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PROOF OF INSURANCE (2022) CLOSED=E /DDNYYY) M ACCOR"' CERTIFICATE OF LIABILITY INSURANCE 05(/IM7/2022 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 CONTACT Tina Cowie NAME. Cornerstone Specialty Insurance Services, Inc. PHONE (714) 731-7700 AX i,4,1: (714) 731-7750 ­­ .... ... ........ . . 14252 erCulvDrive, A299 E-MAIL'.. tina@cornerstonespecialty.com Annor INSURER(S) AFFORDING COVERAGE NAIC # Irvine CA 92604 INSURERA: RLI Insurance Company 13056 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............. . . . . . . .................................. ................................................ — INSURED INSURER B: Aspen American Insurance Company 43460 MILLER ARCHITECTURAL CORP. INSURER C .... .............................. 1177 Idaho Street INSURER D Suite 200 _INSURER E . .. . ........................... . .......... . ....................... . Redlands CA 92374 INSURER,F: COVERAGES CERTIFICATE NUMBER: 2022 COVERAGES 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. INSR A SUER POLICY E F POLICY EXP ILTR TYPE OF INSURANCE INSID WVD POLICY NUMBER (MM/DDffYYY) (MMIDDfYYYY) LIMITS .................. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE . ...... $ 2,000,000 . ........... . . ................ X DAMAG N 1,000,000 CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ X ADDTL INSURED / P & NC MED EXP (Any one person) . ................... ............... —­­­'­­­­— $ 10,000 A X BLNKT WVR OF SUBRO PSB0006782 01/03/2022 05/29/2022 ftR�t�LLIL.YJNUURY $ INCLUDED GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY PROJECT El LOC [g PRODUCTS- COMPIOPAGG $ 4,006,766 ........... OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .......................... .. $ 2,000,000 ANYAUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED PSB0006782 01/03/2022 05/29/2022 ......... BODILY INJURY (Per accident) .. . . . . . . ...... . . ....... $ AUTOS ONLY AUTOS . . ............ ............. . . . . . . . . . . . . . .. X HIRED X NON -OWNED )AlAA PRONRTY fr.E $ AUTOS ONLY AUTOS ONLY nccdwwt) . . .......... . ....... R .............. . ......... UMBRELLA LAB OCCUR EACH OCCURRENCE . ............. $ 3,000,000 A X1 AEXCESS LB CLAIMS -MADE PSE0002919 01/03/2022 05/29/2022 : AGGREGATE $ I DED I I RETENTION $ $ WORKERS COMPENSATION . ............... . ..................................... . . ..... FER . ........... I—'T—05fH— AND EMPLOYERS' LIABILITY YIN . .. ............ . . .......... ........ A ANYPRO N I A PSWO003805 01/03/2022 05/29/2022 E.L EACHACCIDENT $ 1,000,000 . ...................... OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) EA., DISEASE- EA EMPLOYEE $ If yes, describe under . .............................. 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ ........ . . ................. ............. .. . ..... --- Each Claim $3,000,000 Prof' ssional Liability B Claims Made AAAE300196-01 05/29/2021 05/29/2022 Annual Aggregate $3,000,000 _L DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of El Segundo is Additional Insured for General Liability but only if required by written contract with the Named Insured prior to an occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. *30 days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability coverage, the aggregate limit is the total insurance available for all covered claims reported within the policy period. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo Public Works Deparment ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE ElSegundo CA 90245 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Policy Number: PSB0006782 Named Insured Miller Architectural Corp. RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, RLIPack° FOR DESIGN PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY C. WHO IS AN INSURED is amended to include as an additional insured any person or organization that you agree in a contract or agreement requiring insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy. This insurance does not apply to the rendering of or failure to render any "professional services". c. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K. 2. Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION II — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or ogranization that you have agreed withi in a written contract to provide this agreement. 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 01 /03/2022 Insured Miller Architectural Corp. Insurance Company RLI Insurance Company WC000313 (Ed. 4-84) Policy No. PSW0003805 Countersigned by: Endorsement No. Premium $ © 1983 National Council on Compensation Insurance.