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PROOF OF INSURANCE (2024 - 2025) CLOSED (2)ti$r DATE (MM/DD/YYYY) ACC)Ra� CERTIFICATE OF LIABILITY INSURANCE 5/16/2024 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 endorsement(s). PRODUCER I<I ACT ...,,,,.,... .FAX— .�. .— NAME ._ TO 71 -619 t1905 N 714 549 294.- Arthur J. Gallagher Risk Management Services, LLC PHONE g FAX— 3 500 N Brand Boulevard, Suite 100 (Art Nor Exo ... -- E MAIL Glendale CA 91203 A2Rss T.pr� alding.aId c r_rc _n ,,,,,, __ .NAIC#, INSURED — •-----LicenSeRTIICDONS-03 INSURElj9: Republic Indemnity Company 0f Ca lfornla _. 43753 1N,.S,U.,F,IER A: Travelers 5 8TI Consulting , g, Inc. �.9 y _ _ 237a 325 McConnell Ave. I>su�c ,Houston Casualty Com an 4 Los Angeles, CA 90045 INSR o [INS RE .�,..,.,--n.n..,,,m........ ._......... ... ........... ......... INSURERE: A^+e%#OmAl..e_+Co 1%r_0"rI N-A =NIIIIRRRFQ+Ir..1AAA')1Q7 ptFVlgi^IN!rkIMAR R 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. - .............. ......._ ... ,,.,__..._ Md..... .__ .............-_ ...-- --- INS YYV ®. LIMITS ,.,m-..._MRLICYF VYYY MM/DD/ TYPE OF INSURANCE POLICYNUMBER p/VYY A X COMMERCIAL GENERAL LIABILITY Y Y 6809H2765932447 3/30/2024 3/30/2025 EACH OCCURRENCE $2,000,000 - -NAMAG6T0` IvrL6� _ CLAIMS -MADE X OCCUR _P_RFMISE,$,,,(,„,�mgccuerenP,e)„ _$ 1 0 OQ000 MED EXP (An one arson $ 10 000 PERSONAL & ADV INJURY s 2,00Q000 EN'L AGGREGATE LIMIT APPLIES PER. GREGATE GENERAL AGCOMP/OP, 0 000G � POLICY LOC � JECT PRODUCTS AGG �=o 000 17 $ OTHER A AUTOMOBILE LIABILITY Y Y 6809H2765932447 3/30/2024 3/30/2025 MBIN OSIN 4CLIMIT $1,000000 ANY AUTO BODILY INJURY (Per person) $ �OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY X... AUTOS F GA4YAGyr' - — $ AUTOS ONLY AUTOS ONLDY i°E10PERTY iarGg far 1 ..... n $ A X UMBRELLALIAB X OCCUR -�- Y Y CUP4W7386532447 3/30/2024 3/30/2025 EACH OCCURRENCE $2.000,000 m..,....__. � EXCESS LIAB CLAIMS -MADE GGREGATE A ,..„„„„,.....,. _ _. _ 12.1.001101.1000 .. ._ ...... ....... _.._... X RET..... RETENTION $ $ e COMPENSATION 25580603 6I112024 6/1/2025 X P OTH .S�,TAm ER YERS' LIABILITY ,AND EMPLOYERS'LIABILITY AND EMPLOYERS' Y /❑N .,..... ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1 OOQ000 _ - OFFICER/MEMBEREXCLUDED. ( (Mandatory }DISEASE Mandato in NH � - EA EMPLOYEE E.L.E,L �____ ..$ 1,000.000 If Kea, describe under 0 nCRIPTION OF OPERATIONS below IE,L DISEASE - POLICY LIMIT $1,000,000 C Professional Liabili HCC2325328 6/25/2023 6/25/2024 Per Claim $1,500,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (GENERAL LIABILIY) PER BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) FORM CG 03 81 09 15. PRIMARY & NON-CONTIBUTORY AND WAIVER OF SUBROGATION WHEN REQUIRED BY CONTRACT. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (AUTO LIABILIY) PER AUTO COVERAGE. PLUS ENDORSEMENT CA T4 20 02 15. WORKERS COMPENSATION POLICY INCLUDES BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC 00 03 13 (Ed. 04-84). Project: Park Vista Senior Living Center Plumbing Upgrade - 615 East Holly Ave, El Segundo, CA 90245. THE CITY OF EL SEGUNDO 350 MAIN STREET EL SEGUNDO CA 90245 USA III 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 © 19US-2015 ACUHD GUMIPUKA I IUN. All ngnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD �°!CASR '""" CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 5/16/2024 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 end'orsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, LLC 500 N Brand Boulevard, Suite 100 Glendale CA 91203 INSURED RTI Consutting, Inc. 8325 McConnell Ave. Los Angeles, CA 90045 Tom IBaldin PHONE 11714,619m (/V� hay Fu MAIL p,�calalr�s , _Taml�Bald _ INSI #: OD69293„, INSURE.......R A : Travelers. RTICONS-(71 _INSURER B ; Republic INSURER C ,Houston INSURER..N..:..---- I INSURER E : 714-549-2943 ig com AFFORDING COVERAGE 00 f America 25674 of California 43753 42374 CGVFRAGFS CERTIFICATE NUMBER:58925'1996 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. )Cr4sR'•._ .........,,... .,_,......e.,,m .._, _.._.. MI LSC,16W....... ..... ..„........ -....-_._ -- ,-...,POLICYEFF I.I_'POLfCYEF¢P TYPE OF INSURANCE POLICY NUMBER MM1001YYYY 6 MMMONYYY. LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 6809112765932447 3/30/2024 3/30/2025 EACH OCCURRENCE $2,000,000 0Na ) CLAIMS -MADE ]OCCUR . .— ED EXP (An one erso n) _M ............._.� ) p $10 -.10,000 PERSONAL & ADV INJURY $ 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL $4,000.000 ,..,m..,...... — - POLICY �� PRO- LOC I:X � JECT PRODUCTS COMP/OFAGG $4,000.000 ..... OTHEPi $ A AUTOMOBILE LIABILITY Y Y BA-1S98785A-23-47-G 9I1212023 9/12I2024 COI NE0 SINFI F & IMIT ,,..... $1,000,000 Xµ. ANY AUTO BODILY INJURY.(Per person) $ _... ............ OWNED SCHEDULED ...... ..... ........_..........-A-_-...,�...,,..� BODILY INJURY (Per accident) -- ......... $ AUTOS ONLY '._. AUTOS HIRED NON -OWNED �FIROI"IrRTYIUARuIA6.E .'. $ AUTOS ONLY AUTOS ONLY II'ar a.. ident Is A UMBRELLA LAB X OCCUR Y Y CUP4W7386532447 3/30/2024 3/30/2025 EACH OCCURRENCE $ 2.000,000 X EXCESS LAB CLAIMS -MADE AGGREGATE $ 2 000.000 TION $ $ B WORKERS COMPENSATION Y 25580603 6/1/2024 6/1/2025 TH X PERAND EMPLOYERS'LIABILITY Y/N AmL .....,. EACH ACCIDENT $ 1,000 000 OFFICER/MEMBEREXCLUDED7 � (Mandatory m BEREX EXCLUDED? NIA E„.. ...._...ER......_._ .L. DISEASE EA EMPLOYEE $ 1.000 000 If Yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE LIMIT POLICY $ 1,000,000 C Professional Liability HCC2325328 6/25/2023 6/25/2024 Per Claim $1,500,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101„Addildanal Remarks Schedule, maybe attached itmore ore space is required) EMPLOYMENT PRACTICES LIABILITY INSURANCE- HOUS'TON CASUALTY COMPANY - POLICY* H723-936250 - 10/4/2023-10/4/2024 - $1,000,000 EACH CLAIM LIMIT $1,000,000 AGGREGATE LIMIT. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (GENERAL LIABILITY) PER BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) FORM CG D3 81 09 15, PRIMARY & NON-CONTIBU'T'ORY AND WAIVER OF SUBROGATION WHEN REQUIRED BY CONTRACT. DESIGNATED PERSON OR ORGANIZATION — NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US (30 DAYS) FORM IL T4 00 05 19, CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (AUTO LIABILITY) PER AUTO COVERAGE PLUS ENDORSEMENT CA T4 20 02 15. DESIGNATED PERSON OR ORGANIZATION — NOTICE OF CANCELLATION See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN THE CITY OF EL SEGUNDO ACCORDANCE WITH THE POLICY PROVISIONS. 350 MAIN STREET EL SEGUNDO CA 90245 AUTHORIZED REPRESENTATIVE USA 1 f A ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: RTICONS-01 LOC #: 61? "� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Arthur J. Gallagher Risk Management Services, LLC RTI Consulting, Inc. 8325 McConnell Ave. Los Angeles, CA 90045 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ACORD 101 (0001) © 2008 ACORD CORPORAI IUN. AR rlgnts reservea. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE, PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However„ coverage for any injury„ damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement, The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. B. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT —INCREASED LIMIT I. WAIVER OF DEDUCTIBLE — GLASS J. PERSONAL PROPERTY K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is under a contract or agreement in an "em- An Insured, of SECTION II — COVERED AUTOS ployee's" name, with your permission, while LIABILITY COVERAGE: CA T4 20 02 15 0 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted materlal of Insurance Services Office, Inc. with its permission. IRIAI 401DI{ .f„ak,L hires;foi n o c Irnfor i alian COMMERCIAL AUTO Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph C.1. of SEC- TION I — COVERED AUTOS: 1. "Trailers" with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired "autos" are covered "autos" for Covered Autos Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Cover- age is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" to any one "auto" that you hire, rent or borrow is the lesser of: (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. Page 2 of 3 (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or bor- rowed with a driver; or (b) Any "auto" that is hired, rented or bor- rowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT —INCREASED LIMIT Paragraph C.1.b. of SECTION III — PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. J. PERSONAL PROPERTY The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property Coverage We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage only applies in the event of a total theft of your covered "auto". No deductibles apply to Personal Property cover- age. © 2015 The Travelers Indemnity Company. Al rights reserved. CA T4 20 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. MIp1MAI I`v;1 DE 5.�lu l Ir+^aa;r lx�rii°u•w � fire"^rii'i°i^..atir,�n K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and CA T4 20 02 15 COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the 'loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident' or 'loss", pro- vided that the "accident' or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. I R AI MODE 4', ck 4 r i c 4o i rn of i, i i if'or i n atim COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person or organization; or d. For "bodily injury", "property damage" or "personal injury" for which such person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. f. This insurance does not apply to the rendering of or failure to render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III — Limits Of Insurance. h. Thisinsuranceoes not apply to"bodily injury" or "property damage" caused b "your ns"w work and included in the p roducts- completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81 09 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury' offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After you have signed that written contract; b. While that part of the written contract is in effect; and c. Before the end of the policy period. Page 2 of 2 m 2015 The Travelers Indemnity Company. All rights reserved. CG D3 8109 15 Includes the copyrighted material of Insurance Services Office, Inc., with its permission WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule State Person or Organization Job Description California � _.....�. All persons or organizations All jobs whom the Named whom the Named Insured has Insured has agreed by written agreed by written contract to contract to furnish this waiver. furnish this waiver. The charge for this endorsement shall be 3% of total manual premium, subject to a minimum premium of $100. This charge will be billed on your next invoice based on current manual premium, and the final charge will be calculated and billed at the final audit. WC 00 03 13 (Ed. 04-84) 1 of 2 Insured Copy © 1983 National Council on Compensation Insurance.