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PROOF OF INSURANCE (2026 - 2026)tea" CERTIFICATE OF LIABILITY INSURANCE o6,ov2025 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). .... _ PRODUCER .•CONTACT ...... NAME: _.. Myers -Stevens & Toohey & Co., Inc. PN rct 800-827-4695 FAX o) 949-348-2630 E-MAflL mloolroe fT1 ets skevens,com 26101 Marguerite Parkway, PRODUCER ADDRESS: y� y Mission Viejo, CA, 92692 TM ' _ INSURER 5... AFFORDING COVERAGE NAIC # INSURED Sports Marketing Program Management Inc. INSURER A: Texas Insurance Company 16543 Beach Volleyball Camps.com LLC/Sinjin LLC INSURER B INSURER C : 426 4th Street INSURER D : Santa Monica, CA, 90402 —••• INSURER E INSURER F : rre� as srxsc nPPTIFInATF NIIMRFR- AW P-R,11_9q_0 -02.3 641111 REVISION NUMBER 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 OF INSURANCE AEKXJ VAMSLAT PfX,gCyf LIMITS OENERALLIABItJTY OCCURRENCE $ I. 000 000.00 A N N BESGLPTNV011301,,,,170012_02 06/01/2025 06/01/2026 _EACH COMMERCIAL GENERAL LIABILITY FIRE DAMAGE PREMISES $ 300,000.00 X RENTED (Any onene premises) CLAIMS -MADE OCCUR MED EXP (any one person) $ 5,000.00 X INCLUDES ATHLETIC PARTICIPANTS PERSONAL & ADV INJURY $ 1 000.000.00 GENERAL AGGREGATE 3 0 .00,,,,,, PRODUCTS - COMP/OP AGG $ 2 00( GENERAL AGGREGATE LIMIT APPLIES PER: ,000,00 X POLICY PROJECT LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO HIRED AUTOS H BODILY INJURY (Per person) $ ALL OWNED NON -OWNED BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE SCHEDULED AUTOS Per accident $ A UMBRELLA LIAB X OCCUR N N BESGLXTNV011301_170012_02 06/01/2025 06/01/2026 EACH OCCURRENCE $ 1,000,000.00 ''. X EXCESS LIAB CLAIMS -MADE AGGREGATE $ 1,000,000.00 $ DEDUCTIBLE RETENTION $f�^ $ VWCOMPH�ISATION C S ATU- .0 ...........®. ANDEMPLOYERSLIABLIfY ANY PROPRIE'TORP ;CUM OFFDERMEMBER EXCLUDED? E.L, EACH ACCIDENT $ (Mmdalayn*Q N / A If yes, describe under El DISEASE -EA EMPLOYEE ',$ SPECIAL PROVISIONS below E.. L..DISEASE-POLICY LIMIT S OTHER A Abuse/Molestation FN N BESGLPTNV011301_170012_02 06/01/2025 06/01/2026 Each Occurrence: $ 25,000.00 Aggregate: $ 50,000.,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Liability Policy Deductible: $0,00 Deductible for Bodily Injury and $ 1000.00 per Property Damage Claim. ISO Occurrence form CG 00 01 04 13 and company's specific fors, Coverage for Participant Legal Liability requires that every participant signs a waiver/release. RE: Registered Volleyball participants: 06/01/2025 -06/01/2026, 06/01/2025 - O6/01/2026, 06/01/2025 - 06/01/2026; CERTIFICATE HOLDER k; AN UtL.L A IJUIN Beach Volleyball Camps.com LLC/Sinjin LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 426 4th Street AUTHORIZED REPRESENTATIVE Santa Monica, CA, 90402 p Mark Di Perno ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ©1988- 2009 ACORD CORPORATION. All rights reserved. AGENCY CUSTOMER ID: A-SPSU-25-04-02-336410 LOC# A""�CMI'"0• ADDITIONAL REMARKS SCHEDULE Page 1 of 1 .............. AGENCY NAMED INSURED Myers -Stevens & Toohey & Co., Inc. Beach Volleyball Camps.com LLC/Sinjin LLC POLICY NUMBER BESGLPTNV011301170012 02 426 4th Street CARRIER NAIL CODE Santa Monica, CA, 90402 Texas Insurance Company 116543 EFFECTIVE DATE: 06/01/2025 ©2008 ACORD CORPORATION. All rights reserved. ACORD 101 (2008101) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BESGLPTNVO11301_170012_02 CERTIFICATEM A-SP-SU-25-04-02-336410 COMMERCIAL GENERAL LIABILITY NAMED INSURED: Beach Volleyball Camps.com LLC/Sinjin LLC CG 20 26 0413 POLICY PERIOD: June 01, 2025 to June 01, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I 1 0. 1 11 �i� :1 :1 0.4 a�mel ki go] oil This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization if required by an insured contract provided such contract was executed prior to the occurrence or offense. ity of El Segundo. its officers, officials, employees, agents and volunteers )1 Sheldon Street I Segundo, CA, 90245 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 "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: 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. If coverage provided to the additional insured 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 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 BEACDBA-02 AULL DATE (MM/DD/YYYY) A�oRo CERTIFICATE OF LIABILITY INSURANCE 6/4/2025 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 mmmmmmmD p ITITITmm � �� a 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 LRPAK:.-.... AP Intego Insurance Group, LLC PHONE 1601 Trapelo Rd Suite 280 i (Aac wXdowBxk) Waltham. MA 02461 I A ". `� ypppr!#aplrltegta com INSURED BeachVolleyballCamps.com DBA Sinjin Smith Beach , INSURER C Volleyball Camps _... _. 426 4th Street INSURER D Santa Monica, CA 90402 il-INSURER E c INSURER(S�, AFFORDING_CO_VERAGE NAIC,# State Compensation Insurance Fund- State Fund in California 135076 COVERAGES CERTIFICATE NUMBER.' ..................... REVISION NUMBER, 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. - .......w, .... — I NTSR ADDL SUB R? POLICY EFF POLICY EXP I LIMITS TYPE OF INSURANCE r - POLICY NUMBER (� f COMMERCIAL GENERAL. LIABILITY - l� EACH OCCURRENCE I $ _„ .... DAMAGETO RENTED %CLAIMS -MADE I OCCUR I PFR%h9I'SECEro�au�G'pIS'k�Y $ .... _ .. �j._MED EXPJAoyy one perscn) . $ . PER .ONAL&"A,,DV INJURY I $ „ ... I G�L N'L AGGREGATE LIMIT APPLIES PER: ,,GENERAL_AGGREGATE$ _______ _ POLICY , � PMCT F-1 LOC PRODUCTS - COMP/OP,AGG, II S _ ......... ............�. _. ..........., COMB,NEDIN AUTOMOBILE . SINGLE LIMtlT E LIABILITY ................ I...LElaaPC4*PiJ ...... . . . ----- ANY AUTO HAIRED ONLY AUTOS LED ��el�de URV�Perao idenU. $ �,. OWNED I AUTOS ONLY , AUTO N N-C'WRVE,O DAMAGE PROPERTYDAMAGE""' . , $ -.,-� AUTOS 0 AR TO'..^ ONL ' � II ff�� $ _. --_-- ... _I...............L ... ..............,,.. ......................_....m.. L....,......1 UMBRELLA LIAB 1 _ .. OCCUR I _EACHOGGURRENCE ...... EXCESS LIAB L CLAIMS MADE,1 A,,,,,GGREGATE... .......... $...,.,.. .... .. DED j RETENTION $ _ $ ,.. PER WORKERS COMPENSATION A ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N�� I N / A I9376305-2025 IT 3/7/2025 3/7/2026 EC EACH ACCIDENT O�H , AND EMPLOYERS' LIABILITY'TA000 00(I OFFICERIMEMBER EXCLUDED. J 1,000,000 (Mandatory in NH) ELL DISEASEµ EA EMPLOYEE $ If yes, describe under i DESCRIPTION OF OPERATIONS -,below r E I DI, SE POLICY LIMIT ..-. .............. .,.........m.......... M ..,..� 1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY 9 ACCORDANCE WITH THE POLICY PROVISIONS. Department of Recreation, Parks and Library 401 Sheldon Street .............. _. _.......... _............ . El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ( � ...... .a . ........................ ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION 9376305-25 NEW SC 8-55-69-99 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE JUNE 5, 2025 AT 12.01 A.M. AND EXPIRING MARCH 7, 2026 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME BEACH VOLLEYBALL CAMPS 426 4TH ST SANTA MONICA, CA 90402 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, BEACH VOLLEYBALL CAMPS IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY -OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. JUNE 6, 2025 COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 2570 AUTHORIZED REPRESENT I PRESIDENT AND CEO SCIF FORM 10217 IREV.4-2018) OLD DP 217