PROOF OF INSURANCE (2025)0 DATE (MMIDDIYYYYI
ACC>R" CERTIFICATE OF LIABILITY INSURANCE 9/2512024
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 WNRA4..T TOR Hubbard
Bradford Insurance Agency 5HONr
Street 061-283-8100 IMC, N 4 661 283,8111
Bakersfield CA 93301-4315
INSURED
KERNTEC Industries, Inc.
PO Box 60130
Bakersfield CA 93386
FMIH
iIRDIN1jqQVERAG�E_ NAIC 9
Ins Fund 35076
Insurance Co 44776
M"1!u^A'r= K11 11U111500. �07nnn,iqln R=VIQInN MI]RARFR*
THIS IS TO CERTIFY THAI THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE ROD& PERIOD
INDICATED NOTWTHSTANDING 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 I EFOAS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
.... . ....... . ..... -- — ------- "alm-a 'Pualcy EFF _Pd_L7JCyEX_P_
YNSR .... . .......................TYPELIMITS
TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMiDD"f'YYYY1 EML99=
_LIR
B
X COMMERCIAL GENERAL LIABILITY
SSEP0198240AEM
8115/2024
8/15/2025
EACH OCCURRENCE
$1 000000
CLAIMS -MADE E)��OCCUR
$100000
_ME_DEE( �Yone.p2mn
_UL(LOL
PERSONAL& ADV INJURY
$1,000.000
GENrl. AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$2.000-000
POLIC'r' 7—PR O- r I
1 JECT L LOG
Raq[�qCTS - COMP/OP AGG
$ 2.000,000
11 OTHER
—
B
AUTOMOBILE LIABILITY
SSEP0198240AEM
8/15/2024
8/15/ 2025
C�.)MHINLV MLELIMII
_LFa -xytgntL
$ 1 ,000,000
ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
HIRED NON -OWNED
X
AUTOS ONLY AUTOS ONLY
LIAR OCCUR
EACH OCCURRENCE
$ ...... .
k.UMBRELLA
EXCESS LIAB Cl-AIMS-IVIADE
1� .......... . ......
AGGREGATE . ....
. ...........
DED RETENTION $
A
WORKERS COMPENSATION
Y
90697652024
8115/2024
8/15/2025
X FIR
AND EMPLOY RS'LIABILITY YIN
ANYPROPRIETORIPARTNER)EXECUTIVE
__J"PER
.5
E L EACH ACCIDENT
$1,000,000
OFFICERIMEMBER EXCLUDED)
(Mandatory in NH)
NIA
LOYEE'
_E.LELISEASE - EAEMPLOYEE __
$ 1,000,00Q
Ues, desr6b�� under
D.SCRIPI10N OF OPERATIONS Wow
. . ..........
E L DISEASE - POLICY LIMIT
1.000.000$
DESCRIPTION OF OPERATIONS / LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
ENDORSEMENTS ATTACHED AND/OR DESCRIBED HEREIN APPLY WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED AS
REQUIRED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS: SUBJECT TO STATUTE AND POLICY PROVISIONS
ANY ENDORSEMENTS ATTACHED AND/OR DESCRIBED HEREIN APPLY WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED AS
REQUIRED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS; SUBJECT TO STATUTE AND POLICY PROVISIONS WAIVER OF SUBROGATION
APPLIES TO WORKER'S COMPENSATION PER ATTACHED FORM
7501WOT40
City of El Segundo
350 Main Street
El Segundo CA 90245
ACORD 25 (2016103)
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
1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ENDORSEMENT AGREEMENT BROKER" COPY
STATECOMPENWAIVER OF SUBROGATION
IN S URA NCE BLANKET BASIS 9069765-24
RENEWAL
NE
HOME OFFICE 7-63-55-08
SAN FRANCISCO PAGE 1 OF 1
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC EFFECTIVE AUGUST 15, 2024 AT 12.01 A.M.
STANDARD TIME OR THE AND EXPIRING AUGUST 15, 2025 AT 12.01 A.M.
TIME INDICATED AT
PACIFIC STANDARD TIME
KERNTEC INDUSTRIES, INC
PO BOX 60130
BAKERSFIELD, CA 93386
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.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE
2.00% OF THE TOTAL POLICY PREMIUM.
SCHEDULE
PERSON OR ORGANIZATION
ANY PERSON OR ORGANIZATION
FOR WHOM THE NAMED INSURED
HAS AGREED BY WRITTEN
CONTRACT TO FURNISH THIS
WAIVER
JOB DESCRIPTION
BLANKET WAIVER OF
SUBROGATION
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO; SEPTEMBER 13, 2024
loot -ter+^ l�te��
2572
AUTHORIZED REPRESENT IVE PRESIDENT AND CEO
SCIF FORM 10217 (REV.7-2014)
OLD OP 217