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PROOF OF INSURANCE (2020) CLOSEDJt I DATE (MM/DD/YYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE 8/31/2019 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.. CONTACT Deale Renton & Associates NAME. y, PHONE;510-452-2193 P. O, Box 12675 (arc, Ncl, Exlp,. 510-465-3090 (a,'(A�dC� Nn); Oakland CA 94604-2675 ADDR1ESS cealdicates@dealeyren'ton com IINSURER('S)iAFFORDING COVERAGE NAIC # .., ... INSURER A: Transportation Insurance Company 20494 INSURED CANNOCORP INSURER B: Continental Insurance Company 35289 Cannon Corporation PENCO a Cannon Corporation INsuRelx c :Hartford Fire Ins. Co 19682 1050 Southwood Drive INSURER D: Beazley Insurance Company, Inc 37540 San Luis Obispo CA 93401 INSURERS; Valley Forge Insurance Company 20508 INSURER F COVERAGES CERTIFICATE NUMBER: 1345042217 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 POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE ADDL-SUBR POLICY EFF POLICY EXPLIMITS LTR INSD WVD POLICY NUMBER (MMIDDIYYYYI (MMIDD/YYYY) -_- L, X COMMERCIAL GENERAL LIABILITY Y Y 6079204724 9/1/2019 9/1/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR UAPREMISTS�O P.E`I�CTEt''9 : GEN'L AGGREGATE LIMIT APPLIES PER 1Eac'ccprmence� $'1,00'0,000 POLICY X JE � X LOC $15.0'00 PERSONAL & ADV INJURY OTHER GENERAL AGGREGATE A AUTOMOBILE LIABILITY Y Y 6079209373 X ANY AUTO 9/1/2019 9/1/2020 aOMk'311ud:1LaSINGLE R.WIT ' $1,000,000 OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY a UMBRELLA LIAB X OCCUR Y Y 6079210751 X EXCESS LIAR CLAIMS -MADE DED RETENTION $ C WORKERS COMPENSATION Y 51 WEAA5OF4 AND EMPLOYERS' LIABILITY Y I N ANYPROPRI ETOR/PARTNER/EXECUTIVE j OFFICER/MEMBER EXCLUDED? 11A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below D Professional V27737190101 Liability UAPREMISTS�O P.E`I�CTEt''9 : 1Eac'ccprmence� $'1,00'0,000 MED EXP IAn7 one porsan',I $15.0'00 PERSONAL & ADV INJURY $ 1,0'00,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2, 000,000 $ 9/1/2019 9/1/2020 aOMk'311ud:1LaSINGLE R.WIT ' $1,000,000 ,, 6 arcs s1ly BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ .(I.1 ,q 'e"qx' lli:dikllt)' 9/1/2019 9/1/2020 EACH OCCURRENCE $9,000,000 AGGREGATE $ 9,000,000 $ 9/1/2019 9/1/2020 STAH TUTE ER EL EACH ACCIDENT $ 1.000,000 EL DISEASE - EA EMPLOYEE, $1,000,000 EL DISEASE - POLICY LIMIT $ 1,000.000 6/8/2019 9/1/2020 Limit 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project Number/Name: #190638 / City of EI Segundo Water Yard Improvements City of EI Segundo, its officials, and employees are named as Additional Insured as respects General and Auto Liability as required per written contract or agreement. General Liability and Auto Liability are Primary/Non-Contributory per policy form wording. 30 Days Notice of Cancellation CERTIFICATE HOLDER City of EI Segundo 350 Main St. EI Segundo CA 90245 ACORD 25 (2016/03) 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. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or B. additional insured coverage with "arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Page 1 of 2 AMERICAN CASUALTY CO OF READING,PA Insured Name: CANNON CORPORATION Policy No: 6079204724 Endorsement No: s Effective Date: 0 9 / 01 / 2 019 Copyright CNA All Rights Reserved Includes copyrighted material of Insurance Services Office, Inc,, with its permission ""' .A Primary and Noncontributory Insurance CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed .Operations Coverage Endorsement ...� ....................._ ........... .................� With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (10-16) Page 2 of 2 AMERICAN CASUALTY CO OF READING,PA Insured Name: CANNON CORPORATION Policy No: 6079204724 Endorsement No: 8 Effective Date: 09/01/2019 Copyright CNA All Rights Reserved Includes copyrighted material of Insurance Services Office, Ino, with its permission. Business Auto Policy Policy Endorsement w, mIB w.� ,�� ,I L�� I« II Ip�illlllll6�mll I,�VfdI111�IM1 a Ilwum,,,�akfltllV� !Illlmlllllll� 16Vo,d.I NI I„uI ,.,Il,tiuuh�, dkllY^III� d,I�H �«o � I6. VII VaInIII \ Yltll V@ 411111 11,1u INIIII �I I,� Irl�� a'iq��rA V� IIV IIIVII� �� a �� (II'li �� . 111111 IIIIIIIIIIII IIIIIIIIII IIIVOm�. 11I'1,!!V �wo�^"Urr,��oulM h ��IIV rl,mwwn�� IM,,MMffI II I1iM it, 1 y Ips VII �� .v �i�ll {p� 1Yu pgY�IMjM,�� '�� V ��, VIII III II m p .,. iI� I �II ullll� � 1116 II Pu, �i I Gil ".11 „ VIII �Yllq „, �Yilq I)II pwll, � �o � ^wuuuuulQ ��i �� Ili, lil I � � flM� V � "'SII II �w, ipIiY111111 PMI It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Person Or Organization ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT TO NAME AS AN ADDITIONAL INSURED ...... ........... ....... 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No: CNA71527XX (10-2012) Endorsement Effective Date: Endorsement Expiration Date: Endorsement No: 15; Page: 1 of 1 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Policy No: 6079209373 Policy Effective Date: 09/01/2019 Policy Page: 69 of 170 CNA CNA PARAMOUNT Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART ...... ..................... _m .................................... .. SCHEDULE ................................................................. _ ....... ........... Name Of Person Or Organization: W ...................._. .......... .............. I','�I',I iJ ',''I`9 I'4i1, I? G;I"I I I'\I'lI I'11''1l I '�( :^;.I'I II`\II I',L'II',) 6\!: I . .,,Il 'II k, '\ _........ ..........................................,_. y I .I .; II:„I i•II,""'I I ','�,'I+ 'I'�'� 'i lil' I;i,'I'il l 'w' III,IIIi 'v' i'f' I I I Ir\i'�I��; ', ',.)I.. I I I ?�;)'I�',,i� /`I'I'I 1.1 'I \,'p.'�I,'.'I;' I ' ' I,li,'� I I,li,ll,;`r' I', \i,' I'•11,'� I I I 'I i,) i I I� �"11 I',ri (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products -completed operations hazard. All other terms and conditions of the Policy remain unchanged.. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75008 (10-16) Page 1 of 1 AMERICAN CASUALTY CO OF READING,PA Insured Name: CANNON CORPORATION Policy No: 6079204724 Endorsement No: 10 Effective Date: 09/01/2019 Copyright CNA All Rights Reserved, Includes copyrighted material of Insurance Services Office, Inc , with its permission Business Auto Policy Policy Endorsement „I a wN'w, .,I MwIN.II .L..I ill � �M.„dlYAll lugl �IM1,IW M". SI�ItIINh uVN.I IO�IN„JIT 1NII1� IIIV«i,ll"7ill uuu�IIIM1111J IMIIV1l„� .AL. IIIVN.I,!Mo� �MIIN. I I �,uI�INIl �«V�mnn II I I t. Bw 6 „u,� II lI ... � IMI IM u� „Mlnnl �I I wuNl1) ,iuollY Mtli 1...�Y lw 11�,�41�1 �Yh �..�0, .111.„ N.,�I�plpp6lll �.�, �I,NyJ� .hullo^ `I�1111, IL.iiiiir�iiiV;IIW�Slu N Li�,.VuI��VY I��N I �III� Illl�d IOII� �l I, °"""""""A«V!!N�II I��I IIIIN �� I dNW�� I I �� NII � M �p� �� .� � I � � .,.°I niAr III, I �� w, m �¢u^ m I� �.„,' � i” a �� 1•,� a ��. W � aiu � �Y,�J �� l l Ilim Y I Y � ,�I I�� II�� I (I � R.. IAV . ,��Illl �IIIIIIIII�„ 1. Illh!„ I 111 IpW,M..� I IIS I� II I I I I I .I I I �ul III �I 11iM I n u I 1. IIII I ,, I M� i�,l .,III II I ul II �I«M, u I I I �M All Illul 1111h ,hu...I« Y.II�iNII I �„ II II, �II@II�.0 �IIq.III�Nu,�'gIIIIIlu111lrYlax�l!�VIrI.I��I,11h� 11�14ialJ1,u.I��a�I��I��i�II.N,,„I�dVMhlhlllil�ll,l�«c�iw,��u�I�W,.1�W.V�I ��'I ,..IV,II�III'.o ntill"1'!�1�6�u� "N�VIMN�ww�VU��wwwl�.lJ, 16�.��1�,�� I�i I... �M� J�h�1�1�«.l.l.l.,l., I,� �� a..�lw�l�,�l. �1��1111419 .11'1.,>�I I�M"I� �V THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: CANNON CORPORATION Endorsement Effective Date: 09/01/2019 SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss” under a contract with that person or organization. Form No: CA 04 44 10 13 Policy No: 6079209373 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 09/01/2019 Endorsement No: 6; Page: 1 of 1 Policy Page: 54 of 170 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 © Copyright Insurance Services Office, Inc., 2011 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) Policy # 51 WEAA5OF4 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA 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 @@@@@@@@@@ of the California workers' compensation premium otherwise due on such remuneration. Schedule People of Organization WC 04 03 06 (Ed. 4-84) Job Description