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PROOF OF INSURANCE (2021 - 2022) CLOSED
DRAYTON INSURANCE BROKERS, INC. 2500 CENTER POINT ROAD, SUITE 301 POST OFFICE BOX 94067 BIRMINGI IAM, ALABAMA 35215 BIRMINGHAM, ALABAMA 35220 TELEPHONE: (205) 854-5806 FAX: (205) 854-5899 CERTIFICATE OF INSURANCE NO. 112020 We certify that insurance is afforded as stated below. This Certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the insurance policy and the insurance afforded is subject to all the terns, exclusions and conditions of the policy. INSURER Admiral Insurance Company POLICY NO. CA000002771-35 NAMED INSURED Pyro Spectaculars, Inc. Pyro Spectaculars by Souza Pyro Events, Inc. Pyro Spectacular Industries, Inc. Pyro Spectaculars Productions, Inc, North American Fireworks Co., Inc. (NAFCO) P.O. Box 2329 San Diego Fireworks Rialto, California 92377 POLICY TERM January 13, 2021 to January 13, 2022; Both Days 12:01 A.M. Standard Time COVERAGE Commercial General Liability: N Occurrence Basis ❑ Claims Made Basis LIMiT OF LIABILITY $5,000,000 each occurrence, $10,000,000 general aggregate, $5,000,000 products/completed operations aggregate The limit of liability shall not be increased by the inclusion of more than one insured or additional insured. INSURED OPERATIONS Public fireworks display and special effects contractor It is certified that, if named below, this policy includes as Additional insureds 1) the sponsor(s), promoter(s), organizer(s) (including other entities having similar interests), of insured pyrotechnic events and/or 2) the owner(s) of real property (or barges) at which insured pyrotechnic events are held and/or 3) the owner(s), manager(s), tcnant(s), mortgagLe(s) (including other entities having similar interests), of buildings, stadiums, arenas and similar facilities at which insured pyrotechnic events are held and/or 4) the licensing or permitting authority, or other authority having jurisdiction, issuing licenses/pennits for insured pyrotechnic events and/or 5) any other entity for which the insurance is required to be afforded under written contract. Coverage applies only as respects the legal liability of such Additional Insured(s) for bodily injury and property damage caused by the operations of the Named insured. The insurance afforded any Additional insured does not include coverage for any bodily injury or property damage arising from the failure of such Additional Insured to fulfill its obligations specified in its contract with the Named Insured. NAME & ADDRESS OF INSURED SPONSORS, PROPERTY OWNERS, LICENSORS City of El Segundo 350 Main St. El Segundo, CA 90245 ADDITIONAL INSURED(S)City of El Segundo, Chevron El Segundo Refinery, El Segundo Recreation Park, El Segundo Fire Department and their officers, agents and employees when acting in their official capacity as such. DISPLAY LOCATION El Segundo Recreation Park El Segundo, CA DISPLAY DATE(S) July 4, 2021 it is certified that this policy requires a 30 day mutual notice of cancellation betwecn that. Insurer and than 'Named Insured, In the event of sucl a cancellation we will endeavor to mail 10 days written notice to [lie Additional Insured(s), whose mmic sand address is shown he -con, but I'ai2u' to mail such notice shall impose no obligation or liability of any kind upon tloc insurer and/or the undersigned. DRAY'I'ON INSURANCE BROILERS, INC. March 8 2021 DATE OF ISSUE 1' v r �- ., . STR'INGER, PRESIDE "" `' °ALIFORNIA LICENSE NC . 614 18664 A, �A. Policy Number: CA000002771-35 CG20370704 Endorsement No. 103 Effective Date: March 4, 2021 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 GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of El Segundo, its officers, officials, employees, agents, All locations for which coverage is required by and volunteers. written contract. Information re uired to complete this Schedule, if not shown above, will be shown in the Declarations. 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". CG 20 37 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 13 Policy Number: CA000002771-35 CG 20 10 07 04 Endorsement No. 102 Effective Date: March 4, 2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR Ci � l�1:�►�f�II:����i lI This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oreanization(s): City of El Segundo, its officers, officials, employees, agents, and volunteers. Information required to complete this Schedule, if not shown 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; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: Of Covered All locations for which coverage is required by written contract. will be shown in the Declarations. 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 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 a principal as a part of the same project. CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13 Policy Number: CA000002771-35 Al 08 76 02 03 Effective Date: 01 / 13/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. z This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART It is hereby declared and agreed that the following entities are included as Additional Insured(s) hereunder.. 1) Sponsor(s), promoter(s), organizer(s) (including other entities having similar interests), of insured pyrotechnic events and/or insured pyrotechnic premises. 2) Owner(s) of real property (or barges) at which insured pyrotechnic events are held and/or insured pyrotechnic premises are located. 3) Owner(s), manager(s), tenant(s), mortgagee(s) (including other entities having similar interests), of buildings, stadiums, arenas, stores and other similar facilities at which insured pyrotechnic events are held and/or insured pyrotechnic premises are located. 4) The licensing or permitting authority, or other authority having jurisdiction, issuing licenses/permits for insured pyrotechnic events and/or insured pyrotechnic premises. 5) Any duly licensed pyrotechnician acting either as a licensing cover for an insured pyrotechnic event or, alternatively, as an operator for a pyrotechnic event fired by the Named Insured. 6) Any other entity for which the Named Insured is contractually obligated to provide insurance such as is afforded by the terms of this policy. but only if such entities are listed as additional insured(s) in a certificate of insurance issued under the terms of this endorsement and always subject to the limitations or conditions set out in such certificate of insurance. The coverage afforded such Additional Insured(s) does not apply to injury or damage arising from the failure of any such Additional Insured to fulfill its obligations specified in its contract with the Named insured. AI 08 76 02 03 Page I of 1 13 Policy Number: CA000002771-35 Al 08 76 02 03 Effective Date: 01/13/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY COVERAGE FORM PROFESSIONAL LIABILITY COVERAGE FORM It is hereby declared and agreed that, if so stated in a certificate of insurance, the coverage afforded any entity included as an Additional Insured under the terms of this policy shall l) Be primary and non-contributory with any policy of insurance (or self-insurance) issued directly to the Additional Insured. 2) Provide a waiver of subrogation in favor of such Additional Insured. Al 08 76 02 03 Page 1 of 1 13 DATE(MM/DDIYYYY) �°I � CERTIFICATE OF LIABILITY INSURANCE 3/8/2021 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 o 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 endo'rsement('s . CONTAC PRODUCER NAME Britton E. ill �. ,.. One Cleveland Center, Floor 30 ........,. 5 StreetPHONE EXIt 216 658 7100 gAAac N 216-658 7101 Gallagher Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC M 11 ...." ... .,,�.. „ _ ... INSURER Axis Surplusm Insurance Company ®" .a 26620 „ " INSURED INSURER B Everest Denali Insurance Compen ............ 16044 Pyro Spectaculars Inc. San Diego Fireworks INSURER c P. O. Box 2329' D INSURER°.. ..�.....-... .., ..... ....." .. .� ..,,,. ,...,... Rialto CA 92377 INSURER E ........... ...............w.m.... _.....,... . INSURER F COVERAGES CERTIFICATE NUMBER: 327846622 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. TYPE OF INSURANCE. ...�-,.,.,me�.-.... A� ')S -,... ..." 1�Cdka ........... ..-_....�....w., ...,..._ .. POLIO __._..... � � �i�� °ITI�CICY"dMr:l��.. .......mmm LTR V NUMBER MMPIDDPYYYY MWDDFYYYY LIMITS GENERALLIABILITV EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY EMA +r4Vrfl." .u4 CLAIMS -MADE E —1 OCCUR MED EXP one person) S PERSONAL & ADV INJURY $ GENERALAGGREGATE $ GEN'L AGG..REGATE. LIMIT APPLIES PER: PRODUCTS COMPlOP AGG ,......... .... ........_m___.m ..-.. .......�,-„_._. POLICY PRO LOC $ B AUTOMOBILE LIABILITY SIOCA00031-211 1/13/2021 1/13/2022 COMBINED SINGLEIL1MI _X...� ANY AUTO person) $ BODILY INJURY (Per .. .... .". ._......... ...... ",_... '.... T ALL OWNED " SCHEDULED BODILY INJURY (Per accident) $ ......,,,.., AUTOS ,.,.„„ AUTOS ,."XHIRED AUTOS NON -OWNED PROPIMITT'Y DAIuCA..'G'L $ - X... AUTOS i9s111prt8A ....... 7xl- UMBRELLA LIAR X .� CLAIMS -MADE P-001-000063946-03 1/1312021 1/13/2022 EACH OCCURRENCE $4 000 000WDEO RETENTION $.4 000 tl00 EXCESS LIAR e, �.e�Pe�.P., AOGREOATE $.. w..,.._.-,._ ... . WORKERS COMPENSATION WC S1'AT'U OTH- ANY PROPRIETOR/P RBTNER/EXECUTIVE ❑ E.L EACH ACCIDENT Y I N T4�BYAC CID OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L DISEASE EA EMPLOYEE $ ....... If yes, describe under E.L. OISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS below ............ $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate Holder is named as an Additional Insured in regards to General Liability. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF EL SEGUNDO ACCORDANCE WITH THE POLICY PROVISIONS. CITY CLERK 350 MAIN STREET AUTHORIZED REPRESENTATIVE EL SEGUNDO CA 90245 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Pyro Spectaculars, Inc. Pyro Spectaculars North Inc. Policy #: SI8CA00031-211 COMMERCIAL AUTO ECA 04 506 0310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. C OM M EC IAL AUTO EN HAN C EM ENT EN DORSEM ENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverage, please refer to policy language in this endorsement and the underlying Business Auto Coverage Form. Cover a A p2licable Enhancement Subsidiaries As Insureds Broadened Newly uired O anixations As Insureds Broadened MINNWNMNWm„Ols Broadened Em to ees As Insureds Non-Ownersh' Broadened SuppLep2pgtmPayments — Bail Bonds $3,000 Limit Supplernen Pa nts — Loss Of Earnings $1,000 per day Fellow Emplo ee Bodi In'u Broadened TovAn2 Cover a —All Covered Autos Broadened Glass Brea a Cove e — Waiver of Deductible Broadened Loss of Use Expenses $50 per day $1,000 Limit Stolen Vehicle Extra Exp2nse Broadened Airbag Discha a Broadened Electronic E ui nt (Permanen#y Installed Broadened Sin le Deductible Provision Broadened Notice To ComNny Broadened Blanket Waiver Of Subr atidn Broadened Unintentional Failure To Disclose Hazards Broadened Bodi Injury Includes Mental Anguish Broadened CoveENe Ten ito Extension - Mexico Broadened ECA 04 506 0310 Copyright, Everest Reinsurance Company, 2010 Page 1 of 4 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. INSURED COPY A Who Is An Insured The following is added to Paragraph Al. of Sec- tion II —Liability Coverage: d. Any: (1) Subsidiary which is a legally incorporated entity of which you own greater than 50% interest in the voting stock on the effective date of this Coverage Form. However, the insurance afforded by this provision does not apply to any subsidiary that is an 'In- sured" under any other automobile liability policy, or would bean "insured" under such policy but for the termination of such policy or the exhaustion of such policy's limits of insurance. (2) Organization you newly acquire or form, and over which you maintain majority inter- est. The coverage afforded by this provision: (a) Is effective on the acquisition date, and is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; (b) Does not apply to 'bodily injury" or "property damage" resulting from an "ac- cident" that occurred before you ac- quired or formed the organization; and (c) Does not include any newly acquired or formed organization that is: (i) A joint venture or partnership; or (ii) An "insured" under any other auto- mobile liability policy or would be an 'Insured" under such policy but for the termination of such policy or the exhaustion of such policy's limits of insurance. e. Any person, organization or governmental entity with respect to the operation, mainte- nance, or use of a covered "auto" if you are re- quired to add such person, organization or go- vernmental entity to this policy as an additional insured in order to comply with the terms of a written 'Insured contract" or written agreement. This does not apply when such contract or agreement: (1) Involves the owner or anyone else from whom you hire or borrow a covered "auto" unless it is a "trailer" connected to a covered "auto" you own; or (2) Is executed after the date of loss. Paragraph e.(2) does not apply if: (1) The terms and conditions of the written "insured contract" had been agreed upon prior to the "accident" or'loss"; and (2) You can definitively establish that the terms and conditions of the written 'Insured con- tract" ultimately executed are the same as those which had been agreed upon prior to the "accident" or 'loss". f. Any of your "employees" while using a covered "auto" in your business or your personal af- fairs, provided you do not own, hire or borrow that "auto". B. Coverage Extensions - Supplementary Payments Paragraphs A2.a.(2) and A2.a.(4) of Section II — Liability Coverage are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "in- sured" at our request, including actual loss of earnings up to $1,000 a day because of time off from work. C. Fellow Employee The following exception is added to exclusion 5. Fellow Employee under paragraph B. Exclusions of Section II — Liability Coverage: This exclusion does not apply if the "bodily injury" results from the use of a "covered auto" you own or hire. The coverage provided under this excep- tion is excess over any other collectible insurance. D. Towing Paragraph A2. of Section III — Physical Damage Coverage is replaced by the following: 2. We will pay for towing and labor costs each time that a covered "auto" is disabled. All labor must be performed at the place of disablement of the covered "auto". If the auto is not a private passenger type, a $250 deductible will apply to this coverage but it will not reduce the available limit of insurance. For all types of "auto", the most we will pay under this coverage is $1,000 per disablement. "Autos" which are disabled do not include stolen vehicles. Page 2 of 4 Copyright, Everest Reinsurance Company, 2010 Includes copyrighted material of Insurance Services Office, Inc. used with its permission. ECA 04 506 0310 ❑ E. Glass Breakage — Hitting A Bird Or Animal — Falling Objects or Missiles The following is added to Paragraph A3. of Sec- tion III —Physical Damage Coverage: Any deductible shown in the Declarations will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. If the glass must be replaced and there is no other damage associated with the 'loss", the deductible will be $100 unless a lower deductible is shown in the Declarations applicable to this coverage. F. Loss Of Use Expenses Paragraph A4.b. of Section III —Physical Damage Coverage is replaced by the following: b. Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an 'Insured" becomes le- gally responsible to pay for loss of use of a ve- hicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Decla- rations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any ex- penses for loss of use is $50 per day, to a maximum of $1,000. G. Extra Expense —Stolen Vehicle The following is added to Paragraph A4. of Sec- tion III — Physical Damage Coverage: c. Stolen Vehicle We will pay for all reasonable and necessary expenses to return a stolen covered "auto" to you. H. Airbag Coverage The following exception is added to Paragraph B.3.a. of Section III — Physical Damage Coverage: The accidental discharge of an airbag shall not be considered mechanical breakdown if it occurs in a covered "auto" for which Comprehensive coverage is purchased. This provision does not apply to "au- tos" you hire with a driver and is excess over any warranty specifically designed to provide this cov- erage. I. Electronic Equipment Coverage Section III — Physical Damage Coverage is amended as follows.- 1. The sublimit in Paragraph C.2. of the Limit Of Insurance Provision is increased to $3,000. 2. No Physical Damage Coverage deductible ap- plies to the first $3,000 of 'Moss" to electronic equipment described in Paragraph C.2, of the Limit Of Insurance Provision. J. Single Deductible Provision The following is added to Paragraph D. of Section III — Physical Damage Coverage: If a Comprehensive or Specified Causes of Loss Coverage "loss" from "accident" involves two or more covered "autos", only the highest deductible applicable to those coverages will be applied to the "accident", if the cause of the loss is covered for those vehicles. This provision only applies if you carry Compre- hensive or Specified Causes of Loss Coverage for those vehicles, and does not extend coverage to any covered "autos" for which you do not carry such coverage. If a 'loss" covered under this Coverage Part also involves a 'loss" to other property from the same "accident", which is covered under a Commercial Property or Inland Marine Coverage Part issued by us to you, only the highest deductible applicable to those coverages will be applied to the "accident". K Notice To Company Paragraph A2. of Section IV — Business Auto Conditions is amended as follows: 1. With respect to notification requirements, your obligation under Paragraph A2.a. applies only when the "accident" or'loss" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; c. A member, if you are a joint venture or limited liability company; or d. An executive officer or insurance manager, if you are an organization other than a part- nership, joint venture or limited liability com- pany. 2. With respect to the requirements pertaining to you providing us with document concerning a claim or "suit", your obligation under Paragraph A2.b. will not be considered breached unless the breach occurs after such claim or "suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; c. A member, if you are a joint venture or limited liability company; or ECA 04 506 0310 Copyright, Everest Reinsurance Company, 2010 Includes copyrighted material of Insurance Services Office, Inc. used with its permission. Page 3 of 4 ❑ d. An executive officer or insurance manager, if you are an organization other than a part- nership, joint venture or limited liability com- pany. L. Blanket Waiver Of Subrogation The following is added to Paragraph A.S. of Sec- tion IV — Business Auto Conditions: a. However, we waive any right of recovery we may have against a person, organization or government entity when you have waived such right of recovery under a written 'insured con- tract" that is: (1) Currently in effect or becoming effective during the term of this policy; and (2) Executed prior to the "accident" or "loss", or executed after the "accident" or "loss" if: (a) The terms and conditions of the written "insured contract" had been agreed upon prior to the "accident" or 'loss"; and (b) You can definitively establish that the terms and conditions of the written 'In- sured contract" ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss". b. We hereby waive any right of subrogation against any of your officers, directors or em- ployees which might arise by reason of any payment under the insurance afforded by the policy for the operation, maintenance, use, loading or unloading of a non -owned "auto". This waiver extends only to payments in excess of other valid and collectible insurance available to the officer, director or employee. M. Unintentional Failure To Disclose Hazards The following is added to Paragraph B.2. of Sec- tion IV — Business Auto Conditions: If you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form, we will not deny coverage under this Cover- age Form because of such failure. However, this provision does not affect our right to collect addi- tional premium due to us as a result of these un- disclosed hazards in accordance with our filed rat- ing plans. N. Bodily Injury — Including Mental Anguish Paragraph C. of Section V — Definitions is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including "men- tal anguish" or death resulting from any of these at any time. For the purpose of this provision, the term "mental anguish" shall mean any type of mental or emotional illness or distress. O. Mexico Coverage The coverage provided by this policy for covered "autos" you own or lease on a long term basis without drivers are extended to "accidents" or "losses" occurring in Mexico if: 1. The covered "auto" is in Mexico for a period not exceeding 10 days; and 2. The covered "auto" is principally garaged and used in the United States; and 3. The driver of the covered "auto" does not re- side in Mexico; For Liability Coverage to apply to "accidents" oc- curring in Mexico, the following must also apply: 1. Valid and collectible auto liability insurance for the covered "auto" has been purchased from a licensed Mexican Insurance Company and is in force at the time of the "accident"; and 2. The original "suit" for damages is brought with- in the United States. For 'losses" payable under Physical Damage Cov- erage this additional restriction applies: We will pay 'losses" under Physical Damage Cov- erage in the United States, not in Mexico. If the covered "auto" must be repaired in Mexico in order to be driven, then the most we will pay for 'loss" is the lesser of the following: 1. The cost of repairing the "auto" or replacing its parts in Mexico; or 2. The cost of repair or replacement at the nearest point in the United States where the repairs or replacement could be made. Other Insurance: The insurance provided by this section will be ex- cess over any other collectible insurance. Page 4 of 4 Copyright, Everest Reinsurance Company, 2010 Includes copyrighted material of Insurance Services Office, Inc. used with its permission. ECA 04 506 0310 ❑ Pyro Spectaculars, Inc. Pyro Spectaculars North, Inc. Policy # S18CA00031-211 COMMERCIAL AUTO ECA 24 509 04 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. e "" ' aI= OJPWAI1' I • This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART Paragraph c. of the Other Insurance General Condition is replaced by the following: c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any liability assumed under an "insured contract" that requires liability to be assumed on a primary noncontributory basis. Additionally, only the coverage and limit of insurance requirements of the "insured contract" shall apply, and in no event shall those requirements exceed the coverage and limits of insurance provided under this policy. E A 24 509 04 14 Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with its permission Page 1 of 1 0 aLuRF'r'b COPY POLICYHOLDER COPY SP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-08-2021 CITY OF EL SEGUNDO SP 350 MAIN ST EL SEGUNDO CA 90245-3813 GROUP: POLICY NUMBER: 0803749-2020 CERTIFICATE ID: 2073 CERTIFICATE EXPIRES: 10-14-2021 10-14-2020/10-14-2021 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer, We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2020-10-14 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF EL SEGUNDO ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-14-2002 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT N2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2021-03-08 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF EL SEGUNDO EMPLOYER PYRO SPECTACULARS, INC. SP PO BOX 2329 RIALTO CA 92377 [P1Y,SD] IREV.7-2014f PRINTED : 03-08-2021 ENDORSEMENT AGREEMENT •TEE WAIVER OF SUBROGATION REP 25 803749-20 FUND RENEWAL SP HOME OFFICE 5-41-39-14 SAN FRANCISCO PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC EFFECTIVE MARCH 8, 2021 AT 12.01 A.M. STANDARD TIME OR THE AND EXPIRING OCTOBER 14, 2021 AT 12.01 A.M. TIME INDICATED AT PACIFIC STANDARD TIME PYRO SPECTACULARS, INC. PO BOX 2329 RIALTO, CA 92377 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, PYRO SPECTACULARS, INC. IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: MARCH 10, 2021 2570 AUTHORIZED REPRESENT IV PRESIDENT AND CEO T ni n no 017