - LIABILITY Coverage: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair such rights. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce them. 4 Hi6nover Insur.111ce Group_ 063 D429971 1001567 We waive any right of recovery we may have against any person or organization with whom you have a written contract, permit or agreement to waive any rights of recovery against such person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This condition does not apply to Medical Expenses Coverage. L. Transfer of Your Rights and Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die, your rights and duties will be transferred to your legal representative but only while that legal representative is acting within the scope of their duties as your legal representative. Until your legal representative is appointed, anyone with proper temporary custody of your property will have your rights and duties but only with respect to that property. 1-1003 08 16 Includes copyrighted material of insurance services Office, Inc , with its permission Page 81 of 81