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PROOF OF INSURANCE (2020 - 2021) CLOSEDPolicy Number: Date Entered: .++� C A"""91 DATE (MMMDIYYYY) :� CERTIFICATE OF LIABILITY INSURANCE 1 3/172020 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 I CNrA:CT Michael Watters Benedetti Insurance Agency NAOME 199 California Dr. #202 ryc No.E01v (650) 697-7224 H Nei: (650) 697-4506 [RA wLMillbrae, CA 94030 Rk_klj—_ INSURER(S) AFFORDING COVERAGE NAIC N 94030 -..._.� I INSURER A: The Hartford Insurance Company 22357 INSURED Race Tele..co,mmunications_ I ..-..-.c,®_,,,,,,, ..._....._ aC . INSURER 8: INSURER C 1325 Howard Ave Ste 604 INSURER D: . ................. _..-......................................................... Burlingame, CA 99 L 010 I NSURERE: I 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 114SURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS GF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TN -SR ...... AOOL SU._ .............._....,._................... R .._._........ A R COMMERCIAL GENERAL L INSURANCE.. r% __. *D � CY EFF POLICY EXP II !Nr POLICY NUMBER IMM Ipp/YYYYI_IMM/pp/YYYY1 LIMITS I IA131UTY EACH OCCURRENCE 51,000,000 CLAIMS -MADE ® OCCUR X 5�7SBABK3443 2/26/2020 2/26/2021 � � n 'y $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) Certificate of GL, Auto, and Workers Comp for Race Technologies Inc. 30 day notice of cancellation to cert. holder. Insurance is primary and non-contributory City of E1 Segundo is named as additional insured per attached blanket endorsement CERTIFICATE HOLDER CANCELLATION City of E1 Segundo 350 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo, CA 90245 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTM'OR5'ZED R'EPRE. NTATVVE� I _ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD rseD EaP,n_o5ort- S10,000 ` _ PERSON . ADV INJURY - $ 1, 000, 000 _- GEN'LAGGREGATE LIMirAPPLIESPER: J I2NEPJ,LAGGREGATE 52,000, 0000 PULI,N I LOO _ JECT��-_ ` ._, _,........ _...._._.,.....�.. _ PRCDUCTtl - -- COMP;OPAGG � . ......,....�.......5....._..,.,........._....__—__-`__ ..., __..-. $2,000,300 — OT'MIEIk, ..�._... —_ AUTOMOBILE LIABILITY fd'PuFtEr9ARdJE wl7'ANMti_wIALE(a� 00p 0,.0_0 0 X ANY AUTO X 57UECFN1611 2/26/2020 2/26/2G21 ' ."l"L.',O BCDILY NJRrpersn)S ...... . .- _.-- -'"• SCHEDULEO AUTOS ONLY _J AJ __.._ BODILYIURY(Per ent) _ . .s$ .1."-,' _ y HIRED NON -OWNED df'Y: BL� Q AUTOSONLY OC (arWA n A UMBRELLA L---�' OLA S 58,000,000 8 0, MS -MADE EXCESSIJAIIB 57SBABK3443 2/26/2020 ;2/26/2021 AGGREGATE B _66.6 �- $81, 0Q0 DED I I RETENTION S S WORKERS COMPENSATION I STATUTE ERH AND EMPLOYERS'LIABILITY 000,000 ANY PROPRIETORIPARTNERIEXECUTIVE � A rYN NIA 57WECAB3DTL 2/26/2020 2/26/2021 E L. EACH ACCIDENT 5 r _ _ OFFICERIMEMBEREXCLUDED? (Mandatory In NH) E.L. DISEASE -EA EMPLOYEES 1 000, 000 If yes, describe under _ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 00 $1,000,0 A Professional Liab. 57SBMZ3172 2/26/2020 2/26/2021 Limit $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) Certificate of GL, Auto, and Workers Comp for Race Technologies Inc. 30 day notice of cancellation to cert. holder. Insurance is primary and non-contributory City of E1 Segundo is named as additional insured per attached blanket endorsement CERTIFICATE HOLDER CANCELLATION City of E1 Segundo 350 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo, CA 90245 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTM'OR5'ZED R'EPRE. NTATVVE� I _ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER • 57SBABK3443 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 ollowing=•COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization(s)_ Any person or organization for whom you are performing "commercial construction" during the period of this policy and have agreed in a written contract to add as an additional insured for products -completed operations. "Commercial construction" does not include any habitational or residential construction other than hotels or apartments, Location And Description Of Completed Operations All Jobs/Locations L Infornqati.... q._._ p Schedule, r .. " � �.lule. if not shown above, will be shown in the Declarations. nn re uer�..d to complete this ;a�.h �. Section II - Who Is An Insured is arnended 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"_ CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER_ 57SBABK3443 COMMERCIAL GENERAL LIABIUTY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization for whom you are performing operations during the policy period 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. Location(s) Of Covered Operations All Jobs/Locations inforniation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Se -.,.ion Il -- Who Is An Insured is amended to B. include as an additional insured the person(s) or organization's) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in pari, by: 1_ Your acts oromissions; or 2. The acts or omissions of those acting on your behalf. in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above_ Neth respect to the insurance afforded to il:ese additional in the following additional :xclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, including materials, parts or equip•• ment furnished in connection with such work, on the project (other than service, mainlerance 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 2. That portion of "your work' out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a .principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: 57SBABK3443 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 (2) You have agreed in writing in a contractor Condition and supersedes any provision to the agreement that this insurance would be primary contrary: and would not seek contribution from any other Primary And Noncontributory Insurance insurance available to the additional insured. 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 CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 57SBA13K3443 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization when you and such person or organization have agreed in writing in a contract or agreement that you will waive any right of recovery against such person or organization. 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 opera'_ions hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1