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PROOF OF INSURANCE (2017 - 2017) CLOSED MAGEL-1 OP ID: DL A`ORO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/15/2017 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 _ CONTACT Bruce Gendelman Co.,Inc. NAMIE; Diane Larson Suite 101 alp,C.Ilz 262-478-1000 FAX, -478-1001 Nay:262-478-1001 500 W Brown Deer Rd ip JREss�dlarson@gendelman.com Milwaukee,WI 53217 INSURERS)AFFORD)NG COVERAGE NAIC p INSURER A:Mount Vernon Fire Insurance Co 26522 INSURED Magellan Advisors,LLC INSURER B:Transportation Ins.Co. 20494 Mr.John Honker INSURER c:US Liability Insurance Company 25895 1000 South Pointe Drive,#703 Miami Beach, FL 33139 I INSURER D: INSURER E; INSURER F: COVERAGES 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. --.. CE yA_ � VD. POLICY NUMBER PMEOM�'DOY1fYY, PLI'CYEKP� f ... CMWOOfYYYY! LIMITS 4 S TYPE OF INSURANCE (, COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00; CLAIMS-MADE I X I occuR X PPP2550445 04/12/2016 04/1212017 DAMAar ( HEWED, I $ 300,00 X Hired&Non Owned PPP2550445 04/12/2017 04/12/2018 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L,AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,0100,000 X POLICY JECT j LOC PRODUCTS-COMPlOP AGG $ Include O"IVi6:1N: I H&NOA 1$ Included AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1$ h ANY AUTO SEE ABOVE BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ (AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMiAR'a17 HIRED AUTOS (AUTOS (Persccidong $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,0'00,00'0 C X EXCESS LIAR I CLAIAwSWACE XL1561356B 09/06/2016 09/06/2017 AGGREGATE $ 100,000 DIED I X I I'tE1E'ATIf'NS 0 $ B OFFICEOPRIETERIEXCLUD/E ECUTIVE �,N„',� N/A X WC585214092 07/01/2016 ._L EACH l _J OTI-°Y�N WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY 07/01/2017 E L EACH ACCIDENT $ 500,000 (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ 5001,000 IE yos describe undor n� '$4:RTIl"'o Iia;7N R:oP OI''II&AI"hC7NS badt:w' E L DISEASE-POLICY LIMIT $, 500,000 A ('TECH PROFESSIONAL PPP2550445 04112/2016 04/12/2017 EA CLAIM 5,000,0001 LIABILITY PPP2550445 04/12/2017 0411212018 ANNL AGGR 5,000,00011 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace is required) The Certificate Holder is included as an Additional Insured under eneral liability coverage as required by written contract and per form L7'1f (02-11 attached, A Waiver of Subrogation applies under the Workers Compensa'ti'on coverage. (CERTIFICATE HOLDER CANCELLATION CITEL01 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 El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved„ ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD UNITED STATES LIABILITY INSURANCE GROUP WAYNE, PENNSYLVANIA This endarsenient mo difies insura=provided under the(011Gwing:- COMMEIZCIAL GENE,RAL LIABILITY COVE,RAGE FORM BLANKET ADDITIONAL INSURED ENDORSEMENT Section 11—Who Is An Insured is amended to include as an additional insured any pmrson(s)or for whom you avc perlbrining"your woo k"°under a written contract or agreentent, that requires wch person(s)or org;fliization(s)to be added as an additional insured on your policy. is an additional insured only with rQsl)ect to liability k)r"bodily injury"", "property(Ianiat ",or"punK)nal and advo-tising injury"Occurring after the effective(late ol'such contiaQt or agreellient Illat is caused, ill Whole or ill part lay; 1) Your acts or omissions;or 2) The acts or omissions of those acting on your behalf, in the performance of "your work"for the additional insured. Coverage for an additional insured under this endorsement ends when"your work" for that additional insured ends or is put to its intended use by any person or organization. EXCLUSIONS There is no coverage under this endorsement for loss or expense, including but not limited to the cost of defense for"bodily injury","property damage'or"personal and advertising injury" occurring: 1) After all of"your work",inchiding nimerials,parts or equipment Wrnished in connection with"Your work"and performed under the above referenced written,contract(s)or agreements)has ended; or 2) When that portion of"your work"out of which the"bodily injury","property damage" or "personal and advertising injury"arises and performed under the above referenced written contract(s)or a V� cenient(s) has been put (o its intended use by any Person or organization; whichever occurs first. All other terms and conditions of this policy remain unchanged. This endorsement is a part of your policy and takes effect on the effective date o[your policy unless another effective date is shown. 1, 712(02-11) Page I of 1