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PROOF OF INSURANCE (2025 - 2025) CLOSEDcnn w c'yrrwa",r u.vr r r r o p .LC"R"CERTIFICATE OF LIABILITY INSURANCE 04/21/2025 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 have ADDITIONAL INSURED provisions or be endorsed.lf SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Mass Merchandising K&K Insurance Group, Inc. PHONE 1-800-426-2889 _ FAX 1 260 45 1712 Magnavox Way (AIC, No, Ext): (A/c No) 9-5105 Y Info s _ .A.-.... s Fort Wayne IN 46804 E-MAIL ADDREs IT @ portsinsurance kk com PRODUCER CUSTOMER ID: INSURER(S) AFFORDING COVERAGE NAIC # INSURED: 2001713264 CP# 3890 INSURER A: - AIG Specialty Insurance Com pany 26883 RK Sports LLC INSURER B DBA: Sportball INSURER C. 2008 W Carson St INSURER D .... """" _uuuu Torrance, CA 90501 INSURER E: A Member of the Sports, Leisure & Entertainment RPG INSURER F: COVERAGES 155 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MM/DD/YYYY) _.w._....u......... ... A X COMMERCIAL GENERAL LIABILITY X ... 9YAPG0001334486100 ._............. 06/05/24 06/05/25 .,.�.. EACH OCCURRENCE $2,000,000 X 12:01AM 12:01 AM DAMAGE TO RENTED PREMISES $1,000,000 CLAIMS -MADE OCCUR (Ea Occurrence) MED EXP (Any one person) $5,000 -- PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY PROJECT E LOC PRODUCTS —COMP/OP A G G $2,000,000 PROFESSIONAL LIABILITY mmmmmmmmmIT $2,000,000 OTHER: LEGAL LIAB TO PARTICIPANTS $2,000,000 P` AUTOMOBILE 9YAPG0001334486100 02:05 ITIT COMBINED SINGLE LIMIT 0000 AM 112:01 AM Ea -----.•............ OLIABILITY BODIeYI)NJUR (Perperson ... .......... OWNED AUTOS SCHEDULED BODILY INJURY (Per accident) ONLY AUTOS X HIRED AUTOS X NON -OWNED PROPERTY DAMAGE(Peraccident) ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE ...._. ....... ........_. DED RETENTION WORKERS COMPENSATION N/A PER STATUTE OTHER .............._._. AND EMPLOYERS' LIABILITY YIN E.L.. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE ry L, DISEASE EA EMPLOYEE E"SE """"' OFFICERIMEMBER EXCLUDED? . (Mandatory in NH) If yes, describe under E"L, DISEASE —POLICY LIMIT DESCRIPTION OF OPERATIONS below A MEDICAL PAYMENTS FOR PARTICIPANTS9YAPG0001334486100 06/05/24 06/05/25 PRIMARY MEDICAL 'EXCESS MEDICAL $25,000 12:01 AM 12:01 AM DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Sport(s): Motor Skills Development Age(s): 12 & Under The City of El Segundo, its elected and appointed officials, employees, and volunteers are added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured. Sexual Misconduct Liability - $250,000 each "Insured Event" limit/ $1,000,000 aggregate Primary and Noncontributory is added via form PRG 4288 This certificate replaces certificate #000102351 effective 04/17/25 CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 350 Main Street EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH El Segundo, CA 90254 THE POLICY PROVISIONS. Owner/Manager/Lessor of Premises AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved. Coverage is only extended to U.S. events and activities. " NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 9YAPG0001334486100 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) The City of El Segundo, its elected and appointed officials, employees, and volunteers 350 Main Street El Segundo, CA 90254 Named Insured: RK Sports LLC DBA: Sportball CP# 3890 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(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 or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. 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; 2. If coverage provided to the additional insured whichever is less. is required by a contract or agreement, the This endorsement shall not increase the applicable insurance afforded to such additional insured will Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement, effective 12:01 A.M. 04/17/2025 Forms a part of Policy No. 9YAPG0001334486100 PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE PROVISION - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Person Or Organization: The City of El Segundo, its elected and appointed officials, employees, and volunteers 350 Main Street El Segundo, CA 90254 Named Insured: RK Sports LLC DBA: Sportball CP# 3890 Effective Date: 04/17/25-06/05/25 The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Person Or Organization shown in the Schedule of this endorsement, provided that: (1) Such Person Or Organization is an additional insured under your policy; (2) The additional insured is a Named Insured under such other insurance; and (3) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of the policy remain the same. 91-�414210-� Authorized Representative PIRG 4288 12-23 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. POLICY NUMBER: 9YAPG0001334486100 INTERLINE IL 12 01 11 85 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 1 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE 9YAPG0001334486100 04/17/25 AIG Specialty Insurance Company NAMED INSURED AUTHORIZED REPRESENTATIVE RK Sports LLC I K&K Insurance Group, Inc. Sportball COVERAGE PARTS AFFECTED ALL COVERAGE PARTS CHANGES Member Certificate # 000075754 Form PRG 4290 "Member Certificate" is amended as follows: Form PRG 4289 is added to the policy CP# 3890 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 Copyright, ISO Commercial Risk Services, Inc., 1983 ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE DEAD IT CAREFULLY. This endorsement, effective 12:01 A.M. 04/17/25 Forms a part of Policy No. 9YAPG0001334486100 NOTICE OF CANCELLATION TO THIRD PARTY PERSONS OR ORGANIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Ngrni, gq Of Dgys Advance Notice Nonpayment For Any Person(s Or Organization(s)For s) Of Premium Other Reason The City of El Segundo, its elected and appointed officials, employees, and 10 30 volunteers 350 Main Street El Segundo, CA 90254 Named Insured: RK Sports LLC DBA: Sportball CP# 3890 Effective Date: 04/17/25-06/05/25 A. If we cancel this policy for any reason, we will notify the Person(s) Or Organization(s) shown in the Schedule of this endorsement according to the applicable Number Of Days Advance Notice shown in the Schedule of this endorsement. However, in no event will the Number Of Days Advance Notice to such person(s) or organization(s) exceed the number of days advance notice to the first Named Insured. B. Our obligation to notify the Person(s) Or Organization(s) shown in the Schedule of this endorsement will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person(s) or organization(s) to maintain insurance coverage under a policy which requires notification to the person(s) or organization(s) in the event of cancellation. C. Failure to provide such notification will not extend the policy cancellation date nor negate a cancellation of the policy. All other terms and conditions remain unchanged.. PRG 4289 12-23 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 with its permission. Authorized Representative PRIG 4289 12-23 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with its permission. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 01 /03/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONMATTER 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 p R, AND THE CERTIFICATE HO_L_DER. IMPORTANT: the certificate Rho deR isanNSUREDC he olic Ies must be endorse ROG �". () _ p y(' ) d. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does s). not confer rights to the certificate holder in lieu of such endorsement( _, _ """"."., PRODUCER CONTACT NAME: ...._... P.....,..,... ,m. PAYCHEX INSURANCE AGENCY HONE (800) 472 0072� FAX PHONE 76210762 No, Ext): (A/C, No) 225 KENNETH DR STE 110 E-MAILADDRESS : ROCHESTER NY 14623 s INsuRER ( ) AFFORDING COVERAGE NAIL# INSURERA: Hartford Casualty Insurance Company ca4cY ................ INSURED INSURER _ _...............................T...... - _....._........ RK SPORTS LLC INSURER Cu 2008 W CARSON ST _ ..._........ _..._.................. _...._. ._...... TORRANCE CA 90501 INSURER . INSURER E a INSURER F COVETTHIS IS ECERTIFICATE NUMBER: CERTIFY THAT THE POLIC ES OFIINSURANCELI TD BELOW HAVE BEEN ISSUED TO THE INSUREDSURED NA NAMED OABOVE 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. _ .... _ _ m.... �` NCLIABILITY AD SPOLICY NUMBER UER POLICY EFF POLICY EXP LIMITS .t�?f+i&.� gry'""" TYPE I _ RL �..G BSI" �........m-.,..... _ ..... .,L!4t!NI99 P�'...%L. .......... COMMERCIAL GENERAL ......... .....�. EACH OCCURRENCE _. CLAIMS-MADE❑OCCUR DAMAGE TOHEN b PREM��5 lEe 9, uprrencel MED EXP (Any one person) ............... PERSONAL& ADVINJURY f .^. APPLIES PER: GENERALA GEN'L AGGREGATE LIMIT APPL mmmmmmmmmmmmmmmmmmITITmJ ....�. ^ _ GGREGATE POLICY p PRO- I LOC PRODUCTS - COMP/OP AGG' 4 ,EJECT I.,.....11 ',.-- _ .........- ..,. OTHER: ....".._ ..�.____...-. ._,..,. _ .�� .a.._..._... _..mmm.u... .................._. .. COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY i d .1��:fascis)yn�l _.... ANY AUTO BODILY INJURY (Per person) _ ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS -.-. HIRED NON -OWNED PROPERTYDAMAGE AUTOS AUTOS (Peraccident) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS- AGGREGATE MADE OEOF 'RETENTION $ X - .m ...�....... ...,�. .. m.w _.._.._. WORKERS COMPENSATION PER OTh- AND EMPLOYERS' LIABILITY TAT T .",_, ,E,R„m„ „_,w,"„",,,_w, ANY YIN E.L EACH ACCIDENT $1,000,000 A PROPRI ETORIPARTNERIEXECUTIV E OFFICER/MEMBER EXCLUDED? N/A X 76 WEG ADSFJY 07/01 /2024 07/01I2O25 E.L "DISEASE EA EMPLOYEE $1,000,000 (Mandatory in NH) Ifyes, describe under E.L DISEASE -POLICY LIMIT $1,000,000 - ._...... ..�. ..,,m.,,,, .--..,. 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. Blanket Waiver of Subrogation applies in favor of the Certificate Holder per the Waiver of Our Right to Recover from Others Endorsement WC040306, attached to this policy, �_..�CATE _ CANCELLATION The City CERTtylof El Segundo t SHOULD Y OF THE ABOVE ._._ _-�....... AN �....._.....�. DESCRIBED g BEFORE HE EXPIRATION DATE THEREOF NOTICE BE CANCELLED 3501 MAIN ST OTICE WILL BE DELIVERED EL SEGUNDO CA 90245 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