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PROOF OF INSURANCE (2026 - 2026)DATE (MM/DDIYYYY) C "R" CERTIFICATE OF LIABILITY INSURANCE kh. , 09125/2025 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("es) 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 NACOME;NTACT Justine Bellevue Kulchin Ross Insurance Services, LLC PHONE (818) 996-0900 FAX o :(818) 279-6999 A/C.. aN. _ 18757 Burbank Blvd. ADD tREss: justine@kulchinross.com ADDRESS, Suite 320 INSURER(S) AFFORDING COVERAGE NAIC # Tarzana CA 91356 INSURERA: Scottsdale Ins Company INSURED INSURER B : y LLO ds of London Geekopolis, LLC, DBA: GameTruck LA South Bay INSURER C : 2748 Pacific Coast Hwy INSURER D Unit 1010 INSURER E Torrance CA 90505 INSURERF: COVERAGES CERTIFICATE NUMBER: 25-26 COI Master 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. iR Alf. �' POIJCY EFF POL CV EXP R TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDrrYYY= MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ AMA"r. N 100,000 CLAIMS -MADE � OCCUR PREMISES Ea occurrence $ A Y I 1I CPS8263887 GEN'L AGGREGATE LIMIT APPLIES PER: JPOLICYDIFI?El LOC THER: AUTOMOBILE LIABILITY ANY AUTO OWNED 'SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY H AUTOS ONLY UMBRELLA LIAR OCCUR EXCESS LIAB CLAIMS -MADE I BED l._. U RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE [7 �Nl OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Sexual Abuse & Molestation B (Primary Layer) MED EXP (Anv one person) $ 5,000 08/01/2025 08/01/2026 PERSONAL & ADV INJURY $ 1,000,600 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000.000 ....... COMBINED SOLE LIMN to a3G wenh .�.�.�. BODILY INJURY (Per person) $�� BODILY INJURY (Per accident) $ 6 ar 'HO°ycPERTY DAMA.GE:. (�ldevrti $ EACH OCCURRENCE $ AGGREGATE $ E1, EACH ACC E.L.. DISEASE - �SEXUALABUSE $2,000,000 B0621PGEEK000125 05/28/2025 05I28/2026SEXUALABUSE $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Excess Layer Details: Policy Number: B0621PGEEK000225 Policy Term: 5/28/2025 - 5/28/2026 Coverage Type: Sexual Abuse & Molestation Policy Limit: $1,000,000 The City of El Segundo, its officers, officials, employees, agents, and volunteers are included as Additional Insured on General Liability Policy, if required by a M a . 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 AUTHORIZED REPRESENTATIVE ElSegundo. CA 90245 ,p J @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00054007 LOC #: AC " ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Kulchin Ross Insurance Services, LLC Geekopolis, LLC, DBA: GameTruck LA South Bay POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: AnnITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance written contract. Amon 4n4 i,3nnamii 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT A SCOTTSDALE INSURANCE COMPANY® NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE DATE FORMING A PART OF (12:01 A.M. STANDARD TIME) NAMED INSURED AGENT NO. POLICY NUMBER CPS8263887 08/01/2025 GEEKOPOLIS, LLC, DBA: GAME TRUCK SOUTHBAY 040BM THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to this endorsement, SECTION II —WHO IS AN INSURED is amended to include as an additional in- sured any person or organization whom you are required to add as an additional insured on this policy under a written contract, written agreement or written permit which must be: a. Currently in effect or becoming effective during the term of the policy; and b. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury." The insurance provided to these additional insureds is lim- ited as follows: 1. That person or organization is an additional insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations for that additional insured are completed. a. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional insured(s) at the loca- tion of the covered operations has been com- pleted; or b. That portion of "your work" out of which the in- jury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. 3. The limits of insurance applicable to the additional insured are those specified in the written contract, written agreement or written permit or in the Decla- rations for this policy, whichever is less. These lim- its of insurance are inclusive of, and not in addition to, the Limits of Insurance shown in the Declara- tions for this policy. 4. Coverage is not provided for "bodily injury," "property damage," or "personal and advertising injury" arising out of the sole negligence of the additional insured. 2. With respect to the insurance afforded to these 5. The insurance provided to the additional insured additional insureds, the following exclusions are does not apply to "bodily injury," "property damage," added to item 2. Exclusions of SECTION I— or "personal and advertising injury" arising out of COVERAGES: an architect's, engineer's or surveyor's rendering of or failure to render any professional services This insurance does not apply to "bodily injury," including: "property damage" or "personal and advertising injury" occurring after: Includes copyrighted material of ISO Properties, Inc., with its permission, Copyright, ISO Properties, Inc., 2004 GLS-150s (7-06) Page 1 of 2 a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, re- ports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engi- neering activities. 6. Any coverage provided hereunder will be excess over any other valid and collectible insurance avail- able to the additional insured whether primary, ex- cess, contingent or on any other basis unless a written contract specifically requires that this insur- ance be primary. When this insurance is excess, we will have no du- ty under SECTION I —COVERAGES to defend the additional insured against any "suit" if any other in- surer has a duty to defend the additional insured against that "suit." If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. AUTHORIZED REPRESENTATIVE DATE Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc., 2004 GLS-150s (7-06) Page 2 of 2 ACOW"�06127IM2'ff)25 may° CERTIFICATE OF LIABILITY INSURANCE 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 W_ PRODUCER CONTACT NAME; Pr r v mrner vall urwi Customer and Ace svi m PIAIDIAMOND VLY INS PHONE FAX 3009 DOUGLAS BLVD 300, ROSEVILLE, CA95661 IAIC NQ Eut};_'-0 -44 -44 AFFORDING COVERAGE INSURER A: INSURED INSURER B GEEKOPOLIS LLC DBA: GAME TRUCK LOS ANGELES 274E PACIFIC COAST HIGHWAY, #1010 INSURER C r TORRANCE, CA 90505 INSURER D INSURER F t --- _ COVERAGES CERTIFICATE NUMBER: 138168091298392638DO62725Tl82113 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. ........ INSR ADDL SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM)DDIYYYY) (MMMOIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE OCCUR Azal a-m . MED EXP (A perl— a PERSONAL &ADV INJURY GENERAL AGGREGATE t` ":N'LAGGRE A,TE LINT TAPPLIES PER: ❑ �. PRODUCTS- COMPIOPAGG wmm. POLICY .lEC�T LOG �JECT '.OTHER SINGLE LWllr' La wxldmu $1,M CaRO AUTOMOBILE LIABILITYCIOUSINhfED BODILY INJURY (Per person mm 'r ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AIUFFO a ONLY Y N D1095918 04106/2025 10/06/2025 BODILY INJURY (Per accidenfb 1'1VAMAGE wr eca;rderli. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE $ DED RETENTION $ WORKERS COMPENSATION YIN AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE ❑ OFFICEPJMEMBEREXCLUDED7 (Mandatory In NH) NIA E.L. EACH ACCIDENT F:.L. DISEASE_- EA E.MPL,OY $ E..L„ DISEASE- POLICY UMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below See ACORD 101 for additional coverage details. $ A Y N 01095910 04/0612025 10/0612025 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo Department of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Recreation, Parks and Library ACCORDANCE WITH THE POLICY PROVISIONS. 401 Sheldon Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: A'" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED PIAIDIAWIDND VLY INS GEEKOPOLIS LLC DBA: GAME TRUCK LOS ANGELES POLICY NUMBER 2748 PACIFIC COAST HIGHWAY, #1010 TORRANCE, CA 90505 01095919 CARRIER NAIC CODE Unlled Financial Casualty Company 11T70 EFFECTIVE DATE:04/06/2025 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability IIsurance Additional Coverages Insurance coverage(s) Limits ... ....................... ,,...,,,.......... ........ .............. ......*..... ........................ UninsuredlUnderinsured Motorist C. ombined ...Singl....... Lim.it $1,000,000 e Description of LocationNehicleslSpecial Items Scheduled autos only ... ......... ,........ _....... _............... .. ..... 2009 CHEVROLET SILVERADO C2500�1GCHC441<69E126988 Collision $1,000 Dad Comprehensive $1,000 Dad Medical Payments $5,000 each person ,....... .............. ................. .. .._.., ........ ........,.. 2009 CHEVROLET SILVERADO C2500 1 GCHC446X9F180887 Collision $1,000 Dad Comprehensive $1,000 Dad Medical Payments $5,000 each person VC84CZ143323 Collision $1,000 Dad Comprehensive $1,000 Dad Medical Payments $5,000 each person 2618 FORD T-350 TRANSIT W 1 F8ZX2ZMXJKA978847............. ... .... ... Collision $1,000 Dad Comprehensive $1,000 Dad Medical Payments $5,000 each person .... . ......... .. ....... ........ 2009 GRAVELY Trailer 1 G9CT32219A220005 ............. Collision $1,000 Dad Comprehensive $1,000 Dad ..... .. .. ........ ..., , .,, 2009 GRAVELY Trailer 1 G9CT32218A220005 _ ................................. _..,.,. ....... .._.. Collision $1,000 Dad Comprehensive $1,000 Dad ,.......... ,... ...... ..,..,..... .., ,. .....,,, ...., .... .......... 2009 GRAVELY Trailer 1 G9CT24218A220005 ........................ .... ...... ...,,,... Collision $1,000 Dad Comprehensive $1,000 Dad .. ............ .......,..,... .................................. 2014 Bravo Trailer 5426E2425EB0060138 ........ ....... ... ......... .... ... .............. Collision $1,000 Dad Comprehensive $1,000 Dad ........ 2014 RAM 2500 3C6TR5HT9EG173444 ..... ...................... Collision $1,000 Ded Comprehensive $1,000 Dad 2014 Bravo Trailer 542B*E2422EBO06268 Collision $1,000 Dad Comprehensive $1,000 Dad ........ 2618 RAM 2500 3C6UR5.C......JSJG20838................................................... 6 ...... ......... ... .... .. . ....... Collision $1,000 Dad Comprehensive $1,000 Dad Additional Information Certificate holder is listed as an Additional Insured. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F09/29I2025 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 CON-NAMTACT AP Intego In Group LLC %P INTEGO INSURANCE GROUP, LLC PHONE 888 289 2939 ,,,,,,,,,,,,,,, IAIG,��.tttl............. ............ SGo.No14� 375 Woodcliff Dr. E-MAIL AD RE p ,. orn UWss o�rts ,rote 0.C... .......�, 3ulte 103 INSURERS) AFFORDING COVERAGE _ „NAIC,# ------------------- -airport NY 14450 INSURERA Employers Preferred Insurance Company 10346 INSURED INSURER B : _ Geekopolis LLC DBA GameTruck Los Angeles ...- INSURER C : 2748 Pacific Coast Highway #1010„ono Torrance CA 90505 1 INSURER F : ......�.,.�.�e. -T1C1^ATC uuuAocn. RFVICIl1N NIIMRFR• 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 BY PAID CLAIMS. .-._ _.,..u.,,,,,,.......... .....---- (REDUCED ... ..,.._,- --.-.TYPE OF INSURANCE... ,,. -----.-.- j �.......... ......POLICY NUMBER ,... ... .7 MP OPYY'VV k1IM/00 ..... ............... ILTR jA7dL S1J9,°" POLICY EF'F POLICY EXP LIMITS GENERAL LIABILITY 1_ EACH OCCURRENCE $ . COMMERCIAL GENERAL_ LIABILITY ....... ....... F- C.P SE;M1 ES m�o4N,r Er cvr.) [11$ _ ,. CLAIMS -MADE I OCCUR MED y one person) $ PERSONAL ADVINJU$ R.Y......� ,._,---- ......... ..... ............ GENERAL AG..... AGGREGATE ., f$ - ........- GEN L AGGREGATE LIMIT APPLIES PER: ... �... AGG ROMDBUCTSNNGME .,......... ....._ $ - .... .......... I POLICY PR" r LOC OM,,.........,.,.,. AUTOMOBILE LIABILITY ...lty rau,cvdont,)„m , �T $ ......... ...... ANY AUTO N BODILY INJU RY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY OAMACE (,?a�awt^v_dnnt}. HIRED AUTOS AUTOS ......... ......... ............. .......,. UMBRELLA LIAR OCCUR EACH OCCURRENCE $ i EXCESS LIAR CLAIMS -MADE AGGREGATE„ _ i RETENTION$,.,.,.... ............. ... $ DED..�..,..... WORKERS COMPENSATION �/ TpRV T MTIU- ,,, Eke,, �,,, ,,,„--- ----- ---------" AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N L OFFICE/MEMBER EXCLUDED? N / A F EIG591858701 07/01/2025 „f� ... I E L EACH ACCIDENT 07/01I2026 .., $ 1,000,_000 E.L.. DISEASE EA EMPLOYEE$ 000 (Mandatory in NH) If yes, describe under W . - E.L. DISEASE POLICY LIMIT ...... PP-- .... S 1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ULK I Irl(:A I t MULUtK El Segundo Parks & Recreation 401 Sheldon Street 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 /I /�J ElSegundo CA 90245 �/(�/(,�////1 �.`�/(— i V lUtitl-ZU7U AGUKU GUKI-UKAI IUIV. All ngncs reserveu- ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Clear All