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PROOF OF INSURANCE (2025)0 DATE (MMIDDIYYYY) Ate"R" CERTIFICATE OF LIABILITY INSURANCE 0912012024 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 CONTACT MARSH USA, LLC. linnip_qs• HONE . NAMP 445 SOUTH STREET Ad ...a:_xt9< c, NeS N .. MORRISTOWN, NJ 07960-6454 MAIL -MAI CN102147003 RA . 1111111 INSURED SIEMENS INDUSTRY, INC.. 1000 DEERFIELD PARKWAY BUFFALO GROVE, IL 600894513 ( )... AGE -------- NAIC,i' INSURER S AFFORDING COVER INSURER A: HDIGI.O I 1 p.Np.GoM .... 41343........... 25674 INSURER C TIYVIPiw1'a05.41'0)I° .','(Amwu _. 19036........... rs.CauliY.ltwrlly011aR61Y —___ ---- , INSURER D : ,,,,,,,__ INSURER E e.wT� ue .—M nnuoec ne RFVICIAN IUIIMRFR- vv. tee..-..,�.. ..�..... .�..._.__._.—_. _. ...--'------ THI'S 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. _........ ---................. ...... .. ..........----- ... _ ,,.R ..�.... y....POLICY._.,.,..... - ._.— T POLICY EXf^ ............ .....„-. T40DLISCJ......... .NUMBER ,..TYPE INS I LIMITS POLNCY....... OF INSURANCE 1 s MNA!S'A61,rrri` yy MMIDO Y A COMMERCIAL GENERAL LIABILITY I GLD1110116 1010112024 1010112025 HOCCURRENCE5 $ 1,000,000 X 1 CLAIMS -MADE X ! OCCUR I.. .. ca) 100000 .'1 MED EXP Any aae per era) t 100 000 P ERSONAL A ADV INJURY $ - 1,000,000 EN'L G... AGGREGATE LIMIT APPLIES PER: G E $10,000,000 ..,.,..... POLICY JECT' LOC H'C 1l 4� TSGCOMPAOP,AGG „ $ INCL � __, $2.000,000 B AUTOMOBILE LIABILITY TC2J-CAP-7440L34A-TIL-24 1010112024 10/0112025 PoIT COMBINED §NGL£ LIMIT E � az,cident) X ANY AUTO BODILY INJ11 URY (Per person) $ NIA OWNED SCHEDULED I. X.... I BODILY RY (Per X..mmAUTOS ONLY X HIRED NON -OWNED ROPERNY AMAGEaccident) N/A $--- AUTOS ONLY AUTOS ONLY 1 r [pr_CcrPntl ""..".._ _ ------ $ UMBRELLA OCCUR OCCURRENCE EACH OOCU"". $ "." EXCESS LIAB CLAIMS MADE � AGGREGATE .." $"""".. ... . . .... , jLIAB DE D RETE'N"'LIONS Is B WORKERS COMPENSATION UB�81R83929A 24-51-K AOS ( ) 10M 024 10101/2025 ° X J ST�H"A C GBH �� C AND EMPLOYERS'LIABILITY v AN'' TMd'F,XECUTAVC N UB 8P79233A-24-51-R (AZ,MA,WI) 10/0112024 10/0112025 E.L EACH ACCIDENT $ 1,000,000 B OF in TWX 10I0112024 1010112025 o RATUONS belowNIA V ,IMandescribe $5 OK4LIMIT3 $5 OK SIRH)"'^ E.L, DISEASE • POLICY LIMIT' $ 1 000 000 DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 0063V00000A7GSWOAN / SP - EL SEGUNDO - ON -CALL SERVICES SEE ATTACHED a•x..,ux a ee uvree w e u*,w u�.w.. w.ux CITY OF EL SEGUNDO _- -. -._ — .. . ....... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 150 ILLINOIS STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EL SEGUNDO, CA 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA LLC - - - -- - -- ——--------._.. ... ..---.�.. V 1U00-AU 10 AV VRIJ VvF%F-%0 r rve.. nu a eynw , cave — . ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN 102147003 LOC #: Morristown ADDITIONAL REMARKS SCHEDULE Page 2of 2 AGENCY NAMED INSURED MARSH USA, LLC. SIEMENS INDUSTRY, INC. 1000 DEERFIELD PARKWAY POLICY NUMBER BUFFALO GROVE, IL 60069-4513 CARRIER kraMIi InMAI OCRAADWO NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance RE: 0063V00000A7GSWQAN / SP - EL SEGUNDO - ON -CALL SERVICES CITY OF EL SEGUNDO IS HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT UNDER THE REFERENCED GENERAL LIABILITY AND AUTOMOBILE LIABILITY INSURANCE POLICIES. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY. WAIVER OF SUBROGATION IS EFFECTUAL WHERE REQUIRED BY WRITTEN CONTRACT, COMPLETED OPERATIONS COVERAGE IS INCLUDED IN THE GENERAL LIABILITY POLICY.. IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS„ ACORD 101 (2008/01) V [Uuo A%,VMLj L UF%r'vrv+i iV1M. n III,IILA ICJGI Y6Y The ACORD name and logo are registered marks of ACORD HDI GLOBAL INSURANCE COMPANY MANUSCRIPT ENDORSEMENT# 31 PolicyNumber Named Insured GLD1110116 SIEMENSCORPORATION Policy Period: " IrAon (M-0-VI Effective Date and 10-01-2t124 10-01-2025 Time of Endorsement 10-01-202412:01 a.m. Standard Time at Address ofthe Insured. This Endorsement Changes The Policy. Please Read h Carefully. This endorsement modifies insurance provided underthe following: Commercial General Liability Coverage Form Who Is an insured is amended to include as an additional Insured any person whom you are required to add as an additional insured on this policy under a written agreement, but only with respect to liability for "bodily Injury", "property damage" or *personal and advertising injury"' caused, to whole or In part, by 1. Your acts or omissions; or 2. The acts or omissions of those aging on your behalf. The insurance coverage provided to such additional insured applies only to the extent required within the written agreement. The insurance coverage provided to the additional insured person shall not provide any broader coverage than you are required to provideto the additional Insured person in the written agreement and shall not, provide limits of Insurancethat exceed the lower of the Limits of Insurance provided to you in this policy, or the limits of Insurance you are required to provide in thewrittenagreement. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other insurance, whether primary, excess, contingent, or on any other basis, that is availableto the additional insured for a loss we cover under this endorsement. However, if the written agreement spwffically requires that this insurance apply on a. primary basis, this insurance is primary. If the written agreement specifically requires this insurance apply on as primary and norKontributory basis this Insurance primaryto other insurance available to the additional Insured and we will not share with thatother insurance. This endorsement shall prevail over additional insured endorsements that may apply underthis policy unless required otherwise in thewrittenagreement. Authorized Representative All terms and conditions of the policy remain unchanged. THIS ENDORSEMENT MUST BE ATTACHED TOA CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY IS WRITTEN. Page - POLICY NUMBER: GLD1110116 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person OrOrganization: ZANY PERSON OR ORGANIZATION TO THE EXTENT REQUIRED BY WRITTEN CONTRACT Information Mquired to complete this Schedule if not shown above will be shown In the Declarations. The fallowing is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for Injury or damage arising ocrt of your ongoing, operations or "your wcoW done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown In the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1