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PROOF OF INSURANCE (2024 - 2024) CLOSEDN 0 DATE (MM/DDIYYYY) ACt0R" CERTIFICATE OF LIABILITY INSURANCE 10/18/2023 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 CONTACT JASON KOHANOFF .. —.. ..,_._ ......... PROGRESSIVE TOWER INSURANCE SERVICES, INC. (E M EIh(81 PHONY ) ..,68 FAX 8 704 10. .....,, � ...tAt� �!�1— ... ---- ADDRESS;. 16530 VENTURA BLVD., SUITE 612 EMAIL JASON PROGRESSIVEINS NET — ENCINO, CA 91436 INSURERS) AFFORDING COVERAGE NAIC # .. PHONE:iNsuReR (818) 704-1068 INSURE,A: _ASSOCIATED INDUSTRIES INSURANCE COMPAI INS ... B. AUTOLIFT SERVICES INC. 10764 LOS VAQUEROS CIRCLE LOS ALAMITOS, CA 90720 Fr HAMILTON SELECT INSURANCE COMPANY PALOMAR SPECIALTY INSURANCE COMPANY ^�M lrlr A..7r u11RAoon. RFVICInN PJIIMRFR- 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. -.. _. _ ILTR- J...TYPE OF ....--- AO I�W,Y' i,... POLICYNUMBE ..� .n..... POLODt YY' KSMD EXP' LIMITS INSURANCE R MdODtYYY'Y � MM/d10FYYYY COMMERCIAL GENERAL LIABILITY CO EACH OCCURRENCE 1 $ 00O 000.00 ,0__ ..... 100 000 0 CLAIMS -MADE FXI OCCUR P,REM.IBES (Ea occunen.ce),,,,,, „$ MED EXP�Any one Person)................--............�.�........---.__•, 5,000.00�� A Y Y AES1232485-00 06/30/2023 06/30/2024 PERSONAL&ADVINJURY $ 1,000,000.00 .0 .0 GENPO.....AGGREGATEPOIT _.....__..._„ ... APPLIES PER: GENERALAG� GREGATE $ 2,000,000.00 PRO _ 7 LOC _COMP/OPAGG PRODUCTS -_ $ ,000,000.00 ... ...... .. ..... OTHER: AUTOMOBILE LIABILITY I COM$ ..(EA a�cNicDC� INOkPII IM...T ..$_--. ......�....... ANY AUTO BODILY INJURY Per person) $ .._ ..----... SCHEDULED .._ OWNED ''. OO/OO/OOOO OO/OO/OOOO ..... _ __ BODILY INJURY (Per accident) $ ...... --_ AUTOS ONLY AUTOS HIRED NON -OWNED 0RonRIYDAMAGE � ... $ AUTOS ONLY .,.,._,._. AUTOS ONLY -I—er.. - UMBRELLA LIAB CCUR OCLAIMs-MADE EA RENCE 5,000,000.00 C EXCESS LIAR S Y Y XCHS344327 O6/30/2023 O6/30/2024 AGGREGATE A ^ $ 5,000,000.00 000 D'..ED RETENTION $ $. WORKERS COMPENSATION PER IIOTH ,STAThJT,,,,E. ER ,..,......„.�„.,..,,.-- ,..,... D AND EMPLOYERS'LIABILITY Y/N NIA' Y PSIC08312-06 01/30/2023 01/30/2024 _X .. __-.9 IDENT E.L. EACH ACCIDENT $ 1,000,000.00 OFFCERIMEEMBB REXCLUDED?ECUTIVE E.L.DISEASE EA EMPLOYEE $ 1,000,000.00 (Mandatory in NH) If yes, describe under a DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 00/00/0000 00/00/0000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (GENERAL LIABILITY) PER ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION CG2010 AND PER ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS CG2037. PRIMARY AND NON -CONTRIBUTORY -OTHER INSURANCE CONDITION CG2001. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US CG2404. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT -RESTRICTED UCG2503. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WITH PRIMARY AND NON-CONTRIBUTORY LANGUAGE AND WAIVER OF SUBROGATION WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. CERTIFICATE HOLDER CANCELLATION 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. AUTHORIZED REPRESENTATIVE EL SEGUNDO, CA 90245 JASON KOHANOFF ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE °ATE`MMI°°"Y�"' 11/21/2023 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 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 !m4cf Noden, CPCUWigmore Insurance Agency Inc.14)979-6543 N Ir14>880 W. 19th St.ercial@wigmoreins.comLicense #0811959 INSURERS AFFORDING COVERAGE NAIC# Costa Mesa CA 92627 fornia Automobile Insurance Co. INSURED INSU:rwriters at Lloyds.- London AUTOLIFT SERVICES INC INSURERC: AUTOLIFT & EQUIPMENT SERVICE, INC. INSURER0: 10764 Los Vaqueros Cir INSURER E: LOS Alamitos CA 90720-2515 INSURERF;: /`nveo Af_FQ r1=DTICIr_ATF IdIIMRFR•23/'24 Auto & PL rev.10.23 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. INSR AVOL -SUBR POLICY NUMBER MMIDDIYYYY POM UC Y UTB TYPE OF INSURANCE POLICYEFF P<�EICYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 1:1 OCCUR OAMAGETTO N PREMISES Ea o2gUMMce $ MED EXP (An one person) PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG $ .. POLICY ❑ JECT ❑ LOC AUTOMOBILE LIABILITY Co SINEO SINGLE. LIMIT aacc.Ideral $ 1,000,000 BODILY INJURY (Per person) $ A ANYAUTO ALL OWNEDqL AUTOS HIREDAUTOS S Y BA040000029989 10/30/2023 10/30/2024 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ UMBRELLA LIAR EACH OCCURRENCEEXCESS AGGREGATE $ LIAB DED ''. RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE PER TH- S7AT ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA E.L,DISEASE - EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ If yes, desc6be under DESCRIPTION OF OPERATIONS below B Professional Liability ''. B0621PAUT0013623 6/30/2023 6/30/2024 Each Claim Limit $2,000,000 Aggregate Limit $2 , 00 0 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (AUTOMOBILE LIABILITY) WITH PRIMARY AND NON-CONTRIBUTORY LANGUAGE AND WAIVER OF SUBROGATION WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT PER BUSINESS AUTO BROADENING ENDORSEMENT MCA85100817-CA.. CERTIFICATE HOLDER L;ANL;r-LLAI IUN abola@elsegundo.org City of El Segundo 350 Main Street E1 Segundo, CA 90245 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 imothy Wigmore/K140 n 1 ATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) POLICY NUMBER: AES1232485 00 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): All persons or organizations where written contract with the Named Insured requires additional insured completed operations. This form cannot apply to your work on "residential property". Location and Description of Completed Operations All locations where the Named Insured is performing operations on behalf of the designated additional insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 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. A person's or organization's status as an addition- al insured under this endorsement ends when your operations for that additional insured are complet- ed. B. With respect to the insurance afforded to these additional 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 render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. 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 ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(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 subcon- tractor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 COMMERCIAL GENERAL LIABILITY CG 20 34 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS WHEN REQUIRED IN LEASE 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(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). 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 required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 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. CG 20 34 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: AES1232485 00 COMMERCIAL GENERAL LIABILITY NX GL 009 08 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTING INSURANCE (THIRD -PARTY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Third Party: All persons or organizations where required by written contract with the Named Insured (Absence of a specifically named Third Party above means that the provisions of this endorsement apply as required by written contractual agreement with any Third Party for whom you are performing work.) Paragraph 4. of SECTION IV: COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance: With respect to the Third Party shown above, this insurance is primary and non-contributing. Any and all other valid and collectable insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for loss covered by this policy, shall in no instance be considered as primary, co-insurance, or contributing insurance. Rather, any such other insurance shall be considered excess over and above the insurance provided by this policy. NX GL 009 08 09 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1 POLICY NUMBER: AES1232485 00 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER SFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations where rewired by written contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 outof your ongoing operations or "your worm" 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 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC ON04WSA (Ed. 01-19) 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. Blanket Waiver: The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Specific Waiver: The additional premium for this endorsement shall be 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation As respects to all CA jobs performed by the named insured during the policy period where by written contract a waiver of subrogation is required prior to the commencement of work. 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: 01 /30/2023 Insured Autolift Services, Inc. WC ON 04 WS A (Ed. 01-19) Policy No.: PSIC08312 - 06 Endorsement No.: Insurance CompanyPalomar Specialty Insurance Company Countersigned By - Print Date: 1/30/2023