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PROOF OF INSURANCE (2024 - 2024) CLOSEDAC" DATE (MM/DD/YYYY) tea' CERTIFICATE OF LIABILITY INSURANCE 05/01/2023 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER nMIE CT NoCLIENT CONTACT CENTER OFFICE: MUTUAL BOX 3 8ANCE COMPANY PHO No, 88�333�..,..m HONE HOME Eat)• _ 949 (A/C, No): 507- 46-4664 OWATONNA, MN 55060 E•MAN nm,�ux..ac. f`I IGNTC`f1NT6f`Tf FNTFR(nlFF1'11NC C`f11u1 INSURED HORIZON MECHANICAL CONTRACTORS OF CALIFORNIA PO BOX 661461 ARCADIA, CA 91066-1461 INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 .......................... 315-809-4 INSURER B: INSURER C: ............... INSURER - U.............._. ....................,. INSURER E: --� .......................................................................... ............................-. INSURER F: COVERAGES CERTIFICATE NUMBER: 211 REVISION NUMBER: 0 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. ...... ................ TNIT R TYPE OF INSURANCE ADDL SUBR: POLICY NUMBER h" FF PO CY E7S..P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 • ........ ..........00CUR .........i',. CLAIMS -MADE X, DAMAGE TO• ENTE"..................................... D PREMISES •.. _ $100,000 MED EXP (Any one person) EXCLUDED A N ' N 1854207 03/15/2023 03/15/2024 PERSONfLL a Anu �n,ImurxY 1�000 (100 GENL X AGGREA7E LI�-..... GATE LIMIT APPLIES PER: POLICY � CT ❑ LOC N R AGGREGATE �-•-••��� PRODUCTS & COMP/OP AGO 0 .0. $2,000,000 OTHER: AUTOMOBILE LIAML1TY' OMBINED SINGLE LIMIT s a e $1,000,000 AUTO '.. BODILY INJURY (Per Person)AOW14 JANY E'D At.)TOSON LY A&THRULED N N 1854207 03/15/2023 03/15/2024 BODILY INJURY IPer Accident) HIRED AUTOS ON LY U� PN I'fP. ) DAMAGE fl X�EXCESS RELLA LIAR wX OCCUR EACH OCCURRENCE „„„ 0 A LIAB '.. CLAIMS -MADE N N 1854209 03/15/2023 03/15/2024 AGGREGATE $3,000,000 RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER STATUTE THER E.L EACH ACCIDENT ANY PROPRI TOR/PARTNERI EXECUTIVE OFFICERIMEMBER EXCLUDED? N/A E.L DISEASE EA EMPLOYEE (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE • POLICY LIMIT ........'"."".'� -. ................... ........ .. ......... .. ......... L... ........... DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ..... .. .... CERTIFICATE HOLDER CANCELLATION 315-809-4 CITY OF EL SEGUNDO PUBLIC WORKS 350 MAIN ST EL SEGUNDO, CA 90245-3813 211 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 CG 20 01 04 13 Policy Number: 9130916 Transaction Effective Date: 03/15/2022 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 B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract 1. "Bodily injury", "property damage" or or agreement that such person or organization be "'Personal and advertising injury" arising out added as an additional insured on your policy. of the rendering of, or the failure to render, Such person or organization is an additional "bodily any professional architectural, engineering or insured only with respect to liability for surveying services, including: „ injury', "property damage or 'personal and advertising injury" caused, in whole or in part, by: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, 1. Your acts or omissions; or opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims against additional insured: any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others by 2. Will not be broader than that which you are that insured, if the "occurrence" which caused the required by the contract or agreement to "bodily injury" or "property damage", or the provide for such additional insured. offense which caused the "personal and advertising injury", involved the rendering of or A person's or organization's status as an the failure to render any professional additional insured under this endorsement ends architectural, engineering or surveying services. when your operations for that additional insured are completed. © Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 33 04 13 Policy Number: 9130916 Transaction Effective Date: 03/15/2022 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 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 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 organization 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 Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured 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 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 © Insurance Services Office, Inc., 2012 CG 20 33 04 13 Policy Number: 9130916 Transaction Effective Date: 03/15/2022 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 CG 20 01 04 13 Policy Number: 9130916 Transaction Effective Date: 03-15-2021 [fE,MMIDDIYYYY) ACR" CERTIFICATE OF LIABILITY INSURANCE/O1/2023 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 rights to the certificate holder in lieu of such endorsement(s).. iPRODUCER CONTACTNAME: Gabriel Hill 9�( 415rChinoance &HS11awy tPkSerStee403LLC NCI (909' 703-9396 P No;_( PHONE 909) 614 7396 ,.��iM Lic. 0167797 E-MAIL ADDRESS; aINSURERS AFFORc com -.. .. Chino Hills CA 91709 . rrrrr._ ... AVERAGE' . NAIC 9 INSURER A:Securit National Insurance Co 19879 .... ........... .�..m.. _ _._....._.._. INSURED (626) 574-0900 INSURERB: Horizon Mechanical Contractors of California,—ll............ •---.__- ••••- ..................... Inc INSURER C P.O. Box 661461 INSURERD: Arcadia CA 91066 INSURERE: INSURER. F :. nn%1=0Ar_=c rFRTI=Ir_ATP h11IMRFR• CPrt Tn 11R9 REVISION NUMRFR! 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. ^^^ nnnnYX AflOL" �� . �.. POLICY EFF POLICY EXP Ngk TR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY. MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR _PREM)SES(Faraccurrene $ ........... MED EXP (Any one person) mm.-_,�. ............ $ _�.. PERSON AL & ADV INJURY $ GENI AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ ................ POLICY I::]JE 1:1LOC PRODUCTS COMP/OP AGG $ OTHFR: $ COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY (Per person) $ ......-_... OWNED SCHEDULED BODILY...............................................— r P (e accident) (Pe _�...���.�.�..........,,,..,.---...... $ AUTOS ONLY AUTOS HIRED NON -OWNED ._. �._...._„. �_.��. �....W�W�W�.....— PROPERTY DAMAGE .... $ AUTOS ONLY _,. AUTOS ONLY lP�/. rapcmd-w,��t), ... � ...,,,.__...-__ UMBRELLALIAB OCCUR EACH OCCURRENCE II$ U $ . EXCESS LIAB - CLAIMSMADE AGGREGATE ... ,,,...�- �. $ DED RETENTION $ A WORKERS N Y SWC1428254 03/01/2023 03/01/2024 PER ORH................ 'ANDEMPLOIEOTOR/ ARTNOR XECUTIVE OFFICER/MEMBEREXCLUDED. Y N / A EL EAT&TUTE DENT ..... CH CC $ 1 , 000, 000 .. ,,.0 0 ....... ..,.,,,..... Mandato in NH ( ry ) `� DISEASE�$_1,0001000 E L DISE_ If yes, descri se under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT1, 000, 000 $ $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of Subrogation applies per attached WC 040306 04/84 endorsement. 0%E7'nr1.I`1f%A'TC U^1 MCo rAPJrF1 I ATInki 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. AUTHORIZED REPRESENTATIVE El Segundo CA 90245-3813 w T JSif-LU"10 At.uKU %Iumrur%A 11UN. All rlgnta reserveu, ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract. 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 3/1/2023 Policy No. SWC1428254 Endorsement No. 0 Insured Horizon Mechanical Contractors of California (A Corp) Premium $ 17,473 Insurance Company Security National Insurance Company Countersignedby ....- ....... ..-___m ...... ........................................__._ WC 04 03 06 (Ed. 04-84)