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PROOF OF INSURANCE (2026)DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY 01106/2025 .. . ...... ...INSURANCE . . . .... ........ THIS CERTIFICATE IS ISSUED AS A MATTER OF IN 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. — ----- . .. . ...... - R � the POIicyVo'S''__'_'�g' IMPORTANT: If the certificate holder is an ADDITIONAL INSUEb"_-jj' _' ) must on rsed. If SUBROGATION IS WAIVED, SU ec a 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). "CdafA PRODUCER_._. .... ..NAA1E FAX The Camp Team, LLG ""8"0 ' 0 7 ' 47- ' 9573 J" 303-422-1276 ... ... .... 9035 Wadsworth Park -way, awaalL oRps' s Suite 3820, '_,.JnfOiPcampte,am-com PRODUCER Westminster, CO. 80021 - ----------- --- - - - INSURED Sporb Marketing Program Management Inc , INSURERA� AccalerantSpec. Insurance Cany . . ......... . ....... City of El Segundo [NSURERB: ......... ... - ------- INSURER : — - - --- - - - ------------------- 350 Main Street El Segundo, CA, 90245 INSURER E! INS UR ER F: COVERAGES CERTIFICATi—NUMBER. A-SP-SU-2 TE NOTWITHSTANDING U R MENT. TERM OR CONDITION THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED ANY REG I E 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 POUCIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS SUBIR _06CE �EFF INS& J� SEA GENERAL LIABILITY EACH OCCURRENCE is A N N S0019GL000001-04 01/0612025 01/06/2026 FIRE DAMAGE , T - 0 - PREMISES REMISES Is - 300,000-00 7xi COMMERCIAL GENERAL LIABILITY RLNT'ED(��Py' T"r!:t9n) ". -- CLAIMS -MADE OCCUR I ED MEDEX (any 50 J IN LUDES ATHLETIC PARrcipAws INCI - lP I'll INJURY . . . . ...... x. GENERAL PRODUCTS COMP/OP AGG fS2,QL0,P9Q�P4_ GENERAL AGGREGATE LIMIT APPLIES PER: POLICY PROJECT F_]1 111C AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO HIRED AUTOS . . ..... .... BODILY INJURY (Per person) $ ALL OWNED NON -OWNED BODILY INJURY (Per accident) AUTOS AUTOS PROKKfV6AMAGF SCHEDULED AUTOS wt) ...... . .... . ..... - I$ UMBRELLA LIAB OCCUR . .......... AGGREGATE . ............. EXCESS LIAR CLAIMS -MADE DEDUCTIBLE .... .. s .Rg1FN7R S . ..... 7 WC�VfWi J: OT I ANDENIPLOYERVIAISLWY ANYPROPRIETCWARTINSVIEXECUTIVE OFFKZVVEMBEIREXCLUDED? E L EACH ACCIDENT (Miniftyin" NIA It yes, describe under SPECIAL PROVISIONS below EL AISE ASf - EA EMPLOYEE. is . . .......... . .. . ........... OTHER A Abuse/Molestation N N S0019GL000001-04 01/06/2025 01/06/2026 Each Occurrence: $ 100,000-00 Aggregate: $ 500,000.00 .......... . . . . . . ...................... . .. ... .CIRIPTIONRAIVEHDerkuity Cqb PolicyDeductible: $0 00 Deductible for Bodily Injury and $ 1000,00 per Propeity Damage Claim ISO Occurrence form CG 00 0104 13 and companys specific forms. Coverage for Participant Legal Liabilityreuires that every participant signs a waiver/release. RE: Registered Drama participarils: O1I'0612025 - 01 QW2026: _�OLD —E'—" CERTIFICATE R .......... CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AU'MORUED REPRESENTNINt El Segundo, CA, 90245 Mark Di Perna ACORD 25 (2016/03) The ACORD name and logo are registered marks ofACORD 91988- 2009ACORD CORPORATION. All rights reserved. ACORO' AGENCY The Camp Team, LLC AGENCY CUSTOMER ID: ASPSU-25-01-06-327552 LOC* ADDITIONAL REMARKS SCHEDULE .,._ ..._.__._----..--- -... NAMED INSURED City of El Segundo POLICY NUMBER S0019GL000001-04 CARRIER Accelerant Specialty Insurance Company _ ....._-� 350 Main Street NAIC CODE a...A�.�.. El Segundo, CA, 90245 16890 EFFECTWE DATE: 01/06/2025 ACORD 101 (2008101) The ACORD name and logo are registered marks of ACORD Page 1 of 1 ©2008 ACORD CORPORATION. All rights reserved. CITY OF EL SEGUNDO WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES. I affirm under penalty of perjury under the laws of California one of the following declarations: (_) I have and will maintain a certificate of consent of self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Labor Code § 3700 for the performance of the work set forth the agreement with the City of El Segundo. Policy No. L_) I have and will maintain workers' compensation insurance as required by Labor Code § 3700 for the performance of the work for which the agreement with the City of El Segundo is executed. My workers' compensation insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # a) I certify that, in the performance of the work set forth in the agreement with the City of El Segundo, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Labor Code § 3700 1 must Signature ly comply p o sions or the agreement will automatically become void. immediate) com I with th�oeyr µ Date 11/1' 9Applicant Print Name Haley Cron ki Agreement for: Dated: Reviewed by: