The URL can be used to link to this page

PROOF OF INSURANCE (2025 - 2026)-0 DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/I4i2026 l/2125 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TH 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 e'ndorsement($). PRODUCER Lockton Companies, LLC CONTACT ANTC DBA Lockton Insurance Brokers, LLC in CA PHONE CA license #01715767 F A9AtL 8110 E Union Ave., Ste. 100 INSURERdS)APPOF 7NNG COVERAGE # 1j- L`L" �.OII'I. �,It"VAGE N165 Denver 16543 Screamline Investment Co .....-• -j s 1° ° ...�-IT 1540911 __ y ..___ Corp _ p1, � ............ I�� _. t 24319 t1�°r�s°taw.�aty(�t7Rtv�;let�aracattpt INSUStEPA;�dOr10�dCCtrl�h.U�l'�ClBinarVv:.eCi)S1I a 12936 dba Tour Coach Charter and Tours, Inc. INSURER c "HOU � Lines Insurance C'"trotsa Tat INSURED INSURER B A111e Starline Tours of Hollywood, Inc. INSURER O Movieland Charter and Tours, Inc. INSURER E 2130 S. TubewaAve.INSURER F CA 4444(� VV VGr W THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT„ TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. mm If�TYPE ALSUEr— NUMBER Y LIMITS COMMERCIAL LIABILITY O YN ESB-HS-GL-0002250-00 5/29/2025 5/27/206_EACHOCCURRENCE OA A.t S ly.0000.° CLAIMS -MADE a OCCUR ° r„C-ptSF,S tEa occp�Lya?•c,a l,dl. 1 . MED EXP lAr,y Oar pa',„rsony s 1..,iCtal.Lld Y. PERSONAL & A'wOV tN! URY S.) 000 090 GEN'LAGGREGATE LIMIT APPLIES WPER: [.GENERAL GENERALAGGREFwATE�...s 20 00 •• .X POLICY PRO<. LOC PRODUt fS CtM�PfOP AGG ;$ Included A OTHER: AUTOMOBILE LIABILITY N N BRPCLLTCA011500_082820 01 5/27/2025 5/27/2026 COMBINED SINGLE a.,lMN $ 00 0(1Q() ANY AUTO BODILY INJURY (Per person) $ XXXX�XXX OWNED SCHEDULED X. BODILY INJURY (Per acadent) $ XXXXXXX AUTOS ONLY AUTOS HIRED NON -OWNED --.. PROPt RG OAh1AGE Y er iEk°@ $ XXYIN= AUTOS ONLY ,,_,.,.•.. AUTOS ONLY °°- •.. $ 50„000 C F UMBRELLA LWB N N ESB-HS-UCX-0001926-00 5/29/2025 5/27/2026 EACH OCCURRENCE www• •__ $ 5, k�00 . J,JoccuR EXCESS LIAB CLAIMS -MADE AGGREGATE ...._- $ 5000 fl,fl'" N''S $ XXXX.X.°XX DE'.G7 REiE'.N'T1i' PLR OTI-I WORKERS COMPENSATION NOT APPLICABLE TA;TL/TE ,¢H AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIME'��M'BER EXCLUDED? N / A E L E4CH ACCIDENT ... .... $ XrX X mX°. .•X. (Mandatory in NH) E L O/"'w5E EA EMPLOYEE.:(; .MSE°....°.A ...._...°... $ X -... ,XX.X• DEes, describe underSCRIPTION OF OPERATIONS bWow+l EL DNSEAS:E, -POLICY LIMIT' $ X.XX.rX.X. B Auto Physical Damage N N 0314-2633 411412121 4/14/2026 Limit: Per schedule Ded.: $25k EXCEPT $50k fire loss DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR TIES HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. City of El Segundo its elected and appointed Officials, employees, and volunteers is an Additional Insured to the extent provided by the policy language issued by the insurance carrier. insurance provided to Additional Insured(s) is primary and non-contributory as per the attached endorsements or policy language CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2OS2SSSG THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo its elected and appointed officials, employees, AIUTHORIZEDREPRESENTATIVE and volunteers 350 Main Street El Se do CA 90245 ©158»20 a ACORD CORP tf' TION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Attachment Code: D672698 Master ID: 1540911, Certificate ID: 20825886 HSIC IL ES 01 04 03 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE ENDORSEMENT I' ENT Policy No.: ESB-HS-UCX-0001926-00 Endorsement No.: 1 Named Insured: Screamline Investment Corp Policy Period: 5/29/2025 to 5/27/2026 ....... ..... Endorsement Effective Date: 7/14/2025 Commercial Excess Liability Countersigned By: HIS ENDORSEMENT CHANGES THE POLICY EFFECTIVE ON THE INCEPTION DATE OF THIS POLICY UNLESS ANOTHER DATE IS INDICATED ABOVE. THE ENDORSEMENT EFFECTIVE DATE AS SHOWN ABOVE IS AT THE SAME TIME OR HOUR OF DAY AS THE POLICY BECAME EFFECTIVE,. Additional Premium: $3,750.00 Pro Rate Short Rate Return Premium: $0.00 Flat Rate Minimum Premium CHANGE DESCRIPTION It is hereby understood and agreed that the following changes have been made to the policy: • The Excess Liability Limits are increased from $4,000,000 to $5,000,000. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED,. HSIC IL ES 01 04 03 22 Includes copyrighted material of Insurance Services Office, Page 1 of 1 Inc., with its permission. TOURTRA-01" CERTIFICATE OF LIABILITY INSURANCE DATE A E(MMI ) O25 _. .......... 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 riohts to the certificate holder in lieu of such endorsement(s). ...mmwA______ f PRODUCER IMA, Inc. - Pasadena 3475 E. Foothill Boulevard Suite 100 Pasadena, CA 91107 INSURED Screamline Investment Corporation dba Tourcoach Charter & Tours Starline Tours of Hollywood Inc.; Movieland Charter 8: Tours 2130 S. Tubeway Ave. City Of Commerce, CA 90040 CONTACT NAME: (JC(/-3233A,No„Ext): (626) 799-7000 AC,No):(626) 441 E-MAIL ADDRESS:_ _ ___ MSURE.R(S) AFFORDING COVERAGE NAIC 1! _ INSURER A -:Pacific Compensation Insurance Company 11555 INSURER B : INSURER C : INSURER D : INSURER E: INSURER F : 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. R. AODL'SUSR ...... POLICY' EFF POLICY EXP 5...... ._.4i+1' .5$...,.,''. Fkf.. ........-,.,._. POLICY NUMBER "iifyJ,_.t Wppd X."X"dY.)._.-� ..�. 7YPE OF INSURANCE .—__.-- POLICY .... -- _. .,,..._ _.. LIMITS_ . -__. _._........ _ ...� COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO PEN "I"k:.D PREMISES (Ea oc,^.v me ce) $ GEN'Il... AGGREGATE LIMIT APPI...IES PER: PC.:UCY I"IA,1y*,!. LOG wE: AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EXCESS LIAB CLAIMS -MADE DED _ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILI Y Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE �FRCER/MEMBER EXCLUDED? Ni N / A (Mandatory in NH) II vu,..,, cowito toefor MED EXP (Any one person) , $ PERSONAL A ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS -COMPIOPAGG $ BO�I:I LY INJURY (P er perrson) _ $ Ik4)�DR..Y (INJURY (Pei zaarxndenl), $ PROPERTY DAMAGE Pu( adder;). I S IEAGu I OCCURRENCE AGGRII::.GATI x PER OTH- „"a'TATrUTE ER WC1028873 11 P6f2024 11/6/2025 L. 1,000,000 E.EACH ACCIDENT $ E L, DISEASE - EA EMPLOYEE_ $ 1 ,000,000 ..,. f 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Proof of Insurance 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CITY OF EL SEGUNDO WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES. I affirm under penalty of perjury under the laws of California one of the following declarations: (_) I have and will maintain a certificate of consent of self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Labor Code § 3700 for the performance of the work set forth the agreement with the City of El Segundo. Policy No. (_kJ1 have and will maintain workers' compensation insurance as required by Labor Code § 3700 for the performance of the work for which the agreement with the City of El Segundo is executed. My workers' compensation insurance carrier and policy number are: P Y Carrier c , ' sp a .a� �q Policy Number Expiration Date" - —c - ` I t . Name of Agent a µ. Phone ( -e �1 1j' r� r � r;�, 1 (_) I certify that, in the performance of the work set forth in the agreement with the City of El Segundo, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Labor Code § 3700 1 must immediately comply with those provisions or the agreement will automatically become void. Signature of Applicant Date Print Name Agreement for: Dated: Reviewed by: