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PROOF OF INSURANCE (2020) CLOSEDClient#: 422600 TAITASSOC ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/27/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER kAMEACT Yen Dang Marsh & McLennan Agency LLC PHONE No. E,,,,: 949-362-2209 (AX No); Marsh & McLennan Ins. Agency LLC E-MAIL OCCerIs@MarshMMA.com 1 Polaris Way #300 Lic# OH 18131 AQQI1-ss. """"""""""'� INSURER(S) AFFORDING COVERAGE NAIC # Aliso Viejo, CA 92656 INSURER A: AXIS Surplus Insurance Company 26620 INSURED Tait & Associates, Inc. Tait Environmental Services, Inc. 701 N. Parkcenter Drive Santa Ana, CA 92705 COVERAGES CERTIFICATE NUMBER: INSURER B INSURER C : INSURER D: 1111---.1111111111 .............. INSURER E: INSURER F: 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 CONTRACTOR 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. Y 601................................................................................................................ .. ADDLSUBR OF INSURANCE l.Rr?�%�....__.%'�..........-1111., POLICY NUM w..-_............._...... ER�09/01/209 LIMITS .........a AR GENERAL LIABILITY 1 SP002747032019 09/OD202a EACH OCCURRENCE $2TYPE 000..X000 ��MERCIAL CLAIMS -MADE � OCCUR DAMqGE TO RENTED I PREMISES (Ea occurrence) ....................................... $50,000 X Professional Liab MED EXP (Any one person) $5,000 X„ Pollution Liab PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I. -GENERAL AGGREGATE $2,000,000 POLICY JECOTLOC PRODUCTS - COMP/OPAGG $2,000,000 OTHER: Deductible $$10,000 AUTOMOBILE LIABILITY wMBINeD SINGLE LIMIT E�a ace 1111... $ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) __ _ $ _ HIRED NON -OWNED PROPERTY D4MAGE $ AUTOS ONLY AUTOS ONLY (Per accident) A UMBRELLA LIAB X OCCUR SX002748032019 09/01/2019 09/01/202 EACH OCCURRENCE $9,000,000 X EXCESS LIAB X E..........................................._-�... CLAIMS -MADE *Follows Form 1 AGGREGATE $9,000,000 ......._................ ................. DEQ...........: kL...RE:PCJT;%.01N.:?mo WORKERS COMPENSATION .$ 0T . LIABILITY YIN ER................ E ..........H .. ....-.....m. APROPRIETOR/PARTNER/EXECUTIVE F A E1 T $ OFFICER/MEMBER EXCLUDED? N/A 11.1.1..................,......................_..-..-.. --_1_1_._1_..1_........_....... (Mandatory in NH E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ 1111, 1111 1111, ., DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) *Professional Liability is Claims -Made coverage* City of EI Segundo, its officials, and employees are named as Additional Insured per the attached. Insurance is Primary and Non -Contributory. Cancellation provisions apply per the attached. CERTIFICATE HOLDER L+#7 [+644W11111141rI City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 314 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE I 6� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S4579426/M4272721 WOSEF INSURED: Tait & Associates, Inc. POLICY PERIOD: 09/01/2019 POLICY #: SP002747032019 TO: 09/01/2020 ADDITIONAL INSURED/PRIMARY COVERAGE INCLUDING COMPLETED OPERATIONS (CGL & CONTRACTORS POLLUTION COVERAGE) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the Specialty Package Policy. In consideration of the premium charged, it is agreed that: SECTION III — WHO IS AN INSURED is amended to include as an Additional Insured the person or organization shown in the schedule below as respects Coverages A, B and D, but only for liability arising out of Your Work or Covered Operations performed by you or on your behalf for that Additional Insured and not due to any actual or alleged independent liability of said Additional Insured. This endorsement does not apply to Bodily Injury. Property Damage or Loss arising out of the sole negligence or willful conduct of, or for defects in design furnished by the Additional Insured. As respects the coverage afforded the Additional Insured, this insurance is primary and non-contributory where a written contract or written agreement in effect prior to any related Claim requires you to provide such coverage. When this insurance is primary and non-contributory, our obligations are not affected by any other insurance carried directly by such additional insured whether it is primary or excess coverage. However, regardless of the provisions above: We will not extend any insurance coverage to the additional Insured person or organization: (1) That is not provided to you in this Policy; or (2) That is broader coverage than you are required to provide to the additional Insured person or organization in the written contract or written agreement. This endorsement does not increase the Company's Limits of Insurance as specified in the Declarations of the Policy. SCHEDULE OF ADDITIONAL INSUREDS As required by written contract in effect prior to any related Claim SPP 0024 (Ed. 06 12) Page 1 of 1 INSURED: Tait & Associates, Inc. POLICY #: SP002747032019 Policy Number: SP002747032019 Insured Name: Tait & Associates, Inc. POLICY PERIOD: 09/01/2019 TO: 09/01/2020 ENDORSEMENT - NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS THIS ENDORSEMENT MODIFIES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the SPECIALTY PACKAGE POLICY. In consideration of the premium charged, it is agreed that in the event you or we cancel this Policy prior to the expiration date, we will endeavor to provide a thirty (30) day notice of such cancellation to certificate holders, provided that: 1. you are under an existing contractual obligation to notify such certificate holders when this Policy is cancelled; and 2. you have provided the following to us, either directly or indirectly, through your broker of record: a. The name of the entity shown on the certificate; and b. The address of such entity where notification may be mailed. We shall not provide a thirty (30) day notice if the cancellation is due to nonpayment of premium to us or to a finance company authorized to cancel the Policy. Such notice of cancellation will be provided via mail to the certificate holders. Proof that we have mailed the notice of cancellation, using the information provided by you, will serve as proof that we have fully satisfied our obligations under this endorsement. Such notice of cancellation is provided on an informational basis and solely to assist you in meeting your contractual notice requirements to such parties. Our failure to provide such advance notice to the certificate holder(s) will not extend any Policy cancellation date, negate any cancellation of the Policy, or grant, alter, or extend any rights or obligations under this Policy and we shall have no liability for failure to provide the notice herein. All other terms and conditions of the Policy shall apply and remain unchanged. SPP 0063 (Ed. 01 17) Page 1 of 1 '^ DATE (MMIDD/YYYY) � CERTIFICATE OF LIABILITY INSURANCE 12/27/2019 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 CONTACT DMGS Risk Management & Insurance Services NAME: 8201 Oak Canyon, Suite 100 Irvine, CA 92818 Ix�txt4. (949) 559-6700 Cr No), (9499) 559-6703 ADDRESS. www.gmgs.com OB84519 .............. .- .......................... ... INSURED Tait & Associates, Inc. Tait Environmental Services, Inc. 701 Parkcenter Dr. Santa Ana CA 92705 INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Travelers Property„Casualty Co of America 25674 INSURER B: INSURER C : INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 53247576 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 'OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE ADDL UOR POLICY EFF POLICY EXP LTR I POLICYNUMBER IMMIDDI)/YXX) fMMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY = CLAIMS -MADE 1-1 OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: �I POLICY JJERC( LOC O. OTHER: A AUTOMOBILE LIABILITY V ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY + AUTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRI ETOR/PARTN ER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This certificate may be relied upon only if the certificate addendum referred to herein is attached hereto. CERTIFICATE HOLDER City at EI Segundo 314 Main Street EI Segundo CA 90245 ACORD 25 (2016/03) 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 Michael Finn ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 53247576 1 19-20 A/WC I John Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 1 of 7 EACH OCCURRENCE $ TO RENTED $ PR.DAMAGE PREMISES Fa ooaurrenca), MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ 810 -7138R642 -TIL -19 9/1/2019 9/1/2020 &OMBINEDSINGLE LIMIT adent Ear $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PF¢?YPJPAA"t'Y DAMAGE $ $1,000 Comp. Ded.?:.uct�nt'a $1.000 Coll. Ded. $ EACH OCCURRENCE $ AGGREGATE $ UB -4J588939 -19-43-G 9/1/2019 9/1/2020/ I PEE,aTUTE I I OERH E L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This certificate may be relied upon only if the certificate addendum referred to herein is attached hereto. CERTIFICATE HOLDER City at EI Segundo 314 Main Street EI Segundo CA 90245 ACORD 25 (2016/03) 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 Michael Finn ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 53247576 1 19-20 A/WC I John Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 1 of 7 AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY GMGS Risk Management & Insurance Services POLICY NUMBER CARRIER NAIC CODE NAMED INSURED Tait & Associates, Inc. Tait Environmental Services, Inc. 701 Parkcenter Dr. Santa Ana CA 92705 EFFECTIVE DATE: Page of ADDITIONAL. REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of EI Segundo ADDRESS: 314 Main Street EI Segundo CA 90245 As respects Automobile Liability coverage, City of E1 Segundo, its officials, and employees are added as Additional Insured as per CAT3530215 attached, and this insurance is primary per CA00011013 attached. As respects Automobile Liability coverage, 30 -day written notice of cancellation (10 days for non-payment of premium) applies per ILT0010107 attached. As respects Workers' Compensation coverage, 30 -day written notice of cancellation (10 days for non-payment of premium) applies per WC040601(A) attached. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 53247576 1 19-20 A/WC I John Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 2 of 7 Tait & Associates, Inc. 810 -7138R642 -TIL -19 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — 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 dur- ing 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 un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever 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 addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT 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 Is 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 li — COV- ERED 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 busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "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. 53247576 1 19-20 A/WC I John Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 3 of 7 810 -7138R642 -TIL -19 4. Loss Payment — Physical Damage Cover- ages At our option, we may: a. Pay for, repair or replace damaged or sto- len property; b. Return the stolen property, at our ex- pense. We will pay for any damage that results to the "auto" from the theft; or c. Take all or any part of the damaged or stolen property at an agreed or appraised value. If we pay for the "loss", our payment will in- clude the applicable sales tax for the dam- aged or stolen property. 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obligations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally con- ceals or misrepresents a material fact con- cerning: a. This Coverage Form; b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form, 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the re- vision is effective in your state. 4. No Benefit To Bailee — Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any per - COMMERCIAL AUTO son or organization holding, storing or trans- porting property for a fee regardless of any other provision of this Coverage Form. 5. Other Insurance a. For any covered "auto" you own, this Coverage Form provides primary insur- ance. For any covered "auto" you don't own, the insurance provided by this Cov- erage Form is excess over any other col- lectible insurance. However, while a cov- ered "auto" which is a "trailer" is con- nected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is: (1) Excess while it is connected to a mo- tor vehicle you do not own; or (2) Primary while it is connected to a covered "auto" you own. b. For Hired Auto Physical Damage Cover- age, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Para- graph a. above, this Coverage Form's Covered Autos Liability Coverage is pri- mary for any liability assumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy be- gan. We will compute the final premium due when we determine your actual ex- posures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospective pre- mium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund. CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 9 of 12 53247576 1 19-20 A/WC I John Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 4 of 7 Tait & Associates, Inc. Tait Environmental Services, Inc. COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions: A. Cancellation during the policy period and up to three years 1. The first Named Insured shown in the Decla- afterward. rations may cancel this policy by mailing or D. Inspections And Surveys delivering to us advance written notice of 1. We have the right to: cancellation. 2. We may cancel this policy or any Coverage a. Make inspections and surveys at any Part by mailing or delivering to the first time; Named Insured written notice of cancellation b. Give you reports on the conditions we at least: find; and a. 10 days before the effective date of can- cellation if we cancel for nonpayment of premium; or b. 30 days before the effective date of can- cellation if we cancel for any other rea- son. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. If the policy is cancelled, that date will become the end of the policy period. If a Coverage Part is cancelled, that date will become the end of the policy perlod as respects that Coverage Part only. 5. If this policy or any Coverage Part is can- celled, we will send the first Named Insured any premium refund due. If we cancel, the re- fund will be pro rata. If the first Named In- sured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a re- fund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara- tions is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us as part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time c. Recommend changes. 2. We are not obligated to make any inspec- tions, surveys, reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advi- sory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or rec- ommendations we may make relative to certi- fication, under state or municipal statutes, or- dinances or regulations, of boilers, pressure vessels or elevators. E. Premiums 1. The first Named Insured shown in the Decla- rations: a. Is responsible for the payment of all pre- miums; and b. Will be the payee for any return premi- ums we pay. 2. We compute all premiums for this policy in accordance with our rules, rates, rating plans, premiums and minimum premiums. The pre- mium shown in the Declarations was com- puted based on rates and rules in effect at IL TO 01 01 07 (Rev. 06-09) Includes the copyrighted material of Insurance Services Office, Inc. with its pennisslon. 53247576 1 19-20 A/WC I Sohn Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 5 of 7 Page 1 of 2 the time the policy was issued. On each re- newal continuation or anniversary of the ef- fective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in- sured. If you die, your rights and duties will be trans- ferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary cus- tody of your property will have your rights and duties but only with respect to that property. G. Equipment Breakdown Equivalent to Boller and Machinery On the Common Policy Declarations, the term Equipment Breakdown is understood to mean and include Boiler and Machinery and the term Boller and Machinery is understood to mean and include Equipment Breakdown. This policy consists of the Common Policy Declarations and the Coverage Parts and endorsements listed in that declarations form. In return for payment of the premium, we agree with the Named Insured to provide the insurance afforded by a Coverage Part forming part of this policy. That insurance will be provided by the company indicated as insuring company in the Common Policy Declarations by the abbreviation of Its name opposite that Coverage Part. One of the companies listed below (each a stock company) has executed this policy, and this policy is counter- signed by the officers listed below: The Travelers Indemnity Company (IND) The Phoenix Insurance Company (PHX) The Charter Oak Fire Insurance Company (COF) Travelers Property Casualty Company of America (TIL) The Travelers Indemnity Company of Connecticut (TCT) The Travelers indemnity Company of America (TIA) Travelers Casualty Insurance Company of America (ACJ) secretary /�" - 71,", b--., President Page 2 of 2 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. IL TO 01 01 07 (Rev. 06-0g) 53247576 1 19-26 A/WC I Sohn Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 6 of 7 Tait & Associates, Inc. Tait Environmental Services, Inc. TRAVELERS JW WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 04 06 01 (A) POLICY NUMBER: UB -4J588939 -19-43-G CALIFORNIA CANCELATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the information page. The cancelation condition in Part Six (Conditions) of the policy is replaced by these conditions: CANCELATION 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancelation is to take effect. 2. We may cancel this policy for one or more of the following reasons: a. Non-payment of premium; b. Failure to report payroll; c. Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued by us; d. Failure to pay any additional premium resulting from an audit of payroll required by the terms of this policy or any previous policy issued by us; e. Material misrepresentation made by you or your agent; f. Failure to cooperate with us in the investigation of a claim; g. Failure to comply with Federal or State safety orders; h. Failure to comply with written recommendations of our designated loss control representatives; I. The occurrence of a material change in the ownership of your business; J. The occurrence of any change in your business or operations that materially increases the hazard for frequency or severity of loss; k. The occurrence of any change in your business or operation that requires additional or different classification for premium calculation; I. The occurrence of any change in your business or operation which contemplates an activity excluded by our reinsurance treaties. 3. If we cancel your policy for any of the reasons listed in (a) through (f), we will give you 10 days advance written notice, stating when the cancelation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will be sufficient to prove notice. If we cancel your policy for any of the reasons listed in Items (g) through (1), we will give you 30 days advance written notice; however, we agree that in the event of cancelation and reissuance of a policy effective upon a material change in ownership or operations, notice will not be provided. 4. The policy period will end on the day and hour stated in the cancelation notice. DATE OF ISSUE: ST ASSIGN: 53247576 1 19-20 n/wc I John Gallegos 1 12/27/2019 2:41:47 PM (PST) I Page 7 of 7 Page 1 of 1