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PROOF OF INSURANCE (2025 - 2026)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/13/2025 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 HUB International New England 300 Ballardvale Street Wilmington MA 01887 INSURED FirstTwo, Inc 1 Blackfield Drive #242 Tiburon CA 94920 FIRSINC-04 978-657-5100 AFFORDING COVERAGE Hiscox Insurance Com Admiral Insurance Com COVERAGES CERTIFICATE NUMBER: 1225782736 REVISION NUMBER: 248 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 ........................................... A L.. U ............. ......,._.......... POLICY EFF POLICY EXP... ............. LTR TYPE OF INSURANCE POLICYNUMBER MWDD/YYYY,.. MMIDD/YYYY LIMITS A X COMMERCIALGENERAL LIABILITY P100.780.946.6 12/9/2024 12/9/2025 OCCURRENCE $1,000,000 1 flOCCUR [EACH $w100m000 CLAIMS -MADE REMISES (Ea occurrence),d,,,_. MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,OOOmITITmmm^^^ POLICY F PIwC?w LOC X JECT PRODUCTS - COMP/OP AGG $ 2,00q,2 OTHER: $ AUTOMOBILE LIABILITY COMBiNED SINGLELIMiT Ea accdmant $ ...................... ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODIL.._. Y INJURY (Per accident) .................._ $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE ........_..._- $ AUTOS ONLY AUTOS ONLY Per accident) .... ........... ...... � UMBRELLA LIAB CCUR OCLAIMSMADE OCCURRENCE H........ $ ......................�..,...... EXCESS LIAR - AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER H- '.,..... SLA,TU7EIT..ITIT,,, ER ....AND EMPLOYERS' LIABILITY YIN ,, .....,.... APdYPROPRtET,"JR/PJ'RTk' M'EXECUTIVE OFFMCERlMEMSEREXCtU0E0?' NIA E.L. EACH ACCIDENT $ .................... (;Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ ................_----- If yyda, descHbe under' mm DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ B Tech E&O/Cyber E0000041340-08 1/1/2025 1/1/2026 Each Claim/PolicyAgg 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) The City of El Segundo, its elected and appointed officials, employees, and volunteers as additional insureds. The City of El Segundo will receive thirty (30) days written notice in the event of cancellation, nonrenewed or reduction. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St El Segundo CA 90245 AUTHORIZED REPRESENTATIVE United States , -A , . _ _ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 4W4 HISCOX Policy Number: P100.780.946.6 Named Insured: FirstTwo, Inc. Endorsement Number: 7 Endorsement Effective: 12/09/2024 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any per- son(s) or organization(s) for whom you are performing operations or leasing a premises when you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tions) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia- bility 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 opera- tions; or 2. In connection with your premises owned by or rented to you. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. CGL E5421 CW (02/14) Includes copyrighted material of Insurance Services Office, Inc., with its Page 1 of 1 permission. TWC AC0.FATE Ik4WDD(YYYY) ("'" CERTIFICATE OF LIABILITY INSURANCE 08/28/2025 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 endorsements . PRODUCER AAon Risk Services, Inc of Florida ON RISK SERVICES SOUTH INC NNAME:ME: A 3550 LENOX ROAD NORTHEAST SUITE 1700 ATLANTA GA 30326 INSURED TriNet Group, Inc. LJC/F FirslTwo Inc. 1 Park Place, Suite 600 Dublin, CA 94568-7983 INSURER A: INSURER B : INSURER C INSURER D : INSURER E : work.com --R(S) AFFORDING COVERAGE Insurance Company of North America COVERAGES CERTIFICATE NUMBER: 15933269REVISION NUMBER: NAIC # 43575 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 LTR TYPE OF INSURANCE ADDL INSR '... SUBR WVD '.... POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD. LIMITS COMMERCIAL GE:N'ER�AL. LIABILITY EACH OCCURRENCE $ '... DAMAGE TO RENTED CLAWS -MADE [] OCCUR PRkMBSES Eaueoucr xtce $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ .. POLICY PROJECT LOC PRODUCTS - COMP/OPAGG $ OTHER{ $ CO BIN LIMIT AUTOMOBILE LIABILITY Ea $ ANY AUTO BODILY INJURY Per erson $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident) $ PROPERTY DAMAGE (HIRED NON -OWNED ''.. AUTOS ONLY AUTOS ONLY Per accident. $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DEC RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X PER OTH STATUTE ER .. E.L. EACH ACCIDENT $ 2,000,000 A TOR/PARTNER/EXECUTIVE ANY PROPRIEMBER EXCLUDED? OFFICER/MEu N / A X WLR — C7321581A 07/01/2025 07/01/2026 E1. DISEASE - EA EMPLOYEE' $ 2,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E...L., DISEASE - POLICY LIMIT $ 2.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Workers Compensation coverage is limited to worksite employees of FirstTwo Inc. through a co -employment agreement with TriNet HR III, Inc. Waiver of subrogation in favor of CITY OF EL SEGUNDO as required by written contract, CERTIFICATE HOLDER CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90250 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. AUTHORIZED REPRESENTATIVE - dI on C&ek 8etvice6 8oiuth Qac © 1988-2015 ACORD CORPORATION„ All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured TriNet Group, Inc. L/C/F FirstTwo Inc. Endorsement Number 1 Park Place, Suite 600 Dublin, CA 94568-7983 07/01/2025 TO 07/01/2026 red 0y (Name of Insurance Company) Indonnity Insurance Comnanv of North America Policy Number Symbol: WLR Ntmiber: C7321581A Effective Date of Endorsement 09/08/2025 Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy, This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. (X) Specific Waiver Name of person or organization: CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90250 () Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED Authorized Representative WC 90 03 75 (05/18)