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PROOF OF INSURANCE (2023) CLOSEDD/YY =1'6/17 022 YY) CERTIFICATE OF LIABILITY INSURANCE 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 Aon NAME: NE Services Central, Inc. (402) 697-1400 FA Omaha (402) 697-0017 Omahaa (A+C'•' Ne. Ewa NE Office p' A+C, No.)! 17807 Burke Street EMAIL Suite 401 ADDRESS: Omaha NE 68118 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED Musco Sports Lighting, LLC c/o Musco Corporation 100 15t Ave W Oskaloosa IA 52S77 USA INSURER A: Indian Harbor Insurance Company 36940 INSURERB: Travelers Property Cas Co of America 25674 INSURER C: Sentry Casualty Company 28460 INSURERD: Sentry Insurance Company 24988 INSURER E: INSURER F: i'.V"t15I "IRACLGC" rFRTIFI[`ATF KIIIIIARFR• _1;7r1nQ4nQ4,R0q RFV'I:SI()N N.IIRbA1C-1.FR". THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ,ABOVE FOR THE POLICYPERIOD 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. Limits shown are as re uesIRW fetf LT TYPE OF INSURANCE A1111IP,Y�SD4 Vjpgpg0 111 POLICY NUMBER R1MrDD/yyy p�pO�yyyy LIMITS X COMMERCIAL GENERAL L��IABILITY - EACH OCCURRENCE $1,000,000 CLAIMS -MADE II X II OCCUR iL�.y PREMISES !Ea accurrenca $300,000 MED EXP (Any one person) $10 , OOO PERSONAL & ADV INJURY $1,000,000' Ii GEN`LAGGREGATE; LIMITAPPUES" PER: GENERAL AGGREGATE $2 , 000, 000, POLICY PRO ED LOC PRODUCTS - COMP/OP AGG $2 , 000, 000' JECT OTHER: D AUTOMOBILE LIABILITY Y '90-16877-003 07/01/2022 07/01/2023 COMSINED}SINGLELIMIT $1,000,000 (Ea agoiden X ANYAUTO BODILY INJURY ( Per person) SCHEDULED BODILY INJURY (Per accident) j dOWNED AUTOS ONLY AUTOS X HIRED AUTOS X NON -OWNED PROPERTYDAMAGE (Per accident - ONLY AUTOS ONLY B X UMBRELLALIAB X OCCUR CUP356333 7/01J2022' 07'01/2023 EACH OCCURRENCE $10,000,000 ''.. EXCESS LIAB CLAIMS -MADE AGGREGATE $10,0001000 OED X RETENT90N$10,000 C WORKERS COMPENSATION AND 7 7 1 20 6 07 1 X .PER STATUTE C EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE �Y/N N / A A05 9016877002 07/01/2022 07/01/2023 ERH• E.L EACH ACCIDENT $1,000,000 .. - E..L DISEASE -EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? ili (Mandatory in NH) AZ, WI If yes, describe under DESCRIPTION OF OPERATIONS below --- E.L. DISEASE -POLICY LIMIT $1, 000 , 000 A Archit&Eng Prof CE0742113902 07/01/2022 07/01/2023 Aggregate 5,000,00 Claims -Made SIR $250,000 SIR applies per policy terms & conditions Each Claim $5,000,000, DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Musco Project SVC-463792 - City of El Segundo. City of El Segundo, its officials and employees are included as Additional insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability and Automobile Liability policies evidenced herein are Primary and Non-contributory to other insurance available to Additional Insured, but only in accordance with the policy's provisions. 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 POLCY PROVISIONS. City of El Segundo AUTHORIZED REPRESENTATIVE 350 Main Street, ROOM 5 E1 Segundo CA 90245-3813 USA cc z 2 J w In a d c G! N 0 2 cc 0 0 r Lo 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 9016877004 COMMERCIAL GENERAL LIABILITY CG20101001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions 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 site 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. CG20101001 9016877 Sentry Insurance Company 1 00001 0000000000 21179 0 N © ISO Properties, Inc., 2000 e8cd7ec3-8168-4f7e-8975-826229b00133 Page 1 of 1 POLICY NUMBER: 9016877004 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. K4%11-- 0' ' 16 41I 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 Any person or organization you are required to add as All Locations an additional insured by written contract or agreement See Continuation Page 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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 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. CG 20 37 0413 9016877 Sentry Insurance Company 1 00001 0000000000 21179 0 N © Insurance Services Office, Inc., 2012 3a5145d7-469a-46d0-8768-e50a80ce797a Page 1 of 2 Continuation Page in effect prior to any loss or damage.. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 37 04 13 9016877 Sentry Insurance Company COMMERCIAL AUTO CA 80 07 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A w This endorsement modifies insurance provided under the following - AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. The Who Is An Insured provision of Covered Autos Liability Coverage 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. The status of an additional insured under this endorsement ends when your operations for that additional insured are completed. B. The most we will pay on behalf of the additional insured is the lesser of the amount payable under the Limit of Insurance for Covered Autos Liability Coverage or the amount of insurance required by the contract or agreement. C. Notwithstanding any requirement, term or condition of any contract or agreement with respect to which this endorsement may pertain, the insurance afforded to the additional insured is subject to all the terms, exclusions and conditions of the COMMERCIAL AUTO COVERAGE FORM to which this endorsement is attached. CA 80 07 0618 9016877003 Sentry Insurance Company 1 00001 0000000000 21179 0 N Includes copyrighted material of Insurance Services Office, Inc., with its permission. e4a5e02d-Oc7a-4afa-953c-5e2d86fc8f 64 Page 1 of 1 POLICY NUMBER: 9016877003 COMMERCIAL AUTO CA 76 0106 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Musco Corporation Endorsement Effective Date: 07/01/2022 SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization you are required to add as an additional insured by written contract or agreement See Continuation Page I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in: (1) Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. B. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1) The person or organization is a Named Insured under such other insurance; and (2) Prior to the "accident" 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 person or organization. CA 76 01 06 15 9016877 Sentry Insurance Company 1 00001 0000000000 21179 0 N Includes copyrighted material of Insurance Services Office, Inc., with its permission. 1e3a5bb9-80d8-4d40-9d52494290 e319f Page 1 of 2 Continuation Page in effect prior to any loss or damage. Me 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., CA 76 01 0615 901 877 with its permission. Sentry Insurance Company 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 9016877004 Sentry Insurance Company 1 00001 0000000000 21179 0 N © Insurance Services Office, Inc., 2012 d51 c9085-fbef-4cdd-a67f-40150eac1 c75 Page 1 of 1 IL 70 58 02 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM COMMERCIAL AUTOMOBILE COVERAGE PARTS COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PARTS COMMERCIAL EXCESS/UMBRELLA LIABILITY COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY POLLUTION LIABILITY COVERAGE ERRORS AND OMISSIONS COVERAGE FORM In the event we cancel this policy, we shall endeavor to also mail to the person(s) or organization(s) listed in the Schedule for this endorsement advance written notice of cancellation. This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s) or organization(s) shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule below to any benefit, rights or protection under this policy. Failure by us to provide this notice of cancellation to the person(s) or organization(s) listed or described in the Schedule below will not impose liability of any kind upon us. Any of these provisions that conflict with a law that controls the notice of cancellation of the insurance in this endorsement is changed by this statement to comply with the law. Schedule Person(s) or Organization(s) including mailing address: Per the listing of certificate holders provided by the Broker upon our request. All other terms and conditions of this policy remain unchanged. IL 70 58 02 14 Page 1 of 1 9016877004 Sentry Insurance Company 1 00001 0000000000 21179 0 N ecc6dblb-e566-4a90-a466-d55ef474254f THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The person(s) or organization(s) listed or described in the Schedule below have requested that they receive written notice of cancellation when this policy is cancelled by us. We will mail or deliver to the Person(s) or Organization(s) listed or described in the Schedule a copy of the written notice of cancellation that we sent to you. Such copies of the notice will be mailed as soon as practicable to the address or addresses provided by your broker or agent. This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s) or organization(s) shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule below to any benefit, rights or protection under this policy. Failure by us to provide this notice of cancellation to the person(s) or organization(s) listed or described in the Schedule below will not impose liability of any kind upon us. Any of these provisions that conflict with a law that controls the notice of cancellation of the insurance in this endorsement is changed by this statement to comply with the law. SCHEDULE Person(s) or Organization(s) including mailing address: Per the listing of certificate holders provided by the Broker upon our request. All other terms and conditions of this policy remain unchanged.. 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 Insured Insurance Company Policy No. Countersigned by Endorsement No. Premium: WC 99 06 72 (Ed. 0911) 9016877 Sentry Casualty Company 1 00001 0000000000 21179 0 N 820bO871-0750.470a-bcc4-19755249ce95 Page 1 of 1