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PROOF OF INSURANCE (2026)"' ttfd DATE(MMIDDIYYYY) ' CERTIFICATE OF LIABILITY INSURANCE I 06/231202e 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 d this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). y PRODUCER CONTACT NAME: Aon Risk Insurance Services west, Inc. PHONE ... - �nic,.lvo) (800) ..m..,_-. ` ADDRESS: .......... 6) ....... .. 3...01Q5 9 Los Angeles CA Office A N F t}: (866} 7C3# 11.22 i6. c 707 Wilshire Boulevard EMAIL = Suite 2600 Los Angeles CA 90017-0460 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED ''. INSURERA: American Zurich Ins Co 40142 In-N-Out Burgers g INSURER _- ERB: Zurich American Ins Co 16535 4199 Campus Drive, ............................ ....... .......... Ninth Floor INSURER C: _. Irvine CA 92612 USA INSURER D: INSURER E: ......................�. _..........� ..... __....... INSURER F: COVERAGES CERTIFICATE NUMBER: 570113541102 REVIMN 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. Limits shown are as requested TYPE OF INSURANCE ADOLTR INSD WVD POLICY NUMBER MOLD Y E " (MM/DD/ EI'F POL7CY E P (POLI YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY Y GLO913 78 1 06/01/2025 /0 EACHOCCURRENCE $1,000,000 nJM2MarrF GccuR SIR applies per policy terms & condi Lions ,vAC a e (Eaecuruenoe) ....... $1,000,000 ,.PREMISES MED EXP(Any one peson) EXCluded .._ _._�.�...................................... ...... ........__ ....................... ..... PERSOIVAI..I4ADVINJIJRY ......_......_. $1,000,0001 N GENIL AGGREGATE LIMIT APPLIES PER AGGREGATE T2, 000, 000 8 PRO G'C7p..YCY I- I II JE(ur C`C _GENERAIL PRODUCTS COhfiPIOPAGU $2,000,000 no — R SIRITS1S0,000OTHE 0 B AUTOMOBILE LIABILITY BAP 3808168 21 06/01/2025 06/01/2026 GOME..IYNEI) SINGLE LIMP $1 000 000 O (Ee a,,,c de✓it) , , XANv ro,I.a rca BODILY INJURY ( Per person) ,,,,,,,,,,, " OWNED """°' SCHEDULED BODILY INJURY(Peraccdent) Z 01 AUTOS AUTOS ONLY . .... _....�. PROPERTY DAMAGE ....... ..................... - 0 AU105 NON -OWNED (Per accident} ONLY AlJ'I"OS ONLY ONLY 01 AGGROCCURRENCE ATF RFIVCE U EXCESS ABIAB� CI.AIMOCCU6-MADE ........ ....IT.IT.. .DED I QCTL;usrKW A WORKERS COMPE14SATION AND wc380816721 06/01/2025 06/01/2026 X P rArl.aT= I fERTH..''', EIVIPLOYERS'LIABIL.rrY YINPP ANY PROPRIF rOR t PAR'FMFR t F.XECU'INE J,„.�„ E I . E .,.,.�.,..... ..' 0 $1,000,000 gFFILFRIhMEfl0.5FR FXCI.Uf3F. fYt N NIA � � mmmmmmmmmmmmm, ryin } L._. (Mandator NH FI rAOHAC.CIOENT DISEASE EA EMPLOYEE $1,000,000.... Ot yy¢..'.dsu hay inner SCRIPT' ON OF OPERATIONS below ....._............ E. I_ MSr A S POLICY I IIVI1' .....m.m._ $1, 000, 000..,..... DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Location/Site: 401 Sheldon St. El Segundo, CA. 90245; Contract: 8/7/25; Certificate Holder, The City of El Segundo, it's elected and appointed and officials and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. General Liability policy evidenced herein is Primary to other insurance available but in with the General Liability policy evidenced herein is to an Additional Insured, only accordance policy's provisions. Non -Contributory to other insurance available to an Additional insured, but only in accordance with the policy's provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ml City of El Segundo, it's elected and AUTHORIZED REPRESENTATIVE appointed officials, and employees �.. Main St. El El Segundo CA 90245 u5a n ©1988-2015 ACORD CORPORATION. All rights reserved ACORD 25 (2016/03) The ACORD name and logo are registered marks ofACORD POLICY NUMBER: GLO 9137898-19 COMMERCIAL GENERAL LIABILITY CG20261219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): ONLY THOSE WHERE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT, EXECUTED PRIOR TO LOSS. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1