SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
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. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2016 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
1,000,000 1000068067261 1,000,000 LOS-002288075-22 1,000,000 X 25674 Irvine, CA 92614
N
X
Comp/Coll Deductibles BI & PD Ded. $25,000 07/01/2026 07/01/2027 07/01/2026 BA-1N96406A-26-CAG Errors & Omissions-Claims Made B 2,000,000 *See Acord 101 for GL XS 1,000,000 Travelers Property Casualty Co. of America 1,000,000 X C
X
1,000 06/29/2026 07/01/2026 5,000,000 The City of Redondo Beach, its officers, elected, and appointed officials, employees, and volunteers are included as additional insured (except workers’ compensation) where required by written contract. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability. X Contractors Pollution Redondo Beach, CA 90277 City of Redondo Beach X
A
HDI Global Specialty SE CN115158923--01-26-27 Each Claim/Aggregate 10,000 07/01/2027 1,000,000 Retro Date: 7/1/2012 2,000,000 13604 1,000,000 1,000,000 07/01/2027 UB-7K728676-26-43-G 17901 Von Karman Avenue, Suite 1100 Marsh Risk & Insurance Services
(949) 399-5800; License #0437153
Attn: [email protected]/F: 212-948-4323 3 MacArthur Place, Suite 1100 PlaceWorks, Inc
Santa Ana, CA 92707 FRS-H-P-PL-00013383-02 07/01/2026 415 Diamond Street B
07/01/2027 Starr Surplus Lines Insurance Company
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
2 2
Aggregate Limit: $5,000,000� Per Occurrence Limit: $5,000,000� Irvine Carrier: Starr Surplus Lines Insurance Company � Policy: 1000338168261 � Expiration Date:07/01/2027 � Effective Date:07/01/2026 � Subject to policy terms, conditions, limitations and exclusions.� ��Excess General Liability� Certificate of Liability Insurance CN115158923 Marsh Risk & Insurance Services� 3 MacArthur Place, Suite 1100� PlaceWorks, Inc� Santa Ana, CA 92707 25
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF B. BLANKET ADDITIONAL INSURED USE - INCREASED LIMIT
C EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE - TRANSPORTATION • EXPENSES - INCREASED LIMIT D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS - INCREASED
LIMITS
F. HIRED AUTO - LIMITED WORLDWIDE COVERAGE - INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE - GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II - COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form during the policy period over which you maintain 50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A. 1 .,
Who Is An Insured, of SECTION II - COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an additional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured''
under the Who ls An Insured provision contained
in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A. 1 ..
Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name with your permission, while performing
duties related to the conduct of your business.
2. The following replaces Paragraph b. in S.S.,
Other Insurance, of SECTION IV - BUSINESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name. with your
CA T3 53 0215 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy Number: BA-1N96406A-26-CAG
Effective Date: 07/01/2026
SL 780 (04/12) Page 1 of 1
Copyright © Starr Surplus Lines Insurance Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS
- SCHEDULED PERSON OR ORGANIZATION
Policy Number: 1000068067261 Effective Date: 07/01/2026 at 12:01 A.M.
Named Insured: Placeworks, Inc.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
Where required by written contract or agreement.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) A. SECTION II -WHO IS AN INSURED is amended to include as an insured; The person or organization shown in the schedule, but only with respect to liability arising out of your ongoing operations performed for that additional insured.
B. With respect to the insurance afforded to these additional insureds,
SECTION I- COVERAGES, COVERAGE A - BODILY INJURY AND
PROPERTY DAMAGE LIABILITY, 2. -Exclusions, is amended to include the following additional exclusion;
This insurance does not apply to "bodily injury" or "property damage" occurring after:
(1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or,
(2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
All other terms and conditions remain unchanged.
COMMERCIAL GENERAL LIABILITY
SSGL-0288 02 24
Copyright © Starr Surplus Lines Insurance Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
SSGL-0288 02 24 Page 1 of 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED, PRIMARY AND NONCONTRIBUTORY AND
WAIVER OF SUBROGATION AMENDATORY ENDORSEMENT
Policy Number: 1000068067261 Effective Date: 07/01/2026 at 12:01 A.M.
Named Insured: Placeworks, Inc.
This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully.
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
It is hereby agreed as follows:
1. SECTION II - WHO IS AN INSURED is amended to include the following:
a. Any person(s) or organization(s) that you are required to include as an additional insured under this policy by written contract or written agreement or that is listed in the SCHEDULE above is an additional insured under this policy. Such additional insured status applies only with respect to liability arising out of “your work” for or on behalf of that person(s) or organization(s) pursuant to such written contract or written agreement.
However, the insurance afforded to such additional insured(s):
(1) only applies to the extent permitted by law; and
(2) will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured(s).
b. With respect to the insurance afforded to the additional insured(s), SECTION III – LIMITS OF INSURANCE is amended to include the following:
The most we will pay on behalf of the additional insured(s) 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.
2. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance is amended to Where Required By Written Contract
Name Of Person(s) Or Organization(s):
Copyright © Starr Surplus Lines Insurance Company. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
SSGL-0288 02 24 Page 2 of 2
include the following, which supersedes any provision to the contrary:
Primary And Noncontributory Insurance
This insurance is primary to, and will not seek contribution from, any other insurance available to an additional insured under your policy provided that:
a. The additional insured is a Named Insured under such other insurance; and b. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
3. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include the following:
We waive any right of recovery against any person or organization, because of any payment we make under this policy, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss.
All other terms and conditions of the policy remain unchanged.