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PROOF OF INSURANCE (2025)WILLPIP-02 .44c"R"" DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 8/27/2024 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 (PNAME;HONE T Lisa Ybarra CONTACT LYbair�ra acr Acrisure Southwest Partners Insurance Services, LLC 51 I N�,) ( ) 965 4000 Westerly Place 0 EXt) (714) 516 2976 FAX 714 516 2 Suite 110 AIaxFR LYbairra@acrisure.com Newport Beach, CA 92660 , QiiRFRtsr eFFnwnwr. r0VFRnr,F I NAIC p INsuRER A ..T...he Travelers indemnity Company of Connecticu t !25682 ......_.. --l",I INSURED INSURERB Travelers Property Casualty of America �25674 ............ m-----..._ ....,. Williams Pipeline Contractors, Inc. wsuRI w c . ....... P.O. Box 951030 INSURER w Mission Hills, CA 91395 [INSURER E ............. 11 .,.... _ �,-,�, ,,,, ....... ..,....... _. _ INSURER F : COVERAGES CERTIFICATE NUMBER: ......._ REVISION NUMB..._ ER: 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. _ A X I COMM ii TYPE OF IN GENERAL LIABILITY ADDL�SU 0 _.. ............ .. . 1_(M�, YY ....... LIMITS COMMERCIAL R� POLICY NUMBER POLICY EFF POLICY EXP „ ,,,.... INSD_. 01'.,XYY.I EACH OCCURRENCE 1,000,000 CLAIMS MA I Xi OCCUR X 4T22COOP182323TCT24 911/2024 9/1/2025 DAMAGE TO RENTED 300 OOCI J'b1t B QA ��I rJ t . 1 j�,AAED EXP_LAny onepe sar )$ ... 5 000 GEN L AGGREGATE...... I ........ ..... i PERSONAL $ ADV (JURY $ 000 000, rENERALAGGREG2,000,000 fPLIMIT APPLIES PER: I GRODUCTSCOMP OP AGG ,$ 2,000 000 POLICY X JE' LOC P, �....... , .. ...... ......, OTHER! �rr $ 1,000 000 COMBINE A X.TANYYAUEOLIABILITY X 8104NO58682242SG 9/1/2024 9/1/2025 -BODILY JU Y,(P per,son) $ ..F . � $ OWNED - SCHEDULED AUTOS ONLY .1 AUTOS ... t BODILYINJI Y(Peacc.denNI X,NON-OWNEDPER 'ONLY AUTOS ONLY , ... � 1 UMBRELLA LAB OCCUR EACH OCCURRENCE $ „- ...._ EXCESS LIAB ............ .. �,-CLAIMS-MADE AGGREGATE ..... _ $ ,. I DED RETENTION $ WOREERS COMPENSATION .. � P.TAT ITE _ l FRPER H �..� B ANYDPROPRIEEOR/PARTNER/EXECUTIVE I �NIA� X 'UB4J573465242SG 9/1/2024 9/1/2025 X Ep,CHAGCIDENT_ � $ 1,000 000 �OY='q^IC..EPiF4v71';`MBER EXCLUDED? 1,000,006 andalM In NH) E L DISEASE EA EMPLOYEE $, .,, If f 1 _I es describe under DESCRIPTION OF OPERATIONS below 1 ;,,,,,,,,, �,,,,,,„„„„„„„„„„„, I EL DISEASE POLICY„LIMIT $ 1,000000 I � 1 �......m. _........ ....... _. [ .._........m.. ........ ........_...__.... _........._ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES MD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: EMERGENCY ,STORM DRAIN REPAIR AT GftAND AVE. AND INDIANA ST,, PROJECT NO.: PW 24.11. CITY OF EL SEGUNDO, ITS OFFICIALS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED AND PRIMARY 8: NON-CONTRIBUTORY AS RESPECTS GENERAL LIABILITY AND AUTO LIABILITY PER ENDORSEMENTS ATTACHED. WORKERS COMPENSATION WAIVER OF SUBROGATION APPLIES PER ENDORSEMENT ATTACHED. 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 STREET EL SEGUNDO, CA 90245 _. -------_-- AUTHORIZED REPRESENTATIVE : Im ......,............._....-....................._� ��..,._.........._...._ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WILLPIP-02 _..._.,..ITIT LYBA13RA A+I}2 DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE DATE 024 ...._ .._.. _ ........ _[ 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_. a. .. _ .... ................_ ....... ......... ........ _ .. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(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 ofsuchendorsements) ........... PRODUCER NAMF Lisa Ybarra CONTACT ...,.. ,,,,, Acrisure Southwest Partners Insurance Services, LLC PHONe 16 2976c Nr�(714) 516 2965 4000 Westerly Place E d(AIC. No EXI): (714) 5 Sul rt A4 " s LYb--IN URER{�S) AF ,ORp NG COVER.AG. , Newport Beach, CA 92660 � E NAIL # , ®I INSURER Travelers Indemnity Company of Connecticut I1 25682 1 INSURED �INSueeRcTravelers Propa Casual Company of America 25674 Williams Pipeline Contractors, Inc. P.O. Box 951030 lNsuRElx D Mission Hills, CA 91395 INSURER E ,.. ., ...... .....-.. ....w .. ,.... .INSURER .,. F: ....__..,,,,,,..�...... .� ........... ......... ........�..... ........ .......,,,�.�.�...-. ............. ..._,_ OVERAGES !, 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 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. I A Xy �.p R POLICY nn POLICY EXP IS T.t.,... -,,,,�____a,,,,,,..._.,��pMIDD,l1iY`!Xi � 6M1M�1.,1� - ��A��A4aE p'CF RENTED TYPE OF INSURANCE POLICY NUMBER LIMIT 1,000,000 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE l CLAIMS -MADE X occuR 4T22COOP182323TCT24 9/1/2024 9/1/2025 300 060 fM1S 3(C�aauwa�rVS �.__, � � �, X X L MED EXP (Anyone Fersgn) ,,,�L$.. 1 5,000 ERSONAL 8 ADV IN,�URY 1,000,000 CiI;,Mp.A43GRkIroATELIMIT APPLIES PER: I PRODUCTS, COMPIO.. �$ 2,000000 �f _GENERAL AGGREGATE _ ---------------- POLICY X Pkd " LOC P, AGG „ 2 000,000 A X AUTOMOBILE ABILITY �-------------- COMOINEDSINGLE LIMIT $ 1000000 ' 1 �8104N058682242SG 9/1/2024 9/1/2025 poplLY INduRY (Perperson) OWNED SCHEDULED 1 HIRED Nt3N-rr� NE ODILY INJURY (Per ac..... ) � AUTOS ONLY AUi0�5�NL I ROPE,RT^I I P4IMAGE .. . X AUTOS ONLY wX .: AUTOS .... .......... I�d.r aucll9d raC, .. EXCESS LA LIAR ..-_ ..00CUR -- 1 EGG _QWEGATE RENCE �.�............. UMBRELLA LIAB i CLAIMS MADE AACH OCCU rDE'D...._.....-........ .............. .. I ... ... � $ B ----- WORKERSI RETENTION $ 1 I _ $ ......- COMPENSATION +/' d C�, XTATUT 1 .ERH .. m... ------ AND EMPLOYERS' LIABILITY /1 /2025 1,000, 000 ANY PROPRIETOR/PARTNER/EXECUTIVE L EACH ACCIDENT $ ___ 'I(fFY'NC ERIM�FMBER EXCLUDED? `; N/A'1,000,000 yesdesc,ribefuoder 1 %� UB4J573465242SG 9/1/2024 9 1 E,,;L DISEASE EAEMPL,CYEEa $,..., - 1,000,000 IDESC'RI,PTION,RE_gFFRAT40NSk�elaw..,.,,,w,,..... ......._. E.L DISEASE-POLICY.LIIMIT $ ........,-,,,, .......................................... ............. ...... ._ DESCRIPVON OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AddVtlonal Remarks Schedule, may be aalloched if more space is re udred) RE: PROJECT #ENG 24-32 ON -CALL SEWER SYSTEMS MAINTENANCE AND REPAIR SERVICES. CITY OF ELEGUNDO, ITS OFFICIALS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED, PRIMARY 8r NON-CONTRIBUTORY AND WAIVER OF SUBROGATION AS RESPECTS TO GENERAL LIABILITY PER ENDORSEMENTS ATTACHED. WORKERS COMPENSATION WAIVER OF SUBROGATION APPLIES PER ENDORSEMENT ATTACHED. 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. PUBLIC WORKS 350 MAIN STREET EL SEGUNDO, CA 90245 AUTHORIZED REPRESENTATIVE _... _..,,,,_ _ ............. .......... ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WILLPIP-02 FLAK ,4coRo CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) �� 8127I2024 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 ha ve 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 L RAWL-PHONE.,. FAX Acrisure Southwest Partners Insurance Services, LLC i1 516 2965 4000 Westerly Place A Ex. �714 516 29.— IAJC No} Suite 110 AQPRE$ �E MAIL .1111 a@acrisure.com LYba: �,.... e _ .. ,,. Newport Beach, CA 92660 INQ1IRF1al CI AFFn RnINP. r'nVFRAGF NAIC A ; " Travelers any of Connecticut .. ------ INSURED Travelers Company of America Williams Pipeline Contractors, Inc. INSURERc.., _ P.O. Box 951030 INSURER..0: _ Mission Hills, CA 91395 i INSURER E COVERAGES _CERTIFICATE NUMBER _ ....................... ., REVISION NUMBE...... 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. INSRI TYPE OF INSURANCE "�ADDUL�SUR� .,.,., _._. �.. POLICY EFF POLICY EXP LIMITS " POLICY NUMBER E71,000 000 A X D $ 5,000 COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE _ one ersan 000 CLAIMS -MADE X ( OCCUR X X 4T22COOP182323TCT24 9/1/2024 91112125 1 D1�MAGE T R ���ld�Pn�el � 1 000 1 DAMAGE TO RENTED 300 000 } ED EXP {,'4?a' P ) ..,.,E ..... I GENERAL A 000,000 ADV INJURY 2,000 000 G NL A¢'GRFGATE LIMIT APPLIES PER: �, GGREGATE, $ �.,.__..... POLICY "G J8.r LOC �,"J?RODUCTS,-„COMP(OP AGG 1 $ ............ ".'. ..., 0"fH'ER ___ .....".. 5 ......v....... ...._ _.._.......................................� ......... (, _ I .. m.........,. _._....... 0 ANY AUTO 058682242SG-���9/1/2024 9/1/2025 BooSLv �DIINCLLIIMgT 1 000„000 A J X TOMOBILE LIABILITY AUTOS ONLY AUTOS ... ..._ (. p m OWNED SCHEDULED ODILY INJ _ B P $GMt 4i.!q URY Per er {� r"lPERTY 'RY Peracr $ .., X U ...AUTOS ONLY A "i.y"a" O,Y I I AMAOE i 7 �X HIRED N WN er 7ca,rdeer?,�, ............ .... ,,,,,,,.. ... �.., ....-„_.ter.®.. _ ......, j J ................,......,.._ .......,_. . G, ....... UMBRELLA IAB EXESS ABCLAIMS MADE € ..--- ... " DED J RETENTION $ _ $ AND EMPLOYERS' ' EXCLUDED Y � N NIA ...�� "" ���11 WORKERS COMPENSATION U641 J573465242$G 9/1/2024 9/1/2025 XTATTE EBH I1 1 ,AND EMPLOYERS' LIABILITY ; ANY PROPRIETOR/PARTNER/EXECUTIVE IY X I E.L EACH ACCIDENT '000 000 B W _____I 1f es, dtory in NH) E.L DISEASE -POLICY LIMIT Q'MI E EA EMPLOYEE.I $ , ,- Y�s, describe under 1,000,000 DESCRIPTION OF OPERATIONS helot ........ � _ ...._. � P.L DISEAS f-�...... ...IT...... ITIT.. 1 _..... RE: PROJECT # OPERATIONS I 24-33 LOCATIONS O.S . dd ._ .� _ is re O S I VEHICLES (ACORD 101, Additional Re-rl+a!rks Schedule, may be attached if more space is re utlrad ON -CALL WATER SYSTEMS MAINTENANCE AND REPAIR SERVICES. CITY OF EL E"&NDO, ITS OFFICIALS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED, PRIMARY & NON-CONTRIBUTORY AND WAIVER OF SUBROGATION AS RESPECTS TO GENERAL LIABILITY PER ENDORSEMENTS ATTACHED. WORKERS COMPENSATION WAIVER OF SUBROGATION APPLIES PER ENDORSEMENT ATTACHED. 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. PUBLIC WORKS 350 MAIN STREET ..... EL SEGUNDO, CA 90245 AUTHORIZED REPRESENTATIVE ........................... _....... ...... ................ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NAMED INSURED: WILLIAMS PIPELINE CONTRACTORS, INC.. POLICY NUMBER: 422TCOOP182323TCT24 COMMERCIAL GENERAL LIABILITY POLICY TERM: 09/01/2024 TO 09/01/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury' or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such 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 or agreement applies. Such person or organization does not qualify as an additional insured with respect to, the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury' or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 0419 © 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit' and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit' as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit' to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 0419 NAMED INSURED: WILLIAMS PIPELINE CONTRACTORS, INC. POLICY #422TCOOP182323TCT24 POLICY TERM: 09/01/2024 - 09/01/2025 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurers share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. .--------------- >d. Primary And Non -Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an 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 that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. PRIMARY & NON-CONTRIBUTORY a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website 6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement. Page 16 Of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission, NAMED INSURED: WILLIAMS PIPELINE CONTRACTORS, INC. POLICY NUMBER: 422TCOOP182323TCT24 POLICY TERM: 09/01/2024 - 09/01/2025 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 this 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured —Unnamed Subsidiaries > B. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Operations PROVISIONS A. WHO IS AN INSURED — UNNAMED SUBSIDIARIES C. Incidental Medical Malpractice D. Blanket Waiver Of Subrogation E. Contractual Liability —Railroads F. Damage To Premises Rented To You The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, B. joint venture or limited liability company, that is not shown as a Named Insured in the Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury' or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or a. An organization other than a partnership, joint venture or limited liability company; or b. A trust; as indicated in its name or the documents that govern its structure. BLANKET ADDITIONAL INSURED — <....... GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING TO OPERATIONS The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury', "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II — Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products -completed operations hazard". CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. D. BLANKET WAIVER OF SUBROGATION ............a The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A — BODILY E. CONTRACTUAL LIABILITY — RAILROADS — INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 © 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission, COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured a. Any premises while rented to you or contract" in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner; or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of "premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for a period of seven or fewer consecutive days. "Premises damage" means "property damage" to: CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. NAMED INSURED: WILLIAMS PIPELINE CONTRACTORS, INC. POLICY NUMBER: 8104NO58682422SG POLICY TERM: 09/01/2024 TO 09/01/2025 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION 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. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in 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 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS 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. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 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 CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II — COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs. (iii) may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or in LIMITS in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent uired or compulsory insurance in an or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. 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. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. 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. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. 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. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF'SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph A.4., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will a u to $400 for "loss" to wearing a tent required of you by a written contract pay P 9 P- signed and executed prior to any accident parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. NAMED INSURED: WILLIAMS PIPELINE CONTRACTORS, INC. POLICY NUMBER: 8104NO58682422SG COMMERCIAL AUTO POLICY TERM: 09/01/2024 TO 09/01/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND ON -CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 u 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. ��„� WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: UB4J573465242SG WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 09/01/2024 Policy No. UB4J573465242SG Endorsement No. Insured WILLIAMS PIPELINE CONTRACTORS, INC. Premium Insurance Company Countersigned by TRAVELERS PROP CAS CO OF AMER DATE OF ISSUE: 08-27-2024 Page 1 of 1