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PROOF OF INSURANCE (2022 - 2022) CLOSED� 'ai. DATE (MM/DDIYYYY)
AC�� CERTIFICATE OF LIABILITY INSURANCE
09I24I2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 CO TACT NAME: Hong Ta
Brown & Brown Insurance Services of California, Inc PHONE (805) 965-0071 C (805) 690-3200
AIC No gxt a It
License #OD04053 AW LSS: hta@bbofcaLcom
1001 Mark Avenue, Suite 201 INSURER(S) AFFORDING COVERAGE NAIC #
Carpinteria CA 93013 INSURERA: Great American Assurance Company 26344
INSURED INSURER B : Nationwide Mutual Insurance Company 23787
Cedro Construction Inc. INSURER c : Travelers Property Casualty Company of America 25674
120 E, Santa Maria INSURER D : State Compensation Insurance Fund of CA 231751
INSURER E :
Santa Paula CA 93060 INSURER F :
rnVFRar. FC rFRTIFIrOTF NIIMRFR- 21/22 GL/AUTOIUMB(WC 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 CONTRACTOR 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,
LTR
TYPE OF INSURANCE
,Inq.',
WVD
POLICY NUMBER
MMIDD Y
MM DDIYYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,000.000
�
TZ5_50,000
CLAIMS-MADE OCCUR
PREMISE aaccurrencp$
S.E
Policy contains OCIP exclusion
MED EXP (Any one person) $ Excluded
A
Deductible: $5,000 BIIPD
Y
Y
GLP3415054
01/23/2021
01/23/2022
PERSONAL 1,000,000
ADV INJURY $
GENERALAGGREGATE $ 2,000.000
GEN'UAGGREGATE.LIMITAPPLIESPE.R:'
POLICY JCT F] LOC'
2,000,000
PRODUCTS $
1-1
Employee Benefits $ 1,000,000
OTHER:
AUTOMOBILE LIABILITY
COMkStlNEDSINGLE LIMIT S 1,000,000
Ea mCCidenl. 1
BODILY INJURY (Per person) $
ANYAUTO
B
OWNED SCHEDULED
Y
ACP3029450620
09/24/2021
09/24/2022
BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
AUTOS ONLY �""'" AUTOS ONLY
IX HIRED +�,,� NON -OWNED
P PER DAM G $
'Parr aoclde�nh
$
-
UMBRELLA LIAB ''. OCCUR
'. EACH OCCURRENCE $ 5,000,000
C
X.
EXCESS LIAB (CLAIMS -MADE
ZUP71 M8535521 NF
01/23/2021
01/23/2022
'...AGGREGATE $ 5,000,000
DED RETENTION S 10,000
$
WORKERS COMPENSATION
X1STATUTE ERH
AND EMPLOYERS' LIABILITY Y / N
EL. EACH ACCIDENT s 1,000,000
D
ANY PROPRIETOR/PARTNER/EXECUTIVE
NIA
Y
9207992
04/01/2021
04/01I2022
11000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
'... E.L. DISEASE - EA EMPLOYEE S
'.. E.L, DISEASE- POLICY LIMIT S 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
............... .........
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Project #PW 20-04, DI Project ID #350079. Water Main Improvements Project on Indiana Street,
City of El Segundo, The City, its officers, officials, employees, agents, and volunteers are included as Additional Insureds under the General Liability perform
CG203307 04 and under the Auto Liability per the attached form AC 70 06 03 16, as required by written contract, General Liability policy is Primary and
Non -Contributory per form GAC3649CG1106, Waivers of Subrogation apply to the General Liability per form CG24040509 and to the Workers
Compensation per the attached form SCIF FORM 10217 (REV7-2014), as required by written Contract,
Notice of Cancellation per policy provisions.
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.
350 Main Street
AUTHORIZED REPRESENTATIVE ,/
ElSegundo CA 90245 //� _dc
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Great American Assurance Company
CG 20 33
(Ed. 07 04)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC
STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. SECTION II - WHO IS AN INSURED is
amended to include as an Additional Insured
any person or organization for whom you are
performing operations when you and such
person or organization have agreed in writing
in a contract or agreement that such person
or organization be added as an Additional In-
sured on your policy. Such person or or-
ganization is an Additional Insured only with
respect to liability for "bodily injury," "prop-
erty damage" or "personal and advertising in-
jury" 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 oper-
ations for the Additional Insured.
A person's or organization's status as an Ad-
ditional Insured under this endorsement ends
when your operations for that Additional In-
sured are completed.
B. With respect to the insurance afforded to
these Additional Insureds, the following addi-
tional exclusions apply:
This insurance does not apply to:
1. "Bodily injury," "property damage" or "per-
sonal and advertising injury" arising out of
the rendering of, or the failure to render,
any professional architectural, engineering
or surveying services, including:
a. the preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or draw-
ings and specifications; or
b. supervisory, inspection, architectural
or engineering activities.
2. "Bodily injury," or "property damage" oc-
curring after:
a. 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
b. 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 an-
other contractor or subcontractor en-
gaged in performing operations for a
principal as a part of the same project.
Copyright, ISO Properties, Inc., 2004
CG 20 33 (Ed. 07/04) XS
Great American Assurance Company
GAC 3649CG
(Ed. 11 06)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
PRIMARY NON-CONTRIBUTORY INSURANCE ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM
This insurance is primary to any other insurance held by third parties with respect to work performed by
you under written contractual agreements with such third parties and any other insurance which may be
available to such third parties shall be non-contributory.
GAC 3649CG (Ed. 1 1 /06) XS
Great American Assurance Company
CG 24 04 (Ed. 05/09)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
Schedule
Name of Person or Organization:
Any person or organization for whom or on whose behalf "you" are performing operations when "you" and such person
or organization have agreed in writing in a contract or agreement to waive any right of recovery "we" may have against
such person or organization.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV -
CONDITIONS:
We waive any right of recovery we may have against the person or organization shown in the Schedule above because
of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract
with that person or organization and included in the "products -completed operations hazard." This waiver applies only to
the person or organization shown in the Schedule above.
© Insurance Services Office, Inc., 2008
CG 24 04 (Ed. 05/09) (Page 1 of 1)
COMMERCIAL AUTO
AC 70 06 03 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO PROTECTION - PLATINUM
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SUMMARY OF COVERAGES
A. Effect of This Endorsement
B. Newly Acquired of Formed Entities
C. Employees as insureds — Nonowned Autos
D. Additional Insured by Contract, Permit or Agreement
E. Supplementary Payments — Bail Bonds
F. Supplementary Payments — Loss of Earnings
G. Personal Effects and Property of Others Extension
H. Prejudgment Interest Coverage
I. Fellow Employees
J. Hired Auto Physical Damage
K. Temporary Substitute Autos — Physical Damage Coverage
L. Expanded Towing Coverage
M. Auto Loan or Lease Coverage
N. Original Equipment Manufacturer Parts — Leased Private PassengerTypes
O. Deductible Amendments
P. Expanded Transportation Expense
Q. Extra Expense— Stolen Autos
R. Physical Damage Limit of Insurance
S. New Vehicle Replacement Cost
T. Physical Damage Coverage Extensions
U. Business Income and Extra Expense Coverage
V. Transfer of Rights Of Recovery Against Others To Us
W. Section IV — Business Auto Conditions — Notice of and Knowledge of Occurrence
X. Hired Car Coverage Territory
Y. Emergency Lockout
Z. Cancellation Condition
AC 70 06 0316 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 7
with its permission
LKEV 20104 INSURED COPY AC7006031600 0001 47 0006193
COMMERCIAL AUTO
AC 70 06 0316
A. EFFECT OF THIS ENDORSEMENT
Coverage provided under this policy is modified
by the provisions of this endorsement. If there
is any conflict between the provisions of this
endorsement and the provision(s) of any state -
specific endorsement also attached to this poli-
cy, then the provision(s) of the state -specific
endorsement shall apply instead of the provi-
sions of this endorsement that are in conflict,
but only to the extent of the conflict, and only to
the extent necessary to bring such provisions
into conformance with the state requirement(s)
contained in the provision(s) of the state -specific
endorsement.
B. NEWLY ACQUIRED OR FORMED ENTITIES
The Named Insured shown in the Declarations is
amended to include any organization you newly
acquire or form, other than a partnership, joint
venture, or limited liability company, and over
which you maintain ownership or majority (more
than 50%) interest; if there is no other similar in-
surance available to that organization. Coverage
under this provision is afforded until the 180tn
day after you acquire or form the organization or
the end of the policy period, whichever is later.
C. EMPLOYEES AS INSUREDS — NONOWNED
AUTOS
The following is added to paragraph A.1. Who Is
An Insured of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:
d. Any "employee" of yours is an "insured"
while using a covered "auto" you don't own,
hire or borrow in your business or your per-
sonal affairs.
D. ADDITIONAL INSURED BY CONTRACT,
PERMIT OR AGREEMENT
The following is added to A.1. Who Is An In-
sured of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:
Any person or organization that you are re-
quired to name as an additional insured in a
written contract or agreement that is executed
or signed by you prior to a "bodily injury" or
"property damage" occurrence is an "insured"
for Covered Auto Liability coverage. How-
ever, with respect to covered "autos", such
person or organization is an insured only to
the extent that person or organization qualifies
as an "insured" under A.1. Who is an Insured of
SECTION II — COVERED AUTOS LIABILITY
COVERAGE:
If specifically required by the written contract or
agreement referenced in the paragraph above,
any coverage provided by this endorsement to
an additional insured shall be primary and
any other valid and collectible insurance avail-
able to the additional insured shall be non-
contributory with this insurance. If the written
contract does not require this coverage to be
primary and the additional insured's coverage to
be non-contributory, then this insurance will be
excess over any other valid and collectible insur-
ance available to the additional insured.
E. SUPPLEMENTARY PAYMENTS — BAIL
BONDS
Supplementary Payments of SECTION II —
COVERED AUTOS LIABILITY COVERAGE is
revised as follows:
(2) Up to $3,000 for cost of bail bonds (including
bonds for related traffic law violations) re-
quired because of an "accident" we cover.
We do not have to furnish these bonds.
F. SUPPLEMENTARY PAYMENTS — LOSS OF
EARNINGS
Supplementary Payments of SECTION II —
COVERED AUTOS LIABILITY COVERAGE is
revised as follows:
(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.
G. PERSONAL EFFECTS AND PROPERTY OF
OTHERS EXTENSION
1. The Care, Custody or Control Exclusion of
SECTION II — COVERED AUTOS LIABILITY
COVERAGE, does not apply to "property dam-
age" to property, other than your property, up to
an amount not exceeding $500 in any one "acci-
dent". Coverage is excess over any other valid
and collectible insurance.
2. The following paragraph is added to A.4.
Coverage Extensions of SECTION III -
PHYSICAL DAMAGE COVERAGE:
c. We will pay up to $1,000 for your prop-
erty that is lost or damaged as a result
of a covered "loss", without applying a
deductible. Coverage is excess over
any other valid and collectible insur-
ance.
Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc.
with its permission
ACP BA 30-0-9655625 LKEV 20104 INSURED COPY AC7006031600 0001
AC 70 06 0316
47 0006194
COMMERCIAL AUTO
AC 70 06 0316
H. PREJUDGMENT INTEREST COVERAGE
e. Destruction
The following paragraph is added to SECTION II
The coverage that applies is the same as
— COVERED AUTOS LIABILITY COVERAGE,
the coverage provided for the vehicle being
2. Coverage Extensions, a. Supplementary
replaced.
Payments: L.
EXPANDED TOWING COVERAGE
(7) Prejudgment interest awarded against the
1. We will pay up to:
"insured" on that part of the judgment we
a. $150 for a covered "auto" you own of
pay. If we make an offer to pay the appli-
the private passenger type, or
cable limit of insurance, we will not pay
b. $750 for a covered "auto" you own that
any prejudgment interest based on that
is not of the private passengertype,
period of time after the offer.
for towing and labor costs incurred each
I. FELLOW EMPLOYEE
time the covered "auto" is disabled. Howev-
The Fellow Employee Exclusion of SECTION II -
er, the labor must be performed at the place
COVERED AUTOS LIABILITY COVERAGE,
of disablement.
does not apply if the "bodily Injury" results from
2. This coverage applies only for an "auto"
the use of a covered "auto" you own or hire.
covered on this policy for Comprehensive or
The insurance provided under this provision is
Specified Causes of Loss Coverage and
excess over any other collectible insurance.
Collision Coverages.
J. HIRED AUTO PHYSICAL DAMAGE
3. Payment applies in addition to the otherwise
If covered "auto" designation symbols 1 or 8 ap-
applicable amount of each coverage you
ply to Liability Coverage and if at least one "au-
have on a covered "auto".
to" you own is covered by this policy for Com- M.
AUTO LOAN OR LEASE COVERAGE
prehensive, Specified Causes of Loss, or Colli-
1. In the event of a total "loss" to a covered
sion coverages, then the Physical Damage
coverages provided are extended to "autos" you
"auto", we will pay any unpaid amount due
lease, hire, rent or borrow without a driver; and
on the loan or lease, including up to a max -
provisions in the Business Auto Coverage Form
imum of $500 for early termination fees or
"auto"
applicable to Hired Auto Physical Damage apply
penalties, for your covered less:
up to a limit of $125,000. The deductible will be
a. The amount paid under SECTION III —
equal to the largest deductible applicable to any
PHYSICAL DAMAGE COVERAGE of
owned "auto" for that coverage. Any Compre-
this policy; and
hensive deductible does not apply to fire or
b. Any:
lightning.
1) Overdue lease/loan payments at the
K. TEMPORARY SUBSTITUTE AUTOS —
time of the "loss";
PHYSICAL DAMAGE COVERAGE
2) Financial penalties imposed under a
The following is added to paragraph C. Certain
lease for excessive use, abnormal
Trailers, Mobile Equipment And Temporary
wear and tear or high mileage;
Substitute Autos of SECTION I — COVERED
3) Security deposits not refunded by a
AUTOS:
lessor;
If Physical Damage Coverage is provided by
4) Costs of extended warranties, Credit
this Coverage Form, the following types of
Life insurance, Health, Accident, or
vehicles are also covered "autos" for Physi-
Disability insurance purchased with
cal Damage Coverage:
the lease; and
Any "auto' you do not own while used with
5) Carry-over balances from previous
the permission of its owner as a temporary
leases.
substitute for a covered "auto" you own that
2. This coverage only applies to a "loss" which
is out of service because of its:
Com-
is also covered under this policy for Com-
a. Breakdown;
prehensive, Specified Causes of Loss, or
b. Repair;
Collision coverage.
c. Servicing;
d. "Loss"; or
AC 70 06 0316 Includes copyrighted material of Insurance Services Office, Inc. Page 3 of 7
with its permission
ACP BA 30-0-9655625 LKEV 20104 INSURED COPY
AC7006031600 0001 47 0006195
COMMERCIAL AUTO
AC 70 06 03 16
3. Coverage does not apply to any unpaid
amount due on a loan for which the covered
"auto" is not the sole collateral.
N. ORIGINAL EQUIPMENT MANUFACTURER
PARTS — LEASED PRIVATE PASSENGER
TYPES
Under Paragraph C. Limit of Insurance of
SECTION III — PHYSICAL DAMAGE
COVERAGE, Section 4 is added as follows:
4. We will use new original equipment vehicle
manufacturer parts for any private passen-
ger type covered "auto" where required by
the lease agreement which has a term of at
least six months. If a new original equip-
ment vehicle manufacturer part is not in pro-
duction or distribution we may use a like,
kind and quality replacement part.
O. DEDUCTIBLE AMENDMENTS
The following are added to the Deductible provi-
sion of SECTION III — PHYSICAL DAMAGE
COVERAGE:
If another policy or coverage form that is not an
automobile policy or coverage form issued by
this company applies to the same "accident", the
following applies:
1. If the deductible under this coverage is the
smaller (or smallest) deductible, it will be
waived:
2. If the deductible under this coverage is not
the smaller (or smallest) deductible, it will be
reduced by the amount of the smaller (or
smallest) deductible.
If a Comprehensive or Specified Causes of Loss
Coverage "loss" from one "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 Comprehensive 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.
No deductible applies to glass if the glass is re-
paired, in a manner acceptable to us, rather than
replaced.
P. EXPANDED TRANSPORTATION EXPENSE
Paragraph A.4.a. of SECTION III — PHYSICAL
DAMAGE COVERAGE is replaced by the
following:
curred by you because of the total theft of a
covered "auto" of the private passengertype.
We will only pay for those covered "autos" for
which you carry Comprehensive or Specified
Causes of Loss Coverage. We will pay for tem-
porary transportation expenses incurred during
the period beginning 24 hours after the theft and
ending, regardless of the policy's expiration,
when the covered "auto" is returned to use or we
pay for its "loss".
Q. EXTRA EXPENSE — STOLEN AUTOS
The following paragraph is added to Section A.4.
of SECTION III — PHYSICAL DAMAGE
COVERAGE:
c. We will pay for up to $5,000 for the expense
of returning a stolen covered "auto" to you.
We will pay only for those covered "autos"
for which you carry Comprehensive or Spec-
ified Causes of Loss Coverage.
R. PHYSICAL DAMAGE LIMIT OF INSURANCE
Under SECTION III — PHYSICAL DAMAGE
COVERAGE, Paragraph C., Limit of Insurance
is replaced by the following:
C. Limit Of Insurance
1. The most we will pay for "loss" in any one
"accident" is the lesser of:
a. The actual cash value of the damaged
or stolen property as of the time of the
"loss", or
b. The cost of repairing or replacing the
damaged or stolen property.
2. $2000 is the most we will pay for "loss" in
any one "accident" to all electronic equip-
ment that reproduces, receives or transmits
audio, visual or data signals which, at the
time of "loss", is:
a. Permanently installed in or upon the
covered "auto" in a housing, opening or
other location that is not normally used
by the "auto" manufacturer for the instal-
lation of such equipment.
b. Removable from a permanently installed
housing unit as described in Paragraph
2.a. above or is an integral part of that
equipment; or
c. An integral part of such equipment.
3. An adjustment for depreciation and physical
condition will be made in determining actual
cash value in the event of a total "loss".
We will pay up to $50 per day to a maximum of 4. The cost of repairing or replacing may:
$1500 for temporary transportation expense in -
Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc AC 70 06 0316
with its ermission.
ACP BA 30-0-9655625 LKEV 20104 ASIURED COPY AC7006031600 0001 47 0006196
COMMERCIAL AUTO
AC 70 06 0316
a. Be based on an estimate which includes
titled and which you purchased less than
parts furnished by the original equip-
365 days before the date of the "loss".
ment manufacturer or other sources in-
cluding non -original equipment manu- T.
PHYSICAL DAMAGE COVERAGE
facturers and
EXTENSIONS
b. If a repair or replacement results in bet-
Under SECTION III — PHYSICAL DAMAGE
ter than like kind or quality, we will not
COVERAGE, A. Coverage, 4. Coverage Exten-
pay for the amount of the net improve-
sions, b. Loss of Use Expenses is replaced by
ment.
the following:
5. If we offer to pay the actual cash value of
b. Loss of Use Expenses
the damaged or stolen property, we will
value auto advertising wraps, paint customi-
For Hired Auto Physical Damage, we will
zation, and similar business related advertis-
pay expenses for which an "insured"
ing modifications, in addition to the actual
becomes legally responsible to pay for loss
cash value of the property. Auto advertising
of use of a vehicle rented or hired without a
wraps, paint customization, and similar
driver, under a written rental contract or
business related advertising modifications
agreement. We will pay for loss of use
will be valued at the cost to replace them
expenses if caused by:
with an adjustment made for depreciation
(1) Other than collision if the Decla-
and physical condition.
rations indicate that Comprehen-
S. NEW VEHICLE REPLACEMENT COST
sive Coverage is provided for any
The following is added to the Limit of Insurance
covered "auto";
provision of SECTION III — PHYSICAL
(2) Specified Causes of Loss only if
DAMAGE COVERAGE:
the Declarations indicate that
5. The provisions of paragraphs 1.and 3. do
Specified Causes of Loss Cover -
not apply to a covered "auto" of the private
age is provided for any covered
"auto";
passenger type or a vehicle with a gross ve-
or
hicle weight rating of 20,000 pounds or less
(3) Collision only if the Declarations
which is a "new vehicle."
indicate that Collision Coverage
In the event of a total "loss" to your "new ve-
is provided for any covered
"auto."
hicle" to which this coverage applies, we will
pay at your option:
However, the most we will pay for any
a. The verifiable "new vehicle" purchase
expenses for loss of use is $50 per day, to a
price you paid for your damaged vehi-
maximum of $1,500. The insurance provided
cle, not including any insurance or war-
by this provision is excess over any other
ranties purchased;
collectible insurance.
b. If it is available, the purchase price, as U.
BUSINESS INCOME AND EXTRA EXPENSE
negotiated by us, of a "new vehicle" of
COVERAGE
the same make, model, and equipment
1. Business Income Coverage
or the most similar model available, not
We will pay the actual loss of business in -
including any furnishings, parts, or
come sustained by you as a result of the
equipment not installed by the manufac-
necessary suspension of your business dur-
turer or manufacturers' dealership; or.
ing the period of restoration due to "loss" to
c. The market value of your damaged ve-
a covered "auto' used in your business. The
hicle, not including any furnishings,
loss must be caused by a cause of loss cov-
parts, or equipment not installed by the
ered under item Al of Physical Damage
manufacturer or manufacturer's dealer-
Coverage in this Coverage Part.
ship.
2. Extra Expense Coverage
We will not pay for initiation or set up costs
We will pay the necessary and reasonable
associated with loans or leases
extra expenses that you incur during the pe-
As used in this endorsement, a "new vehi-
riod of restoration that you would not have
cle" means an "auto" of which you are the
incurred had there been no "loss" to a cov-
original owner that has not been previously
ered "auto" used in your business. The loss
AC 70 06 0316 Includes copyrighted material of Insurance
Services Office, Inc. Page 5 of 7
with its permission
ACP BA 30-0-9655625 LKEV 20104 INSURED DOPY
AC7006031600 0001 47 0006197
COMMERCIAL AUTO
AC 70 06 0316
must be caused by a cause of loss listed
under item Al of Physical Damage Cover-
age in this Coverage Part. Extra Expenses
means those expenses you incur to avoid or
minimize the suspension of business and to
continue your business operations.
3. Additional Conditions
We will not pay for "loss" or expenses
caused by suspension, lapse or cancellation
of any license, lease or contract. But if the
suspension, lapse or cancellation is directly
caused by the suspension of your business,
we will cover such "loss" that affects your
business income. We will not pay under this
coverage if you do not repair or replace the
covered "auto". You must resume all or part
of your business as quickly as possible. If
you have other autos you can use to reduce
the amount of loss payable under this cov-
erage, you are required to use them. We will
pay for expenses you incur to reduce the
amount that otherwise would have been
payable under this coverage. We will not
pay more than the amount by which you ac-
tually reduce the business income loss or
extra expense incurred.
4. Limit
The most we will pay for "loss" arising out of
one covered "auto" is $10,000 per loss with
an annual aggregate of $20,000. Payment
applies in addition to the otherwise applica-
ble amount of each coverage you have on a
covered "auto".
5. Definitions
a. 'Business Income" means the:
1.). Net income (Net profit or loss before
income taxes) that would have been
earned or incurred if no loss would
have occurred; and
2.). Continuing normal operating
expenses incurred, including payroll.
"Period of Restoration" means the
period of time that:
1.). Begins:
(a) 24 hours after the time of loss
for Business Income Coverage;
or
(b) Immediately after the time of
loss for Extra Expense
Coverage; and
2.) Ends at the earliest of:
(a) The time required to resume
your normal business opera-
tions; or
(b) The time that is reasonably
necessary to repair or replace
the covered auto with a maxi-
mum time period of 180 days.
Period of Restoration does not
include any increased period
required due to the enforcement
of any ordinance or law that re-
quires any insured or others to
test for, monitor, clean up, re-
move, contain, treat, detoxify or
neutralize or in any way respond
to or assess the effects of pollu-
tants. The expiration date of this
policy will not cut short the peri-
od of restoration.
V. TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
The following is added to the Transfer Of Rights
Of Recovery Against Others To Us Condition:
We waive any right of recovery we may
have against any person or organization to
the extent required of you by a written con-
tract executed prior to any "accident' be-
cause of payments we make for damages
under this coverage form.
W. NOTICE OF AND KNOWLEDGE OF
OCCURRENCE
SECTION IV — BUSINESS AUTO
CONDITIONS, Paragraph A is amended as
follows:
6. NOTICE OF AND KNOWLEDGE OF
OCCURRENCE
a. Your obligation in the Duties in the Event
of Accident, Claim, Suit or Loss Condi-
tion relative to notification require-
ments applies only when the "accident'
or "loss" is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer or insurance
manager, if you are a corporation.
b. Your obligation in the. Duties in the Event
of Accident, Claim, Suit or Loss Condition
relative to providing us with documents
concerning a claim or "suit' will not be
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with its permission
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AC 70 06 0316
47 0006198
considered breached unless the breach
occurs after such claim or "suit' is known
to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer or insurance
manager, if you are a corporation.
X. HIRED CAR — COVERAGE TERRITORY
Item (5) of the Policy Period, Coverage Territory
GeneralCondiionis replaced by the following:
(5) Anywherein the world if a covered"auto"
is leased, hired, rented or borrowed without a
driverfor a period of 30 days or less; and
Y. EMERGENCY LOCKOUT
We will reimburse you up to $100 for reasonable
expense incurred for the services of a locksmith
to gain entry into your covered "auto" subject to
these provisions:
1. Your door key, electronic key or key entry
pad has been lost, stolen or locked in your
AC 70 06 03 16
ACP BA 30-0-9655625
COMMERCIAL AUTO
AC 70 06 0316
covered "auto" and you are unable to enter
such "auto" , or
2. Your keyless entry device battery dies and
you are unable to enter such "auto" as a
result,
3. Your key, electronic key or key entry pad
has been lost or stolen and you have
changed the lock to prevent an unauthorized
entry; and
4. Original copies of receipts for services of a
locksmith must be provided before
reimbursement is payable.
Z. CANCELLATION CONDITION
Paragraph A.2. of the COMMON POLICY
CONDITION — CANCELLATION applies except
as follows:
If we cancel for any reason other than nonpay-
ment of premium, we will mail or deliver to the
First Named Insured written notice of cancella-
tion at least 60 days before the effective date of
cancellation. This provision does not apply in
those states that require more than 60 days prior
notice of cancellation.
Includes copyrighted material of Insurance Services Office, Inc.
with its permission
LKEV 20104 INSURED COPYAC7006031600 0001
Page 7 of 7
47 0006199
ENDORSEMENT AGREEMENT
31-k 101 - 0
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
WAIVER OF SUBROGATION
BLANKET BASIS
EFFECTIVE APRIL 1, 2021 AT 12.01 A.M.
AND EXPIRING APRIL 1, 2022 AT 12.01 A.M.
CEDRO CONSTRUCTION, INC.
120 E SANTA MARIA ST
SANTA PAULA, CA 93060
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.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE
2.00% OF THE TOTAL POLICY PREMIUM.
SrT4F.T)TTT.F.
PERSON OR ORGANIZATION JOB DESCRIPTION
ANY PERSON OR ORGANIZATION BLANKET WAIVER OF
FOR WHOM THE NAMED INSURED SUBROGATION
HAS AGREED BY WRITTEN
CONTRACT TO FURNISH THIS
WAIVER
REP B2
9207992-21
RENEWAL
SC
4-70-41-91
PAGE 1 OF 1
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: APRIL 2 , 2021
2572
AUTHORIZED REPRESENT /IVE PRESIDENT AND CEO
SCIF FORM 10217 (REV.7-2014)
OLD DP 217