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PROOF OF INSURANCE (2025 - 2025)AC"MY DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/14/2024 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 endorsements)_ PRODUCER NAME'_- John Bettis �..� „_..�.,. Bettis Insurance Services, Inc — PO Box 2816 PHONE (310)521-4480 FAx (310 521 0111 (AdD..dAa,-Fsddttisl het _................. _. ......— EMAIL ttisinS OOn i San Pedro CA 90731-0197 ADDUM .............. ... .... _- L�;-.uRELRA 117159 Atain Specialty Insurance- _ INSURED Insurance Company of the West ! 47 Mike Erland il' PURFR B Ore . - Mutual Insurance Co (Rated A VII 149 .. Second City Plumbing 1tt50,R�,°.Oregon M Insurance..._urance07 ) 525 W. Mariposa St. INsyS,f,B,R,.. Company _ 4129 ElSegundo CA 90245--INSURER � .... _. _... .... _.... - 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. ADDL�, IA TYPE INSURANCE M11BR �. POLICY EFF POL.��.......p ICY EXP CIP412509 02/15/2024 2115/2025 �.� ..,�..� .,.... .. .. ,, LIMITS A X � COMMERCIAL GENERAL LIABILITY X O H OCCURRENCE �. d . 1 .000,000.... � ������ CAC'E _. X.. CLAIMS -MADE occuR DAM ib RENTFD 50�000 PREMISES I, ......................� .� m ,..... „i'II:C63%dL*ll.:S"„I—_..�..� M,RD, EXP_(AnY ont.Personl s 5,000 ....... ..... __ _.�..... 1,000 000 000.... RN'1 Af GPEGAT LIMIT APPLIES PER: G N�,RAL AGGREGATE $ 'X JEC LOC POLICY ,PRQDL! Tr-5 _COMPIOP Agg $ 21�000 OOO 000 $ C AUTO E LIABILITY ' I CMO-92D869 iD2/24/2024 2/24/2025 COMBINED SINGLE LIMIT I $ 1 000 000 .BODILYY ... . ........ ., NOY AU TO INJURY NJ(Per ( person) BODILY INJURY Per ersan i µnmY SCHEDULED_..,m.. X ILY INJURY (Per accldenl BODILY ) $ AUTOS ONLY .AUTOS X HIRED X QIRED PER7Y DAMAGE PRO $ AUTOSNON-OWNEDLY ONLY - AUTOS ON (PeE $ D UMBRELLA LIAB X OCCUR CUR CXS4O18342 2115/2025 OOO DOD EACH OCCURRENCE 1,000,000 X EXCESS LIAR CL N1ADB,t �D2/1512024 AGGREGATE - $ . 1. 000 000 y, TVTY �N/A O3/O2/2025 � P ER JCT&6.OMPENSA0XSTATJTE . AND EMPUC YIN 1,DDD DOO ANYPRRdMLMSER'EXRLUOROE ECUTIVE E. L. EACH ACCIDENT _ . _. (Msndeldry In NH) L L.. DISEASE,-, EA EMPLQYF.,t 5 1 ,DOD DDD If yes, describe under E L. DISEASE.- POl ICY LIMIT $ 1,000 000 C Auto Physcal Damage CMO-920869 02/24/2024 2/24/2025 Comp Ded $500 � I f g Coll Dec $1000 s DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLVS ACORD 101, Additional Remarks Schedule, may be aflacho d If more space is required) The City of El Segundo, its officers, officials, employees and volunteers are named as additional, insured when required by written contract 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 perform # AF 001397 0916 CERTIFICATE City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Division AUTHORIZED REPRESENTATIVE 350 Main Street ElSegundo CA 90245- ©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 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 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 Copyright, Insurance Services Office, Inc., 2012 CG 2033 04 13 POLICY N UM BER: Cl P 412509 COM M ERCIAL G EN ERAL LIABI LITY 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: CI P412509 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 tuit"where the damages are caused by the insured§ 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 TH E 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: CIP412509 Named Insured: SECOND CITY PLUMBING Endorsement Effective Date: 2-15-2024 AF001397 (09116) Page 1 of 1