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PROOF OF INSURANCE (2023 - 2023) CLOSEDCERTIFICATE OF LIABILITY INSURANCE �TEIMI 03 02/2622 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 PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P-O. BOX 328 OWATONNA, MN 55060 INSURED HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA PO BOX 661461 ARCADIA, CA 91066-1461 COVFRAGFS CERTIFICATE NUMBER' 1R0 I INSURER(S) AFFORDING COVERAGE INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 315-809A _INSURER _ w..._..�.�_...._.,u INSURER B: INSURER-.Cm.„,„,„,„..............�...........m.,.,...,.-,,,m INSURER D: INSURER E: -..-- ..... --- . ...............----- INSURER F: REVISION NUMBER: 0 em 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, 7N5R 7tlPE OF INSURANCE ADDL SUBR pOLICV NUMBER POLICY EFF POLICY EXP LIMITS TR '. IN WVD IYYVY. Y XYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ]CLAMS -MADE �X OCCUR pffwm -AE�ELEnrJL ww_ 100000 MED EXP (Any one person) $5,000 ''.. q "- N N 9130916 03/15/2021 03/15/2022 PERSONALaoV INdURv - .„ „„- $1,000,000 C3fp,N L AGGREGATE LIMIT APPLIES PER GEPJERAL AGGREGATE $21000,000 X ❑'JECr F —1 ..COM €POLICY LOC PIOP PRODUCTS AGG b $2,000,000 'OTHER: AUIDAMOEHLC I IAWLIITY COMBIOEOIEING'LE' LIMIT 1 $1,000,000 X ANY AUTO BODILY INJURY (Per person) SCHEDULED A I OWNED AUTOS ONLY ''. AUTOS ..„.. N N 913D916 03/15/2021 03/15/2022 BODILY INJURY (Per accident) „ NON -OWNED HIRED AUTOS ONLY m^w AUTOS ONLY PROPERTY trrw41.lLCE its,,w,pSSA ............................ . . „„„„„„„„„„„„ .. m X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000 A ''EXCESS LIAB CLAIMS -MADE N N 9130917 03/15/2021 03/15/2022 AGGREGATE $2.000,000 _....„.„.„ ......................... ' ',, RETENTION ED WORKERS COMPENSATION amvu wuwasssaumwuuwwww PER STATUTE ER AND EMPLOYERS' LIABILITY y A ••�„„„„„„„„„„„„„„„- ANY PROPRIETORIPARTNER/EXECUTIVE , f E.L.. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? IN A E.L.. DISEASE ,. EA EMPLOYEE (Mandatory In NH) II yes, describe under E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) CERTIFICATE HOLDER CANCELLATION 315-809-4 1800 CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245-3813 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE uw.wwwwwvw wwwwn.,ww.rwnwwarmmwexmo amwwimn w,nw»,�ws.w« O 198B-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2010/03) The ACORD name and logo are registered marks of ACORD ACIII CERTIFICATE OF LIABILITY INSURANCE DAT 03/02DD YYVY) 3/D2/2Q22 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 Hants to the certificate holder in lieu of such endorsement(s). PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P,O, BOX 328 OWATONNA, MN 55060 INSURER(5) AFFORDING COVERAGE ^ ..... ...... ... NAIL sr INSURER a: : FEDERATED, MUTUAL INSURANCE COMPANY 13935 INSURED 315-809A INSURER B: HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA -.,.....—........................^,.......:...............�,.A,,,,,,�^,.,.,.� INSURER C: PO BOX 661461 .............. :.:_. ..: ................... ARCADIA, CA 91066-1461 INSURER D: INSURER E: INSURER F Cr1VFRA(:FR CFRTIFICATF NIIMRFR• 1R0 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR': DDL 6UBR POLICY EFF POLICY EXP T TYPE OF INSURANCE I. POL1Cl" kU'hPoB�k'iR M. ID YYYXI Y LIMITS ''. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 m... ... oANI'"GE vo RENTEb DAMAGEE ...�L . $100000 OCCUR cLwMs MADE C X„� r.ED Y .�"�PF�.,,%�.I .... MED EXP (Any one person) $5,000 r—... .... .... .... N N 9130916 03/15/2022 03/15l2023 PERSONAL6 ADVINJURY 6DV IN ........ ..$1,00A 00,000 LwE N'I. AGO�REGA9E LIMIT APPLIES PER GENERX AGGREGATE $2,000,000 PO ,ev LECTLac 6 PRoouaL CTS - COMPIOP AGG$2,000,000 .... _ ',. OTHER: Avr'OMOEHLE LIABILITY CEQMEINEO gINC,I �E'LIMIT $1,000,000 E.R;;a°............................... : .. . '.. X ANY AUTO BODILY INJURY (Per person) SCHEDULED A '', OWNED AUTOS ONLY AUTOS N N 9130916 03/15/2022 03/15/2023 BODILY INJURY (Per accident) HIRED AUTOS ONLY „-. AUTOS ONLY ........ No .............m...,,m PROPERTY DAMAGE dPe. acr:..dentL .....^...., X UMa.REIALA LIA O X , OCCUR EACH OCCURRENCE $2,000000 A ^ EXCESS LIAR CLAIMS -MADE N N 9130917 03/15/2022 03/15/2023 AGGREGATE $2,000,000 .........._. ...... .. .. . ........................... DED RETENTION WORKERS COMPENSATION OTH- PER STATUTE ER AND EMPLOYERS' LIABILITY yeti, ANY PROPRIETORIPARTNER/EXECUTIVE E,L. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? �. N I'o' .. _. W.DISEASE (Mandatory in NH) E LDISEAS E EA EMPLOYEE .................. It yes, describe under .E .W.,.W .L DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) CERTIFICATE HOLDER CANCELLATION 315-809-4 1800 CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245-3813 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ... ..........xa,ww.xw...... © 198B-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD DATE(MM/DDIYYYY) AC" CERTIFICATE OF LIABILITY INSURANCE 03/02/2022 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 CONTANAME; �7 Gabriel Hill Insurance & Surety Services, LLC PHONE FAX NgmEw); C909 703 9396 (A!C Nay (90g1 614 7396 4195 Chino Hills Pkwy Ste 403 Wc' Lic. 0167797 E-MAIL Chino Hills CA 91709 ADDRESS: gabriel@isscllc.com INSURER(S)AFFORDINGCOVERAGE _ NAIL# INSURERA: SecuritV National Insurance CO 19879 INSURED Horizon Mechanical Contractors of California, Inc P.O. Box 661461 Arcadia CA 91066 r^n\rCDAnCQ CFRTILICATG All IMRFR• rorr TT) 117A RFVISI(iN NIIMRFR- 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 .._.� FF POLICY EXP POLICY NUMBER _„ INSRLTR AD47L-SU9it �� POLICY E � TYPE OF INSURANCE PO MMIDD/YYYY MM/DD/YYYY . "".,,,,,, �. ..._. LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S ., .-. .. ..... "i'SAMAt r rs°a Rr�rrrr�..... _ ._ , ,,,,,n� _ CLAIMS -MADE „ = OCCUR „PEEMI E '(1a MED EXP (Any one person} S PERSONAL $ ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S ,,,,,,,, .... l F"RkD ...... ..., E'OL..16:;Y ..I JEC? . LOC; , PRODUCTS COMP/OP AGG S OTHER S AUTOMOBILE LIABILITY )MBINED SiNGLE LIMI6 5 Asa ccr ctnO '.. ANY At.) ft:) BODILY INJURY (Per person) '.... S OVl!NI D SCHEDULED BODILY INJURY (Per accident) S Ad FOS ONLY AUTOS HIRED NON -OWNED ' PROPERTY DAMAGE S AU TOS ONLY '... AUTOS ONLY UMBRELLA LIAR C',}F7C',8112: EACH OCC)URIdl NCI S EXCESS LIAB CLAIMS MAI.:}E ...... - ,,"I'll, ,,,....,,, ,_ ......... AGGREGATE R GATE::. S DED RETENTION $ WORKERS COMPENSATION AY 3WC1377754 03/O1/2022�03/O1/2023 PFH E•3111 R S1FnTt.C°fL R .� AND EMPLOYERS' LIABILITY �`..i.. .. 'ANYPROPRIETORfPAABILITEXECUTIVE E L EACH ACCIDENT S 1,000,000 OFFICERIMEMBEREXCLUE Y NIA '.(Mandatory in NH) "�"'"". '..... 6:: Y DISEASE I n EMPLOYEE S ,,,,, 1,000,000 -� --— If yes, describe under-- DESCRIPTION OF OPERATIONS below E L E'SSEASE POUC,;.Y I.IMI f S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Waiver of Subrogation applies per attached WC 040306 04/84 endorsement. t, =K I] Ir'I1,A I C MULIJCR 6rM IY liCL LM I IVIY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo 350 Main St. AUTHORIZED REPRESENTATIVE 'qrv" E1 Segundo CA 90245-3813 U 1988-2015 AGUKU GUKPUKA I IUN. All rlgnts reserve0. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy, We will not enforce our right against the person or organization named in the Schedule, (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us,) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration, Schedule Person or Organization Job Description Any person or organization as required by written contract 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 3/1/2022 Policy No. SWC1377754 Endorsement No. 0 Insured Horizon Mechanical Contractors of California (A Corp) Premium $ 16,953 Insurance Company Security National Insurance Company Countersigned by ...... ..... ...._. m.m.m.m......... ,. ___---...... WC 04 03 06 (Ed. 04-84) 00 DATE (MNWDNYYY) 11* � " CERTIFICATE OF LIABILITY INSURANCE 03/642M 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 terns and conditions of the policy, certain policies may require an endorsement. A statement on this PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 CONTACT -... ........ ............................ ��, INSURER A: FEDERATED MUTUAL INSURANCE COMPANY .....,,,,,,..,,..,,,,,..........................................................................�.�. ....................... INSU RED 315-809A INSURER B: HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA INSURER C: ------........-.............................._........... PO BOX 661461 W..... ..... ... �._ ------- ARCADIA, CA 91066-1461 INSURER .. .. .... INSURER E: INSURER F: 1-1COA— PPDTILIrnTG AIIINAaGD• 1An RFV131AN NIIMRFR' In NAIC k 13935 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. INSRADDL $OCR POLICY EFF POLICY EXP TR TYPE OF INSURANCE IN, R VPM POLICY NUMBER MML DIYVYVI MMIDDIYYYv LIMITS X '... COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 _ ..... DAIv1AGRENTED E O E T AF.Nf _................. $100,000 CLAIMS -MADE ❑X OCCUR R RN MED EXP (Any one person) $5,000 _.... .... .. .', ... .....-...............m A Y N 9130916 03/15/2022 03/15/2023 PERSONAL F4ACV INJURY . ................._._ $1,DOO,000 "' AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 ,4,g,,,@d'L X ❑JECT $ZOOOOOO dECYPRC' POLICY LOC PRODUCTS COMPIOPAGG .. mm......��........mm. OTHER: AUTOMOBILE LIABILITY coke Mal) SINGLE MMIT $1,000,000 ......._.- X '., ANY AUTO BODILY INJURY (Per person)mmmry SCHEDULED • ''..OWNED AUTOS ONLY . AUTOS .., N N 9130916 03/15/2022 03/15/2023 BODILY INJURY (Per accident) _.... _.. HIRED AUTOS ONLY AUTOS NON -OWNED AUTOS ONLY ] mV3d%F7�PIE-PF DA'��....._.,.,.,., hd ASlE: 65gtpx U ___,, X UMBRELLA. L.OP68 X OCCUR EACH OCCURRENCE $2,000,000 A EXCESS LIAR CLAIMS -MADE N N 9130917 03/15/2022 03/15/2023 AGGREGATE $2,000,000 ........................................_.......................... .. ...___.. TE DED RENTION m '... WORKERS COMPENSATION xewwwwwwwuaaW.uuu� PER STATUTE OTH- '.. ER AND EN4PLOYERS'LIA1i 14,NTY YIN "... ............ .._ .. ANY PROPRIETORIPARTNERIEXECUTIVE �' '.N 1 A---- E L. EACH ACCIDENT --------•___________ OFFICER/MEMBER EXCLUDED? E.L. DISEASE = EA EMPLOYEE (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS helow _ . I - ­­T ........... E WL DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) SEE ATTACHED PAGE CERTWWAT'E HOLDER CANCELLATION 315-809-4 1800 CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245-3813 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4A mmarr wwrnwwiwwww ,. wwaww,wwu�nrxiw © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 315-809-4 LOC #: A4C'" IAA" jh....--�' ADDITIONAL REMARKS SCHEDULE Page 1 of ................ AGENCY NAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA F-60 ...CY NUMBER ........_____ .__........._ ', PO BOX 661461 POLI SEE CERTIFICATE ## 180.0 ARCADIA, CA 91066-1461 SEE NAIL CODE EE CERTIFICATE # 180.0 EFFECTIVE DATE. SEE CERTIFICATE j 180.0 .. _ _.... ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: QfRT„LFjQ#_TEQFj,,,,[AfajjATY INSURAN ADDITIONAL INSUREDS ALSO INCLUDE CITY OF EL SEGUNDO, ITS OFFICIALS, AND EMPLOYEES. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 CG 20 01 04 13 Policy Number: 9130916 Transaction Effective Date: 03/15/2022 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 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 B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract 1. "Bodily injury", "property damage" or or agreement that such person or organization be "'Personal and advertising injury" arising out added as an additional insured on your policy. of the rendering of, or the failure to render, Such person or organization is an additional "bodily any professional architectural, engineering or insured only with respect to liability for surveying services, including: „ injury', "property damage or 'personal and advertising injury" caused, in whole or in part, by: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, 1. Your acts or omissions; or opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims against additional insured: any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others by 2. Will not be broader than that which you are that insured, if the "occurrence" which caused the required by the contract or agreement to "bodily injury" or "property damage", or the provide for such additional insured. offense which caused the "personal and advertising injury", involved the rendering of or A person's or organization's status as an the failure to render any professional additional insured under this endorsement ends architectural, engineering or surveying services. when your operations for that additional insured are completed. © Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 33 04 13 Policy Number: 9130916 Transaction Effective Date: 03/15/2022 2. 'Bodily injury" or "property damage" occurring 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 another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; 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 33 04 13 Policy Number: 9130916 Transaction Effective Date: 03/15/2022 do DATE IMM/DD/YYYYI 1.-`ACOORCERTIFICATE OF LIABILITY INSURANCE 03/040022 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 PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 228 OWATONNA, MN 55060 CONTACT INSURER A: FEDERATED MUTUAL INSURANCE COMPANY ......................................................... INSURED 315-809A INSURER B: HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA INSURER C:� PO BOX 661461 ----- -- �. ARCADIA, CA 91066-1461 INSRER D: �U ... ....................... INSURER E. __........ .................. .... ..._ INSURER F: I . . . n n_C. rCDTICI! ATC MIIRAAi ion RFVISION NUMRFR• 1 NAIc tt 13935 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. ._.._.. .........._ ICY EXP TYPE OF INSURANCE IN,S POLICY NUMBER MMtD IYYYVIR lvvVV IIrSR:. ADDL SUBR POLICY EFFr03/fi15/2022 ..........._...... .... LIMITS '.. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ..._. .. AG ........�.mm� DAMAGE To RENTED .. $900000 P6JE,M,l�F.S a -maw a .. ........ ...,.,,,. ��Cr.AatnVs.MAPJE'. .....m,mNOCCUR MED EXP (Any one person) $5,000 A Y N 9130916 03/15/2021 I PERSONAL& ADV INJURY $1,D00,000 WWWWuuuuu$2,000000 GECtLAGGRf,.,y E. LIMIT APPLIEEm PER�mmmm GENERAL AGGREGATE )LIMIT X POLICYPRODUCTS 'P PRO- LOG JJ ................. ......... - COMPIOP AGG $2,000,000 OTHER: f I AUTOMOBILE LIABILITY BtlEb SUN)LE LUA57 $1,000,000 ''. X ANY AUTO BODILY INJURY (Per person) SCHEDULED A '' ''.OWNED AUTOS ONLY ',AUTOS N N 9130916 03/15/2021 03/15/2022 BODILY INJURY Per accident) HIRED AUTOS ONLY NON -OWNED - AUTOS ONLY PR PE11FY A.VAOE P r atr mvlvl _.............. '.. X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $2,000,000 A ', EXCESS L.A. CLAIMS -MADE N N 9130917 03/15/2021 03/15/2022 -AGGREGATE __ _ ...... -- $2,000,000 „�........................ RETENTIO..�.m.m. DED N '.. WORKERS COMPENSATION PER STATUTE OTI7 ER AND EMPLOYERS'LIABILITY Y(! ANY PROPRIETORIPARTNER/EXECUTIVE —�• E.L.. EACH ACCIDENT OFFICER MEMBER EXCLUDED? N'I A mE L, DISEASE = EA EMPLOYEE .................. (Mandatory in NHI ......................m ............... If yes. describe under E L DISEASE •POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached it more space is required) SEE ATTACHED PAGE CERT)FsCATE HOLDER CANCELLATION 315-809-4 1801 CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245-3813 ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE _f G xrrnww,�,w.,w,ww�m www wa .awwuuuv O 1988-2015 ACORD CORPORATION„ All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 315-809-4 ... KS SCHEDULE � Pa 1 -- ADDITIONAL REMARKS e of g ................ ..... _ :AGENCY _ NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA �EmY NCERTIFICATE # 180..1....... .,..,, .........�. PO BOX 661 -9LIC POUMBER ARCADIA, CAA 91066-1461 E '...... CARRIER NAIC CODE SEE CERTIFICATE 180.1 -EFFECTIVE DATe #� SEE CERTIFICATE # 1801 ADDITIONAL REMARKS _ THIS ADDITIONAL mREMARKS FORM IS A SCHEDULE TO AC.... ......-_. ORD FORM, FORM NUMBER: 25 FORM TITLE' ,( IF! � d l„ ��! !N V E ..... _..m..... .......... .............. _. ... ___. .... .......... ADDITIONAL INSURE ..........._.,, DS ALSO INCLUDE CITY OF EL SEGUNDO, ITS OFFICIALS, AND EMPLOYEES. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. ACORD 101 (20D8101) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 CG 20 01 04 13 Policy Number: 9130916 Transaction Effective Date: 03-15-2021 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 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 insured on your policy. Such person or organization is an additional insured 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal 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 drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. © Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 33 04 13 Policy Number: 9130916 Transaction Effective Date: 03-15-2021 2. 'Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional insureds, the following is added to a. All work, including materials, parts or Section III - Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or 2. Available under the applicable Limits of b. That portion of "your work" out of which Insurance shown in the Declarations; the injury or damage arises has been put whichever is less. to its intended use by any person or organization other than another contractor This endorsement shall not increase the or subcontractor engaged in performing applicable Limits of Insurance shown in the operations for a principal as a part of the Declarations. same project. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 33 04 13 Policy Number: 9130916 Transaction Effective Date: 03-15-2021