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PROOF OF INSURANCE (2020 - 2020) CLOSEDGVPVE-1 OP ID. 'DN . CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)07/09/2019 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 916-773-3800 c NTA11 CT D 11 ian11 ne Nielsen 2266 Lava Ridge Court Ste 200 4 , No, Ext): 6-773-3800 FAX Ne).916-77 p ONE dntel 3-4484 P.O. Box 61 0150 ey Ins. P..... 'ss: 191 e......@ ..................'.com L............... _.................._...................... Roseville, CA 95661-9050 sen Isuors„.._„mm� Bruce Winning INSURERIS A) FFQRDING C VERA E,........ITITITITITIT................ NAIL INSURER A: Philadelphia Insurance Compan 18058 ..INSURED -................................................................................................. ......... ............................ INSURER 8: Hartford Insurance Group 22357 GVP Ventures Inc. . `cayesociates wc....S.....e....n.......t..i..n......e.....l..in.s..u.....rance..Company... �.........y_L....t...d 11000�ekGd280 RoseviA 95691 JNsuRER.... 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 'ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH DOLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS. .�._....._.._.._....�.................... I,NS SUBR .....,_........,....m ........ ...... ,PICEFF OL POLICY NUMBER OF INSURANCE , dh( 1�t=YYYYt LIMITSTYPE I C X COMMERCIAL GENERAL LIABILITY EACkOCCURRENCE $ 2,.0...0..0,0.0......0.... CLAIMS -MADE OCCUR X X 57SBABG7707 06/16/2019 06/16/2020TO RENTED D=%1 $ ,1000 ................................ A ... .......... 0,000 .................ADDL X Professional E&O PHSD1452561 07/10/2019 07/10/2020 PERSONAL BAOV,INJP,RX_, ,, J, 2,000,000 4,000,00 GEN'L AGGREGATE LIMIT APPLIES PER, P _ GENERAL AGGREGATE ...................... .w,,,,,,,,,,,,,,,,,,•,,,..... X I POLICY �m.......ml PRO- LOC PRODUCTS - OMP/OP AGG 4,000,000, JECT OTHER. E&O — _ , 1 ,00,000 C COMBINED'SiNGLE LIMIT 2,000 000 AUTOMOBILE LIABILITY ..tt�Gdnq,1 ' ANY AUTO X „mBO,DILY INJURY (Per Derson)__�s 2,000,000 OWNED AUTOS ONLY SCHEDULED AUTOS BOC�,I„ITY I,NJURX Par acidenl L $ ED X AUTOS p AUOTOS i?me IRd� N IkMAG........ $ ONLY u...X.... SW ...........------... $ UMBRELLA LIAB OCCUR EA ,H_0.._CURRENCE.w.... G , „� , $ EXCESS LIABCLAIMS-MADE... AGGREGATE .......................................... $ DED � � RETENTION $ $ B WORKERS COMPENSATION X STATtITF l OTH- AND EMPLOYERS' LIABILITY YIN N 57WBCGG0320 06/16/207 9 06116/2020 X I.. __ EACH ERP RTNER E ECUTIVE N / A I ACCs DENT ..........mmom ............. ROPRIE OFF CPROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH) ' E L DISEASE - EA EMPLOYEE,$ 1,000,000, ,000,000 m,,,,,,___,,,,,,, If yes, describe under ___„_ E,ggf J,PTIQN OFOPER iS b� -._ E L. DISEASE -POLICY LIMIT $ 1,000,000' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Executive recruitment for CiManagger The City o Official El Segundo Its Officiand Employees are included as additional insured(s) as required by written contract per the attached endorsement(s). Coveraa Is primary and waiver of subrogation applies per attached endorsements? +r i3[a�'Ilni�'1•+3�r7�1r7 City of EI Segundo Attn: City Attorney's Office 350 Main Street EI Segundo, CA 90245 ACORD 25 (2016/03) ELSEG-1 r M0144 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 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GVPVE-1 . CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/04/2019 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(les) 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 916-773-3800 c "CT Dianne Nielsen 2266 ava Ridge Court Ste 200 ((A//C, No, Ext); 916-773-3800 _..................... �, FAX , NO)1916-773 484 .. Roseville, .. le, CA 95661-9050 dnlefser...... s cotta Bruce Winning P.O. Box 619050R .S n .................. _.........(N:.".UR BtI R17,19Vta._CQyERAGE .................N,nl p:__ INSURER A : Philadelphia Insurance Comoan 18058 ......... N ............... _ __._...................................._._._............... • X y..Y 7 INSURED I, SURERB : Groupord Insurance .......................... GVP Ventures Inc. Sent nel Insurance Com an Ltd 11000 ............. 5 A: Bob & A s208ciiates �Nsu.R€.! . ................. Murrayy INsuRB o.. osevi e, A 956tr11 ___ INSURER INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION N'U'MBER: 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 'ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 3OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -W POLICY NUMBER L 2,000,000 TYPE OF INSURANCE I� ADDL SU R POLICY EFF POLICY EXP LIMITS IMSD lw 1 . X LIABILITY EACH OCCURRENCE $ CIX COMMERCIAL OCCUR X X 57SBABG7707 06/16/2019 06/16/2020 DAMAPREGE $ 1,000,000 DAMAGE TO RENTEDD A Professional E&O PHSD1363791 07/10/2018 07/10/2019 MED EXP (Any one oerson) $ 10,000 X Clms Made GE'N'L AGGREGATE LIMIT APPLIES PER: X..� POLICY CT LOC OTHER, C AUTOMOBILE LIABILITY ANY AUTO X OWNED SCHEDULED AUTOS ONLY AUTOS W D X AM$ ONLY X., AC�7OS 41 N1 q UMBRELLA LIAB I OCCUR EXCESS LIAB _[ CLAIMS -MADE W..........�., ....___.......— DED RETENTION $ B MPENSATION AND EMPLORKERS YERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE (OFFF CER///ry n NH) EXCLUDED? N / A If yes, describe under DESCRIPTION OF OPERATIONS below _ PHSD1363791 07/10/2018 57SBABG7707 X 57WBCGG0320 07/10/2019 PERSONAL & ADV INJURY _.....$ XY4........................'..........0 — 0,000 GENERALAGGREGATE $ 4,000,000 �..NoQUCTs_-m�mm..... .. 000, _ 00 4 0 0 Prof.. .OMP,/OP„AGG $ _. .� of Liab $ 1,000,000 COMBINED SINGLE LIMIT (EA.dfpG9deIltd............................................. 06/16/2019 06/16/2020 BODILY,I,NJURY,,,(P,er„persanl,, $ 06/16/2019 06/16/2020 BODILY INJURY�Per aocidant,)„m,$ PROPERTY DAMAGE (Per accident) $ EACH OCCURRENCE,...... AGGREGATE $...... V 2,000,0001 X...I.5TATUTE I °R” E L. EACH ACCIDENT $ 1,000,000 C ^ � ................. E L D A FOLI e,(DISEASE E-EA,EMPLOYEE _...._ ....................1,000,000 ,0 , OO ...Y LIMIT 1$ 1.• ' -. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Executive recruitment for CiMana e'r The City of EI Segundo its Offiela s and Omployees are included as additional Insured(s) as required by Written contract per the attached endorsement(s). Coverage is primary and Waiver of subrogation applies per attached endorsements) Il�lt �[�i"�it�f[waRw3�7 ELSEG-1 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of EI Segundo Attn: City Attorney's Office 350 Main Street AUTHORIZED REPRESENTATIVE EI Segundo, CA 90245 11 I ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLIOYNUMBBIL, S G77oi COMMERCIAL GENERAL LIABILITY MIS EMORSMENT+CHA S THE POUC `. PLWE READ ITCAREFULLY. AMITIONAL,INSURED - DESIGNATED PERSON OR ORGANZAVON This atlontem 1n1tmod18es Insurance proMed under he fo p: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1719iEI1114 Rms of Pwan or Orin can The City of EI Segundo its Officials and Employees RE: Executive recruitment for City Manager (If no entryeppeers above, InlbanaHon required to oomplde wls sndorseneint will be shown In dwDsolaradons as oppibable to this sndumomsnt.) WHO 18 AN INSURED (Beaton II) Is amended In IsMude as on Msursd the ponan or orgnisedon shown In Use 80Wuts n on Insured but only vdth rsspeot b Iddly arising out of your opersildne or promises Owned by or ranted to you. CG 20 2811185 Copyrights Insurssos gervless Ofks, Inc, 1984 POLICY NUMBER.- 57SBA8077707 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. a1 IT, 11 ki k 11*1 J4010101111 Is This endorsement moclfies Insurance provided under the fokwing: GONNERGIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Nasse of Person or Organhation: The City of EI Segundo its Officials and Employees RE: Executive recruitment for City Manager (if no entry appears above, Information required to complete this endorsement wig be shown in the Declarations as applicable to this endorsement. With respect to insurance provided to the person or organization shown in the Schedule of this Endorsernent, Condition 4. Other Insurance Is replaced by the following: 4. Other Insurance. If other valid and oolleatlble Insurance is available for a loss we cover under Coverages A and B of Ws Coverage Part, our obilgatione ere limiled as follows: a. Primary Insurance This Insurance Is primary and we will not seek contribution from other Insurance available to the person or organization shown In the Schedule of this endorsement except when b. below applies. b. Excess Insurance This Insurance Is onset over any of lire other imurance whether primary, excess, contingent or on any otfser balls: Form INC 24 08 11 94 (1) That Is Fire, Extended Coverage, Builderls Risk, Installdon Risk or similar oaverage for *your work;" (2) That Is Fire Insurance Tor prernlees rented to you: or (3) If the loss arises out of the maintenance or use of or roraff, "autos" or watercraft to the extent not subject to Exclusion C. of Covempe A (Section I). When this irssurence is excess, we will have no duty under Coverage A or B to defend any claim or "suit` that any other insurer has a duty to defend. If no other insurer defends, we will undertake to do so, but we will be entitled b the insureds rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, I any. that exceeds the sum of: 0 1985 The Hartford Insurance Croup (Includes copyrighted material cf Insurance Services ONce Pager a oil (1) The total amount that all such other insurance would pay for the lose In tftQ absence of this Insurance; and (2) The total of all doduotible and self-insured amounts under all that other irwurance. We will share the remaining loss, if any, with any other Insurance that Is not described In N Exam Insuranoe provisions and was not bought specifically to apply In excess of the Limits of Insurance shown In the Declarations of ft Coverage Palm. c. Method of Sharing If all of the Wer insurance peva is contribullon by equal shares, we will %flow this Welhod also. Under this approach each insurer contributes equal amounts until fi has paid Its applicable llmit of insurance or none of the loss remains, whidever comes first. If any of the other insurance does not permit conkibullon by equal stages, we will contribute by IhWts_ Under this mollhod, each insur'er's share Is based on the ratio of Its anAuable limit of Insurance to ft total appilcable limits of Insurance of all insurers. Page 2 of 2 Fort HC 24 08 11 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM We waive any right of recovery we may have against: 1. Any person or organization shown in the Declarations, or 2. Any person or organization with whom you have a contract that requires such waiver. Form SS 12 15 03 00 0 2000, The Hartford Page 1 of 1 57SBAEG7707 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. �iM01111 This policy is sLtjw to the foflowving additional c4nmors: A, a. if this PI IS cancelled by 1he Gompany, other than for non-payment of premium, notice of such cancellation w0l be provident at loess thirty (30) days In advance of the canceflation effective date to the certificate holder(s) with mailing addresses on fie with the agent of record or the Company. If this policy Is cancelled by the company for non- payment of premium, or by the insured, notice of such cancellation wli be provided wdthln ten (10) days of the cancellation effeoUve date to the certificate holder($) with mailing addresm on file with the agent of record or the Company. If notice Is madded, proof of mailing to the last known malling address of the certificate hodder(g) on fide with the agent of record or die Company will be sufficient Proof of notice. Any notification provided by this endorsement apply only to motive c ertificab h r(s) who, were Issued a oertifloate of insurance applicable to this policy's term. Failure to provide such notice,to ft certittcals holcler(s) Will not armwW or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall Impose no Ilabdlity of any kind upon the Company or its agerb or representatives. Form SS 12 23 0619 Page 1 of 1 0 2011, The Hartford THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) Policy Number: 57 WBC GG0320 Endorsement Number: Effective Date: 06/16/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: GVP VENTURES INC., 1544 EUREKA RD STE 280 ROSEVILLE CA 95661 This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for non-payment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for non-payment of premium, or by the insured, notice of such cancellation will be provided within ten (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. Form WC 99 03 94 Printed in U.S.A. Process Date: 05/07/19 Policy Expiration Date: 06/16/20 0 2011, The Hartford THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 57 WBC GG0320 Endorsement Number: Effective Date: 06/16/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: GVP VENTURES INC., 1544 EUREKA RD STE 280 ROSEVILLE CA 95661 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 from whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by Authodzed Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 05/07/19 Policy Expiration Date: 06/16/20