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PROOF OF INSURANCE (2025) CLOSED
A`R � CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 08/13/2025 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 NAME.,,,,_ J„enniter Krouse Gary E. Krouse Insurance Services, Inc. PHONE lruc• N�� ,c0 FAX 407 5300 �- t31 �) rt07 5308 To an a Canyon Place, Unit H 9€�20P gCA �2 E-MAILA $ � �m rs rvle �rowseu"rwsa,om� �~ Chatsworth 91311 — ." AFFORDING COVERAGE NAIC # 818 407-5300 Fax No. 818 407-5308 Phone No„ (. Fax (,,,,,,� INSURERA _ an Guarantee and Lwabilit l,nsurance Company 26247 AGL-Americ n Guarantee m, , -__ " INSURED B am ZAI- Zurich American Insurance Co "------ EL SEGUNDOWALK, LLC i�sue� 142 RICHMOND ST El Segundo, CA 90245 Phone No, 213) 804-0044 Fax No. INSURER F: COVERAGES CERTIFICATE NUMBER- 1195367 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. .... ""� .....,.. ..... IN�R TYPE OF INSURANCE... ADCrLU�" .....-,.,....— ........... ... ....._. MMIOR"-- .-.............. ....". ".._.... .._. POLICY NUMBER wyn Y� M PPI � LIMITS 11 ZAI COMMERCIALLIABILITY OML GENERALFLM8303833-01 08/22/2025 08/25/2025 EACHOCCURRENCE0O0O0 'U"MAGI 1I 1�"0,� 0O-0O, ,, .�. f5ff9N E' CLAIMS -MADE OCCUR )X urre)L C]ER, ,oA_LrL ,—$$ 7MED EXPAny one Person)5000O, m -••• PERSONAL &ADV IN JURY $ 1.000 000 Flrtll ,�l,quear, (1-„0�C7,000 0.mm. - GENERAL AGGREGATE $ GEN L AGGREGATE LIMIT APPLIES PER: �. 2,000 000 POLICY ❑ �1F�C'r LOC '�. PRODUCTS - COMP/OPAGG $ 1.,000,000 OTHER: i$ DOMUIN'EO „"$7Y+YLiL.E t.%NgpT " it AUTOMOBILE LIABILITY 1 . ANY AUTO Lc�d,eift' Per person) INJURY ( p rson)�$ OD OWNED ...m,m._" SCHEDULED BODILY INJURY (Per acadenl} $ . AUTOS ONLY AUTOS HIRED NON -OWNED 1 pROI'�iRT+'PAdwIArrC' I " AUTOS ONLY LAUTOS ONLY � m • """"—•— -----"" G$ AGL UMBRELLA LIAB OCCUR SXS7973220-01 08/22/2025 08/25/2025 EACH"OCCURRENCE „2,,000 000 X CLAIMS MADE EDXECDESS LIARETENTION A 21 TE - t 200-0 OOG AGGREGA.... "-� -T-""" $ $ PER OTH WORKERS COMPENSATION T TUTE - -, AND EMPLOYERS'LIABILITY Y/N OFF CER/ME TO REXCLUDR/D ECUTIVE NIA � --- "� ' (Mandatory in NH) E.L. ,. DISEASE EMPLOYEE G...„..--- „m... .mm..._ If yes, describe under ,DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I AI Inland Marine FLM8303833-01 08/22/2025 08/25/20251 See Attached DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES Coverage Location: United States & Canada Event: EL SEGUNDO ART WALK City of El Segundo, its elected and appointed officials, employees, and volunteers are named as additional insured and doss payee as their interest may appear. Coverage is primary and non All coverages expire at 12:01 a.m. Standard Time. contributory. " The actual event dates may be limited. Please review the Scheduled Events form attached to this c rti6'cv e. CERTIFICATE HOLDER CANCELLATION ... CITY OF EL SEGUNDO 350 MAIN SREET EL SEGUNDO, CA 90245 United States Of America Phone No. I Fax No. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WrrH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD This certificate of insurance does not affirmatively or negatively amend, extend, or alter the coverage afforded by the insurance policy. DATE (MMIDWY) ADDITIONAL COVERAGE DETAILS 08/13/2025 INSURED EL SEGUNDO ART WALK, LLC The following is attached to and made part of certificate number 1195367„ Policy Details Coverage Limit Deductible Inland Marine Company: Zurich American Insurance Company Policy Number: FLM8303833-01 "Period: 08/22/2025 - 08/25/2025: 3 Day(s) Equipment, props, sets, wardrobe (rented) 50,000 1,000 Equipment, Props, Sets, Wardrobe (owned) Excluded Rented Furs, Jewelry, Art & Antiques Coverage Excluded Extra Expense Excluded Third Party Property Damage 10,000 1,500 Hired/Non-Owned Physical Damage -Aggregate Excluded Hired/Non-Owned Physical Damage -Per Vehicle Excluded Rental Cost Reimbursement Excluded Waiver of Subrogation Excluded Coverage Extension Endorsement Coverage Extension Endorsement Excluded Terrorism Included General Liability Company: Zurich American Insurance Company Policy Number: FLM8303833-01 "Period: 08/22/2025 - 08/25/2025: 3 Day(s) General Aggregate 2,000,000 Products / Completed Operations 1,000,000 Personal/Advertising Injury 1,000,000 Each Occurrence 1.000,000 Fire Legal 100,000 Medical Payments 5,000 Blanket Additional Insureds (other than city/special certs & Included waivers) City / Other Special Certificates Included Waiver of Subrogation Included Host Liquor Included Liquor Liability -Aggregate 1,000,000 Liquor Liability -Each Common Cause Limit 1,000,000 Abuse & Molestation -Aggregate Excluded Abuse & Molestation -Each Claim Excluded Abusive Act Alleged Participant Supplemental Coverage - Excluded Aggregate Abusive Act Alleged Participant Supplemental Coverage - Excluded Occurrence Participant Legal Liability - Aggregate Limit Excluded Participant Legal Liability - Occurrence Limit - Bodily Injury Excluded Participant Legal Liability - Occurrence Limit - Property Damage Excluded Terrorism Included `All coverages expire at 12:01 a.m. Standard Time. ......... APM-CERT-DETAILS 1009 Certificate Number 1195367 Scheduled Events Certificate Number: 1195367 Event Type Venue Dates Attendees EL SEGUNDO ART EL SEGUNDO ART WALK AND 08/22/2025 - 08/23/2025 at 12:01 am (Setup) 5,000 Spectators WALK PARKING LOT OF 314 MAIN ST 08/23/2025 - 08/24/2025 at 12:01 am Art Festivals 212 EUCALYPTUS DR 08/24/2025 - 08/25/2025 at 12:01 am (Tear Down) EL SEGUNDO, CA 90245 ABANEV-SCHD(05/06) Page 1 of 1 . . . . ................................ DATE (MMIDDNY) SCHEDULE OF FORMS 08/13/2025 .............. Insured: EL SEGUNDO ART WALK, LLC This Schedule of Forms is attached to and made part of certificate number 1195367, as of 08/13/2025 at 04:15 PM PT and lists the forms included in the policy(s) and subsequent endorsement (s) at the time this certificate was issued, . ................ Form # Ed. Name Special Event Package Notices U-GU-319-F 0109 Important Notice - In Witness Clause U-GU-874-BCW 0223 Notice of Disclosure for Agent and Broker Compensation UGUB73ACW 0611 Disclosure Statement U-GL-1197-A CW 0104 Asbestos Exclusion Endorsement U-GU-1191-ACW 0315 Sanctions Exclusion Endorsement Common UGU727ACW 0806 Commercial insurance Policy UGU1292ACW 0422 Notice Of Important Provisions UGUD310A 0193 Common Policy Declarations UGU619ACW 1002 Schedule of Forms and Endorsements UGU621ACW 1002 Schedule Of Named Insured(s) UGU618ACW 1002 Schedule Of Locations IL0017 1198 Common Policy Conditions U-GU-1223-B CA 0916 Revised Definition Of Spouse Endorsement UABI100ACW 0117 Schedule Of Productions UABI101ACVV 0117 Definition Of Employee UAB100ACW 0117 Minimum Earned Premium Endorsement IL0270 0720 California Changes - Cancellation and Nonrenewal Endorsement IL0003 0908 Calculation of Premium U-GU-630-ECW 0120 Disclosure of Important Information Relating to Terrorism Risk Insurance Act Inland Marine UABMD104ACW 0117 Commercial Inland Marine Declarations Entertainment Program UGU619ACW 1002 Schedule of Forms and Endorsements CM0001 0904 Commercial Inland Marine Conditions UABM133ACVV 0117 Common Conditions, Exclusions And Definitions UABM106ACW 0117 Miscellaneous Equipment Coverage Form UABM106ACW 0117 Props, Sets And Wardrobe Coverage Form UABM109ACW 0117 Third Party Property Damage Coverage Form UABMI03ACW 0117 Loss Payable Endorsement UABM128ACW 0117 Excluded Property Endorsement UABMI14ACW 0117 Unscheduled Production, Presentation Or Event Exclusion UABM100ACW 0117 Stunt, Animal Exposure And Pyrotechnic Exclusion U-GU-767-BCW 0115 Cap on Losses From Certified Acts of Terrorism General Liability UABLD10OBCVV 0119 Commercial General Liability Coverage Part Declarations UGU619ACW 1002 Schedule of Forms and Endorsements UABI110ACW 1020 Schedule of Events CG0001 0413 Commercial General Liability Coverage Form CG2011 1219 Additional Insured - Managers of Lessors of Premises CG2012 1219 Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations CG2026 1219 Additional Insured - Designated Person or Organization CG2404 1219 Waiver of Transfer of Rights of Recovery Against Others to Us CG2028 1219 Additional Insured - Lessor of leased equipment U-GL-1327-BCW 0413 Other Insurance Amendment - Primary And Non- Contributory UABL128ACW 0117 Additional Insured - Owners Or Lessees Scheduled Person Or Organization Primary and Noncontributory Coverage UABL121ACW 0117 Limited Stationary Aircraft Coverage CG2106 0514 Exclusion - Access or Disclosure of Confidential or Personal Information and Daia-Related Liability - With Limited Bodily Injury Exception U-GL-1171-B-CW 0719 Fungi Bacteria Exclusion U-GL-1178-A-CW 0703 Asbestos Exclusion CG2147 1207 Employment Related Practices Exclusion U-GL-1517-BCW 0413 Collection or Distribution of Material or Information in Violation of Law Exclusion UABL131ACVV 0117 Non -Performing Animal Exclusion UABL102ACW 0117 Property Damage To Rented Premises Exclusion UABL129ACVV 0117 Assault And Battery Exclusion UGL1250ACW 0905 Abusive Act Liability Exclusion UABL122ACVV 0117 Newly Acquired Or Formed Entity Exclusion UABLI07ACVV 0117 Exclusion - Insureds Conducting Media, Entertainment, Or Internet Type Operations UABL130ACVV 0117 Informational Content Exclusion UABL135ACVV 0117 Media Content Exclusion UABL137ACW 0117 Cross Suits Exclusion UABL138ACW 0117 Personal And Advertising Injury - Exclusion Of False Arrest, Detention, Imprisonment, Libel, Slander, Right Of Privacy, Advertising Idea, And Copyright, Trademark Or Trade Secret UABLI06ACW 0117 Unscheduled Production, Presentation Or Event Exclusion UABLI03ACW 0117 Stunt, Pyrotechnic And Animal Exposure Exclusion UABL144ACVV 1019 Event Conditional Exclusion CG2132 0509 Communicable Disease Exclusion UABL146ACVV 1019 Unscheduled Products Exclusion UABL145A0PJ 1019 Hazardous Activities, Pyrotechnic Activities and Animal Exposure Exclusion UABL147ACW 1019 Loss Arising Out of Participation in a Sports or Athletic Event, Competition, Contest or Exhibition Exclusion UABL143ACVIJ 1019 Mashing Exclusion APA-CERT-FORMLIST 0914 Certificate Number: 1195367 Page 1 of 2 SCHEDULE OF FORMS Insured: EL SEGUNDO ART WALK, This Schedule of Forms is attached to and made part of certificate number 1195367, as of 08/13/2025 at 04:15 PM PT, and lists the forms included in the policy(s) and subsequent endorsement (s) at the time this certificate was issued. Form # Ed. Name UABLISOAC'N 1019 Camping Conditional Exclusion UGLD1036BCW 0904 Liquor Liability Coverage Part Declarations CGO033 0413 Liquor Liability Coverage Form IL0021 0908 Nuclear Energy Liability Exclusion Endorsement (Broad Form) UABL105ACW 0117 Commercial General Liability Changes U-GU-767-BCW 0115 Cap on Losses From Certified Acts of Terrorism Excess Liability Policy Excess Liability Notices U-GU-1191-ACW 0315 Sanctions Exclusion Endorsement U-GU-874-BCW 0223 Notice of Disclosure for Agent and Broker Compensation Forms U-SXS-104-ACW 0911 Straight Excess Liability Policy aacket) UGU621ACW 1002 Schedule Of Named Insured(s) U-SXS-D-100-ACW 0911 Straight Excess Liability Policy Declarations U-SXS-101-ACW 0911 Schedule of Underlying Insurance U-SXS-103-ACW 0911 Schedule of Forms & Endorsements U-GU-630-ECW 0120 Disclosure of Important Information Relating to Terrorism Risk Insurance Act U-SXS-100-ACW 0911 Straight Excess Liability Policy U-GU-767-BCW 0115 Cap on Losses From Certified Acts of Terrorism U-SXS-117-BCW 0514 Professional Liability Limitation Endorsement U-EXS-115-CCW 0411 Communicable Disease Exclusion UEXS319CCW 0514 Liquor Law Liability And Alcohol Consumption Health Hazards Exclusion UEXS101BCW 0411 Abuse Or Molestation Exclusion UEXS107ACW 0499 Athletic Participants Exclusion U-GU-1 223-B CA 0916 Revised Definition Of Spouse Endorsement U-EXS-312-FCW 0514 Exclusion - Recording and Distribution of Material or Information in Violation of Law U-EXS-178-BCA 0411 California Cancellation and Nonrenewal U-SXS-120-A CW 0911 Total Pollution Exclusion with Hostile Fire Exception This Certificate of Liability Insurance includes the Type of Insurance, Limits, and Schedule of Forms in effect as of 08/13/2025 at 04:15 PM PT. it does not affirmatively or negatively amend, extend, or alter the coverage afforded by the insurance policy nor confer any rights upon the certificate holder. You may be required to request an updated certificate in the event of subsequent policy modifications. The intwmation included in this corlpficate that has been provided by Abacus Insurance Brokers, I -LC is for your Wormation oniy, and does nw. create a contract Or agency' relaiion5Np cemeen the certificate hokler or any insured crud Abacus Insurance Brokem, LLC, By accepting ihis certificate the cedificale haider ackoowledges jrat Abacus Insurance Brokers, LLC Is not the agent of the certificate holder or any iosure,d, but is solely Oie agent of the tisted carfler(s) Abacus insurance Brokers, 11C makes no representation whether the coverages listed herein are appropriate for the certificate holder or any insured Please review the listed coverages carefully and direct any questions to your broker. For a complete listing of coverages, terms, conditions and exclusions, please view the referenced Policy(s), APA-CERT-FORMLIST 0914 Certificate Number: 1195367 Page 2 of 2 POLICY NUMBER: FLM8303833-01 COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following„ COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of El Segundo, its elected and appointed officials, employees, and volunteers Information reqj�ired to com iete this Schedule, if not shown above, will be shown in the Declarations.. j A. Section II — Who Is An Insured is amended to 2. This insurance does not apply to: include as an additional insured any state or a. 'Bodily injury", "property damage" or governmental agency or subdivision or political "personal and advertising injury" arising out subdivision shown in the Schedule, subject to the of operations performed for the federal following provisions: government, state or municipality; or 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 'Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Certificate Verification insured: EL SEGUNDO ART WALK, LLC � Abacus provides an efficientwe6site lookup tool for certificate holders to verify the authenticity ofcertificates ofinsurance. z. Navigate u,the websucand input the verification code onScan the ORcode. z. The actual certificate issued through the Abacus Platform will download. y. Compare the details of the downloaded certificate to the certificate presented by the client. We�sbe Verification Codm � � � ` � � wvmwabaouuoot/vohfy'm»rtifioate OHOUP8W1TCN About Certificates Issued through the Abacus.net Platform � � ! ! ° Abacus requires that all certificates beiouedthmughmeAhacmnatfvnn. Certificates issued outside ofthe Abacus � Platform are invalid. ~ Certificates e may be issued through the Abacus Platform uveither the named insured (if e�through uahmAb acus � Platform) ortheir Abacus registered insurance broker. | a Certificates with any stray marks, cross outs or alterations of any sort are invalid. � ° Each certificate is numbered and correlates to the document issued through the Abacus Platform.