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PROOF OF INSURANCE (2024 - 2025)MILLE-9 OP 112; FD CERTIFICATE OF LIABILITY INSURANCE ATE (MMIDD/YYYY) 03/0112024 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 endorsements . PRODUCER 760-471 Alliance Mgt. & Insurance Sery 356 Via Vera Cruz #7 CA AgenUBrok'er Lie# 0737966 San lVlarcos, CA 92078 Michelle A. Nowell & Associates Inc INSURER F StarStone Specialty Ins 760-471-9378 44776 OVERAGES CER11FI ATE NUMBER' rcc I Ivnf :Uffi0 rc: 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. '�NSR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXPITR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH DCCURREtIgg.. '$. 1 000 000 DAMAGE TO RENTED 100,666 CLAIMS -MADE X occuR xWSGP000122 1011312023 10/13I2024 �X Errors & Omission M D F_XP AnyRQ.P_P.@ on 1 5,000 ......, 000 _PE NAL PpVI,N,ILIRY $ 1'0...... ........0 5,000,000 GENLAGGR APPLIES PER: �NERAL AGGREGATE . ......... ELATE LIMIT X POLpCY .._d JEGT LOC PRPap CAMP/OPAGG 1,000,000 OTHER:' COMBINED SINGLE: LIMIT 1000000 A AUTOMOBILE LIABILITY y, gyyq�„„,„„...... ANY AUTO WSGP000122 10/13/2023 10/13/2024 BODILYINJLIRY, Per p.rson OWNED SCHEDULED AUTOS ONLY AUTOS60DILY INJURY Per accident ........... g X.. ACJ ONLY X AAti)S Oh1CY I�C?PETW7Y gAMAC,E er ..i I UMBRELLA LIAB OCCUR AOH ._EACliOCOIO RRENCE 1� ........... ........ '. EXCESS ...................DED ITAGGREGATE ,,,,,,,,,,,CE._ �LIA"BCLAIMS-MADE WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? NIA _E L EACH ACCIDENT �_"IT,_„_, W.15ER/MEMBER anatory In NH) E,L„ DISEASE - EA EMPLOYE If yes, describe uer DESCRIPTION FndPERATIONS below E,L. DISEASE.- POLI Y LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of El Segundo,, its directors, officers, employees, and agents, are named as an additional insured With respects to the Work performed by the named insured.. Investigation, CA -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo Human Resource Manager 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: WSGP000122 COMMERCIAL GENERAL LIABILITY CIGL 79 03 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • • • 9 • `I PA.1% I Lei This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket as required by valid written contract. Blanket as required by valid written contract. Additional Information:. 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 or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your operations for the additional insured at the location shown in the Schedule. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; b. If coverage provided to the additional insured is required by a contract or agreement, the insurance CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2 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; and c. Regardless of the date of occurrence or when the injury or damage first occurs or is first discovered, a person's or organization's status as an additional insured under this endorsement ends upon the earliest of: (1) The completion or termination of the contract or agreement between you and the additional insured for the location shown in the Schedule; (2) The date you cease actively performing operations for the additional insured at the location shown in the Schedule; or (3) The expiration or termination date of the policy or this endorsement. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to liability or damages for "bodily injury', "property damage", or "personal and advertising injury': 1. Caused by, arising from, or included in the "products -completed operations hazard"; 2. Arising out of the additional insured's sole negligence; 3. Arising out of work or operations performed by you that were completed prior to the effective date of this endorsement; or 4. Which continues or progressively deteriorates after you cease actively performing operations for the additional) insured at the location shown in the Schedule, even if the injury or damage first occurred, or is alleged to have first occurred, during the course of your operations for the additional injured. C. Solely for purposes of this endorsement, the following definition is deleted in its entirety and replaced by the following: 1. ""Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed; (b) When all of the work to be done at the location shown in the Schedule has been completed if your contract calls for work at more than one location; or (c) When that part of the work done at the location shown in the Schedule has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. D. 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. CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2 tya DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 10/02/2024 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). PHONE... ....nce Agency Inc Automatic Data Processing Insurance Agency, Inc. CI A 1- 800-5 4-7024Insurance PRODUCER t4AMEA Processing a .._ - ....... "FAX 9fAJC, No, ExW N wa).. ... 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 INSURANCE ..... POLICY.. ...... ... ......... �,..... LIMI..._....__ ....-----....... INSRpp ... .. ......--. �ADSD I$WVD ............. NUMBER --- �..MMIOD/YYYY MMIOD P G fYYYY LIMITS COMM GENERAL LIABILITY OCCURRENCE $ .....,, ^� "DAMAGE Tt�'RENTED .. ..... .. .... AIMS -MADE I REI'aRfS n occtx r_kacel $...... EXP (Any one person) $ PED ERSONAL & ARV NJ Y $ ... .... GEN'L ........ .._.._..- _..........,,... AGGREGATE LIMIT APPLIES PER. i GENERAL AGGREGATE .... ...,.-.. ... $ ......,,�. .... POLICY o; LOC PRODUCTS-COMP/OPAGG $ AUTOMOBILE LIABILITY ,, M N IN L A, ,�k7 ncc9drcanC) $ ........,_._.. ,.. .. ......... -- .... ANY AUTO B 0 I N J U R Y(P er p a rson) $ OWNED SCHEDULED ....,..._ BODILYINJURY(Per accident) $ AUTOS HIRED NON -OWNED PROPFR"9'YCkAMAR°a: $ AUTOS ONLY (Peracg4ent), ......,m. UMBRELLA LIAB OCCUR EACH OCCURRENCE $ LIAB EXCESS CLAIMS MADE AGGREGATE $ - DE RETENTION $ $ WORKERS COMPENSATION E ERH STATUTE AND EMPLOYERS' LIABILITY $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE ��YIN NIA N 9294695-2024 03/18/2024 E.L EACH ACCIDENT 03/18/2025 '° """ , OFFICER/MEMBER EXCLUDED? Y..... (Mandatory in NH) I'll.. 1',000,000 ....... If yes, describe under DESCRIPTION OF OPERATIONS below 1 E.L DISEASE -POLICY LIO IT $ 1,000,000 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) rFRTIFICATF 14AIT[FR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245 Ot 19RR-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD