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PROOF OF INSURANCE (2026 - 2026)
AGUU-U9 ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYW)03/09/2026 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 endorsements . PRODUCER 888-794-7733 gRNTMCT Debby Hernandez MNkk .JKB Insurance Services Inc PHONE 888 794 7733 FAX 8.00 717 8901 CA li OGAAAr7(AIC Na Ext) (NC, No), IC . ---- .. ------ 970 Reserve Drive, Semite 100 E-MAIL l)Her'nandez(cwI�Cb-lns.nej Roseville, CA 95678 ADDRESS Thomas M„ Hernandez Sr.. IIVUREISJ AtcaRD)G cgwErRAGE.... aagLP. R A Kinsale Insurance Comp 38920any INSURER P y N dl E INSURER B Jechnology Company 96 3 o, Inc. Scottsdale le Insurance Com any 4129 8443 Foothill Blvd IfrSa�REr� C ; 7 Sunland„ CA, 91040 _ - NRSURkR O • ,,,.... INSURER E : COVERAGES CERTIFICATE NUMBER' REVISION NUMBER: 1 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 LTR TYPE OF INSURANCE ADDL SUBRd POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $t 1,000,000 "FAMaM1i E Tfi RLPW'iECA 100 000 CLAIMS -MADE X7 OCCUR X X 1,01003918560 08/17/2025,U8/17/2026 . Excluded. PERPONAI, wy cone., INPaURY 000,0100 ML D r XP IRp 'EhmU, AGGREPIATE LIMIITAP PLIES PER: EFN RAL,,A r RECArE 2,000,000 POLICY X LOC PRODUCTS •COMPIOPAGG $ 2,000,000 AUTOMOBILE LIABILITY COVERAGES CERTIFICATE NUMBER' REVISION NUMBER: 1 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 LTR TYPE OF INSURANCE ADDL SUBRd POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $t 1,000,000 "FAMaM1i E Tfi RLPW'iECA 100 000 CLAIMS -MADE X7 OCCUR X X 1,01003918560 08/17/2025,U8/17/2026 . Excluded. PERPONAI, wy cone., INPaURY 000,0100 ML D r XP IRp 'EhmU, AGGREPIATE LIMIITAP PLIES PER: EFN RAL,,A r RECArE 2,000,000 POLICY X LOC PRODUCTS •COMPIOPAGG $ 2,000,000 AUTOMOBILE LIABILITY .IEa ANY AUTO f ",13ONLY INJU IRY (1111 M w soN .. _ S..._._ AUTOS ONLY AUTOSULED BODILY INJURY Per ae�.ydt7nk $ ( I HIRED .... NCht' -•tz NEO PROPERT Y DA.MAOE $ AUTOS ONLY AUTO' ONLY �,(��'r "t�'�'e�'��t�� — � -- ... ._ C UMBRELLA LIAB X OCCUR CH OCCURRENCELAB. , . � , ._ , 1,000„00( X EXCESS LB CLAINIS m MADECXS4080077 X X 1 ,........ ,..._... ,..._.. ®,., . ,. 03/09/2026 08/17/2026: d�uGREOA"i,C 000 00t DED } RETENTION $ i WORKERS COMPENSATION 'AND X PER OTH FR EMPLOYERS' LIABILITY Y I X ITES4699149 ....... ,..IYTIJt, w,,, _. '11/01/2025 11/01/20211 1,000,00C ANY PROPRIETORIPARTNER/EXECUTIVE .' N I A EL AC'CIIDENT S E'1i'FICERIMEMBER EXCLUDED? IMandatory In NH) )': i DISEASE • EA f=A'PLP�YW EE $.... 1,000,00C If yes, describe under ,.. .,,„...,.,. „... ....... ..... � 1.000,00( DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) the City of El Segundo, its officials and employees are included as Idditional insured, and for prints & non-contriburoty and waiver of subrogation„ in accordance With to attached endorsements, but only if squired in a written contract with, the named insured. fie: PW 24-15 Electric Vehicle Charging Improvements (EVCI) El Segundo, CA ELSEGUN City of El Segundo 350 Main Street El Segundo, CA 90245 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 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION �-- _ .w,�, Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100391856-0 08/17/2025 12:01AM at the Named A C D D Inc Insured address shown on the Declarations Additional Premium: W__ urn Premium ..... ..... $0 ................ :it $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations on behalf of the additional insured(s) at the for the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted other than another contractor or by law; and subcontractor engaged in performing 2. If coverage provided to the additional insured operations for a principal as a part of the is required by a contract or agreement, the same project. insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CG 2010 12 19 © Insurance Services Office, Inc., 2018 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100391856-0 08/17/2025 12:01AM at the Named A C D D Inc Insured address shown on the Declarations ... ...._...� _--------- .mm Premium: Return Premium $ 0 ..... .«h� ��.. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100391856-0 08/17/2025 12:01AM at the Named A C D D Inc Insured address shown on the Declarations ..... _.. Additional Premi.um Return Premium: This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE ENVIRONMENTAL CONTRACTING AND PROFESSIONAL SERVICES LIABILITY COVERAGE PRODUCTS POLLUTION LIABILITY COVERAGE PREMISES ENVIRONMENTAL LIABILITY INSURANCE COVERAGE ENVIRONMENTAL COMBINED LIABILITY POLICY - ALL COVERAGE PARTS The insurance provided to Additional Insureds shall be excess with respect to any other valid and collectible insurance available to the Additional Insured unless the written contract specifically requires that this insurance apply on a primary and non-contributory basis, in which case this insurance shall be primary and non-contributory. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED„ CA55003 0717 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY„ WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -BLANKET Attached To and Forming Part of Policy Effective Date of Endorsement Named Insuredry 0100391856-0 08/17/2025 12:01AM at the Named A C D D Inc Insured address shown on the Declarations .................... .. ._.. _ .. .. ...... IAdditional Premium: Return Premium ��„�,z�s$0rrr�� RRR� $0 1,- This endorsement endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE SECTION IV — CONDITIONS, 8. Transfer of Rights of Recovery against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against persons or organizations because of payments we make for injury or damage arising out of "your work" done under a written contract with that person or organization wherein you have agreed to provide this waiver. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS4002 0110 Page 1 of 1 A C4 A�'Y� ,L✓ DATE CERTIFICATE OF LIABILITY INSURANCE o212712026 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 Juan Flores NA ONGUARD INSURANCE SERVICES PHONE" jiA _ 217 E ALAMEDA AVE STE 211 (#IMAR sd)— ._ w_N J. 1987 800 722 3391818 200 0461 818 760 EMAIL hicle@kemper com BURBANK, CA 91502-2693 ADiDR9;L% commeraal. _,. _ _ ,.1, -- . (S) AFFORDING COVERAGE NAIC# ... ..,.._ _ ................ INSURER... ...... ...,..,,..,,_--.__ ...,....._.�._. ........_._...... iuenoao e• Infinity Select Insurance Company 20260 INSURED INSURER B: ACDD, Inc. 8443 FOOTHILL BLVD _IN..SPRE,R.-Ci SUNLAND, CA 91040 wlvs,uRER,oa INSURER E: COVERAGES CERTIFICATE NUMBER: mrVialvry Nuryior-ma 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. INSRLTR ADDL I SUBR I POLICY EFF I POLICY EXP t TYPE OF INSURANCE INSD I, WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY _ LIMITS COMMERCIAL GENERAL LIA51LITY OCCURRENCE CLAIMS -MADE [ If OCCUR ,EACH �.�$-,.,,, ..,„„. ......... DAMAGE TO RENTED v9 .J r�rCt�sr'grmCe„p �$ MEDD EMXPSAEn ( ny one person? $ '{ ..............�...., . PERSONAL 8 ADV INJURY $ AGGREGATE LIMIT APPLIES PER: I GEN'L AG ENERAL A G GGREGATE„ .. ., r�jl uy POLICY JCCq L.OG' PRODUCTS COMP.,, ...... �.' ....�$ .mm,m I OTWER'.; �..... _. ... SINGLE LIMIT1,000 000 " A TOMOBILE LIABILITYAUTOMOBILE r 1 l.. , 50015558101 09l26/2025 09 28 202 Ea aBINED I �$ ,U .. _. _ ..�ANY AUTO �-B NJ URY (Pergerson) �$ OWNED-'-'"" SCHEDULED X F 160DILY INJURY (Peraccldentj $ AUTOS ONLY ... AUTOS HIRED NON -OWNED PROPERTY DAMAGE �.(Per acc�deotj ......, AUTOS ONLY ., AUTOS ONLY ......- ..$$..._. ................ UMBRELLA OCCURURRENCE .EACH .�AGGREGAT. OCC 1$.. ......m.. _ E S LIABIA9 CLAIMS -MADE �....... E ..... v �$ ,. ..... - _,..� it $ DED RETENTION $ WORKERS COMPENSATION EMPLOYERS' LIABILITY YIN _� f I � O7H PER ER f STATUTE I, ANY ROPRIIETOR/PA TNER/EXECUTIVE ❑ LEACH ACCIDENT $ E — OFFICER/MEMBER EXCLUDED? N/A (Mandatory to NH) _E L DISEASE EA EMPLOYEE $ , I& yyw:s, dcsCrib under I E.L. DISEASE POLICY LIMIT �$ „ D[:SCRIPTIO,N OF OPERATIONS below W DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Project Number: Vehicle: The City of El Segundo, its officials, and employees are named additional insureds per attached endorsement City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD KEMPER A �}O Kemper Auto Commercial /`1 l 11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 353-6737 ADDITIONAL NAMED INSURED ENDORSEMENT City of El Segundo 350 Main St El Segundo, CA 90245 50015558101 � 09/28/2026 12:01 a.m. ACDD, Inc. This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. Additional Insured City of El Segundo Part A - Liability Coverage, is changed as follows: The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability. The insurance provided by this endorsement will be excess over any other valid and collectible insurance. All other parts of this Policy remain unchanged. ADDL INSURED COPY AMEND DATE: 02/27/2026 50461AIS01 ENDORSEMENT : 7-6 KEMPE'RAuto COMMERCIAL Customer Service: (800) 722-3391 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 PRIMARY AND NONCONTRIBUTORY ENDORSEMENT 50015558101 1 09/28/2026 12:01 a.m. City of El Segundo 350 Main St El Segundo, CA 90245 ACDD, Inc. This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only if Form Number 500PNCV01 appears on your Declarations Page. This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A — LIABILITY COVERAGE OTHER INSURANCE — PART A ONLY The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. You have agreed in writing in a contractor agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b. Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. ADDL INSURED COPY AMEND DATE: 02/27/2026 500PNCV01 ENDORSEMENT : 7-6 KE PERAuto Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 353-6737 WAIVER OF SUBROGATION 50015558101 f 09/28/2026 12:01 a.m. City of El Segundo 350 Main Sti// El Segundo, CA 90245 ACDD, Inc. This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. In return for your premium payment shown below, we agree that our rights of subrogation or rights of recovery under the policy will not apply against the following person or organization: City of El Segundo (name of person or organization) Additional premium in the amount of $25.00 will be retained by us regardless of any early termination of this endorsement or the policy. All other policy provisions remain unchanged. ADDL INSURED COPY AMEND DATE: 02/27/2026 50461 SWF01 ENDORSEMENT : 7-6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 11 /1 /2025 Policy No. TES4699149 Endorsement No. 0 Insured A C D D, Inc(A Corp.) Insurance Company Technology Insurance Company, Inc. Countersigned by ......... -... WC 04 03 06 (Ed. 04-84)