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PROOF OF INSURANCE (2023) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE (MM1DomvY) 11 /30/2022 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 pollcy(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 y PWONE T 18004 SkyParkEXl)..4_._ t ) E»MALLC 1713�tCk0 aa0„71901 Irvine CA 92614 ADUREss: L,ICe/ase#: Q5f1249 INSURER A: kireal L liylae Insurance C, any INSURED FELILIG-01 INSURER B StarNet Insurance Com an 400455 Felix Lighting Corporation __.___p y 17116 Valley View Avenue INSURER c Tri-State Insurance Company of Minnesota 31003 La Mirada, CA 90638 INSURER D: Hartford Fire Insurance ComRa�m 19682 INSURER E INSURER F : k;VVtKALCiihb LtKII" ;A It NUIVIUbK:20215552189 KtV151ON NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 11 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. LTR ... TYPE OF INSURANCE _�.,,0 ..... POLICY NUMBER ..1 M p EFF F..�..-....-.�. _ _ d.�,.•.._._..._....,,........ --- _w... .. _.r.- ...._ WSR • .�", .�mm A' &IL. 4T'�Lilt, _ POLICY ICY IwXP rYYYY LIMITS GENERXLIABILITY Y CPA750293914 6130/2022 6/3012023 OCCURRENCE �51000,000 A X COMMERCIALCLAIMS-MADE �� OCCUR PREMISES YArN_IEV... . _� . EACH Ea raccunonr i 3 100,000 LAGGREGATE LIMIT APPLIES PER: p� POLICY w PRO- JECT . R LOC AUTOMOBILELIABILITY Y CAA750279114 6130/2022 6/3012023 ANY AUTO X OWNED X SCHEDULED ..,AUTOS ONLY AUTOS HIRED NON -OWNED .._ AUTOS ONLY AUTOS ONLY A I�UMBRELLA LIAR { X i OCCUR CUA750294214 6/30/2022 6/30/2023 EXCESS LIAR W rr nraac_Mnnr: a C [WORKERS COMPENSATION f WCA750288519 'AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ q N 1 A OFFICER/MEMBEREXCLUDED7 V (Mandatory In NH) II ves. describe under 6130/2022 i 6/3012023 MED EXP (And one pe son) $ 5.000 PERS.ONA.L. &ADY INJUTY _..._.,...., $ .1,..0...00...,..0..m0.,m0 .... GENERAL AGGREGATE $2000,000.,, PRODUCTS-COMPIOPAGG $2,000,000 OI'd91 INGLE LIMIT 000,000 $1......_._..�.. Ea 9;gED a .�"..,1?�t) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ '''ROPC.RT"PoARIAG..._ $ .................m... L sr acurdmnd EACH OCCURRENCE $ 10,000,000 E.L. EACH ACCIDENT $ 1 E.L. DISEASE - EA EMPLOYEE; $1 D I Cargo N I � 72MSGZ3677 � 6130J2022 1 6/30/2023 K Property of Others i $100,000 DESCRIPTION OF OPERATIONSI LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: As Per Contract Or Agreement On File With The Insured, City of Ei Segundo„ Its officials, and employees are included as an additional insured on the General Liability(primary and non-contributory) and Automobile Liability policies per the attached endorsements, if required. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Recreation, Parks and Library Department 401 Sheldon Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CAA750279114 COMMERCIAL AUTO CA 20 01 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Felix Lighting Inc Endorsement Effective Date: 06/30/2022 SCHEDULE .._ . ................... Insurance Company: Great Divide Insurance Company Policy Number:,CAA750279114 Effective Date 06/30/2022 Expiration Date: 06/30/2023 Named Insured: Felix Lighting Inc Address: 17116 Valley View Ave, La Mirada, CA 90638 Additional Insured Les ( sor): Blanket As Required by written contract executed prior to loss Address* Designation Or Description Of "Leased Autos": As per Schedule on file with Company CA 20 01 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 2 Coverages Limit Of Insurance Covered Autos Liability $ 1,000,000 Each "Accident" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Comprehensive $ 1000 Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Collision $ 1000 Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Specified Causes Of Loss $ Deductible For Each Covered "Leased Auto" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 1. Any "leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow. 2. For a "leased auto" designated or described in the Schedule, the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: a. You; b. Any of your "employees" or agents; or c. Any person, except the lessor or any "employee" or agent of the lessor, operating a "leased auto" with the permission of any of the above. 3. The coverages provided under this endorsement apply to any "leased auto" described in the Schedule until the expiration date shown in the Schedule, or when the lessor or his or her agent takes possession of the "leased auto", whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a "leased auto". 2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor, we will obtain his or her rights against any other party. C. Cancellation 1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2. If you cancel the policy, we will mail notice to the lessor. 3. Cancellation ends this agreement. D. The lessor is not liable for payment of your premiums. E. Additional Definition As used in this endorsement: "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. Page 2 of 2 © Insurance Services Office, Inc., 2011 CA 20 01 10 13 Named Insured: Felix Liqhtinq Corporation Policy Number: CPA750293914 Effective Dates: 06/30/22 - 06/30/23 COMMERCIAL GENERAL LIABILITY CG20260413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): As Required by Written Contract Prior to toss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section it - 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 additionai 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 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Named Insured: Felix Lighting Corporation Policy Number: CPA750293914 Effective Dates: 06/30/22 - 06/30/23 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 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 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 Invoice Date: 12/1/2022 Policy Number: 790-00-78-84-0012-18777 Policyholder Name: City of El Segundo Contact: Julie Todd Poiic Informati�an Effective Date: 12/2/2022 12:01 AM Expiration Date: 12/4/2022 12:01 AM Insurance Carrier: Atlantic Specialty Insurance Company Transactions 12/1/2022 2:50 PM Description: Initial Rented Production Equipment Policy Purchase Confirmation Number: 64083153335 Billing Name: Julie Todd Total Payment Amount: $608.66 xxxx-xxxx-xxxx-8599 Number of Transactions: 1 Total Payment Amount for All Transactions: $608.66 InsureMyEquipment.com a subsidiary of Heffernan Insurance Brokers lnsureMyEquipment@Hefflns.com Once f3eacon +Y HPAPACZ G o r.�..1V Atlantic Specialty Insurance Company 150 Royall Street Canton, MA 02021 (781) 332.7000 A Stock Company COMMON POLICY DECLARATIONS @ vantage for Inland Marine DECLARATION HOLDER Producer Named and Mailing Address HEFFERNAN INSURANCE BROKERS Heffernan Insurance Brokers SUITE 810 811 WILSHIRE BLVD. Rented Equipment Program LOS ANGELES, CA 90017 811 Wilshire Blvd. #810 License #0564249 Los Angeles, CA 90017 PROGRAM PARTICIPANT/ ADDITIONAL NAMED INSURED Named and Mailing Address City of El Segundo Julie Todd 111 W Mariposa Ave El Segundo, CA, United States 90245 Policy Number 790-00-78-84-0012-18777 In return for the payment of the premium, and subject to all terms of this policy, we agree with you to provide the insurance as stated in this policy Policy Period: from 12/212022 to 12/412022 at 12:01 A.M. Standard Time at your mailing address shown above. Coverage & Premium Summary Rented Equipment Amount: $ 180,364.421 Lease or Rental Payment Fees: $ 10,000.00 Deductible: $ 5,000.00 (2,500.00 deductible for international claims, 2,500.00 deductible for theft from any vehicle) Valuation: Replacement Cost Coverage For Theft from Unlocked Vehicle Endorsement VIM 242 07 05 Applies: No Coverage under Water Use Endorsement Applies: No Coverage for increase Mexico limit Applies: No Premium at inception: $ 518.66 Maximum Total Equipment Coverage while in Mexico is $25,000 Forms applicable to all Coverage Parts: See ASC 00 11 0198, Schedule 1 In witness whereof, we have issued this policy, signed by the President and Secretary, but it shall not be valid unless countersigned by our duly authorized representative. Countersigned Nadia Kt, ry 12/1/2022 Authorized Representative Date 4 VIL 100 10 98 Copyright 1998, Atlantic Specialty Insurance Company COMMON POLICY DECLARATIONS