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PROOF OF INSURANCE (2026 - 2026)DATE (MM/DD/YYYY) C"REP CERTIFICATE OF PROPERTY INSURANCE a w 09/26/2025 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. PRODUCER CONTNAME:.AC Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE 844-357-0403 FAX 5 Concourse Parkway E-MAIL ' . Suite 2150 ADDRESS oontact tlISCOx RQM__ _... ..... ..... ,. . _...... ER Atlanta GA, 30328 c1mmm9 IPL. _. _ ....... .. -.._. ....... INSURERS) AFFORDING COVERAGE NAIC # _....... _._... _._.... _ 10200 INSURED LU HISCOX Insurance COrllpany Inc ^ Dr. Victoria Hall, DC 1425 W 220th St _ Torrance, CA 90501 INSURER E w�rewi+ee rooT�r�rnTe �n i�eQoo. RFVISIAN Nt]MRFR-- LOCATION OF PREMISES / DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 1425 W 220th St, Torrance, CA 90501 23332 Hawthorne Blvd #202, Torrance, CA 90505 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. "POLICY Ili�' EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER _ _ DATE (MMIDDCTnrYYY) DATE (MM/DD/YYYY) COVERED PROPERTY LIMITS (' PROPERTY BUILDING $ CAUSES OF LOSS DEDUCTIBLES X PERSONAL PROPERTY $ $ 10,000 _ ........... BASIC BUILDING..... BROAD •— CONTENTS P103.134.957.2 03/18/2025 03/18/2026— X X BUSINESS INCOME EXTRA EXPENSE $ ........... A X SPECIAL $ 500 RENTAL VALUE $ EARTHQUAKE BLANKET BUILDING $ WIND BLANKET PERS PROP $ FLOOD BLANKET BLDG & PP $ $ INLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS $ POLICY NUMBER NAMED PERILS $ CRIME $ TYPE OF POLICY $ BOILER & MACHINERY / $ --•••• EQUIPMENT BREAKDOWN ......... "•'•'•'•'•'•'•"""""""""" .... $ SPECIAL CONDITIONS / OTHER COVERAGES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of El Segundo its elected and appointed officials, employees and volunteers are additional insureds. (30) days written notice of cancellation. Coverage is primary and non-contributory such that any other insurance that may be carried by the City will be excess thereto. CERTIFICATE HOLDER CANCELLATION El Segundo Police Department 348 Main St. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo, CA 90245 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24 (2016/03) The ACORD name and logo are registered marks of ACORD DATE IMM/DD/YYYY) ! CERTIFICATE OF LIABILITY INSURANCE 09/26I2025 THIS CERTIFICANATIONER UPON THE CERTIFICATE H 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 CONTACT NAME: Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE FAX 5 Concourse Parkway EMAIL ' (888) 202-3007 ac, Nola Suite 2150 contact@hiscox.com ADDRESS: �.°-...° Atlanta GA, 30328 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Hiscox Insurance Company Inc 10200 INSURED Dr. Victoria Hall, DC 1425 W 220th St Torrance, CA 90501 /`CCTICl/`A-rC A11111A01=0- INSURER C : INSURER E : RFVISInN hitl'MRFR. 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. �' _ POLICYEFF POLICYEXP LIMITS 7R TYPE OF INSURANCE WVD l POLICY NUMBER MM/OD MMdOOFYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X 100,000 CLAIMS -MADE OCCUR ERFIuiISE-9 F.a ccurrence $ X CGL is on BOP Form MED EXP (Any one person) $ 10,000 A Y P103.134.957.2 03/18/2025 03/18/2026 PERSONAL & ADV INJURY $ 1,000,000 ........... GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ❑ LOC GECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINEr3SINGLE kIMIT Ea CcirlanC}_.. $ ww............. ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY IN (Per accident) $ AUTOS AUTOS NON -OWNED _JURY PROPERlelYUAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ QED RETENTION $ $ WORKERS COMPENSATION PER OTH- .. R AND EMPLOYERS' LIABILITY Y / N ...STATUTE, ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ •••• • OFFICER/MEMBEREXCLUDED? 1 A NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE I $ If yes, desc6be under '.. DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of El Segundo its elected and appointed officials, employees and volunteers are additional insureds. (30) days written notice of cancellation. Coverage is primary and non-contributory such that any other insurance that may be carried by the City will be excess thereto. El Segundo Police Department 348 Main St. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo, CA 90245 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 17 4"E'71' Policy Number: Policy Type: Named Insured: Policy Period: Original Effective Date: Insured: Practice Address: NCMIC Insurance Company 14001 University Avenue Clive, IA 50325 800-247-8043 CERTIFICATE OF INSURANCE PDC0001018095 Chiropractor — Occurrence Victoria M Hall DC From 02/17/2025 to 02/17/2026 at 12:01 AM Local Time at the address of the Named Insured 02/ 17/2022 Dr Victoria M Hall DC 400 Sepulveda Blvd Manhattan Beach, CA 90266 This professional liability policy of insurance covers the insured identified above for the policy period indicated. This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend, extend, or alter the coverage afforded by the policy. 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 policy described herein is subject to all the terms, exclusions, and conditions of the policy. Coverage Type Policy Period Liability Limit Retroactive Date Per Claim/Aggregate) Medical Professional Liability 02/17/2025 to Limits: $1,000,000 per 02/17/2026 claim $3,000,000 aggregate The policy also covers ancillary providers identified in the relevant policy forms for duties performed while working under the supervision of the Named Insured. Dated at Clive, IA this day of: 09/2/025 NCMIC Insurance Company Authorized Representative Certificateholder The City of El Segundo 348 Main St El Segundo Police Dept El Segundo, CA 90245 MPL-CERT 1 04/24 Additional Insured Endorsement Named Insured: Victoria M Hall DC Policy Period: 02/17/2025 to 02/17/2026 Policy Number: PDC0001018095 Effective Date: 09/26/2025 Subject to the terms of the policy, this endorsement provides coverage that is limited to the liability imputed to the additional insured, which solely results from professional services rendered by an insured under this policy. Section I. Definitions is amended to include the following: Additional insured means the person or entity listed as such on the Additional Insured Endorsement. Section V. Limit of Liability is amended to include the following: The additional insured will share in the limits of liability of the named insured. This extension of coverage only applies to a claim for an incident that took place on or after the effective date and before the termination date listed below and is otherwise covered by the policy. The additional insured will not have coverage for any claim which alleges injury caused by the acts, errors, or omissions of the additional insured. Additional Insured The City of El Segundo, it's elected and appointed officials, employees and volunteers Effective Date 09/26/2025 Termination Date This endorsement does not provide a separate limit of liability. Nothing herein contained shall be held to vary, alter, waive, or extend any of the other terms, conditions, or limitations of the policy, other than stated above. MPL-10 1 01 /23 Policy Number: Policy Type: Named Insured: Policy Period: Original Effective Date: Insured: Practice Address: NCMIC Insurance Company 14001 University Avenue Clive, IA 50325 800-247-8043 CERTIFICATE OF INSURANCE PDC0001018095 Chiropractor — Occurrence Victoria M Hall DC From 02/17/2025 to 02/17/2026 at 12:01 AM Local Time at the address of the Named Insured 02/ 17/2022 Dr Victoria M Hall DC 400 Sepulveda Blvd Manhattan Beach, CA 90266 This professional liability policy of insurance covers the insured identified above for the policy period indicated. This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend, extend, or alter the coverage afforded by the policy. 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 policy described herein is subject to all the terms, exclusions, and conditions of the policy. Coverage Type Policy Period Liability Limit Retroactive Date Per Claim/Aggregate) Medical Professional Liability 02/17/2025 to Limits: $1,000,000 per 02/17/2026 claim $3,000,.000 aggregate The policy also covers ancillary providers identified in the relevant policy forms for duties performed while working under the supervision of the Named Insured. Dated at Clive, IA this day of: 09/29/20 5 NCMIC Insurance Company Authorized Representative Certificateholder The City of El Segundo 348 Main St El Segundo Police Dept El Segundo, CA 90245 MPL-CERT 1 04/24 14001 University Avenue Clive, IA 50325 800-247-8043 CHIROPRACTIC PROFESSIONAL LIABILITY INSURANCE OCCURRENCE DECLARATIONS ISSUING COMPANY: NCMIC Insurance Company POLICY NUMBER: PDC0001018095 ❑ New ❑ Renewal ® Change Change Effective Date: 09/26/2025 THIS POLICY SHALL NOT BE EFFECTIVE UNLESS THE FIRST INSTALLMENT PAYMENT IS RECEIVED ON OR BEFORE THE DUE DATE DISPLAYED ON THE INVOICE. ITEM 1 NAMED INSURED: Victoria M Hall DC PRACTICE ADDRESS: 400 Sepulveda Blvd Manhattan Beach, CA 90266 ITEM 2 POLICY PERIOD: 02/17/2025 to 02/17/2026 at 12:01 AM Standard Time at the Named Insured's address above ITEM 3 RETROACTIVE DATE: N/A Only applies to a claims -made policy. ITEM 4 LIMITS OF LIABILITY: Professional Liability: $1,000,000 Per Claim $3,000,000 Aggregate ITEM 5 PREMIUM: Policy Premium: $2,197.00 Surcharge/Taxes: $ N/A An installment fee may be charged. This is not a bill. ITEM 6 FORMS and ENDORSEMENTS: Refer to attached SCHEDULE OF FORMS AND ENDORSEMENTS *Items 3 and 4 above apply to the Named Insured. Refer to the SCHEDULE OF INSUREDS for Retroactive Dates and Limits of Liability applicable to all Insureds. Form: DEC 04/24 Page 1 of 1 Print Date: 09/29/2025 14001 University Avenue Clive, IA 50325 800-247-8043 CHIROPRACTIC PROFESSIONAL LIABILITY INSURANCE SCHEDULE OF INSUREDS ISSUING COMPANY: NCMIC Insurance Company POLICY NUMBER: PDC0001018095 POLICY PERIOD: 02/17/2025 to 02/17/2026 ❑ New ❑ Renewal ® Change NAMED INSURED: Victoria M Hall DC Change Effective Date: 09/26/2025 IN RETURN FOR PAYMENT OF PREMIUM AND SUBJECT TO ALL TERMS OF THIS POLICY, THIS SCHEDULE AMENDS THE POLICY TO ADD EACH OF THE FOLLOWING AS AN INSURED UNDER THE POLICY. Coverage Coverage Retroactive Effective Termination Insured Information Date Date Date Premium Dr Victoria M Hall DC N/A 02/17/2022 $2,197.00 Limits: $1,000,000 per claim $3,000,000 aggregate Audit & Legal Defense Coverage Limits: $60,000/$60,000 Legal Defense Coverage Inception Date: 02/17/2022 Endorsement Original Effective Date: 02/17/2022 Form: SCH-INSD 04/24 Page 1 of 1 Print Date: 09/29/2025 14001 University Avenue Clive, IA 50325 800-247-8043 CHIROPRACTIC PROFESSIONAL LIABILITY INSURANCE SCHEDULE OF FORMS AND ENDORSEMENTS ISSUING COMPANY: NCMIC Insurance Company POLICY NUMBER: PDC0001018095 POLICY PERIOD: 02/17/2025 to 02/17/2026 ❑ New ❑ Renewal ® Change NAMED INSURED: Victoria M Hall DC Change Effective Date: 09/26/2025 IN RETURN FOR PAYMENT OF PREMIUM AND SUBJECT TO ALL TERMS OF THIS POLICY, THIS SCHEDULE LISTS ALL FORMS, SCHEDULES AND ENDORSEMENTS ATTACHED TO THIS POLICY. Form Number Edition Date Description DC-ALDE 02/23 Audit and Legal Defense Endorsement MPL-10 01/23 Additional Insured Endorsement MPL-11 04/24 Delegation of Certain Policy Rights DC2020-OCC 02/23 Professional Liability Insurance Policy (Occurrence) Form: SCH-FORM 04/24 Page 1 of 1 Print Date: 09/29/2025