PROOF OF INSURANCE (2026)0 DATE (MM/DDIYYYY)
aCOR"' CERTIFICATE OF LIABILITY INSURANCE
07/25/2025
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
O
JOhn Wallace
Vouch Insurance Services, LLC��b
PHONA
(415488 6728 FAX N L (415)-366 2758
Vouch Specialty Insurance Services, LLC
E-MAIL COgslu vou�1 tIs ... ..
��-
3739 Balboa St, #1073
San Francisco, CA 94121
INSURER(S� AFFORDING COVERAGE NAIC
�..
_.�
INS..._
URERA: State National Insurance Company 12831
INSURED
INSURER B : ............. ................. _
Civic Calling Corporation
INSURER C ... _ ........
125 Western Avenue
INSURER D
Boston, US -MA 02163
INSURER E
INSURER F ;
rnvconnce 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. ...__. .....•
........._ ...._. ,.._._
INSR AOOL SUBR LIMITS
MAOA.IDD/YI(YY
LTR TYPE OF INSURANCE POLICY NUMBER MM OYlY'Y'YPY''
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$100,000•,
CLAIMS -MADE X OCCUR
ll(aIEN'
PREMASES,�;G�a occ�aaer�r�neal_
$ 5n 0„�Q,,,„Q ,,,,,,,,,,,,,,,,, ,
MED EXP (Any one person)
$ 10 000
A
Y
HDG.BOP.25.21PY-UQA4
02-20-2025
02-20-2026
PERSONAL &ADV INJURY
$EKQLUDEP
GEN'L
AGGREGATE LIMIT APPLIES PER:
RAL AGGREGATE
GENE -.... ...._
$ 4 00.Q 0 Q
X
PRO-
POLICY ElMIECT LOC
PRODUCTS - COMPIOP AGG
_.......
$ 4 0 ..5�....,._..--._-...._..
OTHER:
INED IN xt E LIMIT`
AUTOMOBILE LIABILITY
• a awc dent4
ANY AUTO
BODILY INJURY (Per person)
,,,,. _.. -
$
......
A
WWWWWW OWNED SCHEDULED
HDG.BOP.25.21PY-UQA4
02-20-2025
02-20-2026
BODILY INJURY (Per accident)
$
AUTOS ONLY ..,.,... AUTOS
HIRED NON -OWNED
--m-••••—
PROPERTY OAMAGE
•••-
$
X AUTOS ONLY X AUTOS ONLY
Par rucc{ 0 -•
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
$
EXCESS LIAR CLAIMS -MADE
AGGREGATE
$ ,.
DEp._. RETENTION$
$
WORKERS COMPENSATION
PER OTH-
STATUTE ER
IT„„•,
AND EMPLOYERS' LIABILITY YIN
„
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
.._•_.•
$ WW ..-.�
OFF
(Mandatory In NH)
NIA
NIA
E.L. DISEASE EA EMPLOYEE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E L, DISEASE -POLICY LIMIT
$
See Additional Remarks Schedule
'.. DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
See Additional Remarks Schedule
tK
City of El Segundo
350 Main St
El Segundo, CA 90245
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
V 1ySt$-LU10 AGUKU GUKYUKA I IUIY. All rignib' rt5tlrlrvu.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: Civic Calling Corporation
LOC #:
ADDITIONAL REMARKS SCHEDULE
Page 2 of 2
AGENCY
NAMEDINSURED .
Vouch Insurance Services, LLC
Civic Calling Corporation
Western Avenue
Boston, US -MA 02163
Boston,
POLICY NUMBER
CARRIER NAIC CODE
EFFECTIVE DATE:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
Businessowners Policy HDG.BOP.25.21PY-U A4 includes a waiver of subrogation for any person or organization that Civic Calling Corporation enters into a
written contract with and such contract requires the coverage provided by the endorsement (BP 04 97).
Insurer A: HDG.NY_TPL.25.VTVU-18AY, Effective 02/20/2025 - 02/20/2026
Policy Aggregate Liability Limit: $2,000,000
Cyber Aggregate Liability Limit: $2,000,000
Errors & Omissions Liability Limit: $2,000,000
Cyber Data Liability Limit: $2,000,000
ACORD 101 (2008/01) W ZUU0 A%.UKU %oVKrvf%M11V rv. r%n 11ynw 1=*=1 VWU.
The ACORD name and logo are registered marks of ACORD