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PROOF OF INSURANCE (2022 - 2023) CLOSEDCERTIFICATE OF LIABILITY INSURANCE I�DATE 130/2° z "' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must 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 E- Daniel Katz Daniel Katz Insurance Agency, Inc. PHONE FAX Arc, Neesron�.A797 I✓.Nei 8665 Wilshire Blvd., Ste. 200 MAIL Beverly Hills, CA 90211 ADOREss. ))Aitg3rr�ma49.ctlnro INSURED Mr. Fish Aquarium & Pond Service., Inc. INsuRER s 622N, La Brea Avenue ., IINSURERC Inglewood, CA 90302 I,me„ocan 9879 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. WNW ._._. ____-- TYPE OF INSURANCE POLICY NUMBER... '.� �� �ImyMpffmi LIMITS LITY A X coMMER�cIALGENERALuaeluTY Y Y 798B004299 09/22/2021 I09/2212022 ^ T CLAIMS -MADE � OCCUR �' PERSONAL & AOV INJURY S m 1,0_00 000. GENERAL AGGREGATE S .....20000 (aEN'LAGOAEGATELIMIT APPLIES PER: PRODUCTS -COMPIOPAGG S X LOC POLICY 6 C AUTOMOBILE LIABILITY 504-MOOS-2672-001 01/20/2022 01/20/2023 COMBINED SINGLE LIMIT s Me acclderdi 1,000,000 ANY AUTO Y Y �) X Y(Par�rson) S k ALL OWNED AUTOS aODILYINJURY(.......r.� �"-__...... I' acgdent) S X SCHEDULEDAUTOS PROPERTY DAMAGE 5 x HIREDAUTOS (Peracadent) .m a NON -OWNED AUTOS I Uninsured Motorist 1,000 I 000.... D X uMBReLLA uAs X OCCUR EBU 038179644 09/2212021 09/22/2022 EACH OCCURRENCE $ 2 000 000 EXCESS LIAR GATE CLAIMS -MADE.. � � AGGREGATE $ 2,000,000e RETENTION $� B WORKERS COMPENSATION 00/0712021 06/07/2022 X AND EMPLOYERS' LIABILITY Y f.. N SWC1340695 ., ANY PROPRIETOR/PARTNERIEXECUTIVE E..L EACH ACCIDENT 5 1 OFFICERIMEMBER EXCLUDED? � NIA Y --- -a 1lisndelrary In NHl E.L. DISEASE - EA EMPLOYE S_ f Y d'.*2Abp unndda E.L. DISEASE - POLICY LIMIT i I r 1 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 101, AddlUenal Remarks Schedule, If more space Is requlrem City of LEI Segundo Is an additional insured on the general liability policy as Its interests may appear, Waiver of subrogation applies for general liability and Workers' compensatlon. Coverage is primary and non-contributory :over any insurance maintained by additional insured. City of Ell Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFJJJZD BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN ACCORDANCE WITH THE 350 Main Street POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE Daniel Katz ® 1 988- 2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OFF CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED ED 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 organization have agreed in writing in a contract or This insurance does not apply to: agreement that such person or organization be 1. "Bodily injury", "property damage"" or "personal added as an additional insured on your policy. and advertising injury" arising out of the Such person or organization is an, additional rendering of, or the failure to render, any insured only with respect to liability for "bodily professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury" caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, 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 additional insured: This exclusion applies even if the claims against any insured allege negligence or other wrongdoing 1. Only applies to the extent permitted by law, in the supervision, hiring, employment, training or and monitoring of others by that insured, if the 2. Will not be broader than that which you are "occurrence" which caused the "bodily injury" or required by the contract or agreement to "property damage", or the offense which caused provide for such additional Insured. the "personal and advertising injury", involved the rendering of or the failure to render any A person's or organization's status as an professional architectural, engineering or additional insured under this endorsement ends surveying services. when your operations for that additional Insured are completed. CG 20 33 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 2 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 Oflice, Inc., 2012 CG 20 33 0413 POLICY NUMBER: 79esao4299 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 x l*111:* 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 with whom you have agreed, in a written contract, to waive the transfer of rights of recovery against others to us, provided such written waiver is fully executed prior to an "occurrence" in which coverage is sought under this policy. Information required to complete this Schedule, if not shown 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 organizetion shown in the Schedule above will be shown in the Declarations. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 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 0413 @ Insurance Services Office, Inc., 2012 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 agent 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 6/7/2021 Policy No. SWC1340695 Endorsement No. 0 Insured Mr Fish Aquarium & Pond Service, Inc. (A Corp) Premium $ 11,168 Insurance Company Security National Insurance Company Countersigned by WC 04 03 06 (Ed. 04-84)