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PROOF OF INSURANCE (2026 - 2026)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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(pes) 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 CONTACT NAME _ Betty_Tran ICIA Insurance Services PHONE' 949 297 FAX 130 Vantis, Suite 250 E-MAIL heft ,(rarl. ,ioau to/' IN 949 29a 60 Aliso Viejo, CA 92656n1dtlLamw.""ry INSURER(S) AFFORDING COVERAGE NAIC # www_ioausa.com CA License #OE67768 INSURED Omnis Consulting Inc. 14726 Ramona Avenue, Suite S20 Chino CA 91710 /-GGTICIP ATC 411111AC1=13— rea +ro'-v Vic.... �._— e Com_pany 13056 Fire Insurance ComDanv 19682 PI=VlAI0N1 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, .... _..,.... _ ......., SR f .... ......, ........... IN :... .... ......_... ......... .... .........___ AODL SUa'aa ........... .._ ---- ........ POLICY EFF .., POLICY EXP OF INSURANCE �.MM/t7 tYYYY /Y ( MM/DDYYY LIMITS LTR TYPE i POLICY NUMBER A ✓ I COMMERCIAL GENERAL LIABILITY ,� ✓ PSB0002339 7/22/2025 7/22/2026 2,000 Q00 Scheduled Al Endt CLAIMS -MADE ✓ ESEaoccue0000"...._- . #PPB3130212IPREMS Prim/NonCon EXP (Any one person) $ 10,000 ..°°•-.-.° Professional Services "MED _ Y ✓ . Wvr of Subr " _ performed by the Insured GEN'LAGGREGATE LIMIT APPLIES PER: are Excluded '.. GENERAL AGGREGATE $4,000 000, ✓..� PRO PRODUCTS -COMP/OPAG.G...... $4,000000 ...,.,... JECT LOC L 'POLICY OTHER A AUTOMOBILE LIABILITY ✓ ✓ PSA0001537 7/22/2025 7/22/2026 E 0CiGi%aCNa1 $w,1,µ000,000_ ✓ ANY AUTO Designated Insured Endt 9 e INJURY (Per person) $ " OWNED SCHEDULED #CA20481013; Prim/NonCon BODILY ..` BODILY INJURY (Per dent) $ AUTOS ONLY NON -OWNED and Blkt Wvr of Subr P � OPERTI" bAMAGC Ifp`ffbAM_ � $ ✓ AHIRED UTOS ONLY ._ ,f,", AUTOS ONLY Included on 2 of Form 4�c �„ w,,, "" $ ✓ PrimfNonCon ✓ Wvr of Subr #PPA30003 3 UMBRELLA LIAB OCCUR E OCCURRENCE $ ... _. EXCESS LIAB CLAIMS -MADE AACH „GGREGATE $ _ ... RETENTION$ ED D $ A WORKERS COMPENSATION ✓ 73 OWaiver 7/22/2025 7/22/2026 ER OTH- STA UTE I BR AND EMPLOYERS'LIABILITY YIN AN Y ECUTIVE N / A USL&H Included; ScheduledOof E L EACH ACCIDENT- $1,000,000 OFFICER/MEMBER EXCLUD D� (Mandatory in NH) Subrogation Endt �.P $ 1 _ OQO Q0.0... If yes, describe under DESCRIPTION OF OPERATIONS below #WC0403060484 YLOY E L. DISEASE POLICY LIMIT $ 1 OOO,OOO B Professional Liability 720H067020125 7122/2025 7/22/2026 $1,000,000 Each Claim Claims -Made $2,000,000 Annual Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate Holder is an Additional Insured with res ect to General Liability (GL) and Automobile Liability when required by contract with the Indorsements Contractual Liability Insured„ but only to the extent provided' within the' noted above. GL includes Separation of Insureds and per Iimitationsin the BuslnessOwners' Coverage Corm. A Workers" Compensation Waiver is included for the person or organization named in the Sobedule that are parties to a written Contract, but ON to the extent provided within the Endorsement noted above. Coverage is subject to all l policy terms„ in limitations and exclusions. 30 Day Notice oYCancellation / 10 Days for Non -Payment accordance with policy provisions. GIzK I IIr lk;A I HULUt=K n "111 Engineering, Design and Plan Check Services of the Insured SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of EN Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN De artment Of Public Works -Engineering Division ACCORDANCE WITH THE POLICY PROVISIONS. 35(3 Main Street El Segundo CA 90245 AUTHORIZED REPRESENTATIVE I AVC Alicia K. I ram U 1988-2U15 AGUKU GUKF'UKA I IUN. Alf rignLs reserveu. ACORD 25 ( 1 10) The ACORD name and logo are registered marks of ACORD 86356277 1 7/25-26 GL, AUTO, AC & PL I Noel Zemla 1 7/22/2025 9:42:29 AM (PDT) I Page 1 of 5 Policy Number: PSB0002339 RLI Insurance Company Named Insured: Omnis Consulting, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPacko FOR PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM — SECTION 11 — LIABILITY Schedule Name of Person(s) or Organization(s): City of El Segundo 1 . SECTION 11 C. Who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any "professional services". b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION 11 — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION IIII K.2 Transfer of Rights of Recovery Against Others COMMON POLICY CONDITIONS (BUT APPLICABLE TO SECTION I — PROPERTY AND SECTION 11 — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 313 02 12 66356277 1 7/25-26 GL, AUTO, WC & PL I Noel Zemla 1 7/22/2025 9;42:29 AM (PDT) I Page 2 of 5 Page 1 of 1 POLICY NUMBER: PSA0001537 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Omnis Consulting, Inc. Endorsement Effective Date: 7/22/2025 SCHEDULE Name Of Person(s) Or Organization(s): City of El Segundo Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 86356277 1 7/25-26 GL, AUTO, WC s PL I Noel Zemla 1 7/22/2025 9:42:29 AM (PDT) I Page 3 of 5 This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50%) or more of the business entity and the business entity is not separately insured for Bus-iness Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage is excluded by endorsement. B. Employees As Insureds The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Blanket Additional Insured The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the "bodily injury" or "property damage" occurs is an "insured" for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II — COVERED AUTOS LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non-contributory basis to the additional insured's own business auto coverage if you are required to do so in a contract or agreement that is executed by you before the "bodily injury" or '.property damage" occurs. Transfer Of Rights Of To Us: We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of the operations . - plated by such contract. waiver ,.. only to the person or organization designated E. Employee Hired Autos 1. The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions: Paragraph 5.b. of the Other Insurance Con- dition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". F. Fellow Employee Coverage SECTION II — COVERED AUTOS LIABILITY COVERAGE, Exclusion B.5. does not apply if you have workers compensation insurance in -force covering all of your employees. G. Auto Loan Lease Gap Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance, is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered ..auto", less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and 2. Any: a. Overdue lease/loan payments at the time of the "loss"; PPA 300 03 13 86356277 1 7/25-26 GL, AUTO, WC & PL I Noel Zemla 1 7/22/2025 9:42:29 AM (PDT) I Page 4 of 5 Page 2 of 5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy, We will not enforce our right against the person or organization named in the Schedule, (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization City of El Segundo Schedule Job Description Jobs performed for any person or organization that you have agreed with in a written contract to provide this agreement. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 7/22/2025 Policy No.PSW0002073 Endorsement No. Insured Insurance Company Omnis Consulting, Inc. RLI Insurance Company Countersigned By ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. 86356277 1 7/25-26 GL, AUTO, WC & PL I Noel Zemla 1 7/22/2025 9:42:29 AM (PDT) I Page 5 of 5