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PROOF OF INSURANCE (2025 - 2025)[C"R"DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/04/2024 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 Mike Lowry Amusement And Event Planners Insurance Specialists PHONE O.8,p sll}.r (866) 380 3372 (AAC _ E-MAJI`.Ss p. p.. .. y FAX Ne) ............ �.... - 25422 Trabuco Rd Suite 105-406 ADDRE MAIL ae Insurances ecialists o alioo com .... ..... Lake Forest, CA 92630 S AFFORDING COVERAGE NAIC # ...... INSURERA: Lloyd's-Beazley Group Syndicate #2623 AA-112862 INSURED..... ................ ....... .-------- --__.___�...�........... ......... ......... ..,�.,„ ---.... ................ -.µ ...�.� ....�.......... Jump For Joy 25200 S. Western Ave. Harbor City, CA 90710 F COVERAGES CFRTIFICOTF NIIMRFR• R5=VICIr1M IdI1MRF12• 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 SUISR� LTR TYPE OF INSURANCE I ( ( POLICY NUMBER ..m.. ..... ....... ..... ... .... POLICY EFF POLICY EXP .'.... ......--- __. .________ _________ ___._._._ .________.. MMIOD/YYYV MM/DOIYYYY LIMITS LIABILITY CO EACH OCCURRENCE $ 1 OOO,OOO �CLAIMIS-MADEE�L OCCUR � .. '5AMAff 'i'lJ Rt rff . ...... .PRFMI$ES...(Ea occurrgnre,) $ 3�G,GOD MED EXP (Any oneper­`­1 $, Excluded ....._......- Y Y ZISMB203202 ... .. __ .......,. ... 08/06/2024 08/06/2025IPERSONAL&ADVINJURY $ ...._...-__ Gk.'NLA0.: GRFGA E, LIMIT APPLIES PER: RALAGGREGATE $ 2 000 000 PRO POLICY _. ,.......: JECT ...,� Loc �:,qENE........... ....... ....._ ....... ........ S COMP/oP AGG $ 2 000 000 ..PRODUCT .... .. ........ .... ..... v"JThIF_'R; AUTOMOBILE LIABILITY ( COMMNEO SINGLE LI'MIT .. 1 ANY AUTO BODILY INJURY (Per person) '� $ J ___ AUTOS ONLY AUTODULED If 00/00/0000 00/00/0000 BODILY INJURY$ (Per accident} ...... _ HIRED NON -OWNED .( DAMAGE PROPERTYIa ,,.....4 AUTOS ONLY AUTOS ONLY .__, .,.,..( Per gnden " .... .................... $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB J CLAIMS -MADE 00/00/0000 00/00/0000 AGGREGATE DED j' I. RETENTION $ $ WORKERS COMPENSATION PER 61 H ADP Y/N STATUTE ER AORIFT S EXC UER/E OFFICE JMEMB R/PARTNE EEXECUTIVE ❑ NIA 00/00/0000 E L EACH ACCIDENT 00/00/0000 , . $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE:! $ If yes, describe under - - - - - - - - - ... - "' - DESCRIPTION OF OPERATIONS below E,.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD101, Additional Remarks Schedule, may be attached if more space is required) The City of El Segundo, It's officers, officials, employees, agents and volunteers are added as an additional insured but only with respect to liability arising out of operations of the named insured during the policy period. nvL-ur=rc City of El Segundo 350 Main St. 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. AUTHORIZED REPRESENTATIVE Mike Lowry ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION Policy Number: ZISMB2032 02 Insured: Jump For Joy This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization s City of El Segundo 350 Main St. El Segundo, CA 90245 The City of El Segundo, It's officers, officials, employees, agents and volunteers. required to complete not shown above will be shown in the Declarations. Section II - WHO IS AN INSURED is amended to include as an 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 of the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: Policy Number: ZISMB2032 02 Insured: Jump For Joy COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of El Segundo 350 Main St. El Segundo, CA 90245 The City of El Segundo, It's officers, officials, employees, agents and volunteers. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above 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 waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 13 Endorsement # 2 GENERAL CHANGE ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.: This endorsement changes the policy on the inception date of the policy or on the date shown below. It is agreed that the policy is changed as follows: In consideration of an additional premium shown below, the following coverages have been MODIFIED on the policy hereby modifying the Declarations page - M 5605 (0212011). Coverage Old Limit New Limit Coverage Old Limit New Limit Liability 50,000/100,000150,000 1.000,000 um 50,0001100,000 1,000,000 Veeh Liab UM UIM PIP Med Pay Liab um 1 I 3,4731 Incl, 1167) Inct. ,..... ............. 2 4,839� Incl. j Subtotal 1,626� Incl. 2.693`.............�.........�..ncl., M-2904 (11/80) Premium UIM PIP Med Subtotal by Pay Vehicle 1,167 1,626 UM Premium: Old Annual: $249.00 New Annual: $710.00 Prorated: $356.00 Additional Premium $3,149 Pro -Rate Factor: 0.773 Return Premium $ All otner terms, COnaltlons ana agreements remain unman, ea, ocra any Name Polic rl mbar t w1wood Fire and Casualty Insurance Company 01 AyP(a 134695 - 01 Endorsement Effective 09/29/2023 3:53 PM Named Insured Countersigned at r UL INGERSOLL by (Authorized Representative) (The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy .) M-2904 (11/80) 10102/2023 MOI 03-23 COMPANY: INSURED: GEICO General Insurance Company One GEICO Boulevard Fredericksburg, VA 22412 1-866-509-9444 This memorandum is furnished to you as a matter of information for your convenience. It is not intended to reflect all/ the terms and conditions or exclusions of such policies. This memorandum is not an insurance policy and does not amend, alter, or extend the coverage afforded by the listed policies. The insurance afforded by the listed policy is subject to all the terns exclusions and conditionsofsuch plcies, TYPE OF INSURANCE POLICY EFF. DATE EXP. DATE LIMITS SHOWN ARE AS REQUESTED NUMBER COMMERCIAL..._ ..._._aa......_..-__.._._�.. __.�.....�. ......,�............___m.... COMBINED SINGLE LIMIT $1,000,000 AUTOMOBILE LIABILITY (Ea. Accident) ❑ANY AUTO BODILY INJURY El OWNED AUTOS 9300056818-6 07l08/2024 01/08/2025_(Per Person/ Per Accident) ❑ALL HIRED AUTOS PROPERTY DAMAGE © SCHEDULED AUTOS (Per accident) ❑ NON -OWNED AUTOS ... OTHER COVERAGES __ .,.,_.. .... _.._.... _ .. ..__w. ._ COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea. Accident) ❑ALL OWNED AUTOS UNINSURED MOTORISTS $300,000 ❑ HIRED AUTOS (UMCSL ) © SCHEDULED AUTOS 9300056818-6 07/08/2024 01/08/2025 ElNON-OWNEDAUTOS UNDERINSURED ❑ ,MOTORISTS (UIMCSL) UNINSURED MOTORISTS (Per Person/ Per Accident) UNDERINSURED MOTORISTS (Per Person/ Per Accident} _. UNINSURED MOTORISTS _PD (Per accident) PERSONAL INJURY PROTECTION (PIP)RX MED EXP Not Included „ � M PHYSICAL DAMAGE COVERAGE ACTIVE VEH�CLE(�... m..... VIN —_ _ ❑COMPREHENSIVE DEDUCTIBLE 2006- BLE .__. FORD E-350 ❑ COLLISION DEDUCTIBLE 1990 FORD E-350 ' 78 ❑ FIRE, THEFT AND SPECIFIC CAUSES OF LOSS II DEDUCTIBLE 2001 ISUZU NPR 74 NIA „j COMPREHENSIVE DEDUCTIBLE ❑ COLLISION DEDUCTIBLE ❑ FIRE, THEFT AND SPECIFIC CAUSES OF LOSS DEDUCTIBLE ❑ N/A ACTIVE DRIVERS, �. Paul Ingersoll, MOI 03-23 "Rl CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 02/17/2024 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 polfcy(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 NAME:: Lockton Companies for CoAdvantage PHONE . 5423 45 8.." C PAX 444 West 47th Street #900 4119„"�8.4, kXfl (866) fxcr�l E MAIL ante O FOm .... Kansas City, MO 64112 co afo�SS� icoadv g, ..............._. .... tNSURER'QS,T AFFORDING COVERAGE .......... ... ...,_ _ .. .NAIC,..#....."..., INSURER American Zurich Insurance Company 40142 INSURED INSURER 0 : CoAdvantage Corporation Labor Contractor, for co -employees of: Pico Rents, Inc. dba: — "­' - """""`"—'------ - ................ Pico Party Rents INSURER c 101 Rlverfront Blvd Suite 300 INSURER D Bradenton, FL 34205 -- -- -. INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER:24FLO901137143 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. ILNSRTR -.. TYPE OF INSURANCE ............. AD, , SWVE3 ,... _..,.. POLICY NUMBER.. ,P I Irvp OdOD" VF 'q POLICY EXP YY 1 MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S �......- r .... .... ,.. .. _ CLAIMS -MADE ocruR Metir9d4l GCltit dittD . Pt�ErxrtS�� t�fa, f� �Lr��� mot. � s ED EXP (Any one person] $ . >...,.__.....m_ _........ .. ...._ .— _ a.._ V'A GR ... ... li`1Ce........_ t. GENERAL GADVINJURY S ... ....... ... ,., F hkd"J NERAL,AGGREGATE GEN L AGGRCUATNE LIMIT APPLIES PCR; G" ....1 M➢L:.k'W 6 .._ I PRODUCTS - COMPIOP AGG , .... O"TH R: ...... AUTOMOBILE LIABILITY COMBINED MBINED SiN 1 Fr WIFT ANY AUTO BODILY INJURY (Par person) S ...... OWNED .... SCHEDULED BODILY !INJURY (Per accident) $ AUTOS ONLY ......]AUTOS .,., .._.,, , _ i„_._.._...------------- ---------------------- HIRED NON -OWNED 'FMYEt H! d il=tt V kftWhlAI,JC $ AUTOS ONLY AUTOS ONLY (fuer podr*.nX1 S UMBRELLALIAB OCCUR�CH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE, 'T y ...... _ ,.. „"",,,,"GREGATE S DED RETENTION S WORKERS COMPENSATION I P"' Ip AND EMPLOYERS' LIABILITY YIN I •"" T.AY6I1"E (FV'". •.. ... ANYPROPRIETORIPARTNERIEXECUTIVE C.L. EA $ 2000,000 A OFFICER/MEMBEREXCLUDED7 N -NIA WC 14-14-991-02 04/01/2024 04/01/2026 - --_ _ __._ .(Mandatary In NPI) E. DISEASE-EAEMPLOYEE. $ 2,000,000 yyes, dascrltta under -...,,..._.,."..... ....... ............... .. .,,..,, .... ..-._. ..,..„.-- -'E.SCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S 2 000,000 Edwards, Wlillam Included. - Edwards III, William Included, Edwards, Darreen- included. Location Coverage Period: 04/01/2024 04/01/2025 Client# 611980-CA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Coverage ky provided for Pico Rents, Inc. dba: Pico Party Rents Re: Joy Around the World Event 2023 only lhdge co-efnpy dyee,,, 4646 E Los Angeles Ave ElSegundo of. Ltlt not su5c,carfrawtots Simi Valley, CA 93063 to: The City of El Segundo, its officers, officials, employees, agents, and volunteers. %,r—M 111-16A IC ItIULUtl'( The City of El Segundo, its officers, officials, employees, agents & volunteers Attn: Aly Mancini 350 Main Street 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. AUTHORIZED REPRESENTATIVE M ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD