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PROOF OF INSURANCE (2024 - 2025)I DATE(MM1DDNYYY`) ACC)REF CERTIFICATE OF LIABILITY INSURANCE 03/12/2024 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 oNTA - — - --------- Edgewood Partners Insurance Center 4 1 994-8047 C 10877 White Rock Rd Rancho Cordova CA 95670 F I C E GE NAIC 0 _qqamA R .. I----- ._ �NS� �RER �NS�[CECO 7 INSURED Robert's Liquid Disposal, Inc. JqS1.11101C, 14018 Carmenita Road INSURER 0 Santa Fe Springs, CA 90670 1qStLRER E INSURER F COVERAGES SH CERTIFICATE NUMBER: Cert ID 29130 (3) 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. POLICY EF LICY EXP LIMITS LTR TYPE OF INSURANCE POUCYNUMBER A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE lm 000,000 000 CLAIMS -MADE r,7x] OCCUR y ENV56200933202 03/05/2024 03/05/2025-rjmmjwuEax�mrenqo 50 _MED �P(Anyo�ne�Leljon) 51000 PERSONAL &ADVWJURY J_L1A_000R0_0 GENI AGGREGATE LIMIT APPLIES PER: �AENERAL.&G.G.B.,E GATE $ 2,9�00.000 POLICY D PRO- LOC 'PRODUCTS - COM F qcP AGO -1 $ 21000 00 JICT E� OTHER CMMIP9591-NGLE LIMP AUTOMOBILE LIABILITY ANY AUTO $ _BODILY INJURY (Per OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED POPERTYrAOE 0 AUTOS ONLY AUTOS ONLY i- — — $ A UMBRELLALIAB X OCCUR ENV56200005406 03/05/2024 03/051Z07 CH �OCCVR�REI�SLt_.._. L EXCESS LIAB CLAIMS MADE' 2 — X 8116 ON$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN E.L EACH ACCIDENT $ ANIYPROPRIETORMARI'NERiExFcu,rtvE'= OFFICERIMEMSER EXCLUDED? NI: (Nandato�y �n N14) JL.L, DISEASE- EA EMPLOYELI, $ -,car ERATIONS b ow El. DISEASE - ILICY LIMIT $ 62009332 2 03/05/2024103/05/202 'Each Polluto A Pollution Liability Condition Limiin t $ 5,000,000 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached IF more space Is required) Pumping & Disposal per Rate Sheet-2012 Certificate holder is named as additional insured as respects the general liability, but only if required by written contract with the named insured, prior to an occurrence, per form CG 2010 07/04 6 CG2037 07/04 subject to all policy terms and conditions. City of El Segundo, its officials, and employee as "additional insureds" with respects to general liability. CERTIFICATE HOLDER CANCELLATION 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 Public Works Department 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 I @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 2 CERTIFICATE COVERAGES OVERFLOW °AT /DD/YYYY, 03/1212/2024 PRODUCER INSURED Edgewood Partners Insurance Center Robert's Liquid Disposal, Inc., 10877 White Rock Rd 14018 Carmenita Road Rancho Cordova CA 95670 Santa Fe Springs, CA 90670 CONTACT NAME: I PHONE (A/C, No, Ext). I PHONE (A/C, No, Ext): PJ Hawthorne l (949) 994-8047 ADDITIONAL COVERAGES CERTIFICATE NUMBER: Cert ID 29130 REVISION NUMBER: _ _... . ...... INSR ADDL SUER POLICY EFF POUCY ERP LTR TYPE Of INSUFANCE INSR WVD POLICYNUMBER (MM/DD/YYYY) (MM/DD/YYYY) UMITS Deductible $ 2,500 _................ $ _ .__.. Imo- �...�...... S S S $ S 5 S $ S ............... _ ......i S $ S S S S Certificate Coverages overflow (11/2010) Page 2 of 2 CERTIFICATE OF LIABILITY INSURANCE oAoero7/ 02o 4m THIS CF_RT9gCATE IS ISSUED -AS A MATTER OF INFORMATION ONLY AN m D CON � FERS 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CER71FICATE HOLDER. IMPORTANT, if the cartlf vals holder Is an ADDITIONAL INSURM the poll y(las) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVE, subject to the terms and conditions of the policy, cadain policies may require an endorsement. A statement on this certificate does not confer rights to the cordflcsts holder In lieu of such endorsement s OAXIM S,.us_enna Benavl des Staftliiaffll Beth BeGSer Insurance Agency, Inc.562-469-1000 _..___ P iw •.. ._-9559 20220 State Farm Road E-MAIL susana Raotru erC er warn ofto _ _ ..... _, Cerritos, CA 90703 Instil $(S) AfrgRD1N'G COVEIMOE _.� Y NAIL s a'1ttiD�NEd6 a Farm MUtUAII AAalorlaobllta InitiurarnCo Caarrr ry 78 _ ,.. �., m_...... ._.�� - ., ...... .., „w.._ .. ....... ___ .�. tb!UOr$RYdA Stet..w.,.n 261..,..., INSURM IN99A R a o ,a. Roberts Liquid Disposal Inc. INSURER c� .... 14018 Carmanita Rd INISUAVA o tm , , Santa Fe Springs, CA 90670 iNsurREAI r. CERTIFICATE O�N THIS IS TO CERTIFY THAT THE POL NUMBER. C IOND CAATEGD NOTkYiTHSTANDING ANY REQUIREMENT, TERM OR ...-..UMBER; _m....�� REVISION POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 1O TI~CE Nt159„IRED NAMED ABOVE FORTHE POLICY ITFRir�l",I CONDITION OF ANY CONTRACTOR OTHER DOCUMEN TINITH RESPECT rol WHICH iI.03 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES UESCHMED HEREIN iS SUSjEcTo ALL THE TERMS s iN1'' $UB .� _.._ ... POLIC PAID CLAIMS. S. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN_NUa® HAVE BEEN REDUCED L M Poucy � „� LTR TYPE or INafFRA110E #00 WV LIMITS •µD WMI:Iir U�4...DE'nEnAL UAI w0Y' y 4`.ACH Or..'C SENCE I caAY cam. g OCCUR n ME 0 EJ( AL wags as person) 1 �, .� ... .. ° & ADV INJURY _ ., .... GEN'LAGGREGATE UMITAPPLIES PEA I GENEFBaA AUOSReGAIE $ .mw,�, - . P&iO' PRa`JN,IUC r�, • pw4'JmoogPJECI AGG f r _ �LOC A 6219999-801-75B 08/01/2024 02/01/2025 t� 0, i 2m Y000000 .. ANY AUTO BOCILY INJURYIP!!! Prr.1!9fi � t _ ....... '..... AUTG�SGNLY AUTOSY RIIPPodmytR,w� 4zw1"O9ENL9 603-2889-A07-75N 07/0712024 ! 01/07/2025 TT Ir'Y1: R OWNED ScIihOJLED 653 6343 Bpi-75B 08l01 2 AUYOWREO w 4Pe ra�*.i. 663-3372-FO6-751 06/0612024 i 12106/2024 I. AGGREGATE Avp" L f 1 Lug OCCUR MES LAB I DE RETENTION S �. r OLFKERS lCb'AGABWk. k N AhCEUPtOM�LIR&NTTY$N I _.TA Ulh f E L EACH A�ICEATAlly ^E11ARTNA'EC11t11C -- CXCI.4En7 SS N 1 A �.-.... I?p ERLAKOY1Lt (" , ., m. r� uE.L 94 DISEASE POLCY �,1#4w S C r I DESCRIPTION Or OPERATIONa I LOGAMNS I VENICLEa AC.ORD 101, Additk"l Remarks SchedW4 be artaehed If ....� I may space Is. required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of EI Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORRED REP REIIE.NT'ATI EI Segundo, CA 90245 T ®1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD iWAS9 Q2E49.14 04-13-MZ2 P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-113-2024 CITY OF EL SEGUNDO PUBLIC WORKS DEPARTMENT 350 MAIN ST EL SEGUNDO CA 90245-3913 GROUP: POLICY NUMBER: 144BB91-2023 CERTIFICATE Q. 453 CERTIFICATE EXPIRES: 12-31-2024 12-31-2023/12-31-2024 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwlthstand lnq any requirement, term or condition of any contract or other document with respect to which this certificate of onsurance may ba issued or to which it may pertain, the insurance afforded by the policy described herein us subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1.000,000 PER OCCURRENCE. ENDORSEMENT N2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-31-2023 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER ROBERT'S LIQUID DISPOSAL, INC. SP 14018 CARMENITA RD SANTA FE SPRINGS CA 90670 (ERG,CSI