PROOF OF INSURANCE (2025) CLOSED0 F DATE (MMIDDNYYY)
AC"RIDI" CERTIFICATE OF LIABILITY INSURANCE
111 9/12/2025 0/10/2025
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 Lockton Insurance Brokers, LLC CONTACT
AME� - --------------
CA License #OF 15767 PHONE IFAX
___AWC_No): . .... . ..........................
Three Embarcadero Center, Ste. 600 E-MAIL
San Francisco CA 94111
- ---- ---------- INSURE-R(s) AFFORDING COVERAGE NAIC_9
I INSURER A: Berklev National Insurance Company 38911
INSURED iCIMS, Inc. INSURER 8:
1506275 101 Crawfords Comer Road, Building 3, Suite 3-200 [INSURER C
Holmdel NJ 07733 IN,SUBER-D"!
INSURER E
^110MA.—_00 f'CD71C1§`ATr_ KIIIRA12=0- 111 AAQ1 I A Rl=vl.qlnN NJ JMIRIPRyyyyyyy
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.
1 -------------- - . .......
INSR I
L" TYPE OF INSURANCE POLICYNUMBER
..... . . . . . . . . ..................
POLICYEFF POLICYEXP S
LIMITS
A X CO I MMERCIAL GENERAL LIABILITY N N PCP 7023975-11
1 9/12/2024 9/12/2025 EACH OCCURRENCE _ J$
CLAIMS -MADE OCCUR
PR Mt StRaoccurragcol O 0 000
EXP (Any one person) $ l5flOO
----- - -----
-------- ---- ...............
_MED
PERSONAL & A V INJURY 000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GEN L AGGREGATE 1 $ 2,000 00
PR(.'k- F_-7 Coc
x POLICY I —XI A
PRODUCTS-COMPIOPAGG $ 2,000,000
JECT I
............ — -----
$
OTHER�
A I AUTOMOBILE LIABILITY N N TCP 7023975-11
BIN90 SMGLE UWT $
9/12/2024 9/12/2025 000,000
cell�aic"ON
ANY AUTO
.......... . .. .
BODILY INJURY (Per person)
OWNED SCHEDULED
IAUTOS
BODILY INJURY Per accident) j $ xxxxxxx
'To.
A ONLY - --------
HIRED x X] NON OWNED
- --------- ----
04 xx xx - xx . x ----------
AUTOS ONLY AUTOS ONLY
. . . . .. .................... . . . . . ........... . ...... .
i$ xxxxxxx
X 1 Cornp, Ded. S1001 Coll. Ded. S_1,000
A
I I X OCCUR N
UMBRELLA LIAB
N TCP 7023975-11
911212124 911212025
EACH OCCURRENCE
$ 201.0-0101.1000
�� EXCESS LIAB _MADE
CLAIMS
AG .. ... .. ....
s 20,000,000 -- - - - -------- - - .
DED X 1 RETENTION$ $0
f
$ xxxxxxx
WORKERS COMPENSATION I
t
NOT APPLICABLE
ER OTH-
iPTATP E L ER
i
AND EMPLOYERS' LIABILITY YIN I
ANY PROPRIETOR/PARTNER/EXECUTIVE
. .. . ......
E,L, E�ENT sxxxxxxx
--------------- -- .
OFFICER/MEMBER EXCLUDED?NIA'
(Mandatory in NH) F]
I�!,R!SEASIE-_EA EMPLOYEE $ XXXXXXX ------ ----- . . ................
If yes, describe under
$ XXXXXXX
DESCRIPTION OF OPERATIONS below
E L DISEASE- POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Evidence Only.
CERTIFICATE HOLDER CANCELLATION See Attachment
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
21948310 ACCORDANCE WITH THE POLICY PROVISIONS.
City of El Segundo, its elected and appointed
officials, employees, and volunteers AUTHORIZED REPRESENTATIVE
350 Main Street
tir
El Segundo CA 90245
@ 19W-_U_W6 AcORb CORPC&ATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD