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PROOF OF INSURANCE (2025 - 2025)
PICOREN-01 LVO FDATEMMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE �...-�' _11126I2024 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(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 Robert Bell Insurance 605 E Alvarado Street Suite 200 Fallbrook, CA 92028 258-4566 INSURED ...INSURER-B..; ....�............. .......................r _,. _ .... .... .......�..... Pico Rents Inc. INSURER,C 4646 E Los Angeles Ave INSURER,D Simi Valley, CA 93063 C INSURERS: .,... _ .................._....,..,..,..,..._ ...... ....... ........ s INSURER F OVERAGES CERTIFICATE NUMBER: _. REVISION NUkfl)tM _ ......... 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 TYPE OF INSURANCE ADDLSUBR� ------ POLICY EFF !ldI��...... . - h I POLICY NUMBER R ....LIMITS COMMERCIAL GENERAL LIABILITY -EACH0PqVRRgNqE Is _ 1,000 000 CLAIMS -MADE 111, XIOCCUR 0,000 X AlPICA001-040024-06 5/1/2024 5/1/2025 DAIAAGETMED A.,(Ayooepesong �$ TED 105000 - 2,000 000 G ENq. AGGFFECArE' LIMITAPPLIES PER: GENERAL AGGRE11.GA ERY $ 1 000 000 $ _ XY �.. POLICY l JLLi LOC PRODUCTS COMP/OP AGG $ ...... 2,000,000 A OTHER , ....... y ...... GOMBINEOSINGLrumit $ 1,000,000 .AUTOMOBILE LIABILITY 1 �....... ........ i„i',�,a'7.MC%i.'S11i- ..... .5.._.,._._. X ANY AUTO Al PICA001-040024-06 5/1/2024 5/1/2025 ,gOOILY INJURY (,PerpersonJ, $ -- .. AUTOS ONLY AUTOS _ODILY INJURY („„Per accidents $ OWNED SCHEDULED X HIRED NON -OWNED PROPERTY J�,M1AaaL. 1, AUTOS ONLY .., AUTOS ONLY (Peracrl�dmrr___ ------ $ .... ..............._ ........ ....... n.. __.._ 000000 , A UMBRELLA LIAB IX OCCUR EACH OCCURRENCE----- wS.... 1,_ ..-___.. X" uae CLAIMS -MADE A5PICA001-040025-06 5/1/2024 5/1/2025 1,000,000 . AGGREGATE ....,..�. EXCESS.. - .......... .. AE. ........_ ... AND DED RETENTION$ .... .................._ $ _ WORKERS COMPENSATION PER ((OTH D EMPLOYERS' LIABILITY ...... YINTATi1Ti=......w L. i;,R..... ....... ......,. OFFICER/MEMBER EXCLUDED? NIA L EAOH AOOIDENT $ (Mandatory OR PARTNER/EXECUTIVE in E L DISEASE EA EMPLOYEE ... --- DESCRIPTION describe fPTION OF OPERATIONS below ....._.__ . ._ITIT._.... ._.� E,$...... .L DISEASE -POLICYLIMIT _ A Equipment Floater AlPICA001-040024-06 5l1/2024 5/1/2025 Ded: 5,000 1,653,750 DESCRIPTION OF OPERATIONS I LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Schedule, mna be attached U mare space is rety,u@red) The City, Its officers, officials, employees, agents, and volunteers are included as Additional Insured with regard to General Liability. Such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto per forms that apply: ARAX 30 01 08 12, CG 20 01 12 19. Subject to all policy terms, conditions, and exclusions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY 9 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: City Clerk 350 Main St Room 5............ El Segundo, CA 90245-3813 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PICOREN-01 L'VO F_- E (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE �126l024 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 certi ficate 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). f CONTACT son organ Lawson PRODUCER IIAMEI ...,.,_ - Robert Bell Insurance PHONE AIC No„ Ext 0 258-4566 605 E Alvarado Street Suite 200 l t � IWIAIL rn"sacu�alkentalns com Fallbrook, CA 92028 ACI�.Es � , _INS UR'E6iS' AfORDIINGCla .... .......... _. ..... ,.... _,,,,,,,,, INSURER 1.A AXIS Insurance Company INSURED INSURER B_. ....... ,.........._....,... . Pico Rents Inc. INsuR.Rc ... __ ......... 4646 E Los Angeles Ave INSURER D Simi Valley, CA 93063 INSURER E _. REVISION NQMfL ,: ............. COVERAGES ITITIT+�EiTjN=ICATE 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 CONTRACTOR 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. A _...X COMMERCIAL GENERAL LIABILITY ...... .. '~ -------- EACH_._. ._ ,000 OOa,''. INSR �ADDL SUBR POLICY EFF POLICY P� I LIMITS TYPE OF INSURANCE.-.-,-,—.-.— -� POLICY NUMBER £M j X Ph3�ftGETdRRENGE� I $ .... 1, 0, occuR AI PICA001-040024-06 5/1/2024 5/1/2025 Fa �r asr L � � $ 5000, RENrED ( 100 0 — E X '......... ...__ CLAIMS MAD...... ....._ ..------ ED EXP An one person � 1,000 00. .__ m,PERSPNAL 8 ADV INJURY $ 0 ...._. GENERAL AGGREGATE $����� X N'GRt"ACC LIMIT APPLIES PER. 2,000,000, J. ff COMPIOP ---- 4 .PI[�T P/, AGG � $............. .OI LOC PRODUCTS OTHER'.: _..... ... ............._ �............. ..„,.�..,�..... �._.........._..,,,,_ COMBINED "SINGLE LIMIT 1,,000 000 AAUTOMOBILE LIABILITY ,(;,,,i ,.,uy/prd�, ..,..�� $.....,.. ...... ..... X ANY AUTO AIPICA001-040024-06 5/1/2024 5/1/2025 sODILYIN.JURY(PerpersonT _ OWNED SCHEDULED , AUTOS ONLY AUTOS � ,_BODILY INJURY (Per accident) HT& NON -OWNED PROPERTY DAMAGE ........ AUTOS ONLY L.X,,,,,, AUTOS ONLY ..(,Peraccident,)_,.. ......... ..„„it $ ... ....m.....� 1----......... ._ _.-..........._ .... ...........m.. �..._ $ A ACH OCCURRENCE �$ 1,000 000 EXCESS LA une X I OccMR A5PICA001-040025-06 5/1/2024 5/1/2025 AGGREGATE $ 1,000 000 E ORKERS �M� COMPENSATION N.$ CLAIMS -MADE ..-...._..��-.. _ PER OTH AND EMPLOYERS LIABILITY I. $TATI,LTE.. ER .. YPN ANY PROPin NH PARTNER/EXECUTIVE C ndato SCR PEMBER EXCLUDE[ TrON OF OPERATIONS below NIA —YITIT I E d D14EA5 EA EMPLOYE _ If yes, describe under J - I DISEASE POLICY LIMIT $ A Equipment Floater AIPICA001-04002446 5/1/2024 5/112025 Ded:5,000 1,653,750 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD iei, Additional Remarks Schedule, may be attached if more space Is requOtd),_,_� The City, its officials, and employees are additional insureds. Such insurance will be deemed primary such that any other insurance that may be carried by the City will be excess thereto per forms that apply: ARAX 30 0108 12, CG 20 01 12 19. Subject to all policy terms, conditions, and exclusions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo Recreation 8 Parks Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY 9 P ACCORDANCE WITH THE POLICY PROVISIONS. 401 Sheldon St El Segundo, CA 90245 -°°- — ... ....... AUTHORIZED REPRESENTATIVE. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS WHEN REQUIRED BY WRITTEN CONTRACT, AGREEMENT OR PERMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II — Who Is An Insured is amended to include as an additional insured any person, organization, state or governmental agency or subdivision, or political subdivision when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) is to be named as an additional insured on your policy, subject to the following provisions: A. The contract, agreement or permit must be in effect during the policy period shown in the Declarations, and must have been executed prior to the "bodily injury," property damage" or "personal and advertising injury." B. The person, organization, state or governmental agency or subdivision or political subdivision is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. The ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: (a) This insurance does not apply to any 'occurrence" which takes place after you cease to be a tenant in that premises. (b) This insurance does not apply to any structural alterations, new construction or demolition operations performed by or on behalf of the person or organization added as an insured. 2. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s), subject to the following additional exclusions: (a) This insurance does not apply to "bodily injury' or "property damage" occurring after all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) has been completed. (b) This insurance does not apply to "bodily injury" or "property damage" occurring after that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. (c) This insurance does not apply to "bodily Injury', "property damage" or "personal and advertising injury' arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (i) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surreys, field orders, change orders or drawings and specifications; or (ii) Supervisory, inspection, architectural or engineering activities. 3. The maintenance, operation or use of equipment leased to you by such person(s) or organization(s). This insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 4. Operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization, subject to the following provisions: ARAX 30 01 08 12 Includes copyrighted material of the Insurance Services Office, Inc. used with its permission Page 1 of 2 (a) This insurance does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of the operations performed for the federal government, state or municipality. (b) This insurance does not apply to "bodily injury" or "property damage" included within the "products - completed operations hazard." 5. Their liability as a grantor of a franchise to you. 6. Their liability as a grantor of a license to you. A person(s) or organization(s) status as an additional insured under this provision ends when: (a) The license granted to you by such person(s) or organizations(s) expires; or (b) Your license is terminated or revoked by such person(s) or organizations(s) prior to expiration of the license as stipulated by the contract or agreement. ARAX 30 01 08 12 Includes copyrighted material of the Insurance Services Office, Inc. used with its permission Page 2 of 2 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE ANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this 'insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE Accl#: 3082920 12/03/2024 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 ADDITIORAL IINSURED, 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 LOCKTON COMPANIES, LLC PlAlolvl=..... FAX 3657 Briarpark Dr., Suite 700 E-MAIL141.c�1p, Fit) Ins en certs lockto c Na) 888 828-8365 E Mnaffinit com Houston, TX 77042 PPRESs;_."_ P ty ...t @ ... y INSURER A : IndemnitV Insurance Company of North America 1 43575 INSURED INSURER B PICO RENTS, INC. _ .. 4646 E LOS ANGELES AVE INSURERc „ __.. SIMI VALLEY, CA 93063-3407 INSURER D INSURER E \ll IAN'.Mf n� I7=VIClnkl All IMRFQ' 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. _. ......�AIOM]L�' t113'R ... ....... ..._, ----------------..... . ..--- ...._ NN ..i-.M.. ... "..MOLICY El I LIMITS POLICY"NUMBER.......... TYPE OF INSURANCE~~ MfOaI4 DfYYY' " COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I $ � .. --- -- CLAIMS -MADE OCCUR P,)jFfy1 I.S.(l pocyrr4r cel $ .., ... MED EXP (Any one person) ,.�, $ ..... ..... _- ....... .. P ERSONAL 8 ADV INJURY G $ . _ .. PER: GEN1.AGGREGATELIMIT APPLIES . .... -.0 �_.�..._r ... GGREGATE -- $ LOC PRODUCTS-COMP/OP AGG $ JJrCT O"A F4ER; I ....: $ AUTOMOBILE LIABILITY �....... . COMBINED SINGLE LIMN $ ( a aocwlcnl� I .... -- ANY AUTO BODILY INJURY (Per per $ OWNED SCHEDULED _ BODILY INJURY (Per acadent)� $ „ AUTOS AUTOSALL NON -OWNED •• ROPERIIYOAMAGE $ P J....,_..HIRED AUTOS AUTOS �M�'cr gf�.rM�'Ij'�,I. ---........ _ ....,., ............. , UMBRELLA LIAR OCCUR I EACH OCCURRENCE $ EXCESSI CLAIMS -MADE LAGGREGATE m$ j DED I RETENTION $ ''.. L............ $ WORKERS COMPENSATION ' PER OTH AND EMPLOYERS' LIABILITY YIN """""'1,000,000 E EACH ACCIDENTFR $ A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I A i C72482852 10/01/2024 10/01 /2025 L 1000,000 (Mandatory in NH) $ "�.0 ______ ... E L. DISEASE EA EMP.-LIMIT If yes, describe under $ 000,000 DESCRIPTION OF OPERATIONS below r : E L. DISEASE POLICYLOYEE� DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ULKIIFIL;AIL MULUrK n++alr4+cr errl1�'la City of El Segundo ATTN: City Clerk 350 Main St Room 5 El Segundo CA 90545 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 ACORD 25 (2016/03) The ACORD name and logo are registered marks of AcvKU