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PROOF OF INSURANCE (2023 - 2024) CLOSEDSTREE-3 ,4coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) kk/ 1 05/0512023 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 Roberts & Phillips Insurance Services, Inc. 2848 Arden Way, Ste. 110 Sacramento„ CA 95825 Chenoa Phillips RE ht Restoration (ai sts, I"c.*Attn: Brian Cochran Street. Unit 360 Valley, CA 93065 916-484-1001 Chenoa Phillips ya....916-484-1001 Nautilus Insurance Company ♦.� IxE1 916-484-1018 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, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY REDUCED BY PAID CLAIMS. ,EXCLUSIONS wHAVE wBEEN INSR AOOLISUBR POLICYEFF POLICYEXP ITR TYPE OF INSURANCE POLICY NUMBER LIMITS A X - COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ,000,000 CLAIMS -MADE FX] OCCUR X pENV000061700 04128/2023 04/28/2024 DAMAGE TO RENTED pSF�S i',�.�.f�uarxw.crA, _ 100,000 5,000 MEDEXP An one eson $ 1,000,000 PERSONAL B ADV INJURY $ 2'000' 000 GENL X PER: AGGREGATE LIMIT APPLIES PERC OM ITGGENERAL AGGREGATE $ 2,OOO,00POLICY ... AUTOMOBILE LIABILITY I � COMBINED 'DINGLE LIMIT ANY AUTO BODILY INJURY Per person) _._.._.._.. $ ...� ..... OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident A�T OS AiS FI AMAGE. P C ONLY ,...,...�. ,y n, .... .... ...e, $ B UMBRELLA LIAB X OCCUR EACH OCCURRENCE ...................... $ 2,000,000 EXCESS LIAR CLAIMS�NADE ..............S- AN1282857 04/28/2023 04/28/2024 AGra> aTE $ 2,000,000 X DED RETENTION $ $ WORKERS COMPENSATION EMPLOYERS' LIABILITY PER OTH- 5.TA.TUTE. ER .....� •• - .AND YIN ..,•�,.:,DIS.EA,S-,,E, 'OFFICER/MEM ER EXCLUDED' L......."""" (Mandatory in NH) NIA E M,PL;CJYE�..,...$..n,. If yyes describe under DESCRIPTION OF OPERATIONS below . E.L.. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as additional insured per attached endorsement 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. 350 Main St El Segundo, CA 9024S AUTHORIZED REPRESENTATIVE i ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: DENV0000611-00 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON O ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization for whom you are performing In respect to any location where the named insured is operations when you and such person or organization have performing "your work". agreed in writing in a contract or agreement, effected prior to the date your operations for that person or organization commenced, that such person or organization be added as an additional insured on your policy 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. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 2010 04 13 POLICY NUMBER: DENV0000611-00 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OIL CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided underthe 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 for whom you are performing In respect to any location where the named insured is operations when you and such person or organization have performing "your work". ,agreed in writing in a contract or agreement, effected prior to he date your operations for that person or organization commenced, that such person or organization be added as an additional insured on your )olicy 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 contractor 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 0 Insurance Services Office, Inc., 2012 Page 1 of 1 CI CW A021011 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regard- less of the provisions of any other contract, such as between the certificate holderand the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder. CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245-3813 Named Insured: STREETLIGHT RESTORATION SPECIALISTS, INC 2828 COCHRAN ST # 360 SIMI VALLEY CA 93065-2780 Automobile Liability Insurer Name: Allstate Insurance Company PolicyNumber 648796473 x 7 - Any Auto 2 - Owned Autos Only 3 - Owned Priv. Pass. Autos Only 4 - Owned Autos Other Than Priv. Pass. Autos Only 5 - Owned Autos Subject to No Fault 6 - Owned Autos Subject to a Compulsory UM Law 7 - Specifically Described Autos 8 - Hired Autos Only 9 - Non -owned Autos Only Policy Effective Date: 09-11-2022 Policy Expiration Date: 09-11-2023 Limits Of Insurance: $ 1,000, 000 BI Per Person Combined Single Limit (each accident) BI Per Accident PD Per Accident Description of O rations/Locations/Vehides/Endorsements/Special Provisions Interested Pa T : CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER IF TH IS CERTIFICATE INDICATES THAT TH E CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE P0LICY(IES) MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer. MERTES FINANCIAL Authorized Representative: Date: 06-02-23 Cl CW A021011 Includes copyrighted material of Insurance Services Office, Inc., with its permission Allstate Insurance Company Page 1 of 1 Certificate Copy 0 DATE (MMMDNYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE 06/02/2023 1%� 1 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 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 Matt pUllMan NAME: Westgate Contractors Insurance Services, LLC PHONEFAX INC, Neu 760-845-9038 INC, Noy 2211 Encinitas Blvd, 200 ADDRESS, mpuliman@westgater-ontractorsinsurance.com Encinitas, CA 92024 INSURER(S) AFFORDING COVERAGE NAIL # State Compensation Insurance Fund 350,76 INSURED INSURER 6 Streetlight Restoration Specialist, INC INSURER C 2828 Cochran Street #360 INSURER D. Simi Valley CA 93065 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 INSA POLICY EFF POLICY IEXP N TYPE OF INSURANCE POLICY NUMBER (MWDDNyyy)—(MWDPNy'y'y) UNITS . . ......... GENERAL LIABILITY $ DAMAGL fO Fq,!N1'E0 COMMERCIAL GENERAL JAMLIFY PR�IASES tr-a ocwirrumx� , 5, (,,1Af1M,,MAW "ED Ir XP (An) one, CXIM4'4m ::I:, PlInRSONAL & ADV INJURY $ GIE1.NEI18AL AGGFiEGA. FE S. ILN'l A C)CM, D A t Phl PPIV�S PF R PRODU(; I S - COMPIOP AGG $ PkO ... . ..... . . $ . ........ AUTOMOBILE LIABILITY COMBUA D SR0,Af, .LMV 1 �f�a arx'x"P�n�j I S ANY AU rO EaOMLY WURY IPer Ixrson) $ scii� A C,S BODLY U4JLJRY Per acaden�) $ VWAIEW f DAMAGE, $ MRt D AI o1 i� hS UMBRELLA LIAB OCCUR AC1 OCCURRENCE EXCESS LIAR C�,AAAS MAT& I YCGRd G,", I F $ . . . . . . ......... WORKERS COMIPENSATION x Alc S1 60 OfH- AND ENIPLOYERS" LtAMLITY YIN PRC)F�R�E-rC)��6�ART�qER�k..X`..C,L�FuVE. A ANY Y 1,0010,10,010 NIA X OF F CIERnffl. UIBER EXCLUDED? 9227287-23 03/06/2023 03/06/2024 I (Imandaimy in NIH) 1 1,4 �-NIPI YY1 yes domaltsp urulo' DIESCRIP I *N OF RAT�ONS below . . . ............... LL I N 11 �_ ,_I_ M T ..... DESCRIPTION OF OPERATIONS I LOCA nONS I VEHICLES (Attach ACORD 101, Addrdonal Remarks Schedule, if more space is required) Evidence of workers Compensation Insurance Includes Blanket Waiver Of Subrogation, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT AGREEMENT ,. m . WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE MARCH 6, 2023 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING MARCH 6, 2024 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME STREETLIGHT RESTORATION SPECIALIST 2828 COCHRAN STREET #360 SIMI VALLEY, CA 93065 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 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER BLANKET WAIVER OF SUBROGATION 9227287-23 RENEWAL NA 8-76-80-83 PAGE 1 OF 1 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: MARCH 7, 2023 2572 AUTHORIZED REPRESENT/IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) OLD DP 217