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PROOF OF INSURANCE (2020 - 2020) CLOSEDALOHDOO-01 POSORNIO � 10 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDMMIDDIYYYY) 9 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 M CgNTEJtCT Olson Duncan Insurance Service Inc. AA 25550 Hawthorne Blvd. Suite 203 (A/CNNo, Ext): (310) 373-6441 FAX Nol:(310) 378-5336 Torrance, CA 90505 E Al ss+ Ins,@olsonduncan.com INSURED Aloha Doors, Inc. 214 Main St #119 EI Segundo, CA 90245 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Voyager Indemnity Ins Co 40428 INSURERS: California Auto Insurance 38342 INSURERC:State Comp Ins_Fund 35076 INSURER D: INSURER E I INSURER F: COVERAGES CERTIFICATE NUMBER: RE'VISIO'N 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 'OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ..._.... ......... _ ........ .INSR �T.SUBR'� POLICY EFF I POLICY EXP' R INSD POLICY NUMBER LIMITS TYPE OF INSURANCE A X COMMERCIAL GENERAL LIABILITY 11fd4 EACH OCCURRENCE $ 2,000,000 WVD� IMM YYl @M..r IYYY.S �J CLAIMS -MADE I ^ I OCCUR IAMWO024357 3/1412019 3/14/2020 DAMAGE To RENTED 50,000 PRFMISES (Ea QC,CUJNr ',r1W $ _MED EXP (Any one person) $ 6,0001 PERSONAL BADV INJURY $ 1,000,000, AG'GREGAT'E LIMIT APPLIES PER* ! GENERAL AGGREGATE 1$ 2,000,000 -GEN1 POLICY PRO- ❑LOC JECT ,PRODUCTS -COMP/OP AGG , $ 2,000,000 OTHER' I S S AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT 1 1,1100,000 t�"rVtlanlp................................................... ANY AUTO BA040000054325 8!13!2019 8/1312020 ,BODILY INJURY (Per person) $ „ OWNED SCHEDULED X AUTOS ONLY AUTOS Y INJURY (Per accident) $ BODILY X AUTOS ONLY X AUUTOS ONLY PROPERTY Or ck1en,ImAMA4`iE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED I II RETENTION $ ($ C WORKERS COMPENSATION X PER OTH STATLITF FR AND EMPLOYERS' LIABILITY Y d N 9253884 ANY ECUTIVE 5/15/2019 5/15/2020 1,000,000 E L EACH ACCIDENT OFFICERIMEMBERIEXCLUDR/E � I N/A $ (Mandatory In NH) E L, DISEASE - EA EMPLOYEE'- $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional RemaAu Schedule, may be attached if more apace is required) With regard to general liability The City of EI Segundo, its officers, officials, employees, agents, and volunteers are named as additional insured, per the attached CG20330413, if required by contract, with regard to ongoing operations. Certificate holder is additional insured per attached CG 20 37 04 13, with regard to completed operations, if required by contract. Coverage is primary and non contributory. Waiver of subrogation in favor of named insured, if required by contract per attached CG24040509. Policy terms apply WC waiver of subrogation in favor of named insured, per attached 10217. Policy terms apply. 30 notice of cancelation; 10 days for non terms apply. payment; policy C'E'RTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ci of EI Segundo City 9 ACCORDANCE WITH THE POLICY PROVISIONS. 350 Man Street EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.,. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AMW 0024357 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As designated in written contract with the Named Insured for Commercial Work Only I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU 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 person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 2. 'Bodily injury" or "property damage" occurring after: a. 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 location of the covered operations has been completed; or b. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 C Insurance Services Office, Inc., 2012 CG 20 33 04 13 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and 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: (1) The additional insured is a Named Insured under such other insurance; and (2) 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. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: AMW 0024357 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As designated in written contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations, The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 C Insurance Services Office, Inc., 2008 Page 1 of 1 13 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE BROKER COPY 9253994-19 NEW Sc 8-71-41-05 PAGE 1 OF 1 AT 12:01 AM PACIFIC EFFECTIVE JULY 16, 2019 AT 12.01 A.M. STANDARD TIME THE TIME INDICATED ATT � AND EXPIRING MAY 15 2020 AT 12.01 A.M. PACIFIC STANDARD TIME ALOHA DOORS, INC. 214 MAIN ST EL SEGUNDO, CA 90245 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, ALOHA DOORS, INC. IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO, AUTHORIZED REPRESEI'JT IVE SCIF FORM 10217 (REV.7-2014) JULY 18, 2019 2570 PRESIDENT AND CEO OLD DP 217 BROKER COPY 9253994-19 NEW Sc PLEASE KEEP THIS ENDORSEMENT WITH YOUR POLICY Dear Policyholder: These endorsements amend and are part of your policy. Please keep them with your documents for future reference. If you have any questions concerning these endorsements, Please contact your local State Fund office.