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PROOF OF INSURANCE (2023 - 2023) CLOSEDDATE (MM1DDNYYY) 08/25/2022 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 916-364-7380 Sierra Oak Insurance Services Lic4 OC97528 CONTACT Dan Brock NAME: PHONE 916-364-7380 FAX 916-364-7381 (AIC, No, Ext): (AIC, No): 9700 Business Park Dr. Ste 105 E-MAIL certs@einsurancespecialist.com ADDRESS: Sacramento, CA 95827 Daniel E. Brock INSURERS AFFORDING COVERAGE NAIC # INSURERA: Wesco Insurance Company 25011 INSURED FS Contractors, Inc. 14838 Bledsoe St INSURERB:Scottsdale Insurance Company 41297 INSURER C : Insurance Companyof the West 27847 INSURERD:Allied World Surplus Lines Ins 24319 Sylmar, CA91342 INSURERE: Lloyd's of London Insurance Co 85202 INSURER F : COVERAGES CERTIFICATE NLIMRFR- REVISION NHMRFR- 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 LTR 7ypE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD LIMITS C X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR X X BCS0039741 01/13/2022 01/13/2023 GE TO ENTED PPEMISES (Ea o cur ence $ 100,000 X MED EXP (Any one person) $ Exluded E Professional Liab MPL510483922 03/08/2022 03/08/2023 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � JECT LOC PRODUCTS - COMP/OP AGO $ 2,000,000 P rof. Liab 1,000,000 OTHER A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY (Per person) $ ANY AUTO X X WPP197632000 08/26/2022 08/26/2023 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PRO ecc de DAMAGE P rrt $ HIRED U O ONLY AUTOS ONLY $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,000 X AGGREGATE $ 8,000,000 EXCESS LIAB CLAIMS -MADE XLS0121700 01/13/2022 01/13/2023 DED RETENTION $ GL AU WC $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORfPARTNERIEXECUTIVE � OFFICERfMEMBER EXCLUDED? (Mandatory in NH) NIA A X WSA 5032771 07 07I31I2022 07I31I2023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 D Pollution Liab. 50550558 01/13/2022 01/13/2023 Each Occu 1,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job: Concrete Improvements PW 21-10 Various Locations in the City of El Segundo. The City of El Segundo, its officers, officials, employees, agents, & volunteers to be named additional insured on the general liability & auto. Primary & noncontributory applies. Waiver of subrogation applies to general liability, auto & work comp. CERTIFICATE HOLDER CANCELLATION CITYELS 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 El Segundo, CA90245 AUTHORIZED REPRESENTATIVE I r ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BCS0039741 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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) Locations Of Covered Operations THE CITY OF EL SEGUNDO, ALL LOCATIONS AND OPERATIONS AS ITS OFFICERS, OFFICIALS, REQUIRED BY WRITTEN CONTRACT WITH EMPLOYEES, AGENTS, & VOLUNTEERS THE NAMED INSURED 350 MAIN ST EL SEGUNDO, CA 90245 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. CG20101219 O Insurance Services Office, Inc., 2018 Insured Copy Page 21 of 22 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 22 of 22 © Insurance Services Office, Inc., 2018 Insured Copy CG 20 10 12 19 POLICY NUMBER: BCS0039741 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 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 THE CITY OF EL SEGUNDO, ALL LOCATIONS AND OPERATIONS ITS OFFICERS, OFFICIALS, AS REQUIRED BY WRITTEN EMPLOYEES, AGENTS, & CONTRACT WITH THE NAMED VOLUNTEERS INSURED 350 MAIN ST EL SEGUNDO, CA 90245 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG20371219 O Insurance Services Office, Inc., 2018 Insured Copy Page 21 of 21 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 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 LIQUOR LIABILITY COVERAGE PART PROD UCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. 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 CG 20 01 12 19 O Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: WPP197632000 COMMERCIAL AUTO CA990187 0715 This Endorsement Changes The Policy. Please Read It Carefully BUSINESS AUTO COVERAGE EXPANSION ENDORSEMENT This endorsement modifies insurance provided by the fallowing: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the COVERAGE FORM apply unless modified by the endorsement. A. Newly Acquired or Formed e. An "employee" of yours is an "insured" Organizations, Employee Hired Car while operating an "auto" hired or rented Liability and Blanket Additional Insured under a contract or agreement in that Status for Certain Entities. "employee's"name, with your Item 1. Who is an Insured of Paragraph A. permission, while performing duties Coveraga under SECTION II — COVERED related to the conduct of your business. AUTOS: LIABILITY COVERAGE is amended to add: d.. Any organization you newly acquire or form, other than a partnership; joint venture or limited liability company, and over which you maintain ownership of a majority interest (greater than 50%), will qualify as a Named Insured; however, 0.) coverage under this provision is. afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; (2) coverage does not apply to "bodily injury" "property damage" or "covered pollution cost or expense" that results from an "accident" which occurred before you acquired or formed the organization; and (3) coverage does not apply if there is other similar insurance available to that organization, or if similar insurance would have been available but for its termination or the exhaustion of its limits of insurance. This insurance does not apply if coverage for the newly acquired or formed organization is exciuded either by the provisions of this coverage form or by endorsement. f. Any person or organization you are required by written contract or agreement to name as an additional "insured", but only with respect to liability crested in whole or in part by such agreement. B. Increase Of Loss Earnings Payment Subpart (4) of a. Supplementary Payments of Item 2. Coverage Extensions of Paragraph A. Coverage under SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to read:: (4) We will pay reasonable expanses incurred by the "insured" at our request, including actual loss of earnings up to $1,000 per day because of time off from work. C. Fellow Employee Injured By Covered Auto You Own Or Hire Item 5. Fellow Employee of Paragraph B. Exclusions under SECTION 11—COVERED AUTOS LIABILITY COVERAGE is amended to add: This exclusion does not apply if the "bodily injury" results from the use of acovered '"auto" you own or hire. Such coverage as is afforded by this provision is excess over any other collectible insurance. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 5 Used with permission D. Limited Autoirnatic Towing Coverage Item 2. Towing, of Paragraph A. Coverage, under SECTION 1I1--- PHYSICAL DAMAGE COVERAGE is amender to read: 2. Towing We: will pay for towing and labor (;osts each time that a coverers "auto" is disabled. Aft labor must be performed at the place of disablenient of the covered "auto a. The limit for towing and labor for each disablement is $500; b. No deductible; applies to t;-,Is cover- age- E. Item 3. Glass Breakage -- Hitting A Bird Cr Animal — Falling Objects or Missiles of Paragraph A. Coverage under SECTION III — PHYSICAL DAMAGE COVERAGE, is amended to add: Mass Repair Coverage We willwaive the Comprehensive deductible for Glass, if one, is indicated on your covered "auto", for g€ass repairs. We .will repair at no cast to you, any Mass that can be: repaired without replacement, provide -di: the "lass" arises rr€ m a covered Co prehen ve "loss" to your "auto". F. Increase Of Transportation Expense Coverage Su b€cart a. Transportation Expenses of Item 4, Coverage Extensions of Paragraph X Coverage. under SECTION III -- PHYSICAL DAMAGE COVERAGE is amended to read: a. Transportation Expenses W'e will pay up to $50 per day to a r;' aximurn of $1,000 for ternporary transportation expense incurred by you because of the total theft of a covered "auto` of the private passenger type. e will pay only for those covered "autos` for which you carry either Comprehensive or Specified Causes of Loss Covrlraye or Theft: Coverage. We will pay for ternporary transportabon expenses incurred during the period beginning 48 hours after the, theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". G. "Personal Effects" Coverage Item 4. Coverage Extensions of Paragraph A. Coverage, wider SECTION III PHYSICAL. DAMAGE COVERAGE, is amended to add: "Personal Effects" Coverage We S,v €i pay actual ash value for "loss' to "personal effects" of the "insured" while in a covered "auto" subject to a maximum limit of $2,500 per "loss", for that co,rered `zauto" caused by the same "accident". No deductible will apply to this coverage, H. `Downtime Loss" Coverage Itern 4. Coverage Extensions, of Paragraph A. Coverage, under SECTION III. PHYSICAL DAMAGE COVERAGE. is amended to add: "Downtime Loss" Coverage We will pay any resulting "dcawntirrie lass" expenses you sustain as a result of a covered physical damage "loss" to a covered ".auto" up to a maximurn of $100 per day, for a maximum of 30 days for the same physical darr.age 1cuss", Subject ici the following cesnd tions: a, We will provide "dowritime.lo,s" beginning orf the 5"' day after we have given yo.0 oiar,lgreement tc pay for repairs to a covered "auto" aria you have given the repair facility your authorization to ina€ce repairs; b. Coverage for "downtime loss" expenses will end when any of the following occur: 1; ) You have a spare, or reserve 'auto" available to you to continue your operations. (2) You purchase a replacement "auto", (3) Repairs to your covehad "auto"' bravos been completed by: the repair facility ,�ir;d they determine the covered "auto" is road-worthy- (4) You reach the 30 day maxim rn coverage. CAS90187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 2 of 5 Used with permission I. Item 4. Coverage Extensions, of Paragraph A. Coverage, under SECT1ON III. € HYSICAL DAMAGE COVERAGE. is amended to ;add: We will pay any resulting rental reimbursement expenses incurred by you for a rental Of an "auto" because of "loss" to a covered `autcf' up to a rr aArnurn of $100 per day, for a maximum of 30 days for the sarre physical damage 'loss", subject to the follow;ng ccandilions: a, We wiil provide rental reimburnmarA incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy expiration, with the number of days r(<asonal:;Iy required to repair or replace; the covered "auto". If the ''loss" is camsed by theft, this number of days is the number of days it tares to locate the covered "auto" and return it to you or the number of days it tales for the cla►rri to be sett€ed, whichever comes first. h. Our payment is limited to necessary and actual expenses incurred. c. This coverage does not apply, while theM are spare or rest rvt "autos" available to you for your operations. d. If a .`Io:SS!'Te3c:its from the fatal theft of a covered "auto of the private passenger type, we wi>> pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension, J. "Personal Effects" Exclusion Paragraph R. Exclusions € rider SECTION N Ill --- PHYSICAL DAMAGE COVERAGE, is. arr ended to add: "Personal Effects" Exclusion We will riot pay for "loss" to `personal effects" of any of the following; a. Accounts, bills, currency, deeds, avidenc6 of debt, rnor?ey, notes, securities or commercial paper or other documents of value. b. Mullion, gold, silver, platinum, or other precious alloys or metals, furs or fur garments, jeweiry, watches: preomus or serni precious stories. r- Paintings, statuary and other works sal art. d. Contraband or property in the course, of illegal transportation or trade. e. "Loss" caused by theft, unless there is evidence of forced entry into the covered "auto" and a police report is filed. K. Accidental Airbag Discharge Coverage Item 3,a. of Paragraph B. Exclusions under SECTION Ill — PHYSICAL DAMAGE COVERAGE is amended to read: a. Wear and tear, freezing mec:haniCal or eloctrical breakdown. The exclusion relating to rne&iariical break -down rapes not apply to the accidontal disc har€3e cifan air bag. L. Loan or Lease Gaffs Coverage Paragraph C. Limit Of Insurance under SECTION Ill - PHYSICAL DAMAGE COVERAGE is ariende€a to ad.d: if a covered ",auto" is owned or leased and if we provide. Physical Damage Coverage or.. it, we will pay, in the event of a covered total "loss", any unpaid amoun.t.due. on the leave: or loan for a wvered "auto",, less: a. The amount paid under the Physical Damage Coverage Section of the pcalicy; ana b. An y: (1) Overdue leaser or loan payments including penalties, interest or other charges. resulting frorn overdue. payments at the time of the (2) Financial penal ties imposed under a lease for excessive use, abnormal wear and tear car high mileages (3) Costs For extended warra.0es, Credit Life Insurance .Health, Accident or Disabi%l Insurance purchased with the loan or lease; (4) Security deposits not refunded by the lessor; and (5) Carry-over balances frorn previous loans or leases CAS90187 0719 Includes Copyrighted !Material of Insurance Services Offices, Inc. Page 3 of 5 Used with permission M. Aggregate Deductible Paragraph D. Deductible under SECTION III — PHYSICAL DAMAGE COVERAGE is arn.endeu to add, Regardless of the number of d:cjve;red `autos" involved in the sarne "lass", only one; deductible will apply to ttiat "€oss'. If the deductible amounts vary by "autos", theca only the highest applicable deductible will apply to that "loss". N. Diminishing Deductible Paragraph D. Deductible Under SECTION III — PHYSICAL. DAMAGE COVERAGE is arnended to add: Any d€:ductitile will be reduced by the percentage indicated below on the first "loss" reported during the corresponding policy period: r_or:s. i ree Pot icy Periods With the Expansion Endorsement i Deductibla. i Reduction on the : first." loss„ 2 25aic 3 ;it7°/n 4 5 100% If uvr:.pay t: Physical i_ afnage,`loss" during the policy period under any BUS€MESS AUTO COVERAGE FORM you have with its, your cte duetible stated it, the; Declarations page of each such COVERAGE FORM will not be reduced on any subt;o€ ue int claaiirs during thy; rurnaaindur of your Policy period and your deductible reduction will revert back to 0% for each such COVERAGE FORM if coverage is renewed. O� Knowledge of Lass and Notice To Us Subsection, a. of Item 2. Duties In the Event of Accident, Claim, Suit or Loss of Paragraph A. Loss Conditions under SECTION IV -- BUSINESS AUTO CONDITIONS is amended to add: However, pf-ompt notice of the "avddenf% claim' "suit" or "loss" to us or our authorized representative only applies after the "accideff', c€airn, "suit' or "loss' is known to: (f) You, if you are an individual; (2) A partner, if you are a partnership; (3) An "executive: officer" or director, if you are a corporation; (4) A manager or member; if you are a limited liability company; (a) Your €nsurand- manager, or (6) Your legal representative. P. Waiver Of Subrogation For Auto Liability Losses Assumed Under Insured Contract Item S. Transfer Of Rights Of Recovery Against Others To Us of Paragraph A. Loss Conditions under SECTION IV - BUSINESS AUTO CONDITIONS is amended to read; S. Transfer of lights of Recovery Against Others To Us If any person or organ ization to or for whorrr we make payments under this Coverage Form has rights to recover damages from another, those rights are transferred to us, That person or organization must do over�jhirrg necessary to secure our rights and must do nothing after an "accident" or"lass" to impair therm. How ver; if the insured has waived those rights to recover through a written contract, we will waive; any right to recovery we may have; under this Coverage Form, Q. Insurance Is Primary and Noncontributory Subpart a_ of Item , Other Insurance? of Paragraph 8, General Conditions under SECTION IV--- BUSINESS AUTO CONDITIONS is amended to read: a. This insurance is primary and. noncontributory, as respects any other insurance, if required in a written contract with you. R. Other Insurance -- Hired .Auto Ptiysical Damage Subpar. b. of Iteern 5..0thear Insurance of Paragraph B. General Conditions under SECTION IV —BUSINESS AUTO CONDITIONS is amended to read: b. For Hired Auto Physical Damage Coverage, the; fallowing are deemed to be covered "autos" you own: (1) Any covered "auto" you lease: hire, rent or borrow; aa.cl CAS90187 0719 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 4 of 5 Used with permission (2) Any covered "auto" hired or rer3led by your "crnployee" under a contract in that individual "ens pioyee's" name, with your Permission, while performing duties related to the conduct of your business However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "autos". S. Unintentional Failure To Disclose Hazards Paragraph B. General Conditions under SECTION IV —BUSINESS AUTO CONDI- TIONS TIONS is arriended to add: 9. Your failure to disclose all hazards existing as of the inception date of this Polity shall not pri.jUdice tho uwarage afforded by this policy, provided that such failure to disclose all hazards is not intenlio nai. However, you must report such previously undisclosed hazards to usas soon as practicable after its discovery, Tf Additional Definition SECTION V -- DEFINl"f'IONS is amended to add: "Personal effects" means personal pro.peaty yawned by the "insured'. 'Downtime loss" means actual bass of "business income" for tiie period of time that a Covered "auto": t Is. out of service for repair or r<'placennent as a result of a covered physical damage "loss" and 2; Is in }he custody of a repair facility if not a fatal "loss". 'Business income" means: 1. Net income Net Profit of, Lass before income taxes) that would have been earned or incurred; and 1 Continuing normal operating expt ruses incurred, including payroll. In this endorsement, Headings end Titles are inserted solely for the convenience and ease of reference, They do not affect the coverage provided by this endorsement, nor do they constitute any part of the terms and conditions of this endorsement. All other policy wording not specifically changed, modified, or replaced by this endorsement wording remains In effect. CAS90187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 5 of 5 Used with permission POLICY NUMBER: BCS0039741 COMMERCIAL GENERAL LIABILITY CG24041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization for whom the insured has agreed to waive rights of recovery, provided such agreement is made in writing and prior to the loss 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 O Insurance Services Office, Inc., 2018 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET (Ed. 8-00) 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). The additional premium for this endorsement shall be 2% of the total California Workers' Compensation premium otherwise due. Person or Organization Any person or organization for whom the named insured is required under written contract to furnish this waiver. Policy Number: WSA 5032771 07 Endorsement Effective: 07/31/2022 Issue Date: 07/31/2022 WC990634 (Ed. 8-00) Schedule Job Description California operations only. Insured: F S contractors Inc Coverage Provided by: Insurance Co of the West Countersigned by: