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PROOF OF INSURANCE (2025 - 2026)0 DATE (MM/DDNYYY) AC40RDP CERTIFICATE OF LIABILITY INSURANCE 4/23I2025 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 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). CONTACT PRODUCER : NAME NA1+,tE,_ Acrisure Great Lakes Partners Insurance Services PHONE 216-658-7't00 (fP) 21658-7101 223 West Grand River Ave #1 JAXAN ° ')- - - IL Howell MI 48843 ADpxzps . NAIC # 1 ') DING COVSE'd',AGE, ..... .......-.. ......,,,,,. ANShYIt�r2 S AFEOR,......,__ .�.�... INSURER The Continental Insurance Comp r1-y...... ........ 35289 ,.... ,,,,,,, -.m.� ..a .....,.. .. .... ........ ... - .„ INSURED INSURERS Admiral Insurance Corr any -_ ....,....�.. -24856 Pyro Spectaculars Inc. San Diego Fireworks INSURER C Arch Spe Ialty Insurance Cornpa ny 2119------. P. O. Box 2329 INSURER p. AXIS Surplus Insurance Company 2f,ta20 Rialto CA 92377 INSURER National Spew i ,. y mpany t 2260 Iusuu�R F : - &aft Ir�sural�ce CD COVERAGES CERTIFICATE NUMBER: 709940898 FiaVIJIUIV IvumtseK: 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 CONDDITIOITIO N SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS --- ...... bL�'4kI�R -.. LIMITS ILTR f..„, rvNE of IN EOF POLICY NUMBER MANODYM,IYX MGiD'Y+"'�' B 1 GENERAL LIABILITY Y Y CA000055935-01 21112121 2/1/2026 EACH OCCURRENCE $ 1„000 000 X COMMERCIAL GENERAL LIABILITY ' PRM 5L5� 9��htl°1"�L'1 t�.p."�r«gYocmarpLal $ 500 000 „ X„ I CLAIMS -MADE OCCUR MED EXP (Any one person) ..,_- $ „ .............. ,m. j PERSONAL & ADV INJURY ..... �.GENERALAGGREGAT.. - $ 1,000 000..... {� ..-. ,... - ' ..,_._ E $$ 2,000 000 .... PER: GEN'L AGGREGATE LIMIT APPLIESPER: f PRODUCTS COM AGG ._..�. .. -- $ 2 ,.000 000 POLICY, I r.CPFt�N- � LOC � I i „ AUTOMOBILE LIABILITY Y j Y 25091600074 4/2/2025 4/2/2026 COMB'IIWEU SINGLE q NM1G'T E coadotwt BODILY INJURY Pere, ( P rsa AUTO OWNED IX I SCHEDULED BODILY INJURY (Per accident) $ XALLANY . AUTOS ., AUTOS NON60WNED i „ .... , &iO Pi"RTY 10AMACaE .... I $ pr r 4crcnost^?t,) HIRED AUTOS ..X.. .... ..-. ..... ...). .,,. ..., . C X Y Y UXP0057894-10 2/1/2025 2/112026 EACH OCCURRENCE , $ 4 000 000 X ---- EUMBRELLA XCESS LIABAB E ,.... .. .......... .. CLAIMS -MAD., 4,000 000 ._... pp DED RETENTION $ �, $ A WORKERS COMPENSATION Y 37-525906-02-05 (MASTER) 10/1/2024 10/1/2025 X I WC SATATU (OTH 1 TRY ,(MIT OR AND EMPLOYERS' LIABILITY Y F N I CCIDENT $ 1.000 000 PROPRIETOR/PARTNER/F�CECUTIVE OFFICER/MEMBER EXCLUDED? N / A` 1 E L EACH E L DISEASE E EA EMPLOYE $ 1 000 000 (Mandatory in NH) _ If yes, describe under DESCRIPTION OF OPERATIONS below '- E.L. DISEASE -POLICY LIMIT $ 1.,000.000 D Excess Liability #2 Y Y P-001-000056744-07 2/1/2025 2/1/2026 ( Aggregate $5,000,000 { Total Aggregate Limit $10,000,000 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is named as an additional insured in regards to General Liability and Excess Liability. Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. States covered under workers compensation policy: CA,MO,MT,NY,OR Dlsptay Dale„ July 4, 2025 Display I ocat ow El Segundo Recreation Park., EI Segundo, CA Additional lnsured(s). City of EI Segundo, Chevron Ell Segundo Refinery, EI Segundo Recreation Park, EI Segundo Fire Department and their officers, agents and employees when acting in their official capacity as such. CERTIFICATE HOLDER CAN LLA I IVN 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 Segundo 350 Main St. AUTHORIZED REPRESENTATIVE EI Segundo CA 90245 I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD