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PROOF OF INSURANCE (2025 - 2026)',� 0 DATE (MM/DDNYYY) ``C7" CERTIFICATE OF LIABILITY INSURANCE 0311F,"12025 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 NAME: Alex R Ross PHONE Roman Empire Insurance Agency, Inc AJC No, Ent : 818-433-6054 AJC, Nep: 818-433-4220 ADDRESS: Info,romanem irems.com 2110 N Glenoaks Blvd INSURER(S) AFFORDING COVERAGE NAIC # Burbank CA 91504 INSURER A : Penn Star Ins Co/AmWins 10673 INSURED INSURERS: Capitol S ecial Ins Co 10328 Matrix Audio Visual Designs, Inc INSURER C : Infiniti Select Insurance Com an 11738 INSURER D : 2525 W Burbank Blvd INSURER E : Burbank CA 91505 INSURER F : D'1/E0AGES CERTIFICATE NUMBER, KhVlblUN NUfytCIL,CS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEDBELOWHAVE BEEN 188UED TO THE INSURED NAM INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE( EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _..._ R TYPE OF INSURANCE INSD INVD POLICY NUMBER __,.�MPM UDC gMMrDDd`Y4'YY) COMMERCIAL GENERAL LIABILITY �I CLAIMS -MADE ❑OCCUR M GEN'L AGGREGATE LIMIT APPLIES PER: PROi ❑ LOC POLICY JE,C;q` OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED C AUTOS ONLY AUTOS HIRED (NON -OWNED AUTOS ONLY AUTOS ONLY Y I' Y I CPV0087116 N I N 150002550701 UMBRELLA LIAB OCCUR B x EXCESS LIAR CLAIMS -MADE Y Y XS23037645 DED RETENTION $ ....... WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY Y I N ,"YPROPfi,12T IVPART'NEFCEtXECUTIVE OFFICERMEMBER EXCLUDED") ❑ N / A IMa adatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below 10/30/2024 1 10/30/2025 01/26/2025 1 01/26/2026 10/30/2024 1 10/30/2025 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is rec OPERATIONS: Audio & Visual Design & Installation. Additional Insured Endorsement Form CG 2010 04 13 and CG2037 Subrogation Endorsement for GL policy form EPA 1920 01 19. The policy is Primary & Non -Contributory Form EPA 1920 Additional Insured: City of El Segundo 10 days notice of cancellation for non-payment, 30 days cancellation notice for other than non-payment. Coverage is Primary & Non -Contributory. ED ABOVE FOR THE POLICY PERIOD N ENT WITH RESPECT TO WHICH THIS IS SUBJECT TO ALL THE TERMS, LIMITS EACH OCCURRENCE 1.000,000 IEU PREMISES (Ea occurrence) 100,000 MED EXP (Any one person) 000 '.PERSONAL &ADVINJURY L$f2,0000,000 000 I GENERAL AGGREGATE 000 ''. PRODUCTS -COMP/OP AGG Deductible $ 0 (F' a accideno $ 1,000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident} $ $ EACH OCCURRENCE $ 3,000,000 (AGGREGATE $.... 3,000,000 Crises Res onse $ 250,000 UIH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L.. DISEASE - POLICY LIMIT $ aired) )4 13 or Equivalent Form & Waiver of 01 19. 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 AUTHORIZED REPRESENTATIVE 350 Main St Alex R Ross El Segundo CA 90245 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MATRAUD-01 O' DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4121/2025 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. 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 �....... R YIr1 .... SIP Insurance Services - Pasadena 301 E. Colorado Blvd. Suite #205 Pasadena, CA 91101 INSURED Matrix Audio Visual Designs, Inc. 2525 W. Burbank Blvd. Burbank, CA 91505 '«.rm✓riw.Axrw+u r..mr ww r.s+.«s «er..-x. «.. .�.r...,-..�., ... _..—_.__._. .. 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. . .......... .......„-,.m. .........-........,-.. .m,,._.___ ......... m. TYPE OF INSURANCE ..._.� _ ._..,, INSR ADDL SUER. POLICY EFF POLICY EXP POLICY NUMBER LIMITS LTRCOMMERCIAL GENERAL LIABILITY EA.CH..00CURRENGE _$._„ -..... DAMAGE TO RENTED ----.............. CLAIMS -MADE OCCUR Pii,�71..P.GIt£.yR.—..........._ ..................m._.A,.,.,.,. ...m..._. .,..... ........ .-,..........., MED E.?,4,� I RSQNALA& NDV INJURY_,._ „_,..,.....,.,.,...p„ .. OE GGREGA 11LIMITAPPLIESPER: GENERAL AGGREGATE ..mmm...._,_,m�,. ^ POLICY El 9EGT. LOG PRODUCTS-COMP/OPAGG $ OTHER $ COMBINED SINGLE LllwllT AUTOMOBILE LIABILITY ANY AUTO Per arson,•„•„ $ OWNED SCHEDULED AUTOS ONLY AUTOS _m., BODILY I,NJURY_(,Per accident $. ...... ,,,,,, L„BODI,EY,mWJ,URY HIRED NON -OWNED � &��a�dt'TAMdB' � $ ....... AUTOS ONLY AUTOS ONLY --•-_-• •-••••••°°° -m- Is UMBRELLA LIAB OCCUR EACH OOCURRENCE $ EXCESS LWB CLAIMS -MADE AGGREGATE S DED RETENTION $ $ A WORKERS COMPENSATION X T�tTu OTH AND EMPLOYERS LIABILm Y / N WC1026419 2/26/2025 2/26/2026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE EJ_ EACH,ACCIDENT $ _ ... mmmm C'IFFICER/MEMBER EXCLUDED? N / A- 1,000,000 (Mandatory In NH) E L DISEASE EMPLOYE If yes, describe under DESCRIPTION OF OPERATION$. below mEA L... DISEASE -POLICY LIMIT, 11000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Subject to policy terms, exclusions and condition's. RE: 350 Main St., El Segundo, CA 90245; City of El Segundo ITS Department 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 ACORD 25 (2016/03) 9)1938-2015 ACORD CORPORA I IUN. Ali rignts reservea. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS COVERAGE ENHANCEMENT (ONGOING OPERATIONS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Construction Project Aggregate Limit: See General Aggregate Limit in Declarations Maximum Policy General Aggregate Limit: $5,000,000 Lost Key Coverage Each Occurrence Limit: $10,000 Property Damage Extension Each Occurrence Limit: $5,000 Property Damage Extension Aggregate Limit: $25,000 A. The following is added to SECTION II - WHO IS AN INSURED: 1. Any owner, lessee, or contractor for whom you are performing operations is an additional insured if you have agreed in a written contract or written agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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 in the performance of your ongoing operations performed for that person or organization. However, the insurance afforded to such additional insured only applies to the extent permitted by law and will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. A person or organization is not an additional insured with respect to "bodily injury", "property damage", or "personal and advertising injury" arising out of the acts, omissions, or negligence of that person or organization. 2. With respect to the insurance afforded to these additional insureds, 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: a. The preparing, approving, or failing to prepare or approve maps, shop drawing, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or b. Supervisory, inspection, architectural, or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training, or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render„ any professional architectural, engineering, or surveying services. B. SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The following is added to Paragraph 4. Other Insurance and supersedes any provision to the contrary: Primary and Noncontributory The insurance under this endorsement is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. The additional insured is a Named Insured under such other insurance; b. 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; and EPA-1920 (01/2019) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 3 c. The "bodily injury" or "property damage" is The limits shown in the Declarations for Each caused by your sole negligence, or the Occurrence, Damage To Premises Rented To "personal and advertising injury" is caused by You and Medical Expense continue to apply. an offense committed solely by you. However, instead of being subject to the General 2. The following is added to Paragraph B. Transfer Aggregate Limit shown in the Declarations, such of Rights of Recovery Against Other to Us: We limits will be subject to the applicable waive any right of recovery we may have against Construction Project General Aggregate Limit an additional insured because of payments we and the Maximum Policy General Aggregate make for injury or damage arising out of your Limit, shown in the Schedule above. ongoing operations or "your work" done under a d. The Maximum Policy General Aggregate contract with an additional insured and included Limit shown in the Schedule is the most we in the "products -completed operations hazard" will pay for the sum of all Construction Project This waiver applies only when the "bodily injury" Aggregate Limits. or "property damage" is caused by your sole 2. For all sums which the insured becomes legally negligence, or the "personal and advertising obligated to pay as damages caused by injury" is caused by an offense committed solely "occurrences" under SECTION I — COVERAGE by you. A, and for all medical expenses caused by accidents under SECTION I — COVERAGE C, which cannot be attributed only to ongoing C. The following is added to SECTION III — LIMITS OF operations at a single designated construction INSURANCE: project: Construction Project Aggregate Limit a. Any payments made under Coverage A for 1. For all sums which the insured becomes legally damages or under Coverage C for medical obligated to pay as damages caused by expenses shall reduce the amount available "occurrences" under SECTION I — COVERAGE under the General Aggregate Limit shown in A, and for all medical expenses caused by the Declarations or the Products -Completed accidents under SECTION I — COVERAGE C, Operations Aggregate Limit, whichever is which can be attributed only to ongoing applicable; and operations at a single designated construction b. Such payments shall not reduce any project: Construction Project General Aggregate a. A separate Construction Project General Limit. Aggregate Limit applies to each construction 3. When coverage for liability arising out of the project, and that limit is equal to the amount "products -completed operations hazard" is of the General Aggregate Limit shown in the provided, any ,payments for damages because of Declarations. "bodily injury" or "property damage" included in b. The Construction Project General Aggregate the "products -completed operations hazard" will Limit is the most we will pay for the sum of all reduce the Products -Completed Operations damages under Coverage A, except Aggregate Limit shown in the Declarations, and damages because of "bodily injury" or not reduce the General Aggregate Limit shown in "property damage" included in the "products- the Declarations nor the Construction Project completed operations hazard", and for General Aggregate Limit. medical expenses under Coverage C 4. If the applicable designated construction project regardless of the number of: has been abandoned, delayed, or abandoned (1) Insureds; and then restarted, or if the authorized (2) Claims made or "suits" brought; or contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project (3) Persons or organizations making claims will still be deemed to be the same construction or bringing "suits". project c. Any payments made under Coverage A for 5. The provisions of SECTION III — LIMITS OF damages or under Coverage C for medical INSURANCE not otherwise modified by this expenses shall reduce the Construction endorsement shall continue to apply as Project General Aggregate Limit for that stipulated. construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project EPA-1920 (0112019) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 3 D. The following provisions are added to Subparagraph J. Damage to Property of Paragraph 2. Exclusions, of SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: 1. Lost Key Coverage However, if you or your "employees", agents, or any other person acting on your behalf lose keys that have been given to them to access the premises at which you are performing work, we will pay to replace the keys and adjust locks to accept new keys, or, if required, we will pay for new locks of like kind and quality, including the cost of their installation. This coverage does not apply to "property damage" caused by misappropriation, secretion, conversion, infidelity, or dishonest acts by you or your "employees", agents, or any other person acting on your behalf. The most we will pay for damages under this coverage because of "property damage" arising out of any one "occurrence" is the Lost Key Coverage Each Occurrence Limit shown in the Schedule above. This limit is part of, not in addition to, the Each Occurrence and General Aggregate Limits described in SECTION III - LIMITS OF INSURANCE. 2. Property Damage Extension Subparagraphs (4) and (5) do not apply to "property damage" arising out of operations performed at premises under your care, custody or control. The most we will pay for all damages under this extension because of "property damage" is the Property Damage Extension Aggregate shown in the Schedule above. Subject to the Property Damage Extension Aggregate, the most we will pay for all damages under this extension because of "property damage" arising out of any one "occurrence" is the Property Damage Extension Each Occurrence Limit shown in the Schedule above. These limits are part of, not in addition to, the Each Occurrence and General Aggregate Limits described in SECTION III - LIMITS OF INSURANCE. EPA-1920 (01/2019) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 3