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PROOF OF INSURANCE (2021) CLOSED..-«^•r PADPASS-02 DSHARMA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 10i27N2020 ) 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(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 nse # 0757776 _'UMNJACT Concord, CA - HUB International Insurance Services Inc. (PHONES Ext): (925) 609-6500 (AIC, Ne):(925) 609-6550 2300 Clayton Rd Concord, CA 945206,6, INSUBE,RI$)„A,FFORDINm, .m GE NAIC # _...- ... VERA ............. INSURER .A : Hanover Insurance... Com. Pa.Oy....................................................22292 Allm,e,a Fin INSURED ,, INSURER,B,,,;., , ._ . ,. ,,......ric,........._..a.ancial Benefit Insurance Company 41840 Padre Associates, Inc. InastaRa R c,: N,,,, gm, p „ ty„m„ ce C„om,pa,ny_ 36056 . .U., ... _ ........m. avi atars,,,S mec, al Ins-ura,n 1861 Knoll rive INSURER e . Travelers Property Casualty Company of America 25674 Vent.,...,,,...'g.,.. INSURER F: COVERAGE'S 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 3OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN.. ...... TYPE OF INSURANCE INSD 1....�.... ... ........ ....... SR ADDLI,Sy p POLICY NUMBER I POLICY EFF POLICY EXP_LTP , LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS -MADE lil X OCCUR X X Ded:0 — EN'L AGGREGATE! LIMIT APPLIES PER: POLICY l.... .� JECT [_ ...., LOC OTHER' B AUTOMOBILE LIABILITY ............... X ANY AUTO X _. OWNED SCHEDULED AIURTOS ONLY AUTOSSy�N _ AUTOS ONLY _._._� AUOTOS ONLY ..X Ded: 0 C UMBRELLA LIAROCCUR...............X..- MS -M ......_ X EXCESDED II S LIpAB CLAIE MS- .AD.....E X V RETENTION $ 0 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ZHF A587802 05 AWF A834382 04 SE20EXC723141IC X UB -3L545876 -20-43-G 2/1/2020 2/1/2021 DAMAGE TO RENTEDm.................. L_ ........................... s ___.- 1,000,000 ny one person) $ 10,000 PERSONAL 1,000,000 ._...,....�...,. �..'.$........-m_-- 2,000,000' GENERA ..'._.,mm.mm.,.......,m..,_....,�......IT......... ... PRODUCTS - COMP/ oP AGG $ .......... 2,000,000 CCIMBINEDSI'NGLELIMIT 1,000,000' tsa.cranp+ $ 2/1/2020 2/1/2021 BODILY INJURY Perperson) $ ............ BODILY INJURYJPer accident) I $ PRdPER'T'Y OAMAQ,,E (pucC rlenll $ EACH OCCURRENCE $ 9,000'000 2/1/2020 2/1/2021 AGGREGATE 9,000'0,00. S� X I PER U 0TH - 21112020 211/2021 _R_.. STATUTE I :. E,A.....m..EAEEMPL,IJX...:.......���... •A L . .............................. .... ........ 1,, __000,, 000 w. ..... ......$ ..... 1,000,000 00 D§E EL-_. OLICY LIMIT E L DISEASE - POLIC Y LIMITS $.,. 1,000,000 0, DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: EI Segundo Blvd. Improvements. City of EI Segundo, as additional insured as respects to General Liability per attached MAN -0426 0715 8r MAN -0427 0715 and additional insured in respects to Auto Liability per attached CA2048 0299. Waiver of Subrogation applies to Workers Compensation per attached WC990376, all as required by written contract. This certificate supersedes all others dated previously. CE'RTIFI'CATE HOLDER City of EI Segundo 350 Main Street EI Segundo, CA 90245 P ACORD 25 (2016/03) [t 1 T: [$1 d >Wii I I f+7 k 1 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 .a ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: ZHF A587802-05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION MAN -0426 07/15 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Blanket as required By Written Contract Location(s) Of Covered Operations (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or in the performance of your ongoing operations for 2. That portion of "your work" out of which the the additional insured(s) at the location(s) injury or damage arises has been put to its designated above. intended use by any person or organization other than another contractor or subcontractor B. With respect to the insurance afforded to these engaged in performing operations for a additional insureds, the following additional principal as a part of the same project. exclusions apply: ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED,. MAN -0426 07/15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: ZHF A587802-05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS MAN -0427 07/15 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHE)ULE Name Of Additional Insured Person(s) ............................... Or Organization(s): Blanket as Required By Written Contract Location And Description Of Completed Operations (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. MAN -0427 07/15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 POLICY NUMBER: ZHF A587802-05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION IV — damage" to premises rented to the COMMERCIAL GENERAL LIABILITY CONDITIONS, Additional Insured or temporarily occupied Paragraph 4. Other Insurance: by the Additional with permission of the Additional Insured — Primary and Non -Contributory owner; or If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION II — WHO IS AN INSURED, is primary and non-contributory, the following applies: If other valid and collectible insurance is available to the Additional Insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: (1) Primary Insurance This insurance is primary to other insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other insurance available to the Additional Insured except: (a) For the sole negligence of the Additional Insured; (b) When the Additional Insured is an Additional Insured under another primary liability policy; or (c) When (2) below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in (3) below. (2) Excess Insurance (a) This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (ii) That is Fire insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; (iii) That is insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INURY AND PROPERTY DAMAGE LIABILITY. (b) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (c) When this insurance is excess over other Insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (i) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (ii) The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. (3) Method Of Sharing (a) If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. (b) If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. Page 1 of 1 421-0452 12 14 Includes copyrighted materials of Insurance Services Office, Inc., with its permission. POLICY NUMBER: AWF A834382 04 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 02/01/2020 Countersigned By; - Named Insured: PADRE ASSOCIATES INC (Authorized Renresentativel SCHEDULE Name of Person(s) or Organization(s): BLANKET AS REQUIRED BY WRITTEN CONTRACT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 E3 � � ���AW_ WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB -3L545876 -20-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by Page 1 of 1