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PROOF OF INSURANCE (2025 - 2025)rp DATE (MM/DD/YYYY) .�r M CERTIFICATE OF LIABILITY INSURANCE 10/OB/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 pollcy(les) 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 Go V N I MGM NAME: CLIENT CONTACT CENTER FEDERATED HOME OFFICE:UTUAL P.C. BOX 328ANCE COMPANY (Aif;r, No Ext): 888 333-4 AC 949 .... � JAIc, No): 507-446-4664 OWATONNA, MN 55060 'Goass:CLIENTCONTACTCENTER(�FEDINSCOM INSURED C J CONCRETE CONSTRUCTION, INC. 10142 SHOEMAKER AVE SANTA FE SPRINGS, CA 90670-3404 CERTIFICATE NUMBER: ...... __�._._...,�......INSURE... .__ ..... ,.,. IRS AFFORDING COVERAGE NAIC // INSURER A FEDERAT ED MUTUAL INSURANCE COMPANY ..13935 ... INSURER B: ................_......___---------- INSURERC:............................,.,�....,,,,...-_ ______..........,. INSURER D: .......,-.-_..__......__......... ............. .. ......................................., ..n INSURER E: ....... ........ INSURER F: REVISION NUMBER:0 THIS IS TO CEOTdFY THAT THE POLICES 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. NSN" TYPE OF INSURANCE ArSDL SUBR POLICY NUMBER P'01.BCY EFF PDDCY £XP II.T18� INSR. 1VIVT7 MMdODdYYYY CdMPUDdYYYY. LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE [X ]OCCUR ._..m. DAMAGE TO RENTED PREMISES ......... $100,000 ''.. Ea nccurrence ME EXP (Any one person) $10,000 A Y Y 1845023 11/12/2024 11/12/2025 'N" PERSO_NAL'L &ADV INJURY $1t000�00 O GEN'L AOOR.E4ATI• LIMIT APPipI�E'&P'E id,;.. GENERAL AGGREGATE $2 A00 000 X POLICY �O` LOC . CT M .... G PRODUCTS 6 COMP/OP ACC $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accidenU $1,OOD,000 X ANY AUTO Pe ODILY INJURY (Per Person) BODILY A OWNED AUTOS ONLY I:I ',UL Y N 1845023 11/12/2024 11/12/2025 BODILY INJURY (Per Accident) � 81I1'iEf}AUTOS O4YNLY M1AO"INtS..{ "JZY � TV PROPE DAMAGC Per AECiAmflw,,,,, X UMBRELLA LAB ', OCCUR EACH OCCURRENCE $8,000,000 A EXCESS LAB CLAIMS -MADE ....--------- Y N 1845025 11/12/2024 11/12/2025 AGGREGATE $8,000,000 DED RETENTION WORKERS COMPENSATION PER STATUTE THER AND EMPLOYERS' LIABILITY YIN mmmCH �IT IT �� ������� ANY PROPRIETOR/PARTNER/ EXECUTIVE C. E.L EACH^ACCIDENT OFFICER/MEMBER EXCLUDED? N/A IMendatory In NH) E.L DISEASE {A EMPLOYEE If yes, describe under _ .............—_ DESCRIPTION OF OPERATIONS below E.L DISEASE •POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY CLERK CITY OF EL SEGUNDO 1430 350 MAIN ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED EL SEGUNDO, CA 90245-3813 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: A R" LOC #: ADDITIONAL REMARKS SCHEDULE .... Page 1 of 1 .""."".." ........ AGENCY NAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY C J CONCRETE CONSTRUCTION, INC. ..... �._.... _ __..... 10142 SHOEMAKER AVE POLICY NUMBER SANTA FE SPRINGS, CA 90670-3404 SEE CERTIFICATE # 143.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 143.0 SEE CERTIFICATE # 143.0 - ..,.. ......... _._... .......____ ADDITIONAL REMARKS _. __ ......-_ .......-............. ......_........... _... THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: VRAN . ..... ......5 R PW 24-0..�.....,__.... PROJECT: CSBG ADA CURB RAMP INSTALLATION, 350 MAIN STREET, EL SEGUNDO, CA 90245 SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY, ADDITIONAL INSUREDS ALSO INCLUDES THE CITY OF EL SEGUNDO, ITS OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS. SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY, WAIVER OF SUBROGATION ALSO INCLUDES THE CITY OF EL SEGUNDO, ITS OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION ENDORSEMENT. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS - COMPLETED OPERATIONS ENDORSEMENT. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. INSURANCE PROVIDED BY THE BUSINESS AUTO LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. GENERAL LIABILITY CONTAINS A WAIVER OF TRANSFER OF RIGHT'S OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC ENDORSEMENT COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. FOR NON-PAYMENT OF PREMIUM, 10 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". © Insurance Services Office, Inc., 2016 Page 1 of 1 CA 04 49 11 16 Policy Number: 1845023 Transaction Effective Date: 11/12/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto" with your permission. However, this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and.subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss" which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented "auto" or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-127 (03-03) Policy Number: 1845023 Transaction Effective Date: 11/12/2024 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. - • • • . V • Kul • • :1 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR, LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 01 12 19 Policy Number: 1845023 Transaction Effective Date: 11/12/2024 POLICY NUMBER: 1845023 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR. CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Orcganization(s): _ Location(s) Of Covered Operations City Clerk City of El Segundo Any coverage provided by this endorsement 350 Main St applies only to Project: ## PW 24-05, CSBG ADA El Segundo, CA 90245-3813 Curb Ramp Installation, 350 Main Street, El Segundo, CA 90245. Subject to the terms and conditions of the policy, Additional Insureds also includes The City of El Segundo, its officers, employees, agents, and volunteers. I _._ ......... ................ Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the in the performance of your ongoing operations for location of the covered operations has been the additional insured(s) at the location(s) completed; or designated above. 2. That portion of "your work' out of which the However: injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. © Insurance Services Office, Inc., 2018 CG 20 10 12 19 Policy Number: 1845023 Page 1 of 2 Transaction Effective Date: 11/12/2024 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Insured: C J Concrete Construction, Inc. 10142 Shoemaker Ave Santa Fe Springs, CA 90670-3404 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 Policy Number: 1845023 Transaction Effective Date: 11/12/2024 POLICY NUMBER: 1845023 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City Clerk City of El Segundo See IL-F-40-00010 50 Main St El Segundo, CA 90245-3813 . .. p _. _... _._ _... Dove, will be shown in the De Information required to complete lete this Schedule, if notshown a clarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III - Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included 1. Required by the contract or agreement; or in the "products -completed operations hazard". 2. Available under the applicable limits of However: 1. The insurance afforded to such additional insurance; whichever is less. insured only applies to the extent permitted by law; and This endorsement shall not increase the applicable 2. If coverage provided to the additional insured is limits of insurance. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Insured: C J Concrete Construction, Inc. 10142 Shoemaker Ave Santa Fe Springs, CA 90670-3404 © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 37 12 19 Policy Number: 1845023 Transaction Effective Date: 11/12/2024 IL-F-40-00010 Extension Endorsement Any coverage provided by this endorsement applies only to Project: # PW 24-05, CSBG ADA Curb Ramp Installation, 350 Main Street, E1 Segundo, CA 90245. Subject to the terms and conditions of the policy, Additional Insureds also includes The City of E1 Segundo, its officers, employees, agents, and volunteers. IL-F-40-00010 (06-10) Policy Number: 1845023 Transaction Effective Date: 11/12/2024 COMMERCIAL GENERAL LIABILITY CG 24 53 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO CIS (WAIVED OF SUBROGATION) - AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS 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 against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 24 53 12 19 Policy Number: 1845023 Transaction Effective Date: 11/12/2024 Federated Mutual Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED AMENDMENT OF CANCELLATION PROVISIONS All Coverage Parts included in this policy are subject to the following conditions: If we cancel this policy, we will mail advance notice to the person(s) or organization(s) as shown in the Schedule. SCHEDULE Insured: C J Concrete Construction, Inc. 10142 Shoemaker Ave Santa Fe Springs, CA 90670-3404 Includes copyrighted material of Insurance Services Office, Inc., with its permission. IL-F-50 (04-13) Policy Number: 1845023 Transaction Effective Date: 11/12/2024 CERTIFICATE OF LIABILITY INSURANCE FOATE(MM/DDlYYYY) 9/13/2024 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 endorsernent(s). PRODUCER CONTACT NAM4E; Behr Insurance Services Inc. AIG N Ext,. 888-998-2347 (AIC, NO)! 1420 E Los Angeles Ave #203 AbMAIL DpEss, serviccCAb'ehriGis.csYlln Simi VMley CA 93065 INSURER('SI AFFORDING COVERAGE NAIC # INSURER A: COREPOINTE INS CO 10499 INSURED CJ Concrete Construction Inc 10142 SHOEMAKER AVE SANTA FE SPRINGS CA 90670-3404 COVERAGES CERTIFICATE NUMBER- INSURER B : INSURER C : INSURER D INSURER E INSURER F' ; REVISION Nt]MBFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR `I HE 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. TIN TYPE OF INSURANCE 'J"I MiVVtI'O POLICY NUMBER (MMPOp,PY'Y'MY MM/'C L "Y'Yp LIMITS COMMERCIAL GENERALABILITY ! EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISE"SIEa ocxwarreme) $ MED EXP (Any one pwsan) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ F PR POLICY � JECO••G � LOC PRODUCTS -COMP/OP AGG $ OTHER:,$ A UTOMOBILE LIABILITY IEa ac WON) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (Pe, rrecodera) Is UMBRELLA LIAB ! OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ CIRKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRGEl'OF481'PApITNEFVEXEaw';U'PIVE A FFICEFUMEMBEREXCLUDED? � NIA Y CTP1002477 05/08/2024 05/08/2025 IATLITE ER L EL. EACH ACCIDENT $ 1,000,000 IMllandatory'in NH) E.L, DISEASE - EA EMPLOYEE $ 1,000,000 Ilyeayde�snmtotaunder DEEL,RIPTION OF OPERATIONS below IE.L, DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) PROJECT NO..: PW 24-09 Waiver Of Subrogation applies to workers compensation per attached WC 04 03 06 endorsement. CERTIFICATE HOLDER CANCELLATION 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 AUTHORIZED REPRESENTATIVE Jo+.atHaw 13rd+r El Stgiando, CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD