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PROOF OF INSURANCE (2024 - 2025)
�1 HIRSC-1 CERTIFICATE OF LIABILITY INSURANCE °A10`1172024' 11011712024 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'- Unickel & Assoc. Associates c#0827703 Insurance PHONE Ext� 909� 90I-890-9237 N Angelina Quezada PRODUCER 909-890-9707 RA Ange1.�,890 9707 Nc) San Bernardino, CA 92423-0727 P.O. Box 10727 �,Mlk,,,,,aquezada@unickelinsurance.com ...... ..... . I SUCIVD FIrsc& Associates, Inc. 2221 E. Winston Rd. Ste A Anaheim, CA 92806 American Insurance Compa �43460 .. .___. ..--.... I—.... r -..... Irs Prop Cas Co of Am �25674 COVERAGES CERTIFICATE NUMB I RE VIalO N MBER. 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 CO CLAIMS. N POLICIES. LIMITS SHOO BEEN REDUCED BY PAID C�.. I—— "I'll � --- INrR..m...........- �.......... �ADDL�SUB' R POLICY EFF POLICY EXP TYPE OF INSURANCE ^ yy-n LIMITS cYNUMBERE A X COMMERCIAL GENERAL LIABILITY 2,. 000 CLAIMS -MADE occuR 680.8S798388-24-47 10/14/2024 10/14/2025 pI $' _ 1'000 000 000 5 000 �,.MEDEXPGA�Xonempe,son) $ .... ,... ... ...... ,,,..,.. ...... ERSONAL 8 ADV INJURY + .... N L AGGRtGATE� LIMIT APPLIES PER. 4,00.. 0,000 4 ... �.......,,,,, I POLICY X PE T LOC „, „ L_PRODLRIOTS..GrnMP; P AG.G._L. S 4 DUO OOUI A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,0Q00 000 �BA-3W747756-24-47-13 01/2412024 01/24/2025 �Ea3 xTGSJsleJiSJ.. -( Bf�1DLY W I,F:Y�PQr ...ANY . $ 1 OWNED ��������������� SCHEDULED .�U „arson) p ,f DILY INJURY leer accident) S "� L DXNW O A,V "ONLY �AO%Off!g�-Y CPPERTYDAMAGEXH PRerarccidzrr[ CN ..---m........... UMBRELLA.. I LIAB OCCUR -. EXCESS LIAR ¢ CLAIMS MADE I EACH OCCURRENCE Is r .... __. AGGREGATE 1 $. ..... ...Y DEb RETENTION $ ITI .....,.�,. C WORKERS COMPENSATION ILI AND EMPLOYERS' LIABILITY YIN UB-8S799914-24-47-G 10/14/2024 X I PEK 10/14/2025 STATUTE I Edµ 1,DDD OOo ANY PROM MB R/PARTNER/EXECUTIVE NIA pd A IOENT in NH) „Y. EL .E SSE EMPLOYE,R„ .-.- ,,,' DM SCRIPTI bN OF OPERATIDN$ below 00,000 E L DISEASE_ - POLICY LIMIT 11 S 1200,000 B Professional AAAE300078-04 12/12/2023 12112/2024 Ea Claim ; 2,,000„000 Liability IIII Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "Verification of Insurance CITEL-1 City of El Segundo Cheryl Ebert 350 Main Street El Segundo, CA 90245 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 REPRE.SE NTATWE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SEcnON 11 — WHO IS AN INSURED: Any person or organization & at you agree in a "'written contract requiring! insurance" to include as an additional insured on this Coverage D'art, but: a. Only with respect to liabil'Ihr for "bodily injury", "property damage" or "personal injury"; and. b. If, and only to the extent that, the 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. requiring insurance"' applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person :)r organization; or d. For "bodily injury" "prcperty damage" or "personal injury" for whi,:h such person or organization has assuried I'iiabOy in a contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any, person or orgarization for which coverage as an additional insured specificaally is added by another a idorsement to this Coverage Part. f. This insurance does not apply to the rendering of or failure to render any ""professional services" g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of lint ility required by the "written contract requir ng insurance'", the insurance provided to the additional insured shall be limited to the liar is of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of Insurance desc gibed in Section Ill «- Limits Of Insurance. h. This insurance does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the %writt'en contractrequiring insurance"' specifically requites you to provide such coverage for that additional insured, and there the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the permed of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary,excess, contingent or on any other basis„ that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring Insurance" that this insurance provided to the additional 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 available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "writtencontract requiring insurance"'. But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other bads, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81 09 1S C 2015 The Traveler; Indemnity Company. DUI rights roserved. Page 1 of 2 Includes the r*pyrighted material of Insurance Services drew rnc,, with its permission COMMERCIAL GENERAL LIABILITY We waive any right of recov!ry we may have against any person or organization because of payments we make for "bodil;( injury", "property damage" or "personal injury"' arising out of "your work" performed by you, or or your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed lo do so as part of the 'written contract requiring insurance" with such person or organization signed by you before. and in effect when, (Ve "bodily injury" or "property damage" occurs, or tie "personal injury" offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on: this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense cotpmMed.- a. After you have signed that written contract; b. While that part of the written contract is in effect, and c. Before the end of the policy period. Page 2 of 2 4) 2015 The Travelers Indemnity Company. All rights reserved, CIS D3 81 09 15 Includes the nopyrighted material of Insurance Service Ofte, Ina, %41h ns permission COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR ARCHITECTS, ENGINEERS AND SURVEYORS 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 co°rerage is excluded or limited by such an endorsement. The following listing is a general coverage description or-ly. Head a)I the provisions of this endorsement and the rest of your policy carefully to determine rights, dutitm, and what is and is not covered. A. Non -Owned Watercraft — 75 :eet Long Or Less B. Who Is An Insured — Unnamed Subsidiaries C. Who Is An Insured — Retired Partners, Members, Directors And Employees D. Who is An Insured — Employees And Volunteer Workers -- Bodily Injury To Co -Employees,, Co - Volunteer Workers And Retired Partners, Members, Directors And Employees E. Who Is An Insured — Newly Acquired Or Formed Limited Liability Companies F. Blanket Additional Insured — Controlling Interest G. Blanket Additional Insured — Mortgagees, Assignees, Successors Or F.eceivers PROVISIONS A. NON -OWNED WATERCRAFT — 75 FEET LONG OR LESS I. The following repface,-Paragraph (2) of Exclusion g.,, Aircraft, Auto Or Watercraft, in Paragraph 2.. cf SEC ON I — COV'ERAGES COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: (a) 75 feet long or less; and (b) Not being usec to carry any person or property for charge; 2. The following replace:a Paragraph 2.e. of SECTION II —WHO IS AN INSURED: e. Any person or olganiza'tion that, with your express or implied consent, either H. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Premises I. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Operations J. Incidental Medical Malpractice K. Medical Payments — Increased Limit L. Amendment Of Excess Insurance Condition — Professional Liability M. Blanket Waiver Of Subrogation — When Required By Written Contract Or Agreement N. Contractual Liability — Railroads uses or is responsible for the use of a watercraft that you do not own that is: (1) 75 feet long or less; and (2) Not being used to carry any person or property for a charge; B. WHO IS AN INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION 11 — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership or joint venture, that is not shown as a Named Insured in the Declarations is a darned Insured if. a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the fast day of the policy period; and CG D3 79 02 19 0 2017'The Travelers Indemnity Company. All rights reserved. Page 1 of 6 Includes :aoyhghled maledar of Insurance Services Office, Inc,, with its permission. COMMERCIAL GENERAL LIABILF-Y b. Such subsidiary is not En insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "Personal and advertising inju y" caused by an offense committed: a. Before you maintained an )wnership interest of more than: 50% in such subsidiary; or b. After the date, if any, during the policy period that you no longer maintain an ownership interest of more than SO% In such subsidiary. For purposes of Paragraph, 1. of Section 11 — Who Is An insured,, each such ^;ubsjdiary will be deemed to be designated in the Declarations as: a. A limited liability company-, b. An organization other than a partnership, joint venture or limited liability company, or c. A trust; as indicated in its name or the documents that govern its structure. C. WHO IS AN INSURED — RETIRED PARTNERS, MEMBERS, DIRECTORS AN 3 EMPLOYEES The following is added to Paragraph 2. of SECTION 11 — WHO IS AN INSURED: Any person who is your retire I partner, member, director or "'employee" that is performing services for you under your direct supervision, but only for acts within the scope of their ":mployment by you or while performing duties rel�ited to the conduct of your business. However, no such retired partner, member, director of "employee" is an insured for (1) "Bodily injury": (a) To you, to your current partners or members (if you ark a partnership or joint venture), to your current members (if you are a limited liability company) or to your current directors; (b) To the spouse, child. parent, brother or sister of that current partner, member or director as a, consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay camages because of the injury described in Paragraph (11)(a) or (b) above; or (d) Arising out of his 3r her providing or failing to provide pro*essional health care services. Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b)j (c) and (d) above do not apply to "bodily injury" arising out of providing or failingto provide first aid or "Good Samaritan services" by any of your retired partners, members, directors or "employees", other than a doctor. Any such retired partners, members, directors or "employees" 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. (2) "Personal injury": (a) To you, to your current or retired partners or members (if you are a partnership or joint venture), to your current or retired members (if you are a limited liability company), to your other current or retired directors or .employees" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that current or refired partner, member, director, "employee" or "volunteer worker" as a consequence of Paragraph (2)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (2)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (3) "Property damage" to property: (a) Owned, occupied or used by; or (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your retired partners, members or directors, your current or retired .employees" or "volunteer workers", any current partner or member (if you are a partnership or joint venture), or any current member (if you are a limited liability company) or current director. Page 2 of 6 0) 2017 The Travelers fridemnfly Company. AN fights reserved. CG D3 79 02 19 Includes cc pyrighted material of Insurance Services tierce, Inc, with its permission. D. WHO IS AN INSURED — 1MPLOYEES AND VOLUNTEER! WORKERS - BODILY INJURY TO CO -EMPLOYEES, CO -VOLUNTEER WORKERS AND RETIF;ED PARTNERS, MEMBERS, DIRECTORS AND EMPLOYEES The following is added to Faragraph 2.a.(1) of SECTION 11— WHO IS AN INSURED: Paragraphs (1)(a), (b) and (c) above do not apply to "bodily injury" to a current or retired co "'employee" while in the :ourse of the co- "employee's" employment b'f you or performing duties related to the conduct of your business, or to "bodily injury" to ,your other "volunteer workers" or retired partners, members or directors while performing duties related to the conduct of your business. E. WHO IS AN INSURED — NEINLY ACQUIRED OR FORMED LIMITED LIAEILITY COMPANIES The following replaces Paragraph 3. of SECTION II — WHO IS AN INSURED: 3. Any organization you newly acquire: or form„ other than a partnership or joint venture, and of which you are the scle owner or in which you maintain an owners;hip interest of more than 50%, will qualify aa, a Named Insured if there is no other similar insurance available to that organization. However. a. Coverage under this provision is afforded only: (1) Until the 1'80th day after you acquire or form the orgt�nization or the end of the policy period, whichever is earlier', if you do not report such organization in writing to us within 180 days after ",+ou acquire or form it, or (2) until the end of the policy period, when that date is later than 180 days after you acquire or form such organization,f you report such organization it writing to us within 180 days after fou acquire or form it; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage S doe's not apply to "personal and advertising inury" arising outof an offense committ c before you acquired or formed the organization. For the purposes of Paragraph 1. of Section II — Who Is An Insured, each such COMMERCIAL GENERAL LIABILITY organization will be deemed to be designated in the Declarations as: a. A limited liability company; b. An organization other than a partnership, joint venture or limited liability company; or c. A trust; as indicated in its name or the documents that govern its structure. F. BLANKET ADDITIONAL INSURED — CONTROLLING INTEREST 1. The following is added to SECTION 11 — WHO IS AN INSURED: Any person or organization that has financial control of you is an insured with respect to liability for "bodily 'injury", "property damage" or "personal and advertising injury" that arises out of: a. Such financial control; or b. Such person's or organization's ownership, maintenance or use of premises leased to or occupied by you. The insurance provided to such person or organization does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. 2. The following is added to Paragraph 4. of SECTIO N 11— WHO IS AN INSURED: This paragraph does not apply to any premises owner, manager or lessor that has financial control of you. G. BLANKET ADDITIONAL INSURED — MORTGAGEES, ASSIGNEES, SUCCESSORS OR RECEIVERS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a mortgagee, assignee, successor or receiver and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to its liability as mortgagee, assignee, successor or receiver for "bodily injury"' "property damage" or "personal and advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal and advertising injury" caused by 4n offense that it, committed, CG D3 79 02 19 0 2017 The 7rave)ery wdemnity Company. All rights reserved. Page 3 of 6 Includes copyrighted erateral of insuaaince Servtes Office, first, with its permission. COMMERCIAL GENERAL LIABILITY subsequent to the signing of that contract or agreement; and b. Arises out of the ownership, maintenance or use of the premises for which that mortgagee, assignee, suci:essor or receiver is required under that contact or agreement to be included as an add,tional insured on this Coverage Part. The insurance provided to such mortgagee, assignee, successor or receiver is subject to the following provisions: a. The limits of insurance provided to such mortgagee, assignee, successor or receiver will be the minimum limits :hat you agreed to provide in the written, contract or agreement, or the limits shown in the Declarations, whichever are less. b. The insurance provided 0 such person or organization does not appki to: (1) Any "bodily injury" or "property damage' that occurs, or an, "personal and advertising injury" caused by an offense that is committed, after such contract or agreement is no longe, in effect; or (2) Any "bodily injury", "property damage" or ""personal and advediiing injury" arising out of any structural afteraitions. new construction or dernolition operations performed by or oil behalf of such mortgagee, assigneo!, successor or receiver. H. BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIE�i — PERMITS OR AUTHORIZATIONS RELATIh G TO PREMISES The following is added to SECTION 11 — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to premises owned or occupied by, or rented or loaned to, you and that you are required by a -ty 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 the existence, ownership, use, maintenance, repair, constriction, erection or removal, of any of the following for which that governmental entity has issued such permit or authorization: advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, mari�luees, hoist away openings, sidewalk vaults, elevators, street banners or decorations. I. BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING TO OPERATIONS The following is added to SECTION 11 — 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: a. Any 'bodily injury", "property damage" or *personal and advertising injury" arising out of operations performed for the governmental entity; or b. Any "bodily injury" or "property damage" included in the "products -completed operations hazard". J. 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 11 — 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, paramedic, athletic trainer, audiologist,, dietician, nutritionist Page 4 of 6 C 2017 The Travelers Indemnity Campny, AS rights reserved CIS D3 79 02 19 Includes co 70ghted material of Insurantm services Office, Inc, with its permission. occupational therapist or occupational therapy assistant, physical therapist or speech -language patiologist; or (b) First aid or "Good Samaritan services" by any of your "employees" or "'volunteer workers", other tha i an employed or volunteer doctor. An l such "employees", or "volunteer worker," providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to lie acting within the scope of their employment by you or performing duties re atedi to the conduct of your business. 3. The following replaces the last sentence of Paragraph S. 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 of "Good Samaritan services" to any one person will be deemed to be one "occurrence". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION 1 — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the violation 01 a penal statute or ordinance relating to the sale of pharmaceuticals comirritted by, or with the knowledge or consent cf the insured. S. The following is added to the DEFINITIONS Section: "Incidental medical senices" 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 furnishings or dispensing of drugs or medical, dental, o• 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 of on any other basis, COMMERCIAL GENERAL LIABILITY 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. K. MEDICAL PAYMENTS — INCREASED LIMIT The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to Paragraph S. above. the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person, and will be the higher of: a. $10,000; or b. The amount shown in the Declarations of this Coverage Part for Medical Expense Limit. L AMENDMENT OF EXCESS INSURANCE CONDITION — PROFESSIONAL LIABILITY The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis, that is Professional Liability or similar coverage, to the extent the loss is not subject to the professional services exclusion of Coverage A or Coverage B. M. BLANKET WAIVER OF SUBROGATION — WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT The following is added to Paragraph S., Transfer Of Rights Of Recovery Against Others To Us,. of SECTION, IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a written 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, butonly for payments we male because of. a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed: subsequent to the signing of that contract or agreement. CG D3 79 02 19 0 2017 The Travelers indemnity Company, All rights reserved. Page 5 of 6 Includes copyrighted Matedel of Insurance Services Office, Inc. vAth its permission. COMMERCIAL GENERAL LIABILI"-1 N. CONTRACTUAL LIABILITY — 2AILROADS 1. The following replaces Paragraph c. of the definition of "insured contract' in the DEFINITIONS Section: c. Any easement or licen!ie agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITONS Section is deleted. Page 6 of 6 ID 2017 The Travelers Indemnity Company. All d9hts reserved. CG D3 79 02 19 Indudes capyrighted materiel of Insurance Services Office, Inc. with Its permission. AN W_ TRAVELERV WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 04 03 06 (01) — 001 POLICY NUMBER: UB-SS799914-24-47-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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 perso i 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE S. 00% OF THE CALIFORNIA WORKERS' COMPENSATION PREMIUM OTHERWISE DUE ON SUCH REMUNERATION. SCHEDULE PERSON OR ORGANIZATION THE CITY OF LOS ALAMITOS 3TS OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS AS ADDITIONAL 3NSUREDS. 3191 KATELLA AVE. LOS ALAMITOS, CA 90720 JOB DESCRIPTION DESIGNING PLANS FOR RENOVATION OF AN EXISTING 0.3 ACRE PARK DATE OFISSUE: 08-30-24 ST ASSIGN: Pagel of 1