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PROOF OF INSURANCE (2026 - 2026)UKINTER-01 mLH M 'I ACORO DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/6/05 .. . _ _ _ .�. ..... 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 ,._,_ ONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or b p e 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 r hts to the certificate holder m lieu of such endorsemertt(S). _ mmIT „mmmmm PRODUCER License Il 0757776 CONTACT ySandra Jones -Hemmers .........., PO Box 5345 C.iaS.S� 9) 379 1 ernat �n Nn)90) 533 2266 HUB International Insurance Services Inc. NE M Riverside, CA 92517 E M l an 333 U Int " aI con N sartplra hemrners PI'giM NNSURERA"S)AFFORDIN#VERAfiaE .. m p n.,. ,NA INSURER ICIY �_. arrn Unerwtrs at,�l±a U.K. International d, , .aI1803 INSURED iNSU rf Ber dOlphla IndrTtnft Insarano R� Soccer Camps Inc. INSU,K-I O P. O. Box 1838 INSI� D Redlands, CA 92373 COVERAGES CERTIFICATE NUMBER; I EVI_ION NUML R: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE POLICY PERIOD mm VE 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 ,. _ __ ., , u . N MAY HAVE BEEN REDUCED BY PAID CLAIMS. .CONDITIONS OF SUCH POLICIES LIMITS SHOW..... .... _ , ......... A [INR �........ PE OF INSURANCE..., _ TY, ..N_.�........._ ER POLNCY OFF F^.OLICY E1rP f LIMITS ,ADDL�SUBR� POLICY NUMB A N, X I COMMERCIAL GENERAL„LIABILITY Yl ... _... l� !.CE TO RENTED _00,000 CLAIMS -MADE J X OCCUR PHPK2625875 003 1/1/2025 1/1/2026 XBLIh71SF1`Faci urrP�al 1,000,00 . , ,,,. ......... I MED pxP iA,ray one p(rtpm) , 1 S Excluded L¢ LAGGREGATE LIMIT APPLIES PER: EINE13 6V iN NB��Y � $ "" _ 000000 -X E P4Ek, CY /......, PECOT LOC f .I.PF O,I7,%Ir`TS O,Mi dO AC„S;I...�. 5........ .... 3,000 000 1,000,000� .........._....._...._..._,�, I_ .....,., l _........�........ rm_ S _._, .. � - ...... _ ..._ C�NGrpDINLi� SINGLE I:IMir A AUTOMOBILE LIABILITY I � AUTOS ONLY .� AUTOS ` �..ROCCILY RNdS nJ1dWPoAG �....--... HpIR .. RY (Pa` p X d NE NG9N PHPN2625875-003 1/1/2025 1/1/ZO26 P_'M �r iT _ ANY O'u'.mrLD - PE AiITOS ONLY X... AUTOS ONLY ..l„........ rpuml ......... � 5,.�...... . - ... ._ :EXCESS LIAB ��...._�............. �, —... ..... _ .....,.................... .._ _ _+ ___],CLAIMS-MADE1 iPHUB890518-003Aa 5,00000 A X UMBRELLA LIAB X OCCUR CtrRwENCEtl0fil,041. �- DED X RETENTIONS 10,000( I 1/1/2025 1/1/2026 PPR �....RTN• l �.... WORKERSCOMPENSATIONWIT��WWWWWWW..mmmmITITITITmI i S AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE�I � ` � ��WT1a•�rE�, �3pgAl� f YP7f i OI ICERdry in NH} EXOLUDED . L DI"FA.S,r PLN Vm., ,. If xets, awes i v NIA Df .tiSL F1w EcY LOFT S fl Y�f;� de�a�b�runder ,. � � B Misconduct I Ab4seOCRIPTION OF TlriN, r rr _ 130621PUKI.N000125 . _ 21412025 m"w 2J412026 Each Per k IIaIr ..... son , 1,000a00t1 B Misconduct/ Abuse 50621 PUKIN000125 2/4/2025 2/4/2026 Aggregate 2,000,000 ........ _ DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES IACORD 1e1, Additional Remmark% Schedule, may be attached if rnore space Is requkvd) Re: Programs, Camps held during the policy terra City of El Segundo, its officers, officials, employees, agents and volunteers are Included as AdOitiorial Insured on Gonoral Liability as required by written contract for sponsered/supervised activities of the named insured per attached. "Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc (Hub), independent of any rights which may be afforded within the policies to the certificate holder namedbelow, will (provide to such certificate holder notice of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of premium, in which case Hub will provide to such certificate holders (notice of such cancellation within ten (10) days of the cancellation date„" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y 9 ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90425 . ...... ..... �...A.. _.._ AUTHORIZED REPRESENTATIVE NfI4...- z"Kilice......._„,�...... ..........._. �..,......._. ...... ACORD 25(2016/03).......____-�............�.�............. c 1988-2015 ........ ....._. -. .... O ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK2625875-003 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OIL ORGANIZATION IIZATIOIN. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 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 "bodhy 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 2. (f coverage provided to the additional )n ured is required by a contract or agreement, the insurance afforded to such additional insured will 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; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Pagellof 24 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 05/19/2023 Name of Person or Organization (Additional Insured): City of El Segundo, its officers, officials, employees, agents, and volunteers SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 14 of 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. � C"�` "'�`" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) il%. .- 1 04/02/2025 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 endorsementQs . PRODUCER CONTACT NAME; Phltllip Chaffee _ PHONE '. FAX ......... GSP Insurance Services Inc M �tl�t wi (310) 948 03_14522 Woodman Ave unit C241 A.ORr:A.. pt111(dgspinsun-- a"nc.com Sherman Oaks INSURED CA 91423 i INSURER A: SUNZ INSURANCE COMPANY NAIL # 34762 Active Education inc- Playtime Adventure Inc pNSIaRER o UK INTERNATIONAL SOCCER CAMPS INC_,. ...A...... _,. INSURER 0 1 _ 525 Amigos Dr INSURER E _ Redlands CA 92373 INSURER F COVERAGES CERTIFICATE NUMBER, REVISION NIIMRER: 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. .. ...TYPE YR AOA74 52Nk�Fi' J P,MOdA ICoffyY PO2.GCW EXP OF INSURANCE LIMITS LT R NUMBE�R POLNCY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE f $ i I CLAIMS -MADE OCCUR PREMRS arr� ,5, Fag tvcrasnE,e $ I MED FXP (Any one p�rr.srl) $ .. „., w. J GE_ N'L AGGREGATE LIMIT APPLIES PER: f GENERAL AGGREGATE ..I POLICY � PRO. 1 . i _ , LOC PRODUCTS COMP/OP ro RODUCTS, ...... ....... .. OTHER, $ 1 AUTOMOBILE LIABILITY C I I $ F aooadoarty .. . ANY AUTO � Bela BODILY ODILY INJURY Per person) INJURY (Per e on} J $ (Per m OWNED SCHEDULED URY ( accident) $ AUTOS ONLY HIRED NON OWNEDBODILY F 6AWGE j $ 1 AUTOS ONLY a ... AUTOS ONLY (Re fit:. ;P... ,. .,, UMBRELLA LIAB r OCCUR RENCE $ ... ... S LIAB CLAIMS MADE EXDCDEI s9 RETENTION$ WORKERS COMPENSATION PIER �A ERf1 A �OFNCERIMEM�tBE AND EMPLOYERS' LIABILITY 4.. Y' 1 N EXCLUDED? �IVL Y � NIA SZ-2220006501 04/01/20251 I ACCIDENT 04/01/2026' E.L EACHA " -.,1,000,000 i (Mandatory 1 Ij" LOYEL� S 1,000,000 DESC;PI describe OF ... ..0, .. ,...., 1,000,000 P'E'RA'NONS bekyw ' YE..,L. CdISFA:aC:; - POt_LC'Y'_... uMIT s i 1 f DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Proof of Coverage 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 PHILLIP CHAFFEE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD