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PROOF OF INSURANCE (2022 - 2022) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MPX Insurance Services, Inc. NA ---- Lindsey McFarhn 6B Liberty Suite 200 a>y_(': (949)334-0 FAX Nat 9)z �94a-2s77 E-MAIL Lindse m xinsurance com Aliso Viejo, CA 92656 ADDRESS. x� . p........ .....: License #: OH49306 INSURER(S)AFFORDINGCOVERAGE NAIC# INSURED Plumbers Depot Inc 3921 W 139th St Hawthorne, CA 90250 INSURER A: COI DAY,l INSURER INFINITII INSURER C : S_Cottsdi INSURER D : Clear BIDE -----....: INSURER E 4,.VVhKA.L°t:5 ULKI IFIk AIt NUIVIDtK: UUUUU4IU-4t)1141t) KCVI.7IUN NUIVIDCK: LIZ 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 _w................ ..... L, ILTR ... SURANC............... )/k)'3B L� i15RT_ POLICY NUMBER..... ..'D Y' EFF � POLICY E}Ci' i LIMITS TYPE OF IN E D/YYYY d dYYYY A X� coMMELARIMs-MADEGENERAL ❑ LIABILITY occuR Y i Y 103 GL 0202039-00 � 07H2/2o21 i o7/12/zo2z I R��� �� OCCURRENCE mar) I $ 1 A000000 00,000 .... GEN X i � ......... ............... .......—.. _ _.-_. 1 L AGGREGATE LIMIT APPLIES PER: PGDV.IOY PRO LOC OTHER MED EXP (Anyone person) $ � 1 GENERAL AGGREGATE RY $ E $ PRODUCTS COMP/OP AGG S Deuctlble : $ 5,000 1,000,000 2 000 000 2,000,000 2 500 B = AUTOMOBILE AelurY 504610159932001 07/1212021 07/12/2022 go-- p�QO auro - eoov iNJuRY( Per onN) 7; $ OWNED -SCHEDULED ONLY AUTOSI ..., .. JURY (Per accident) I $ ,µl HE D X I NON-OWNED AUTOS ONLY Y I „y L_-- AUTOS ONLY ,�. DAMaGE j - aPccadrrsk:L X 1 COMP:$1,000 X COLL: $1,000 UMBI $ 100000 C X I UMBRELLA LIAB 'OCCUR = XBS0145130 07/20/2021 07/12/2022 EACH OCCURRENCE $ -.-. 10,000,000 --------- EXCESS LIAB I CLAIMS MADE C J - AGGREGATE $ 1071000,000 ..... DED t RE.TPNTION $ [ I $ 1 WORKERS COMPENSATION f I TH STATUTE Era AND EMPLOYERS' LIABILITY YIN 1 „„ I ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA in NH) E L EACH ACCIDENT ( $ E LOYEE $ L DISEASE EA EMPLOYEE (Man Ues, describe understory If YSCRIPTION J below f I 1 1„._ _.....„„„ E LIMIT 1 S L DISEASE POLICY D E OF OPERATIONS EPLI _ _ EX01-000303-01 07/12/2021 07/12/2022 1,000,000 C BPP -Location 1 CPS7408794 07/20/2021 j 07/20/2022 400,000 Deductible $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) Garage Keepers Legal Liability Insurance Carrier: Great Lakes Insurance SE Policy #: RK69211A21 Effective Dates: 8/16/2021-8/1612022 500,000 Any One Unit 3,000,000 Any One Loss, blanket over both locations r cDrII rr �wTa Wrww M=0 c'"Ar11t":1=1I I ATinti SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 150 Illinois St AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 (LML (9 1988-ZU15 AGUKU GUKPUKA I IUN. All rlgnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by LML on 12/15/2021 at 01:59PM AGENCY CUSTOMER ID: 00000410 LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MPX Insurance Services, Inc. Plumbers Depot Inc ............................. ................... . POLICY NUMBER NIA CARRIER NAIC CODE Multiple Carriers EFFECTIVE DATE: Page 2 of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate ofwwLiawbiwli ( Insurance _._................................................ ...._..._._.. The CitySe Is listed as additional ................ of El undo g Tonal insured per attached endorsement and written contract for the General Liability coverage. There is also a waiver of subrogations in favor of the certificate holder per written contract and attached endorsement on the General liability insurance coverage. ACORD 101 (2008/01) U 2008 AGUKU GUKPUKA I IUN. All rlgnts reserves. The ACORD name and logo are registered marks of ACORD Printed by LML on December 15, 2021 at 01:59PM 103 GL 0202039-00 POLICY NUMBER: 103 GL 0202039-00 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) I Location(s) Of Covered Operations As required by written contract with the Named Insured All locations which are afforded coverage under this that is executed by the parties to the contract prior to the policy. commencement of work that is called for in the contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, 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. 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 insurance 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 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 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 103 GL 0202039-00 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. 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 Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 103 GL 0202039-00 POLICY NUMBER: 103 GL 0202039-00 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As required by written contract with the Named Insured All locations which are afforded coverage under this policy. that is executed by the parties to the contract prior to the commencement of work that is called for in the contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products -completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 103 GL 0202039-00 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 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: As required by written contract with the Named Insured that is executed by the parties to the contract prior to the commencement of work that is called for in the contract. 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. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 103 GL 0202039-00 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following:. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) Acct# 2793272 12/16/2021 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 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 COCu1TACT 888-828-8365 Lockton Companies, LLC PHONE FAX 3657 Briarpark Dr., Suite 700 IAJQ.N9,,.Elt); (Adc Nol., E-MAIL Houston, TX 77042 ADDRESS: INSURER(S) AFFORDING COVERAGE ',WC ......... .......... .. ............. .... .......... ,,..........- .. .. ......, ......... ,,,,. ..........,..,...... INSURER A Ace American Insurance Co. 22667 ---- - --- ----- ---- ---- INSURED INSURER B PLUMBERS DEPOT INC. .- ------------- ----- -- ---- ---- 3921 W 139TH ST INSURER C HAWTHORNE, CA 90250-7404 INSURER D : f INSURER E : i COVERAGES 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 POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, . .. ..... ..............-......... ,. v INSR iA L �R _,:--POLICY EFF f'OLdCY EXP ., ........_._._. --..............-.._._. ----- LTRTYPE OF INSURANCE POLICY NUMBER LIMITS � MMIDDIYYYY I M DOfYYYY I LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ CLAIMS MADE OCCUR . .......� „. ,. .,... MED EXP (Any one person) .$ -- .--- „-.- ... ,..m -- ' s....-. PERSONAL ✓3 ADV INJURY $ --. _. GE L AGGREGATE LIME T APPLIES PER GENERAL AGGREGATE J $ POLICY JET �. ......� ILOG; f i PRODUCTS 1 $ OTHER: { 1 $ (� AUTOMOBILE LIABILITY I COMBINED ih" aLE UMIT $ Ewa ar vrAM)- r ANY AUTO i BODILY INJURY (Per person) $ LL OWNED f $A Itf BODILY ODIY INJURY accident) AUTOS � ....., .. NON-OWNED , Iwr14AMAGE I$HIREDAUTOS 1 �SCHEDULED AUTOS y �------..� UMBRELLA LIAR OCCUR I [ EACH OCCURRENGE i EXCESS LIAR I L -.CLAIMS MADE _ - -`DED f AGGREGATE $ � � � I RETENTION $ I ' WORKERS COMPENSATION � X PER 01 H STATI`fE E,R AND EMPLOYERS' LIABILITY YIN _ ANY PROPRIETOR/PARTNER/EXECUTIVE A I OFFICER/MEMBER EXCLUDED? NIAI X C70136703 E,L EACH ACCIDENT $ 1000000 10/1/2021 10/1/2022 a - .. - - .. )(Mandatory in NH) E.L DISEASE EA EMPLOYEES $ 1,000000 If yes, describe under r-DESCRIPTION OF OPERATIONS below " -- EDISEASE""" POLICY LIMIT t $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Notice to Others Endorsement Included RE: 44OP-297661 - CITY EL SEGUNDO PD EXHAUST FAN. PROJECT NO.. PW 20-15 WAIVER OF SUBROGATION IN FAVOR OF CITY OF EL SEGUNDO WHEN REQUIRED BY WRITTEN CONTRACT CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CITY OF EL SEGUNDO 150 IS ST EL EL SEGUNDO, CA 90245 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, INC. UC/F PLUMBERS DEPOT INC. Policy Number 19001 Crescent Springs Drive Symbol: RWC Number: C70136703 Kingwood, TX 77339 Policy Period Effective Date of Endorsement 10/1 /2021 TO 10/1 /2022 10/1 /2021 Issued By (Name of Insurance Company) Ace American Insurance Co. ------------- Insert the polg number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the , reparation of the o1G w CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. (X) Specific Waiver Name of person or organization: CITY OF EL SEGUNDO 150 ILLINIOS ST EL SEGUNDO, CA 90245 ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: RE: 440P-297661 - CITY EL SEGUNDO PD EXHAUST FAN. PROJECT NO. PW 20-15 3. Premium: The premium charge for this endorsement shall be INCLUDED_ percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED Authorized Representative WC 99 03 22