PROOF OF INSURANCE (2026)AIR" CERTIFICATE OF LIABILITY INSURANCE
7E(MM/DDIYYYY)
/04/2025
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 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: Diane DeSilva
Barnard & Associates Insurance Agency, Inc.
FA
(A/CC,NNo, Ext): 408-981-7080 (A/c, No):
2190 Stokes St. STE 201
ADDRESS: brian@barnardinsurance.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: EVANSTON
San Jose CA 95128
INSURED
INSURER B : REDWOOD FIRE & CAS INS CO
11673
INSURER C : State Compensation Insurance Fund
Range Maintenance Service LLC
INSURER D :
302 Mesquite Dr
INSURER E :
INSURER F :
Copperopolis CA 95228-9385
COVERAGES 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.
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DDIYYYY)
(MM/DDIYYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Y
3AA835549
11 /01 /2025
11 /01 /2026
EACH OCCURRENCE
$ 1.000.000
PREMISES (Ea occurrence)
$ 100.000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1.000.000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY ❑PRO- JECT ❑ LOC
OTHER:
GENERAL AGGREGATE
$ 2.000.000
X
PRODUCTS - COMP/OPAGG
$ Included
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
AUTOS ALL OWNED X SCAUTOS HEDULED
HIRED AUTOS X NON -OWNED
AUTOS
01 APM 039834 -03
11 /01/2025
11 /01 /2026
(Ea accident)
$ 1.000.000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
O
(Per accident)
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑Y
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
1760432
11/01/2025
11/01/2026
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1.000.000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
TEN DAYS NOTICE OF CANCELLATION APPLIES FOR NON-PAYMENT OF PREMIUM; 30 DAYS SHALL APPLY FOR ALL OTHER REASONS.
RE: ALL CALIFORNIA OPERATIONS; CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
The City of El Segundo
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
350 Main Street
El Segundo 90245
(�
O j/"(,.>�'vil t✓a''y-��
(U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
gig POLICY NUMBER: 3AA948100
MARKEL' EVANSTON INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
LIQUOR LIABILITY COVERAGE FORM
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM
SCHEDULE
Additional Premium: $Included (Check box if fully earned ®)
Please refer to each Coverage Form to determine which terms are defined. Words shown in quotations on this endorsement
may or may not be defined in all Coverage Forms.
A. Who Is An Insured is amended to include as an additional insured any person or entity to whom you are required by
valid written contract or agreement to provide such coverage, but only with respect to "bodily injury", "property damage"
(including "bodily injury" and "property damage" included in the "products -completed operations hazard"), and "personal
and advertising injury" caused, in whole or in part, by the negligent acts or omissions of the Named Insured and only
with respect to any coverage not otherwise excluded in the policy.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. The insurance afforded to such additional insured will not be broader than that which you are required by the valid
written contract or agreement to provide for such additional insured.
Our agreement to accept an additional insured provision in a valid written contract or agreement is not an acceptance
of any other provisions of such contract or agreement or the contract or agreement in total.
When coverage does not apply for the Named Insured, no coverage or defense will apply for the additional insured.
No coverage applies to such additional insured for injury or damage of any type to any "employee" of the Named Insured
or to any obligation of the additional insured to indemnify another because of damages arising out of such injury or
damage.
B. With respect to the insurance afforded to these additional insured, the following is added to limits of insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the valid written 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.
All other terms and conditions remain unchanged.
MEGL 0009-01 09 18 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1
with its permission.