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PROOF OF INSURANCE (2022 - 2023) CLOSED08E(MMID ACORD. CERTIFICATE OF LIABILITY INSURANCE � 0"/23MID221 ........... ...... ..........,., .,.,..__ -.... �. ....---. ,....,..,�. ------ PRODUCER -.-.-.-.- ..,.................,,_........................,-..,._ ......_ . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION FIRST CENTURY INSURANCE SERVICE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TH'E POLICIES BELOW. 17635 VENTURA BLVD#200 ENCINO, CA ''... INSURERS AFFORDING COVERAGE 91316 '..INSURED COLONY INSURANCE COMPANY PARDESS AIR INC 114SURERA: STARSTONE NATIONAL INSURANCE COMPANY INSURERB: 1769 KELTON AVE INSURERC: LOS ANGELES, CA 90024 INSURER INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING NDING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR -. TYPE OF INSURANCE POLICY NUMBER POLWY EFFECTIVE � ROLICY EXP`11 �ATI01N .., ,... ,. LIMITS m _ EACH — 090 GENERAL LIABILITY A COMMERCIAL GENERAL LIABILITY 600 GL 0006696-13 OCCURRENCE _ - — /27/2022 � _ 300,000 1 0/27/2021 1 0 FIRE DAMAGE QAny one fire) $ CLAIMS MADE 1 OCCUR MED EXP (Any one person) 3; 5, O6O I L...... PERSONAL E ,&ADVINJURY '1,@'0'�'y00,000 `� ......i GENERAL AGGREGATE S ,000,000 � 1,000,000 1 GEN'L AGGREGATE LIMIT LIMIT APPLIES PER: I - PRODUCTS • COMPNOIT AGG I $ I ,... PRO X POLIC1I AUTOMOBILE; LIABILITY j ' COMBINED SINGLE LIMIT $ (Ea accident) -, ANY AUTO '.. ALL OWNED AUTOS '. BODILY INJURY $ SCHEDULED AUTOS (Per person)....... HIREDAUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) ........... ,,,, ...... .�......._ .. ... .....mm.... ... __,,,,...... � ....� ,..-.,...�_.,..._...-,._..., ......__ .., ......_-..... ............... GARAGE LIABILITY _............. AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG 1 '$ ...,.we.,a...,,.va,.... ......_ _..w. .... ............ ............�.........., _ .................. ...._,.. ... .... �...._e..... ..... ......,, �.. 3 j .. EACH OCCURRENCE J $ , n EXCESS LIABILITY �,000,000 B OCCUR ; CLAIMS MADE 71232M220ALI 02/18/2022 10/27/2022 AGGREGATE s_ 15 DEDUCTIBLE RE_TE_NTION .rrrr ......... .,.,...... ,,,, .�.-.-_ .,._ .._..,,,.. .....m .........._,,,,,,.,,,�. __u-.�i ............. ..... .. „�... ............. , ........ „......WORKERS ..... -.... SAo'�Yl��9Mil7f, I (1EIR COMPENSATION AND lciG ',.... EMPLOYERS' LIABILITY E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYE.T $ E L DISEASE - P l lrYLIMIT $ OTHER . , , , ,__.,,.,..... .....�...,.........,, .,... DESCRIPTION OFO ...........w................... _.,a ......,...........,....,._ .. ----.-._- PERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of El Segundo, its officers, officials, employees, agents, and volunteers are named as additional insureds "are named as ADDITIONAL INSURED PER ATTACHED, CG 20 37 12 19, CG 20 01 12 19. CG 20 10 12 19, U047-0310 REQUIRES WRITTEN CONTRACT Re Chiller Unil Replacement] 348 Main St, El Segundo, CA 90245 'EXCEPT 10 DAYS FOR NONPAY �, .. �......... .... ......... ........._ ..�........ -. .. ,.......... .. ..�...., ....., CERTIFICATE HOLDER. ADLIUPIONAL INSURED INSURER LETTER: ....... ...................w. ,.,.----- .......... .... ,,,,,,_„ ..." _.__ - .�.,.�. ,�....... .. CANCELLATION . ,. ....... .SHOULD ANY 0......_- F THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION *30 City of El Segundo, DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN 350 Main Street, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL El Segundo, CA 902455 04 WA Iurr tI [J C Ivp1 FOR II aAUR 111', urlN1011l1 uur�Wi THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) O ACOR(a CORPORATION .. 98 .. } 18 I ;O ,! 40ijl CG 2U 37 W 19 Fi, 1" ""'1 E Vj E JC)[R", E NA, E N I ("', G E S T I E P C) LA C Y P L. EA VS ", E',/'�, I� ' I� I" RI LPi, LY, ,A D �D N A 1. 114 S LJ it EE D -- 0 VV iS , L., E S S E S 0 Fi I is e( I d or Son I c I # I I I I odi I: ie`?II IS III Ul I! I CH � )j O'Videld ta I � k1" 0 1 f:. k-)flo%,(Jj I q i i,11,01H i FY, CC,)AAFF1'/'o7,F: ()PI: ::Z/0-iONIS i I L.)" U SCHEME Name Of AMMUmmil ksw ad PeMs) tiic,� lkunv,-,,d il),iJI 1]l jF, b)r 1,110 pailies to iho pl�lcA tc'� CCHTH H I, I K,� Tnc c I; %lva< ihali IF, a,aUlc, fai i( r U I c� wquilrml v COMMM HTS WMAn H se(A"lic"w) I %/%"llho IS grcd, `,,; ,Im(�,wdcd (o includ,` n ad,(JAwnul kamod tic Poranym 01 MY= Wi To SChoduhn bil My "vilh to kabiiity' (n T)�,,)diiy Off YOUr 1000 of Un UUMH &Qpmd at "he `30i(rduic,, �luh<dod �w " t clp,k"n e,w'n (ld ("ol"Olr�lct ol u�'p"PCHCr, , Ole Wj,,,�I�H�,,�U �-,,Mmrd'wd Io ,A� wjI N�<3dci flh;m Q—A yn�.� of(;� or Ir,W '�o LnwWon And Wsm'ipiriii 0,11 Cornpilpted Ope"'AIwis I, P nft I I I � I I cnvcr(gc undrr ti�is pnHc,,,, hum t a aunt 10H h a Wh�w, I � il I ""Vilil 4n ihE? /dkn'd(`d ()> =kmal kox(M No lAhwirg 's EkWon UK UM AS ot hwumnw if lo ihdd;ilolwi, I eovmd hy H cowu 1 o; agwrwn[ Me nun! W! pay wi lanalf W Uw addiUmA WAM IN Aw, I V, A 13 A TWs endorsemant inudiflos 4n,`Amrince provkJed under the fcfllowCnq� C,0MMERCW- GDIVERAL LIABIL l'Tr,,( (DOVERAGE PAR"T FMRC)EHJC:TEN(3C)NI lP.-[-",I'ED CWERAT l0NS LIABIL H'Y CCME.-�RAGE IPRT Thep loflavvng is um,Oded to Paragraph UQansbr0I'RJgh,ts Of Recovery Aga i inst Other's To Us of Section �IV --- Conditions: We ''Cali me any dghN W nNmvmywe Imaay l-mv(.., agahst any person orcjannzafion because of paylITKNflS W-; Make foir arljUry or darnage osultang fmrn yourongoing operaMns cor"YOUFW(,)urk" done under a coinfiract Mth Rmt pemon or orga ,, lr,,, I Goin and Ncluded Wi Te "pmdudmcompf�eted opemfioiins hazaird" T a. you agmmi W swch waNmr� b. the ram Neir liana, Mcludod as pa of a WHen contract or hase; and c. siuch w6ftein conbact or lease was oxeculed pilor to any loss to wh�ch Uhis kisuralr)(.Em Bj)lPHC'S ALL OTHER TFRMS, AND ("301AUT IIONS OD...Tl UE P0LJIC','Y Rl`,-.MMN L.NC I iAN(.j',[--TD ... u'IY„'^��� END( L.„ ��.� IY;i� .�� CIIIIII� � I������� i ,.� ..� ��,�, �.��,„, ....� ..„„, ..� ������„i ������,�„. � "w��� '�������Y ���,µ. �!�Y:�! ���Iw' I���I� ���� I ���� ����. ` V. ���.,� �. T1' 11,��Wp END( ,R .....E .... „..n Wu q mu' THE �" OL I �...�.a' u � IRI,!! � [') � � � �� .':'�„.11 r I' RIGHTS HTREC(11.)VE[RY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" if: you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. /,, ('�..V'�`wi"V Vylti''I:Q'1��9Y l;�'d lSO l::a�•v1i�"�;�I�C,IIV s, VU7C_ fim 1 ���u d s c u.1 l' o u II POUC'Y' ',JUN,,flE11ER! 6010 C,L 0006ifiq,6-M C0M1Vfl!!!,!JRGiX1 GII' 11JBi!?,AJ L III AB ��l i � i Y CG 20 10 "12 •119 1D �R S E M E I Q�,,IANGES I I 1E ����IOLACY, FU�11 "Al 311 1 ("X� �Ew F U ADEN r IONAL INSURED - OWNERS, LESSEES OR cam rRACTORS - SCHEDULED PERSON OR ORGANIZATION 'Fhis endorsement modifies insurance provided under the following: :7 COMMERCiA[ GENERAI. I MIEM FFY COVERAGE PART A, Section 11 — Who Its Ain Insured is amended to IB include as an additional insured the persons) or organization(s) shown in the Schedule, but only with respect to liability for "bodilly injury", "property damage" or "persona@ and advertising injury" caused, in whole or fin part, by: 1.. Your acts or omissions; or 2. The acts or ornissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 1The 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 lby a contract or agreement, the insurance afforded to such additional insured willl riot be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the -following additional exclusions apply: This insurance does riot apply to "bodilly 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 per -formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. "! hat portion of "your work" out of which the injury or darnage arises has been put to its intended Use by any persoin or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C G ? 0 10 12 19 C)W, � �� , � flacle l of 2 CWth respect to fihe insuiialrnCE,: r-.3ff0I-d0(I to MeSe ,idd H iomfl � ini m u ni d s, Cho foiicm4ig k a d d c (I to Section IIIIIIIII -- Lkin�its Of finsurance!� if coveirago provided Ro 1he addifiondi insured uNdind by a curWact or a0minnent, th(i n-nosh: we, will pay mi behalf of A) MAW insumd 4 kc, amount of unsurance: 2. AvalllaUe undeir the insurance�; whidiever is less, Ilds onckwsement shall ft7-jj1 of jqoujnujjq(,(,,,, appficat)ie HmHs W rKA Wmase the, PMW 2 W 2 :t) OHI� (n(' , ''H 18, CG 20 10 12 19 COI'dIMIERCIAlllL GENERAL Ili...IIABNI...IIr nr Ct 20 01 1219 IIVI ( IIIC" CHANGES "n.. II! m .. ( Y Y) .IIl.........Yi�m IlP m: IIN I11: i r Al i".IIE jW t.pIL...IIR...:Y. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR 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. Chi 20 01 12 19 ��:� Vr���.�� _o ic.�.� �:�r,ilft,�. �'affi� �� Iwo , Flag"I Of 1 lwn/kY|Nsm[ v� wNx� uL *2OO LN{/No.[A9B)5 �21&DW) 7l7) C(111�!krtificla-te of Insurance celmIificatmHolllder OTYOFL L5[GUNDlR5ORl[[R� OFROAB, EVP0YEE5.A( ENT3. 35O�A|N5TREE[.CA9O245 msuea � PARDL8�R|N[ 1769K[[0NAVE Ce,23,b'V� RC�IXV Polkymiumnbleir 04592245 6 unonmwiorllI ow1|[o1111ww11U/u"A', (O m,gon) i. zmz �u us ��p��q —'���� — l5111 CEN0RY|�"Al( 17D35VE1',JTURA 8Lh,lOU �NONO'[A913l() TNs dommC, ntceI I I I Ies1ha�insu�nce po|icIes idend8ed beImw I o been i� sued bv de deagnaI d /nsum/I � ) �e insui C, � I namedabov e fcjrLhepe i Iod(,) IndIc'a IedThis(e I t I8caI oisbaedto/i1-1 � clnnadoopurpoeson|y II J heonohgNsupon Ne ce1 11 e ho|de�and doea 1 laoge. a!te[ mnd��' mext C,od the onemge,, a0orded by he Vo|kIes |istod be|mw ThemvemgesaIfolrdedby� I iepohdes|i"IodbeIo,,vvaesob�a1toaUihp!p/ms.exchmion"'|imha�on�.endn/semenw,'and condihomcl fLheepoUdes PoU� y87azve Uaw�! "Aar9, 20IZ kisw�� ' 80D|LY|�URY�ROP[�YDA�AGE UN|NYURFU/UN0ER1N�UREDMOTOR|sT ' ' . E10Y[ills N0NEDAUTO0PD �esaription of I cKiii�����on/Ve���,i�lc���q:?s/SpeciaI Itenis Scheduled autos only ' 30\5[111EVROLRS|0ERA0]( 1')00 PokyE��m�nDa� Nbr9.Z0� �� �1.00'D0Q[OM8IHN[|NGL1 11 `,/� IT �1.00.O00[0W8IN[D8NQ111 "'lR �1.0 00.8U0{O[,/IB|N[DUNQIUM|[ �l.00,OOU0}Nd0NLD5|NGI �UK0T I)m|m|Amoum 85.0UO �0NPREHLkGh"L %YO0DLD 031 UDDN KI'd 0 PARDAIR-01 AX .4t't►Ro` CERTIFICATE OF LIABILITY INSURANCE DATE 8/29/2022 .............................. _........... ....... ____....................... ....... _� .. 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 ri' hts to the certificate holder in lieu of such endorsement(,$). PRODUCER License# t� M.. Mount2 Inland Empire-Alliantt Insurance Services, Inc. ONNo,E Og) 886 9861 FAX ) a5n E. d&no, Dr CA 9 08 cmo Isuc No �909 886 2013 E-MAtL iant 0Om a09R6.. untz�lll�_._ ...m.. ............... ......... .... I,NSUREI?d'I AFF17t8,ptraq,CdvfGE------- ---_NAIC AI ��� INSURER Insurance qrr ppy ofthewWest 27847 INSURED INSURER B Pardess Air, Inc. INSURER C : ,,,, 1769 Kelton Ave INSURER D . Los Angeles, CA 90024 - -- .........._..rrrr. .........__.... - - '. INSURER E INSURER F : 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. �aINSR ...................... ......................................._.......----- -.._-- -- ADDL SUBR_____.___-___.—___............a_.POLICY.EFF...�,;.......POLICY EXP.....................................................................................................................................................................,. LTRTYPE OF INSURANCE POLICY NUMBER LIMITS .......................... .._.................. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. $ ._..m,,.. ...... ........ CLAIMS -MADE q OCCUR DAMAC;;E TO RENTEO PERSONAL $ ADV INJURY $ OEMs.AGG'REGATE'LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JEST E? LOC PRQD,UGTS ..COMP/pP AGG_� S� _.. CkTHE'R'... � $ AUTOMOBILE LIABILITY COMBINED S9N0LE.. LIMIT ANY AUTO BODILY INJUAe .C.RY Per ,rson _ $ .... --__� OWNED -� SCHEDULED _ AUTOS ONLY _ AUTOS BODILY .INJURY�Peraccident) $ HIRED Ny�,pV'• PROPERTY DAMAGE mm AUTOS ONLY _ AIJ'�TOaC�F�Y' _fPCrm`t3CirteM,l ------------- __._ mm._ $— f UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ ,... ........ ................................................. ........ .... $ A WORKERS COMPENSATION X PER T ORH AND EMPLOYERS' LIABILITYYIN WSD 5058275 01 12/1/2021 12/1/2022 t 1,000 000' OFFICEWMEMBER NSATIOEXCLUEDP ECUTIVE Y N / A X „E L EACH ACCIDENT $ fNyes, SCRIP��JN OE OPERATIOM tL low m..... ....... _ ..........«................ ........ E Lm OISEA,,.SE • PALIMY LIMIT E $ ,.. ...be under 1�.i�011,011ti� nnnnnnn ............................... . nnnnnnnnnnnnn ........................... _... DESCRIPTION OF OPERATIONS I LOCA°nONS P VEHICLES (ACORD 101, Additional Ramarks Schedule, utaY be attached if more space is required) Waiver of subrogation as respects to workers" compensation per endorsement attached. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty El 9 ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department 350 Main Street ......................._...._...... ............................................._ El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET 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 3% of the total California Workers' Compensation premium otherwise due. ANY PERSON OR ORGANIZATION FOR WHOM THIS WAIVER IS REQUIRED. Policy Number: WSD 5058275 01 Endorsement Effective: 12/01/21 Schedule Job Description ALL CALIFORNIA OPERATIONS. Insured: Pardess Air, Inc. Coverage Provided by: Insurance Company of the West WC 99 06 34 (Ed. 8-00)