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PROOF OF INSURANCE (2026 - 2026)1 CERTIFICATE OF LIABILITY INSURANCE y 04/18/2025 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 be endorsed. If SUBROGATIONIS 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). GROSSLIGHT INSURANCE/PHS NAME: PHONE (866) 467-6730 72250765 (A/C, No, Ext): No): T The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESs: INSURER(S) AFFORDING COVERAGE NAIC# INSURED _ INSURERA: Hartford Underwriters Insurance Company 30104 PSYCHOLOGICAL CONSULTING ASSOCIATES INC. INSURER B : 10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024-3910 INSURER C : INSURER D :. INSURER E : INSURER F : COVERAGES NUMBER: REVISION NUMBER: _CERTIFICATE 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. IN TYPE OF INSURANCE AODL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS TR R IMM (MMIDDfY_... ..... COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2„000,.000.. CLAIMS -MADE IX OCCUR DAMAGE TO RENTED $1,000,000 PREN Fs(Eaorrurrenrgj X General Liability MED EXP (Any one person) $10,000 A X 72 SBA BK2J86 04/01/2025 04/01/2026 PERSONAL &ADV INJURY $2,000,000' GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000' X POLICY II I PRO- LOC PRODUCTS - COMP/OP AGG $4,000.00 L........1 JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT iE2Ar_rqPm1_ $2 000 000 BODILY INJURY (Per person) ANY AUTO A ALL OWNED SCHEDULED X 72SBA BK2J86 04/01/2025 04/01/2026 BODILY INJURY (Per accident) AUTOS .AUTOS PROPERTY DAMAGE HIRED NON -OWNED X X AUTOS AUTOS (Per accident) '.. UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED'. RETENTION $ WORKERS COMPENSATION JPER OTH- AND EMPLOYERS' LIABILITY I STATUTE ANY YIN E.L. EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE NIA OFFICER/MEMBER EXCLUDED? E.L.. DISEASE -EA EMPLOYEE (Mandatory in NH) '... If yes, describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION. OF. OPERATIONS below A Data Breach - Defense & Liab 72 SBA BK2J86 04/01/2025 04/01/2026 Limit $100,000 Covg DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Ift Ueclarations: Al*%. Business Liability Coverage Part Your policy includes the liability coverages listed below. The limits in the right-hand column show the maximum amount we'll pay. SL00001018 Personal and Advertising Injury Limit .m.....,,.�,,, Products -Completed Operations Aggregate Limit SL 30 42 10 18 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION SL 30 43 10 18 ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES SL 30 36 10 18 ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS SL 30 48 10 18 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION �... SL 30 32 06 21 e..,.,..,, , , .... ....... ... BLANKET ADDITIONAL INSURED BY CONTRACT SL 30 26 10 18 a.®. ,e„.... HIRED AUTO AND NON -OWNED AUTO LIABILITY SL 30 17 10 18 REIMBURSEMENT OF LEGAL EXPENSES COVERAGE (FOR COURT OR REVIEW BOARDS) SL 30 03 10 18 WAIVER OF SUBROGATION 'Included in Business Liability Limit(s) Included' Included' $5,000 See schedule below SL 30 03 10 18 WAIVER OF SUBROGATION CITY OF OXNARD, RIXK Location: 300 W 3RD MANAGER REF# 7057-15-F1 STREET STE.302 OXNARD, CA. 93030 CITY OF TORRANCE Location: 3300 CIVIC CENTER DRIVE TORRANCE, CA 90503 THE CITY OF MANHATTEN BEACH Location: 420 15TH STREET MANHATTAN BEACH, CA. 90266 CITY OF BEVERLY HILLS Location: 46 NORTH REXFORD DR BEVERLY CA 90210C Form: SC 00 01 10 18 7 5CUff RMAD SL30421018 Declarations: Business Coverage MANAGERS OR LESSORS OF PREMISES ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION re�r�� ��irr[� AA11'1\/!11'1 IAITCCOC UNIT, IT'S ELECTED AND APPOINTED OFFICIALS, OFFICERS, AGENTS, AND EMPLOYEES ........ . CITY OF ONTARIO MONTEBELLO UNIFIED SCHOOL DISTRICT CITY OF RIVERSIDE AND IT'S OFFICERS, EMPLOYEES AND AGENTS Location: 100 NORTH GARFIELD AVE, RM S135 PASADENA,CA 91109 Location: 320 N FLOWER ST SANTA ANA, CA 92703- 5000 Location: 303 E B ST ONTARIO, CA 91764 Location: 123 S MONTEBELLO BLVD MONTEBELLO, CA. 90640 Location: 3900MAIN STREET RIVERSIDE, CA. 92522 5 HUTTON CENTER DRIVE, SUITE 120, SANTA ANA, CA 92707 COUNTY OF ORANGE SHERRIFF- N/A CORONER DEPARTMENT/PURCHASING UNIT COUNTY OF ORANGE SHERRIFF- CORONER DEPARTMENT/PURCHASING UNIT, IT'S ELECTED AND APPOINTED OFFICIALS, OFFICERS, AGENTS, AND EMPLOYEES 320 N. FLOWER ST, SANTA ANA, CA 92703 LOS ANGELES COUNTY N/A DEPARTMENT OF CHILDREN & FAMILY SERVICES 425 SHATTO PL, COMPTON, CA 90220 Form: SC 00 01 10 18 8 300 W 3RD ST STE 302, OXNARD, CA 93030 STATE OF CALIFORNIA: N/A DEPARTMENT OF CORRECTIONS & REHABILITATION OFFICE OF BUSINESS SERVICES 9838 OLD PLACERVILLE RD STE B-2„ SACRAMENTO, CA 95827 THE CITY OF MANHATTAN BEACH N/A 420 15TH STREET, MANHATTAN BEACH, CA 90266 CITY OF RIVERSIDE AND IT'S N/A OFFICERS, EMPLOYEES AND AGENTS 3900 MAIN STREET, RIVERSIDE, CA 92522 CITY OF LONG BEACH LONG N/A BEACH FIRE DEPARTMENT 3205 LAKEWOOD BLVD, LONG BEACH, CA 90808 _o CITY OF BEVERLY HILLS N/A 46 NORTH REXFORD DR, BEVERLY HILLS, CA 90210 SOUTH ORANGE COUNTY N/A COMMUNITY COLLEGE DISTRICT ITS OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS 28000 MARGUERITE PKWY, MISSION VIEJO, CA 92692 CITY OF LONG BEACH BOARD OF N/A HARBOR COMMISSIONAIRES PO BOX 570, LONG BEACH, CA 90801 Form: SC 00 01 10 18 9 IGLKS, AULN 16 ANU ILOYEES. ) DUQUESNE AVE, CULVER e, CA 90232 DEPARTMENT 4700 RAMONA BOULEVARD, MONTEREY PARK, CA 91754 CITY OF ONTARIO N/A 303 E B ST, ONTARIO, CA 91764 MONTEBELLO UNIFIED SCHOOL N/A DISTRICT 123 S MONTEBELLO BLVD, MONTEBELLO, CA 90640 CITY OF TORRANCE N/A 3300 CIVIC CENTER DRIVE„ TORRANCE, CA 90503 CITY OF HUNTINGTON N/A 2000 MAIN STREET„ HUNTINGTON BEACH, CA 92648 CITY OF LONG BEACH POLICE N/A DEPARTMENTATTN BENJAMIN PARAMO THE CITY OF LONG BEACH, ITS OFFICIALS, EMPLOYEES AND AGENTS 400 W BROADWAY, LONG BEACH, CA 90802-4401 Huntington Beach Fire Department .............. N/A 2000 MAIN ST, HUNTINGTON BEACH, CA 92648-2702 CITY OF BURBANK POLICE N/A DEPARTMENT 200 N. 3RD ST., BURBANK, CA 91502 Form: SC 00 01 10 18 10 Declarations: lBusiness Liability Coverage SL 30 48 10 18 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION OFFICERS, OFFICIALS, DIRECTORS, EMPLOYEES, AGENTS, CONSULTANTS, AND VOLUNTEERS & GARDEN GROVE POLICE DEPARTMENT 11301 ACACIA PKWY, GARDEN GROVE, CA 92840 THE CITY OF SANTA MONICA POLICE DEPARTMENT THE CITY OF SANTA MONICA POLICE DEPARTMENT, THE CITY OF SANTA MONICA, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS 333 OLYMPIC DR, SANTA MONICA, CA 90401 CITY OF LONG BEACH N/A 4801 AIRPORT PLAZA DR, LONG BEACH, CA 90815-1263 City of Pasadena N/A 100 N GARFIELD AVE, PASADENA, CA 91101-1726 j City of Santa Barbara N/A 735 ANACAPA ST, SANTA BARBARA, CA 93101-2298 City of Burbank.. N/A 275 E OLIVE AVE, BURBANK, CA 91502-1232 Montebello Unified School District N/A 123 S MONTEBELLO BLVD, MONTEBELLO, CA 90640-4729 City of Riverside N/A 3900 MAIN ST, RIVERSIDE, CA 92522-0001 THE CITY OF MANHATTEN BEACH N/A 420 15th Street, MANHATTAN BEACH, CA 90266 South Orange County Community N/A College 28000 MARGUERITE PKWY, MISSION VIEJO, CA 92692-3635 11 Form: SC 00 01 10 18 LiabilityDeclarations: Biusiness Coverage Part SL 30 36 10 18 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS VOLUNTEERS 333 OLYMPIC DR, SANTA RA-1—A nA nnnna 123 S MONTEBELLO BLVD, MONTEBELLO, CA 90640-4729 SL20301018 SL20781018 12 Form: SC 00 01 10 18 Account Number: CA PSYC 1870 Date: 4/17/25 Initials: KIANNONE ALLIED WORLD INSURANCE COMPANY C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 800-421-6694 This is to certify that the insurance policies specified below have been, issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford. the coverages indicated insofar as such coverages apply to the occupation or business of the Darned Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Named Ins_v ed: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. 10940 WILSHIRE BLVD SUITE 1600 LOS-ANGELES CA 90025 Type of Work Covered: PROFESSIONAL PSYCHOLOGIST Location of Operations: N/A (If different than address listed above) Claim History: Retroactive date is 04/15/2002 Policy Effective Coverages Number Date Additional Named Insureds: GINA L. GALLIVAN, PH.D Expiration Date Limits of Liability PROFESSIONAL/ 1,000,000 I 4/15/2025 4/15/2026 LIABILITY 15011-2743 3,000 000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: Defense Reimbursement Proceedings Limit is $75, 000. 3/31 ADD CITY OF LONG BEACH CITY OF SANTA MONICA CITY OF POLICE DEPARTMENT POLICE DEPT. POLICE D 400 W BROADWAY 333 OLYMPIC DR. 11222 AC LONGBEACH CA 90802 SANTA MONICA CA 90401 GARD This Certificate Issued to: Name: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. Address: 10940 WILSHIRE BLVD SUITE 1600 Authorized Representative LOS ANGELES CA 90025 APA 00138 00 (06/2014) PAGE 1 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY ITEM 2: ADDITIONAL INSUREDS 01. CITY OF LONG BEACH POLICE DEPARTMENT 400 W BROADWAY LONGBEACH, CA 90802 02. CITY OF SANTA MONICA POLICE DEPT. 333 OLYMPIC DR. SANTA MONICA, CA 90401 03. CITY OF GARDEN -GROVE -- POLICE DEPT 11222 ACACIA PKWY GARDEN GROVE, CA 92840 04. CITY OF BURBANK ATTN:PURCHASING DIVISION 275 E OLIVE AVE BURBANK, CA 91502 05. CITY OF ANAHEIM 425 S HARBOR BLVD ANAHEIM, CA 92805 06. CITY OF OXNARD FIRE DEPT RISK MGMNT-REF t705715FI 300 W THIRD ST, STE 302 OXNARD, CA 93030 07. SEE ATTACHED LONG BEACH, CA 90801 08. CITY OF CULVER CITY POLICE DEPT. 4040 DUQUESNE AVE CULVER CITY, CA 90232 09. CITY OF HUNTINGTON BEACH POLICE DEPT/FIRE DEPT 200 MAIN ST., PO BOX 70 HUNTINGTON BCH, CA 92648 10. COUNTY OF LOS ANGELES CA SHERIFF'S DEPT. 211 W. TEMPLE ST LOS ANGELES, CA 90012 *** CONTINUED ON NEXT PAGE *** REPRESENTAUVE PAGE 2 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY ITEM 2: ADDITIONAL INSUREDS 11. CITY OF BEVERLY HILLS HUMAN RESOURCE ANALYST DEPT. 455 N. REXFORD DR. BEVERLY HILLS, CA 90210 12. BEVERLY HILLS POLICE DEPT. 464 N. REXFORD DR. BEVERLY HILLS, CA 90210 - -.13 . - CITY OF EL -SEGUNDO -- 350 MAIN ST. EL SEGUNDO, CA 90245 14. COUNTY OF ORANGE SHERIFF CORONER DEPT PURCH UNIT 320 N FLOWER ST SANTA ANA, CA 92703 15. CITY OF PASADENA 100 N GARFIELD AVE PASADENA, CA 91101 16. CITY OF RIVERSIDE RISK MNAGEMENT 3900 MAIN ST RIVERSIDE, CA 92522 17. STATE OF CALIFORNIA CDCR OFFICE OF BUSINESS 9838 OLD PLACERVILLE B-2 SACRAMENTO, CA 95827 18. THE CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BCH, CA 92647 19. MONTEBELLO UNIFIED SCHOOL DISTRICT 123 SOUTH MONTEBELLO MONTEBELLO, CA 90640 20. CITY OF MANHATTAN BEACH 420 15TH STREET MANHATTAN BEACH, CA 90266 *** CONTINUED ON NEXT PAGE *** REPRESENTATIVE 'E PAGE 3 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY i ITEM 2: ADDITIONAL INSUREDS j i 21. CITY OF TORRANCE 3300 CIVIC CENTER DRIVE TORRANCE, CA 90503 22. COUNTY OF LOS ANGELES DEPT OF CHILDREN & FAMILY SERVICES LOS ANGELES, CA 90020 23. CITY OF ONTARIO 303 -E - B ST ONTARIO, CA 91764 24. CITY OF LONG BEACH FIRE DEPARTMENT 3205 LAKEWOOD BLVD LONG BEACH, CA 90808 25. CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 GIVIC CENTER PLAZA SANTA ANA, CA 92702 26. CITY OF SANTA BARBARA 735 ANACAPA ST SANTA BARBARA, CA 93101 27. DEPT. OF PUBLIC SAFETY/ NV HWY PATROL 555 WRIGHT WAY CARSON CITY, NV 89711 28. SAN BERNARDINO COUNTY 157 5TH STREET SAN BERNARDINO, CA 92415 29. SEE ATTACHED LOS ANGELES, CA 90017 30. CITY OF LONG BEACH BOARD OF HARBOR COMMISSIONERS ATT: RISK MGMT DIVISION, 00000 *** CONTINUED ON NEXT PAGE *** REPRESENTATIVE PAGE 4 POLICY NO.: 501-000012743 ISSUED TO: PSYCHOLOGICAL CONSULTING ASSOCIATES, INC. BY: ALLIED WORLD INSURANCE COMPANY ITEM 2: ADDITIONAL INSUREDS 31. CALIFORNIA STATE UNIV,LA ATTN: PROCUREMENT & CONTRACTS LOS ANGELES, CA 90032 AUT REPRESENTATIVE ENDORSEMENT ADDITIONAL INSURED This Endorsement, effective at 12:01 a.m. on 4/15/25, forms part of Policy No. 501-000012743 Issued to PSYCHOLOGICAL CONSULTING Issued by ALLIED WORLD INSURANCE COMPANY In consideration of the premium charged, it is hereby agreed that any individual, partnership or corporation identified below is an Additional Insured under this Policy, but only as to matters for which a Named Insured may be liable: Additional Insured 007. CITY OF LONG BEACH HARBOR DEPARTMENT BOARD OF HARBOR COMMISSIONERS P O BOX 570 LONG BEACH, CA 90801 029. LOS ANGELES UNIFIED SCHOOL DISTRICT & THE BOARD OF EDUCATION OF THE CITY OF LOS ANGELES 333 S. BEAUDRY AVE., 28TH FLOOR LOS ANGELES, CA 90017 All other terms, conditions and limitations of this Policy shall remain unchanged. 4 AUTHORIZED REPRESENTATIVE APA 00121 00 (06/14) CERTIFICATE OF LIAB THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE C IMPORTANT: If the certificate holder Is an ADDITIONAL INSU subject to the terms and conditions of the policy, certain polici confer rights to the certificate holder in lieu of such endorseme NUTMEG INSURANCE AGENCY INC/PHS 02025657 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251 PSYCHOLOGICAL CONSULTING ASSOCIATES INC. 10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024-3910 ILITY INSURANCE D TE 04/18/2025 ) N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. LY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), ERTIFICATE HOLDER. RED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, es may require an endorsement. A statement on this certificate does not nt(s). CONTACT (A/C, N PHONE (866)467-8730 FAx E•MA14 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A : Hartford Fire and Its P&C Affilia11 tes 00914 INSURER B : INSURER C INSURER D :. '.. INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL 'SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS _LTR NSR.... _ MMIDD MMAD (K. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS4A0E OCCUR DAMAGE TO RENTED P S " nr..curr nce MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS - COMP/OPAGG JECT OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY accidenl ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS HIRED NON -OWNED PROPERTYDAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR _ EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE ED RETENTION $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY STAT TE R,_. ANY YIN I E.L. EACH ACCIDENT $1,000.000 A PROPRIETOR/PARTNER/EXECUTIVE NIA 02 WEG AR6RC3 0311112125 03/11/2026 OFFICERIMEMBER EXCLUDED? E.L DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under EL. DISEASE - POLICY LIMIT $1,000,000 E R,IPTION F OPERATIQNB b low DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL 'SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS _LTR NSR.... _ MMIDD MMAD (K. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS4A0E OCCUR DAMAGE TO RENTED P S " nr..curr nce MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS - COMP/OPAGG JECT OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY accidenl ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS HIRED NON -OWNED PROPERTYDAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR _ EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE ED RETENTION $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY STAT TE R,_. ANY YIN I E.L. EACH ACCIDENT $1,000.000 A PROPRIETOR/PARTNER/EXECUTIVE NIA 02 WEG AR6RC3 0311112125 03/11/2026 OFFICERIMEMBER EXCLUDED? E.L DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under EL. DISEASE - POLICY LIMIT $1,000,000 E R,IPTION F OPERATIQNB b low DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER CANCELLATION CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD (Policy Provisions: WCOOOOOOC) INFORMATION PAGE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INSURER: SEE ATTACHED ENDORSEMENT NCCI Company Number: 14397 Company Code: 9 POLICY NUMBER: 02 WEG AR6RC3 Previous Policy Number: 02 WEG AR6RC3 Suffix LARS RENEWAL 4 1. Named Insured and Mailing Address: PSYCHOLOGICAL CONSULTING ASSOCIATES INC. (No., Street, Town, State, Zip Code) 10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024 FEIN Number: 58-2668663 State Identification Number(s): Refer to the EXTENSION OF THE INFORMATION PAGE — WC990365. The Named Insured is: Corporation Business of Named Insured: Offices of All Other Miscellaneous Health Practitioners Other workplaces not shown above: See Endorsement - WC990366 2. Policy Period: From 03/11/25 To 03/11/26 ANNUAL 12:01 a.m., Standard time at the insured's mailing address. Producer's Name: NUTMEG INSURANCE AGENCY INC/PHS 1120 S TRYON ST SUITE 1100 CHARLOTTE NC 28203 Producer's Code: 02025657 Issuing Office: THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 (866) 467-8730 Total Estimated Annual Premium: $11,493 _ Deposit Premium: Policy Minimum Premium: $570 CA (Includes Increased Limit Min. Prem.) Audit Period: ANNUAL Installment Term: Four Pay (30%Down +2@25%+1 @20%) The policy is not binding unless countersigned by our authorized representative. Countersigned by If 01/30/25 Authorized Representative Date Form WC 00 00 01 A (1) Printed in U.S.A. Page 1 (Continued on next page) Process Date: 01/30/25 Policy Expiration Date: 03/11/26 INFORMATION PAGE (Continued) Policy Number: 02 WEG AR6RC3 3. A. Workers Compensation Insurance: Part one of the policy applies to the Workers Compensation Law of the states listed here: CA SEE ENDORSEMENT - WC 99 03 67 B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily injury by Accident $1,000,000 each accident Bodily injury by Disease $1,000,000 policy limit Bodily injury by Disease $1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any , listed here: ALL STATES EXCEPT NORTH DAKOTA, OHIO, WASHINGTON, WYOMING, U.S.TERRITORIES AND STATES DESIGNATED IN ITEM 3.A. OF THE INFORMATION PAGE. D. This policy includes these endorsements and schedule: SEE ENDORSEMENT -WC 99 03 68 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information re uired below is sub'ect to verification and than e b audit. Premium Basis Classifications Total Estimated Rates Per Estimated Code Number and Annual $100 of Annual Description Remuneration Remuneration Premium Total Standard Premium Premium Discount Expense Constant Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement Catastrophe (Other Than Certified Acts Of Terrorism) Estimated Annual Premium (before Surcharges) Total Estimated Surcharges *See the attached Schedule(s) of Operations for Location and State Level Premium Information Total Estimated Annual Premium: $11,493 Deposit Premium: Policy Minimum Premium: $570 CA (Includes Increased Limit Min. Prem. Interstate/Intrastate Identification Number: Refer to Schedule of Operations NAICS: 621399 Labor Contractors Policy Number: SIC: 8049 $10,782 -$201 $240 $136 $9 $10,966 $527 Form WC 00 00 01 A (1) Printed in U.S.A. Page 2 Process Date: 01/30/25 Policy Expiration Date: 03/11/26 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number: 02 WEG AR6RC3 Endorsement Number: Effective Date: 03/11/25 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: PSYCHOLOGICAL CONSULTING ASSOCIATES INC. 10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024 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. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date: 01/30/25 Policy Expiration Date: 03/11/26 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 02 WEG AR6RC3 Endorsement Number: Effective Date: 03/11/25 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: PSYCHOLOGICAL CONSULTING ASSOCIATES INC. 10940 WILSHIRE BLVD STE 1600 LOS ANGELES CA 90024 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 01/30/25 Authorized Representative Policy Expiration Date: 03/11/26