PROOF OF INSURANCE (2026)0 DATE (MMIDDNYYY)
C<>R'�.3 ACERTIFICATE OF LIABILITY INSURANCE 04/28/2025
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(les) 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 NAMEw Azucena Thorne
Brown & Brown Retail Insurance Services PHONE (714) 221.11300 AIC 1� : (714) 221-4196
ACC N E ''
18100 Von Karman Ave,Suite 850 ADDRESS: AZ.TIlorne�btarown.com
INSURER Si AFFOROWG COVERAGE NAIC #
Irvine CA 92612 INSURERA: Lloyd 'sofLondon 15642
INSURED INSURER a: State Compensation Insurance Fund of CA 35076
Temporary Staffing Professionals Inc. INSURER c,.
18912 Canyon Circle INSURER D t
(INSURER E
Villa Park CA 92861 INSURER F
___�. �.�.�� ... ..... �.._ IF,•.C✓3A \AACTFR CC\/ICInM hII IIIIIRFR•
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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 MAYBE 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.
LTR
TYPE OF INSURANCE
INSO
POLICY NUMBER
''.. IOMCbIYYY OY
MPIMPDDAY'9fYY
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCUR RE:NCE�
$ 2,000,000
CLAIMS -MADE ❑X OCCUR
PREMISFSE ecccarr" ance
$ 250,000
X Ded: $1,000
MEO EXP (Any one error
S 5,000
A
Y
PSNO140224526
01/24/2025
01/24/2026
PERSONAL & ADV INJURY
$ 2,000,000
GENERALA�GGREGATE
;�. 4,000.000
P:v"OOUCT'S,•COM'P1kA°P AGG2,000.000
HLAGGRE'�GATELIM'ITAPPLIESPER:
POLICY JECOT0 LOC
Dishonesty of Employee
$ 2,000,000
OTHERS Ded: $2,500
'..COMBINeD SINGLE LIMIT$
1,0100,000 '....
AUTOMOBILE LIABILITY
BODILY INJURY (Per person)
$
ANYAUTO
BODILY INJURY (Per accident)
$
A
OWNED SCHEDULED
PSNO140224526
01/24/2025
01/24/2026
AUTOS ONLY AUTOS
HIRED AU
PR P RTYDAMAUL'
Per oden
$
AUTOS ONLY � OS ONLY
$
Ded: $7,500
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
HC.
AGGREGATE
$
EXCESS LIAB
NMS-MADE..
DE'O RETENTIONS
OIH
PERS
'WORKER'S COMPENSATION
X STATUTE FFn
AND EMPLOYERS' LIABILITY YIN'
E.L.EACH ACCIOENT
.
$ 1,000,000
ANrYPRGPRtE'rC�RrPARxNCI�r'EXCaJfIVE �
PFICERIMEMBER EXCLUDED?
NIA
935301125
01/24/2025
01I24I2026
1,000,000
Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE • POUC.:YuMIT'
1,000,000
S
AESCRIPTONOFOP
yes. descclbe under
ERATIONS be:•low
Per Claim:
$2,000,000
A
Professional Liability
PSNO140224526
01/24/2025
01/24/2026
Aggregate:
$4,000,000
Ded:
$2,500
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
The City of El Segundo, its officials and employees are named as Additional Insured as respects to General Libility in regards to the operations of the Named
Insured per policy conditions. GL is Primary and Non -Contributory per policy conditions.
GE'N I I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
AUTHORIZED REPRESENTATIVE
EI Segundo CA 90245
W 1.7oo-cv W mNwn aw�r v..r...v... .,u „y..w ........ ......
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD