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PROOF OF INSURANCE (2020 - 2021) CLOSEDA� �® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 5/14/2020 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 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 ICUNIACI Elizabeth DeLaFuente NAME: FAX The Liberty Company Insurance Brokers I rpAH/c"no. Ext): (818)914-3960 I (A/C, No): (866)835-6983 CA License #OD79653 IE -MAIL ADDRESS: ecruz@libertycompany.com I`I 5955 De Soto Ave, Suite 250 INSURER(S) AFFORDING COVERAGE NAIC # Woodland Hills CA 91367IINSURERA:Ohio Security Insurance Company 24082 INSURED INSURERB:American Fire & Casualty 24066 General Lighting And Electrical Services Inc (INSURER C: 11823 Slauson Ave Ste 12 (INSURER D: I INSURER E: Santa Fe Springs CA 90670 IINSURER F: COVERAGES CERTIFICATE NUMBER:20/21 GL BA UMB 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE imgn WVr1 POLICY NUMBER !MM/DD/YYYY) !MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ A = CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ X Y BKS56314241 GEN'LAGGREGATE LIMITAPPLIES PER POLICY ❑ PRO ❑ LOC JECT OTHER: AUTOMOBILE LIABILITY A X ANY AUTO ALL OWNED SCHEDULED _ AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS X UMBRELLA LIAB OCCUR B EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 0 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below RAS56314241 ESA56314241 1/15/2020 1/15/2021 1/15/2020 1/15/2021 1/15/2020 1/15/2021 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) Medical payments $ EACH OCCURRENCE $ AGGREGATE $ PER STATUTE I I EERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Various Project. City of El Segundo, Its Officials and Employees are included as Additional Insureds on General Liability per CG 88 10 04 13, Commercial General Liability Extension, subject to policy terms and conditions. Waiver of subrogation applies to General Liability per CG 88 10 04 13, Commercial General Liability Extension, subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION lsandoval@elsegundo.org 1,000,000 500,000 15,000 1,000,000 2,000,000 2,000,000 1,000,000 5,000 2,000,000 2,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Its Officials and Employees ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE Paul Boulet/PATRA4 ✓ �� I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY -ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B " ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES " KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 8 Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section | - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. |tionot owned by any insured; 2. |tiohired, chartered or loaned with abained paid crew; 3. The pilot in command holds auurnsndy effective m*rtifivabs, issued by the duly constituted authority of the United Sbsbso of America or Canada, designating her or him auommencia| or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible inounanms, whether primary, excess (other than insurance written to apply specifically in excess of this po|iuy), contingent or on any other baoio, that would also apply to the |000 covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2.Exclusions ofSection |- Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) Awatercraft you donot own that is: (a) Less than 52feet long; and (W Not being used to carry persons or property for acharge. C. PROPERTYOAMAGELLAB|LUY-ELEVATORS 1. Under Paragraph 2. Exclusions of Section | -Coveroge A-Bodi|y Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provioion, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section P# - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b.Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. O. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented ToYou ionot otherwise excluded from this Coverage Part: I. Under Paragraph 2.Exclusions ofSection |- Coverage A - Bodily Injury and Property Oornoge Liability: o. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the foUow- Paragnapho (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, |ighhning, exp|ooion, omoke, or leakage from an automatic fine protection system) to: (i) Premises rented to you for a period of 7 o fewer uonmsuudws days; or (ii) Contents that you rent or lease as part ofapremises rental or lease agreement for aperiod of more than 7dayo. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A mspansbs limit of insurance applies to this coverage as described in Section U| - Urnko of Insurance. � 2O13Liberty Mutual Insurance b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions u. through n. do not apply to damage by fire, |ighhning, exp|ooion, smoke or leakage from automatic fine protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. Aoepanahe limit of insurance applies to Damage To Premises Rented To You as described in Section ||| -Lirnito Of Insurance. 2. Paragraph G. under Section ||| -Lirnito Of Insurance is replaced by the following: G. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage Afor damages because of "property damage" to: ~~~~~ o. Any one premise: (1) While rented to you; or (3) While rented to you or temporarily occupied by you with permission of the owner for damage by fine. |ightning, exp|ooion, smoke or leakage from automatic protection sys- tems; or ~ ~~~~~ b. Contents that you rent or lease as part ofapremises rental or lease agreement. 3. As regards coverage provided by this provision O. EXTENDED DAMAGE TO PROPERTY RENTED TO ~~~~~ YOU (Tenant's Property Oornoge) -Panagnaph 9.o.ofDefinitions is replaced with the following: 9.o. Auontnaut for a|eaoe of premises. Hmwewsr, that portion of the contract for a|eaoe of premises � ----- that indemnifies any person or organization for damage by fine. |ightning, exp|ooion, smoke, or leakage from automatic fine protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental orlease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION � If Coverage CK0mdiuo| Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section | -Coveroge C -Medical Payments, Subparagraph (b) of Paragraph o. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OFSUPPLEMENTARY PAYMENTS - COVERAGES A AND 1. Under Supplementary Payments -CoverogeoAand B, Paragraph 1.b. is replaced bythe following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2Paragraph 1 d is replaced by the following: � . .. � ^ d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or ^ouit^, including actual |000 of earnings up to a500 aday because of time off from work. � G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section || -VVho Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in awritten uontnaut, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily irjury^. "property damage" or "personal and advertising irjury^ caused in whole or in part by: o. Your acts or omiooiono, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury^ or "property damage" ouuuru, or the "per- sonal and advertising injury" is uommitted, subsequent to the signing of such written contract or written agreement; or @ 20131-ibonyMutua| Insurance CG 88 10 04 13 Includes copyrighted material ofInsurance Services Office, |no..with its permission. Page 3 of b. Premises or facilities rented by you or used by you; or u. The manbsnanm*, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the obsbs or political subdivision has issued apennit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury". "property damage", or "personal and ad- vertising injury^ arising out of the operations performed for the obsbs or political subdivision; (3) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you mwn, nent, or control but only with respect to the following hazards: (o) The exiohenm*, mainhenanm*, nepair, uonotruution, eneudon, or removal of advertising oigno, mwningo, uanopieo, m*||ar entnanm*o, coal ho|eo, driwswmyo, manho|eo, marqueeo, hoist away openingo, sidewalk vau|to, street bannero, or decorations and similar expo- sures; or (b) The uonotruution, eneution, or removal of elevators; or (u) The mwnerohip, mainhenanm*, or use ofany elevators covered by this insurance. 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 insur- ance 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. With respect to Paragraph 1.o. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All wmrk, including maheria|o, parts or equipment furnished in connection with such wmrk, on the project (other than oemiue, 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 (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 aphnuipa| aoapart of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement endo when their written contract or written agreement with you for such premises or facilities endo. With respects to Paragraph 1.u.above. this insurance does not apply huany ^ouuurnenue^ which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury^ or "property damage". We have no duty to defend an additional insured under this endorsement until we nem*iws written notice ofa^ouit^ by the additional insured as required in Paragraph b. of Condition 2. OuUmo In the Event Of Occurrence, Offense, C|oirn Or Suit under Section |V -Cornrneruio| General Liability Condi- tions. @ 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material ofInsurance Services Office, |no,with its permission. Page 4of8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section | -Coveroge A-Bodi|y Injury And Property Oornoge Liability: This insurance does not apply to: o. "Bodily irjury^ or "property damage" arising from the sole negligence ofthe additional insured. b. "Bodily injury^ or "property damage" that occurs prior to you commencing operations at the location where such "bodily irjury^ or "property damage" occurs. u. "Bodily injury^. "property damage" or "personal and advertising injury^ arising out of the render- ing of, or the failure to nender, any professional aruhiheutuna|, engineering or surveying oemiueo. ~~~~~ including: ~~~~~ (1) The preparing,approving or hu prepare or maps, shop drawings, opiniono . . . . . neporto, ourveyo, field orderu, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or activities. . Thio exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the oupemioion, hiring, emp|oyment, training or monitoring of others by that inoured, if the "occur nenms^ which caused the "bodily injury" or "property damage^, or the offense which caused the ^personal and advertising injury^, involved the rendering of, orthe failure to nender, any professional aruhiheutuna|, engineering or surveying services. � ----- d. "Bodily irjury^ or "property damage" occurring after: (1) All wmrk, including mabsha|o, parts or equipment furnished in connection with such wmrk, on the project (other than msmims, 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 (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 aprinuipa| aoapart of the same project. e. Any person or organization specifically designated aoanadditional insured for ongoing operations byaseparate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made apart of this policy. 3. With respect to the insurance afforded to these additional inounedo, the following is added to Section ||| -LirnitoOf|nouronum: If coverage provided to the additional insured is required by a contract or agneement, the most we will pay on behalf ofthe additional insured iothe amount of insurance: o. Required by the contract or agreement; or b. 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 Deu|anado no. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION [V -COK0K0ERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional inoured's policy has an Other Insurance provision making its policy exueoo, and you have agreed in awhtten contract or written agreement to provide the additional insured coverage on a primary and noncontributory baoio, this policy shall be primary and we will not seek contribution from the additional inouned'o policy for damages we cover. @ 2O13Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material ofInsurance Services Office, |no..with its permission. Page 5of8 b. The following is added to Paragraph b. Excess Insurance: When awritten contractor written agreement, other than a premises lease, facilities rental contract or agnsement, an equipment nenbs| or lease contract or agnsement, or permit issued by aobsbs or political subdivision between you and an additional insured dmso not require this insurance to be primary or primary and non-uontributory, this insurance is exm*oo over any other insurance for which the addi- tional insured is designated aoaNamed Insured. Regardless of the written agreement between you and an additional inounsd, this insurance is excess over any other insurance whether phmary, exueoo, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. i ADDITIONAL INSUREDS -EXTENOB0 PROTECTION OF YOUR ^L|K0US OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. OuUmo In The Event Of Occurrence, Offense, C|oirn or Suit: An additional insured under this endorsement will as soon as practicable: o. Give written notice of an ^ouuumsnue' or an offense that may nsou|t in adaim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available huthe additional insured; and u. Agree to make available any other insurance which the additional insured has for a|000 we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in awhtten contract or written agreement or the limits of insurance as obsbsd in the Declarations of this policy and defined in Section ||| - Limits of Insurance of this po|iuy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO |SANINSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(I) of Section 11 -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) Toyou, to your partners or members (if you are apartnership orjoint venture), to your members (if you are a limited liability uompany), to auo-"emp|oyee^ while in the course of his or her employ- ment or performing duties related to the conduct of your buoineoo, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the opouoe, uhi|d, panent, brother or sister of that co -"employee" or "volunteer worker" as consequence of Paragraph (1)(o)above; (u) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (o) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care oemim*o. However, if you are not in the business of providing professional health care oemim*o or providing profes- sional health care personnel to othero, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endoruement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury' caused by an "employee" who ioacting inasupervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you. includes the directsupervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and @ 20131-ibonyMutua| Insurance CG 88 10 04 13 Includes copyrighted material ofInsurance Services Office, |no..with its permission. Page 6of8 advertising injury" arising out of their willful uonduut, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury', or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED ORAOO|UONAL[fACQUIRED ENTITIES Paragraph 3. of Section || -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority ----- inteneot, will qualify as Named Insured if there is no other similar insurance available to that ~~~~~ organization. However: o. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage Adoeo not apply to "bodily injury^ or "property damage" that occurred before you acquired or formed the organization; and ~ ~~~~~ u. Coverage B does not apply to "personal and advertising irjury^ arising out of an offense committed before you acquired or formed the organization. . d. Records and descriptions of operations must be maintained by the find Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown aoaNamed Insured in the Declarations or qualifies aoaninsured under this provision. L FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section P# -Comnmeruio| General Liability Conditions, the following is added to Condition G. Repre- sentations: Your failure to disclose all hazards or prior ^ouuurnsnueo^ existing aoofthe inception date ofthe policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section P# -Comnmeruio| General Liability Conditions, the following is added to Condition 2. OuUmo In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an ^ouuumsnue', offenms, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself uonodbde knowledge of the insured unless an insured |iobsd under Paragraph 1. of Section || -VVho Is An Insured or a person who has been designated by them to nem*iws reports of ^ouuurnenm*o^, offenoeo, claims or "suits" shall have received such notice from the agent, servant or N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage aoofthe day the revision is effective in your state. 0. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical irjury, sickness or disease sustained by aperson. This includes mental anguioh, mental injury, ohouk, fright or death that nsouko from such physical injury, sick- ness @ 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material ofInsurance Services Office, |no,with its permission. Page 7 of P. EXTENDED PROPERTY DAMAGE Exclusion o. of COVERAGE A. BOO|[f INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the o. Expected Or Intended Injury "Bodily injury' or "property damage' expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury' or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -VVHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section P# -Cornmeruio| General Liability Conditions, the following is added to Condition 8. Trono- hmrOf Rights Of Recovery Against Others To Us: We wmkm any right of recovery we may have against a person or organization 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" provided: 1. You and that person or organization have agreed in writing in auontnaut or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. @ 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material ofInsurance Services Office, |no,with its permission. Page 8 of DATE (MM/DDfYYYY) CERTIFICATE OF LIABILITY .INSURANCE 10/22/2019 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 be endorsed. If SUBROGATIONIS 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 NAME: AUTOMATIC DATA PROCESSING INS AGCY 76250871 PHONE (800) 524-7024 FAX (800) 524-40-13 (AIC,, No, Ext): (AfC, No): 1 ADP BLVD M/S 625 1-1 — ........... ROSELAND NJ 07068 E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# mm INSURER A: Hartford Insurance Company of the Midwest 37478_ ...... . ...... INSURED INSURER B: . .......... GENERAL LIGHTING & ELECTRICAL SERVICES INCINSURER C 11823 SLAUSON AVE STE 12 SANTA FE SPRINGS CA 90670-6544 INSURER D INSURER E: INSURER F: ,COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I'll, ........... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTVVITHSTANDING 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 INSW TYPE OF INSURANCE . ............... POLICY NUMBER POLICY"10 POLICY 60 LIMITS . .......... ............. ....... fflv�, 'ryry COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADEE 'I OCCUR TO RENTV0 LREMISES kEa MED EXP (Any one person) I PERSONAL & AO"�v lk+JURY GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE POLICY r--, PRO- 0 LOC . .. . ...... Li JECT PRODUCTS -COMP/OP AGG OTHER: ........,—._._....,••••............ AUTOMOBILE LIABILITY �1�4d-Cff-CIMIT ........... — ANY AUTO . w ..... . -..........•• I—- _' BODILY INJURY Per person) ALL OWNED SCHEDULED .•.... . ...... AUTOS AUTOS HIRED NON -OWNED AUTOS AUTOS . . .......... . ..... . ....... ,,, UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS - MADE............. . . ............. . ......... RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY YIN A PROPRIETOR/PARTNER/EXECUTIVE N/A X 76 WEG AA8PJT OFFICER/MEMBER EXCLUDED? E (Mandatory in NH) If yes, describe under ............... 11Eg0IPT1ON_q,OPERATION OW_gEE 10/19/2019 10/19/2020 BODILY INJURY (Per accident) PROPERTY DAMAGE (Per ecdconk) EACH OCCURRENCE AGGREGATE X T Allu r F ER E L EACH ACCIDENT ......._.......,•• E L DISEASE -EA EMPLOYEE E L DISEASE - POLICY LIMIT .................. -iiESiRIPTIOWOF OPERATIONS /LOCATIONS/ VEHICLES (ACORD iii,'Additional Remarks Schedule, may be attached if more space i" Is required) Those usual to the Insured's Operations, A Workers Compensation Waiver of Subrogation applies to the certificate holder per form WC040306, Waiver of Our Right to Recover from Others, attached to this policy CERTIFICAT ' E HOLDER CANCELLATION" ... ..... ... City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED EL SEGUNDO CA 90245-3813 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ...... . ...... . ........ @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 76 WEG AA8PJT Endorsement Number: 1 Effective Date: 10/19/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: GENERAL LIGHTING & ELECTRICAL SERVICES INC 11823 SLAUSON AVE STE 12 SANTA FE SPRI CA 90670 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 5 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description City of EI Segundo , 350 main St., EI Segundo CA 90245 1 Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 10/17/19 Policy Expiration Date: 10/19/20