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PROOF OF INSURANCE (2025) CLOSEDFOSTE-2 CIP ID.' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/1912024 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 Atkinson & Assoc. Insurance 1537 Brantley Rd, Bldg C Fort Myers, FL 33907 Paul G. Atkinson A009536 nsurance.com INSURED I I? 0 0 fner Ca o Foster and Foster Consulting tIndian Harbor Insurance Co 36940 Actuaries„ Inc. dba Foster & Foster, Inc. I RtR t,�Travelers Excess & SL Co 29696 13420 Parker Commons Blvd #104 Evanston ° .' Company .."' 35370 Fort Myers, FL 33912 pecialty Lines, Inc. INSURER °vansAtlantic Specialty COVERAGES CERT11=1CATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT TII-IE POLICIES OF INSURANCE I. ISV ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR. 111 IE POLICY PERIOD INDICATED. NO'TtN 1" HS FANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCIJMEN"II" WITH RESPECT TO WI110I THIS CER I IFICATF.. MAY DE ISSUED OR MAY PERTAA, THE INSURANCE AFFORDED BY 'TG IE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL I"FIE. TIERMS, EXCLUSIONS AND CONDI FNCO SUCH POLICIES. Ie"fS SHOWN r9AY HAVE BEEN REDUCED BY PAID CLAIMS- ........ _ 'R I51E- OF INSURANCE O POUCYNUMBR OLIMITSTYPE X COMMERCIAL GENERAL EACH0GwUrrNC,,.... tOpr000E CI..IM-MAD DX OCCUR Y 3AA775888 04/17/2024 01/01/2025 �aTEO ,,. .00 n.... p X CYSER LIABILITY CYB10790987800 01/01/2024 01/0112025 hl dTmc P, ,i rr rs ,v 5,00tI F X CRIME- $1,000,000 _ MML-35098-24 $10K DED 04/17/2024 04/17/2025 PkRSR,'tIAL & AJDV IIiUURY s Excluded 2,000,000 GEN1 AGGREG� TIF LIMIT "['APPLIES PER. EI,9ERRAL AOti.REG .._ Excluded PO Ui` d' �..Y P d&- LOC PRODUCTS - CtiTUrotiP/OP AGG „ X OTHER CYEER RET 10 000 CYI5*EA CL ,000,000 'YIVGCE LIMIT 1,000,000 A AUTOMOBILE LIABILITY .._Elycl fl - . a ........ X ANY AUTO BA-9T746362-24-42-G 01/01/2024 01/01/2025 BODILY INa �vr�����n➢w �'�_ � - OWNED SCHEDULED AUTOS ONLY AUTOS E*DLYINJURY iP'er n, ddenfl_ a X Z X ANA. NM P �eDP�R et' A JGE u ONLY E UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 5,0 0,000 X EXCESS LIAB Cd IMF"MADE, F-ZXS3164662 04/17/2024 01/01/2025 AGG ATE 5,000,000 DF..D RETENTION a A VVOnON d X � AND EMPS YERS' LSA ILIT AND EMPLOYERS' LIABILITY Y CHUL( ,. UIB-8J390688.24-42-E 01/01/2024 01/01/2025 E L E,��C; H A( "YCiEP�T 1, �� �� ANY PROPRIETOMPARTNERIEXECUTIVE XN NIA PICE,t6 EM$Wf, EXCLUDED? ... taY➢datoay an ) NO DEDUCTIBLE E L DJK-, R ^ EA E @PLCd' S _ 1,000,000 VI desPx,he and t Im}�:�i�RIPTIONOFCIPERA71 L LIL E L DI aE,E • pOL4C^, L4hUG"- 1,000,000 C 'PROF LIAB E&O PL-E.A CLM MPP 9037622 05 $250K DED 0 I/6112024 01/U1120Z5IPL-AGGREG 5,000,000 1-7 � 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The Cl ty of El Segundo, Its officials and employees are listed as additional insureds with res ect to the eneral liability per Written contract. General Liability l ou�erage is Primary. 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 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE (.Il.ttJC- jd O. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy #: 3AA775888 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the • Insurance Condition and supersedes any provision to the • Primary And Noncontributory Insurance 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 • insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution • any • insurance available to the additional insured. CG 20 01 04 13 @ Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY III POLICY NUMBER: 3AA775888 MARKIEC EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED COMMERCIAL GENERAL LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PROD UCTSKCOMPLETEOOPERATIONS LIABILITY COVERAGE FORM SCHEDULE Additional Premium: $660 (Check box if fully earned 0) may or may not be defined in all Coverage Forms. A. Who Is An Insured is amended to include as an additional insured any person or entity to whom you are required by valid written contract or agreement to provide such coverage, but only with respect to "bodily injury", "property damage" (including "bodily injury" and "property damage" indUded in the "prod u cts-corn p] eted operations hazard"), and "personal and advertising injury" caused, in whole or in part, by the negligent acts or omissions of the Named Insured and only with respect to any coverage not otherwise excluded in the policy. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. The insurance afforded to such additional insured will not be broader than that which you are required by the valid written contract or agreement to provide for such additional insured. Our agreement to accept an additional insured provision in a valid written contract or agreement is not an acceptance of any other provisions of such contract or agreement or the contract or agreement in total. When coverage does not apply for the Named Insured, no coverage or defense will apply for the additional insured. No coverage applies to such additional insured for injury or damage of any type to any "employee" of the Named Insured or to any obligation of the additional insured to indemnify another because of damages arising out of such injury or 1. With respect to the insurance afforded to these additional insured, the following is added to limits of insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the valid written contract or agreement', or 2. Available under the applicable limits of insurance shown in the Declarations; whichever ieless. This endorsement shall not increase the applicable limits of insurance shown in the Declarations. KMEGL0DUS-01D910 Includes copyrighted material ofInsurance Services Office, Inc.. Page 1of1 WORKERS COMPENSATION TRAVELERV AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-8J390688-24-42-E WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR ACTUARIAL CONSULTANTS WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 Insured Insurance Company Policy No. Countersigned by Endorsement No. Premium DATE OF ISSUE: 12-05-23 STASSIGN: Page 1 of 1