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PROOF OF INSURANCE (2024 - 2024) CLOSEDAC40RO� CERTIFICATE OF LIABILITY INSURANCE DATE,MMIDDIYYYY) 04/04/2023 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 endorsements . PRODUCER CONTACT John Bettis __ PO Box 2816 Bettis Insurance Services, Inc PHONE a Ertk (310)521 4480 WC P uoN � �(310)�521 0111 . I,.Nlef, E-MAIL tbett+s1 betllsins com San Pedro CA 90731-0197 ADDRESS,_.. �.'..-...� µ _.. _.._ _ .. I ..... --........................... . INSURED Mike Erland Second City Plumbing 525 W. Mariposa St. ElSegundo CA 90245- .Atain Specialty Insurance 17159 ........... .Insurance Company of the West 27847 ..._............................ ......... .Oregon Mutual Insurance Co (Rated A VII) 14907 .Scottsdale Insurance Company 41297 (*nVFR'Ar,FeS rFRTIF1rATF Nit IM'RFR- RFVICIr)N NI IMRFR• 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' AODLSUBR. POLICYEFF POLICYEXP ITR TYPE OF INSURANCE LIMITS A X COMMERCIAL GENERAL LIABILITY X CIP412401 02/15/2023 '02/15/2024 EACH OCCURRENCE �" X '. CLAIMS -MADE I OCCUR ,cow E TO RENTED DAMAG ... w1,000,000 50,000 I,.. ...,. ..Pff.EItiIISEs(Eatlas�uCrauaGst)I $ . . ME An eJURY „ P„RSONAL,&,ApvlNauRY SPN, AD $ 1000000 . f�ENLAGGREGATE LIMITAPPLIES -LIMIT APPLIES PER: GENERAL ENERALAGGREGATE $ 2 OOO OOO _X POLICY PRO El LOC � PRODUCTSCOMP/OP A,GG _ $ 2,000,000_........... OTHFI_., $ C AUTOMOBILE LIABILITY CM0920869 02/24/2023 02/24/2024 COMBINED SINGLE LIMIT f,amwIi $ 1,000,000 ,,,,,,,,, ANY AUTO BODILY INJURY (Per person) $ OWNED X '.. SCHEDULED ....... ( BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS .. PROPERTY DAMAGE $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY (Per accident) ........................................ $ UMBRELLALIAB X OCCUR XBS0175449 02/15/2023 02/15/2024 EACH OCCURRENCE $ 1 000,000 ._, X EXCESS IAB C„LAIMS MAmD ...I ...T....� , GREGATE. A�,.... w.............. $ 1,000,000 .�, B WORKERS COMPENSATION WPL 5054200 03 03/02/2023 03/02/2024 X :. PER H^ AND EMPLOYERS' LIABILITY YIN 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? N / A E..L EACHA CIRENT —"--"" S 1,000,000 (Mandatory In NH) i Ifyes, describe under,r.�,r.�!„..z.EAEMPLOYEE ........ 11000,000 DESCRIPTIQNQE OFERATIQNS-beigw.E,L. 102/24/2024 DISEASE- POLICY LIMIT $ C Auto Physcal Damage CM0920869 2/24/2023 Comp Ded $500 Coll Dec $1000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEH'ICLES (ACORD 101, Additional Remarks Schedule, maybe attached It more sppace is rativired) City of El S-egundo is named as additional Insured as per additional insured endorsement CG2033 0413 when required by written contract. Waiver of subrogation applies when required by written contract per attached form # CG 2404 0509. Coverage is primary & noncontributory per form # AF 001397 0916 Al UU1381 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street ElSegundo CA 90245- [ AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing opera- tions 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. Such person or organization is an additional insured only with re- spect to liability for "bodily injury", "property dam- age" 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are re- quired by the contract or agreement to provide for such additional insured. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations for that additional insured are completed, B. With respect to the insurance afforded to these ad- ditional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the ren- dering of, or the failure to render, any profes- sional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "prop- erty damage", or the offense which caused the "personal and advertising injury", involved the ren- dering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 04 13 Copyright, Insurance Services Office, Inc., 2012 Page 1 of 2. 'Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than serv- ice, 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 b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Sec- tion III - Limits Of Insurance: The most we will pay on behalf of the additional in- sured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insur- ance 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 Copyright, Insurance Services Office, Inc., 2012 CG 20 33 04 13 POLICY NUMBER: CIP412401 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following; COM M ERCIAL GEN ERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS 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 we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: CIP412401 This Endorsement Changes the Policy -Please Read it Carefully PRIMARYAND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV -Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: Specifically and solely for the Third -Party shown below, notwithstanding the provisions of sub -paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any quit"where the damages are caused by the insureds sole negligence, this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third -Party to whom this endorsement applies is: ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES, AT A SPECIFIED PROJECT SET FORTH IN A WRITTEN CONTRACT, THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY SEEKING COVERAGE UNDER THIS ENDORSEMENT; AND (2) HAS BEEN ENTERED INTO BEFORE ANY LOSS HAS OCCURRED. Any coverage provided pursuant to this endorsement shall be subject to all other terms, conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number: CIP412401 Named Insured: SECOND CITY PLUMBING Endorsement Effective Date° AF001397 (09116) Page 1 of 1 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 otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER. 2 % of the total California Workers' Compensation premium Schedule Job Description CALIFORNIA OPERATIONS ONLY. 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 03/02/2023 Policy No. WSA 5054200 03 Endorsement No. Insured ERLAND , MIKE (INDV) Premium $ INCL . Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSURED