PROOF OF INSURANCE (2026 - 2026)' DATE (MM/DDN
M YYY
AC40R" CERTIFICATE OF LIABILITY INSURANCE 11/10/2025 )
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(les) 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 " . FTanMo Marc Anthony
. . ....... . . FAIL. . . ............ ........... . . .
-1334 -1336
HARBOUR VILLAGE INSURANCE AGENCY IAIC. M. r (805)477
m.,1: (105)477 iAJC, N4
ADDRESS:
. ...................... . . . . ........... .. ...... . ... . ...............
. - - --------
15 83 Spinnaker Dr Siote #211
. .................. I-N-S-U,RE,R,(S,)AFFO,R,DI,NG-CO..VER,AGE..'I . . . ..... - - - ----------
--------- - -
Ventura Beach CA 93001
INSURER A:
PHILADELPHIA INDEMNITY INSURANCE CO ......
_ _1 8058
111"", � .. . .....
.111- . . ........ ... .. ................ . . . . . . .... ---------- - — - -- — - - --------------------------
INSURED
I'll, — - - - - - - - --------------------------
INSURER B:
. . . ...... . ................................
- - - . ...... 1-11111111-111 1 . .... . . ........... 1111111111- .... "I'll, --------- - ---- - - -
PHILADELPHIA INDEMNITY INSURANCE CO
. .... - ............. . . . ................
18058
GEOEVENT, LLC
. .............. . - ------------ . . . . ........................ . . . . . ......... .......
PRO AUDIO VISUAL RENTAL
-.INSU.RERC:
R DINSURE:
. 1
EMPLOYERS PREFERRED INSURANCE
� - - --- . ........................... .... "I ---------------
10346
-- .......... . . .
7309 Atoll Ave
JNSURERE:
- ---------------- . . . .. .. .. .. ... ... ... ... .......................... ...
. . . . . ............... . .........
North Hollywood CA 91605
INSURERF:
---^ATE ki"RME20M.
DPVIQInM N[IMRF=P-
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. . ........ . . . ......
.
. . ....... .. ..... . . . ..................... .. . F ffil igm
ON LIMITS
, I
S U RA IN CE (M (MM D
INSR WVD
LTR TYPE OF IN POLICY NUMBER
GENERAL LIABILITY
OCCURRENCE 1,000,0000
X COMMERCIAL GENERAL LIABILITY
. . . . ..... . ....... . ..................... . . . ....
DANIAGF TO RENU'D 100,000
CY AIM.S-MADE I x I CCUR
MED EXP (A. 5,000
Y
Y
PHPK2625394-004
01/01/2025
01/01/2026
&ADNJRY 1000,000
PERSOY.
- . . .....
,000,000I 2A
GENERALAGGREGATE
-
G .. E . NT_ AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMPIOP AGG S 2,000,000
POLICY [ JPACOT [ X� LOC
[_ ..... . ................. ...
Property 50,000
AUTOMOBILE LIABILITY
COMB13NEDSE, NGLL Umi"I
1,000,000
- - --------
ANYAUTO
BODILY INJURY (Pe, puwn)
— - ------------------------- - -
B
ALLOWNED SK SCHEDULED
Y
Y
PHPK2625394-004
01/01/2025
01/01/2026
BODILY INJURY (Per accident}
s
AUTOS AUTOS
NON -OWNED
HYREDAUTOS
01crlccu
S
AUTOS
.. ............
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
S
----
EXCESS UAB CLAIMS MADE
-- . . . . . . ............... . . . ..............
AGGREGAIE
s ................. ..........
DM NT I 0 N
$
WORKERS COMPENSATION
FR
AND EMPLOYERS' LIABILITY YIN
E.L EACH ACCIDENT
5 1,000,000
D
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N/A
Y
EIG5377650-02
10/01/2025
10/01/2026
,
_ ...... . ......... . ..... . ""
, , , ....
. ................ .. . . . ... 1,000,000
(Mandatory in NH)
Y L E
_E L, DISEASE - EIAIIEIM,P,L..O .......... . . . .
s
.......-------
Res, e1cw6be undlc,
D SCRIPTTONOPOPERATTONSbeiow
--..E,L,
DISEASE -POLICY LIMIT
s 1,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
The City of El Segundo, its officers, officials, employees, agents and volunteers are included as additional insured with respects to General Liability and Auto Liability"
for event @EI Segundo City Hall 350 Main Street, El Segundo, California 90245 on 41h December
MULUMM
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of El Segundo -City Hall THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
I ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main St - AUTHORIZED REPRESENTATIVE
El Segundo CA 90245 1 Frankie Marc Anthony (agent)
ACORD 25 (2010/05) (D1988-2010ACORD (;QKPUKAIIUN. All rigntsireservea.
The ACORD name and logo are registered marks of ACORD