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PROOF OF INSURANCE (2026)AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 12/09125 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 endorsementt(s), MARKETS r w PRODUCER [INSURER E: COMPLETEQ plp7�,A1'^W,.rX,TS' INC COMPLETE EQUITY MARKETS INC raE Exq 41 ii01 mmN�{8C7)511 �pggIT MAP 1190 Flex Court ) .,_ RESS.° Lake Zurich, IL 60047 INSURERS) AFFORDING COVERAGE NAIC# ._.� .. �..AI n...�n _ ... RERA Underwriters at f»Io,London m 15792 n CA dba CprnpI06 Equity Markets Insurance A L*0D4407 a� INSURED ..�.. �.m, _.. ...-..—...... .. ,.�.-,... ..__..�...,_�.� _.. Rachel Archambault RER 13925 City Center Drive RERD: ,,...._..._...._Chino Hills, CA91709 RERSF : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: r I nM I I nt rULauts Ur INSUKANCE 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,CONDITIONS TYPEOFINSURANCE A taL�$ R POLICY NUMBER-..-�U&pPO�rLrJo�YFY) IMFiT Y ) ..... .�A...� .. ....LIMITS,,,,, —� .•.mmITIT.•m .nn I�Sf1 �� f� COMMERCIAL GENERAL LIABILITY EACH CJCCLNRREN4,!4 $ CLAIMS -MADE OCCUR E'r1I • aEn oiGMXrruIW,dY) $ .--,�..•.i •._._.„„.._.......•. ,,,,...�.„. MED EXP (Anyone person) on) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ L] PERCO- L '$ POLICY LOC PRODUCTS - COMP/OP AGG 1 $ OTHER: AUTOMOBILE LIABILITY y:at Nis �acc e.`T��C"m.• �,.. ._.,.........9 ANY AUTO t BODI LY I NJU RY(Per person) I $ OWNED SCHEDULED BODILY INJURY (Per accident) . $ �.. AUTOS ONLY HIRED NON OWNED ( r')'�Y +r l r r a�ultlenl . $ AUTOS ONLY AUTOS ONLY .,, -........ I $ ._....,,.. UMBRELLA LIAR '.. OCCUR 1 .._.... EACH OCCURRENCE ................................................. _........._................... $ ........--,.................._,m....._. EXCESS UAB CLAIMS -MADE AGGREGATE ...... $ ,........ ._...DED...,_...._�RETE... , ..m... ......_: � NTION $ , $ WORKERS COMPENSATION n AND EMPLOYERS' LIABILrrY Y 1 A tlJYE •..••.. ,.__. ANY OFFICEOPRIE ER EXCLUDR[ ECUTIVE NIA E.L. EACH ACCIDENT $ In NH (Mandatory ) � EMPLOYEE E Lt DISEASE • EA , $ - DMyandata If es, describe under ESCRIPTION OF OPERATIONS below .....,,,, ....•••..•••�� E.L. DISEASE - POLICY LIMIT ................. ............._. $ A Professional Liability 273521 09/10/25 09/10/26 Each Claim $1,000,000 Aggregate $1,000,000 DE5CRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks schedule, may be attached It more space is required) Subject to all policy terms, conditions, exclusions and endorsements. Certificate Holder not afforded coverage under the policy. SURPLUS LINES NOTICE TO POLICYHOLDER - PLEASE SEE ATTACHED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo - Police Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 348 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE 14 ACORD 25 (2016103) ��� ACQ9lJ � name and Ingo are registered m IY CORPORA rlO�r All rights reserve erns �I��4�R� d. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) .................. 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). coN'T T PRODUCER r�near�, COMPLETE EQUITY MARKETS INC COMPLETE EQUITY MARKETS INC 1190 Flex Court DC .............. Lake Zurich, IL 60047 In CA: dba Complete Equity Markets Insurance Agency, Inc. (CASL#OD44077) ...............__ --------- �.�......... ....,..,........,,,, --- ......... .........,, INSURERA: U INSURE D INSURER B t. Rachel Archambault JNSUIRERC 13925 City Center Drive JNS,URERD.:.,,,,,, Chino Hills, CA 91709 "INSURE.RE,:.,1m 1 rrt5J 07AA^�Ci 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. ....., :.INTO ....-_.. .. __..... ....,w., ..,,.....�7IN-R C SU I 11- ._ .MM Y! M'YY LIMITS TYPE OF INSURANCE,.. n POLICY NUMBER. OPOLIPYIYYYY MP Rq AL GENERAL LIABILITY COiML4I $ DAMAGE ffENTE5 ..... ... OCCUR CLAIMS -MADE .,.... ........ r MED EXP Any one person) $ ----------------- PERSONAL.& ADV INJURY I $ GEN L AGG A PLIES PER. _ C GENERAL AGGREGATE $ POLICREGAT PRO- LOC PRODUCTS COMP/OP AGG $ ---) JECT $ { eJT"h1EiC: (.OAMBINrD SINGLE LIMIT AUTOMOBILE LIABILITY & accld0pt) ,.......... ., ... ........._ ... ANY AUTO BODILY INJURY (Per person) ( $ ...BODILYIN.IT.. ......... .............. .........,, ,......OWNED ---^ SCHEDULED " JURY (Per accident) $ .„., AUTOS ONLY AUTOS HIRED NON -OWNED - �RO� $ AiMAGL.._. AUTOS ONLY AUTOS ONLY � die t� .,,,,,, .... ............. UMBRELLA LIAB J OCCUR EACH OCCURRENCE $ ,.._, .---. .. ... EXCESS LIAB E I } CLA MS MAD AGGREGATE $ - - 1 I RETENTION $ $ WORKERS COMPENSATION OTH I STATUTIE � ER AND EMPLOYERS' LIABILITY Y A N - ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMMBER EXCLUDED � '.NIA= "PER E L EACH ACCIDENT $ .. Mandatory in NH E L DISEASE EA EMPLOYEE $ ... ......... If yes, describe under' DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I. $ Professional Liability Each Claim $1,000,000 A X 273521 9/10/2025 9/10/2026 Aggregate $1,000,000 . DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ''.. Subject to all policy terms, conditions, exclusions and endorsements.. The City of El Segundo, its elected and appointed officials, employees, and volunteers is listed as an Additional Insured with Primary/Non-Contributory and a 30 Day Notice of Cancellation but only per the terms & conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. 'Contingent Upon Receipt of Additional Premium SURPLUS LINES NOTICE TO POLICYHOLDER - PLEASE SEE ATTACHED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of El Sequndo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 348 Main Street El Sequndo, CA 90245 AUTHORIZED REPRESENTATIVE �srr 7PA�°"°Y ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IMPORTANT NOTICE: 1. The insurance policy that you have purchased is being issued by an insurer that is not licensed by the State of California. These companies are called "nonadmitted" or "surplus line" insurers. 2. The insurer is not subject to the financial solvency regulation and enforcement that apply to California licensed insurers. 3. The insurer does not participate in any of the insurance guarantee funds created by California law. Therefore, these funds will not pay your claims or protect your assets if the insurer becomes insolvent and is unable to make payments as promised. 4. The insurer should be licensed either as a foreign insurer in another state in the United States or as a non -United States (alien) insurer. You should ask questions of your insurance agent, broker, or "surplus line" broker or contact the California Department of Insurance at the toll -free number 1-800-927-4357 or internet website www.insurance.ca.gov. Ask whether or not the insurer is licensed as a foreign or non -United States (alien) insurer and for additional information about the insurer. You may also visit the NAIC's internet website at www.naic.org. The NAIC—the National Association of Insurance Commissioners —is the regulatory support organization created and governed by the chief insurance regulators in the United States. 5. Foreign insurers should be licensed by a state in the United States and you may contact that state's department of insurance to obtain more information about that insurer. You can find a link to each state from this NAIC internet website: https://naic.org/state_web_map.htm. 6. For non -United States (alien) insurers, the insurer should be licensed by a country outside of the United States and should be on the NAIC's International Insurers Department (IID) listing of approved nonadmitted non -United States insurers. Ask your agent, broker, or "surplus line" broker to obtain more information about that insurer. 7. California maintains a "List of Approved Surplus Line Insurers (LASLI)." Ask your agent or broker if the insurer is on that list, or view that list at the internet website of the California Department of Insurance: www.insurance.ca.gov/01-consumers/120-company/07- lasli/lasli.cfm. 8. If you, as the applicant, required that the insurance policy you have purchased be effective immediately, either because existing coverage was going to lapse within two business days or because you were required to have coverage within two business days, and you did not receive this disclosure form and a request for your signature until after coverage became effective, you have the right to cancel this policy within five days of receiving this disclosure. If you cancel coverage, the premium will be prorated and any broker's fee charged for this insurance will be returned to you. D-2 (Effective January 1, 2020)