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PROOF OF INSURANCE (2026 - 2026)
a DATE (MM/DD/YYYY) COPRV CERTIFICATE OF LIABILITY INSURANCE o, /os/2o2s 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). PRODUCER CONTACT Nicole Lyles NAME: Kessler Alair Insurance Services, Inc PHONE (909) 931-1500 C N� (909) 932-2133 A/C No License # OA 91387 E-MAIE$s: nicole@kessleralair.com 12487 N. Mainstreet, Ste. 240 ADDRINSURER(S) AFFORDING COVERAGE NAIC # Rancho Cucamonga CA 91739 INSURERA: HISCOX 10200 INSURED INSURER B : California Auto 38342 J & L Building Maintenance Services INSURER C : Nautilus Insurance Co 17370 2705 E Van Buren St INSURER D : INSURER E Carson CA 90810 INSURERF.' ^Eff%YICNw Arc u11IReDCD. 95/26 rI_-XS.Auto PFVI. l'nN NIIMRER' THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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. NT TYPE OF INSURANCE I SD yyyD POLICY NUMBER POLICY EFF /D MMD Lt XP M' MWDPfr LIMITS +" COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 Fx_] _D77M7GE TO REWM5 $ CLAIMS -MADE OCCUR PREMISES Ea occurrence MED EXP (Any one erson) $ 5,000 A Y P100.568.762.5 09/23/2025 09/23/2026 'PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATE IAWTAPPLIES PER.. PRODUCTS -COMP/OPAGG $ 2,000,000 fE'IC`El P'CWC,ICY JE'CT GC $ OTHER: ED 9WNGLE L.I'hdl1T COhIBRNkO $ 1,000,000 AUTOMOBILE LIABILITY F r ec ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED BA040000086786 01/22/2025 01/22/2026 BODILYINJURY(Peraccident) $ AUTOS ONLY AUTOS HIRED PROPEGR'MYDAMAGE. (PaT aucldent)$ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 C X EXCESS LIAB CLAIMS -MADE AN1360856 09/08/2025 09/08/2026 AGGREGATE $ 2,000,000 DED RETENTION $ $ WORKERS COMPENSATION STA OTE 1.EER - AND EMPLOYERS LIABILITY YIN ANY PRE'PPRIETOW�`PA9' TN�& RFFXECUTIVE I E L. EACH ACCIDENT $ EL. DISEASE - EA EMPLOYEE $ of FICLRNE;MBER EXCLUDEID? (Mandatory In NH) NIA It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached if more space is required) The City of El Segundo, its elected and appointed officials, employees and volunteers are named as additional insured including primary and non contributory wording per the attached forms. 30 day notice of cancellation applies with 10 days for non payment. CERTIFICATE HOLDER CAN 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 Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 010 HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective: P 100.568.762.5 AL Building Maintenance Services 6 09/23/2025 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any per- son(s) or organization(s) for whom you are performing operations or leasing a premises when you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia- bility for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing opera- tions; or 2. In connection with your premises owned by or rented to you. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. CGL E5421 CW (02/14) Includes copyrighted material of Insurance Services Office, Inc., with its Page 1 of 1 permission. (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practica- ble. c. You and any other involved insured must: (1) Immediately send us copies of any de- mands, notices, summonses or legal pa- pers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the en- forcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment. against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the ap- plicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claim- ant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Para- graph b. below applies. If this insurance is pri- mary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insur- ance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is Fire insurance for premises rented to you or temporarily occu- pied by you with permission of the owner; (III) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occu- pied by you with permission of the owner; or (iv) If the loss arises out of the mainte- nance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Dam- age Liability. (b) Any other primary insurance available to you covering liability for damages aris- ing out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured by attachment of an endorsement. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer de- fends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 11 of 16 ❑ (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds (a) The total amount that all such other Except with respect to the Limits of Insurance, and insurance would pay for the loss in the any rights or duties specifically assigned in this absence of this insurance; and Coverage Part to the first Named Insured, this in- surance applies: (b) The total of all deductible and self- a. As if each Named Insured were the only insured amounts under all that other in- Named Insured; and surance. (4) We will share the remaining loss, if any, with any other insurance that is not de- scribed in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer con- tributes equal amounts until it has paid its ap- plicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Cover- age Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accu- rate and complete; b. Those statements are based upon representa- tions you made to us; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The in- sured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific mar- ket segments about your goods, products or ser- vices for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web -sites, only that part of a web - site that is about your goods, products or ser- vices for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: a. A land motor vehicle, trailer or semitrailer de- signed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equip- ment". Page 12 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 4010 HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective: P 100.568.762.5 AL Building Maintenance Services 21 09/23/2025 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MODIFIED IVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO CIS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: You may waive your rights against another party so long as you do so in writing prior to: (i) an offense arising out of your business that caused a "personal and advertising injury"; or (ii) an `occurrence" that caused "bodily injury" or "property damage". CGL E5402 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 DATE (M/Y MIDDYYY) CERTIFICATE OF LIABILITY INSURANCE 01/08/2026 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). PRODUCER NAME: ACT Automatic Data Processing Agency, Inc. ... sln Insurance FA ..." g PHONE Automatic Data Processing Insurance Agency, Inc. nt ""mmm m N •, _Qx __ .. 1 800 524 70 1 Adp Boulevard Roseland NJ 07068 INSURED J & L BUILDING MAINTENANCE SERVICES,, LLC 2705 E Van Buren St Long Beach CA 90810 .._.....mm.. .... _ ".4. NS_U�RER(�)AF�O�...R-,_D..—ING ......,......_.w............."............�...,....m,- ...C# _ .A INSURERA: Pacific Compensation Insurance Company 11555 INSURER B :. .. RFVISIAN NUMBER, THE POLICIES OF (INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. BE OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY ISSUED S HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND O P LIMITS SHOWN .I„UCH oTCItEdS LIMITS FO INSURANCE Vua DDR'#KV L"rR' POLICY NUMBER Y Mdpol»ff#KP COMMERCIAL GENERAL LIABILITY EACH OCCURRENCES CLAIMS -MADE 1:1 OCCUR PRrMISESfF:a w7C��aERl !tN i MED EXP (Any one perSurctl) x"" PERSONAL & ADV INJURY S �mmmm GEN'L AGGREGATE LIMIT APPLIES PER: GENE .., RAL AGGREGATE S' ..... ........ ................. .............. POLICY r O LOC ",PRODUCTS wCOMP/OP AGG,,,,,,,,,,,,,,,,,,,, .................. OTHER: TTMTF— G ::. $ AUTOMOBILE LIABILITY _fLl.lLc�IdA'e0i2SXX ..mm '''.... ANY AUTO BODILY INJURY (Per person) $ .........,.I,..m. ....e.....___......... OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS $ HIRED NON -OWNED »PrR_ 4 C IGDAMA.C" T AUTOS ONLY _,.,•,,,, AUTOS ONLY $'° UMBRELLA LIABOCCUR ••••-�-EACH OCCUR•RE.ENCE EXCESS LIAB '' CLABM$I.MAOf. AGGREGATE ' .�,�,. ,.,_—.w - S .-�• .........-. •. ..� ........ S RE"rE��,4tid rXiDN',a" WORKERS COMPENSATION PER MR - STATUTE ER AND EMPLOYERS' LIABILITY YIN E L EACH ACCIDENT ID S 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBERF>CCLUDED? NIA N WC1055386 08/25/2025 08/25/2026 •• 1,000,000 .. (Mandatory in NH) E.L.. DISEASE EMPLOYEE •...."_.. .._.....m. If yes, cE�sr,;:ribe under E L. DISEASE POLICY._.._ LIMIT S. 1,000,000 DESCRIPTION OF OPERATIONS lielow DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER 4NIrA4 4 L NI t 1. 214 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 �l 7'I��^�- I 191881-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD