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PROOF OF INSURANCE (2025)FDATE IM-DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/9/2025 1 10/2 1'� 24 .20 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). ON'TAC T PRODUCER Lockton Insurance 13roLers,LLC . . ...... . . . ...... CA License #OB99399 PNrIeE INC, "r 777 S. Figueroa Street. 52nd fl. E,MAIL Los Angeles CA 90017 6poak-$$� . . . ... . .......... . . .......... -- .. .............. . . . . . . ............ 213-689-0065 . . ...................... . ..... -�Su�ws ..... - - - — ----------- M I — INSURER A: Travelers Property Casualty Company ofAmerica 15674 .............................. . ...... . ...... INSURED Wifidan Enaineering INSURER B: Allied World Surplus Lines Insurance Companymmmmm 24319 IS06116 401 East KAtella Aventle, Suite 300 INSURERC: Anaheim. CA 92806 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER* 19811079 REVISION NUMBER: IVXXX:Lxx THIS IS TO CERTIFY THAT THE PCAJCIES 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 C04 OTHER D(.X' UMEN r WRH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 6 SUBJECT TO AJ.J. THE wfim$, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS K&K wJgf----- -- ............ -A61iiE7yw'!- "wrlify"rw'" - T N-S k- TYPE OF INSURANCE WoLIMITS I-TR INcQ POLICY NUMBER JgMDgrr?Yy1 lywomyyyl A COMMERCIAL GENERAL LIABILITY y N P-630-All78471-TIL-24 11,W2024 11/91,20?5 CE _EACH OCCvT URRENGT 0 0 S ' I " 00 '0 0 CLAIM [i] OCCUR S 1-000.000 X EnBenefits Liab L 0 X Contr. Liab. Incl, _PERSONAL&ADK!NJURY­ S I-000QQC 'ENL AGGREGOVE UMITAPPUES PER ..KNERAL,N2RE 2.0,09 000 PRO- LOC POLICY Z JECT PRODUCTS - COMPIOP AGG s 2ffl0.Q00 OT)AER A AUTOMOBILE LIABILITY Y N 810-A1161741-2443-G 11,1912024 CUOMNED SM 5M 11/9,2025 IMilnU--- S 1.000,000 x ANY AUTO BODILY INJURY (Per person) S )C)C�� OWNED SCHEDULED accciden AUTOS ONLY AUTOS HIRED NON -OWNED 5 x)000=— AUTOS ONLY AUTOS ONLY 5 XxXx= A y UMBRELLA LIAR .. Y N Cup-8Y112115-24-43 I V9/2024 11/9/2012:5 EACH OCCURRENCE S 1.000.000 EXCESS LIAR 0111AIMS-NIAU11 _!AGGRE DED RETENTION S I S XxJQCxxx A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECU'nVE y UB-8Y032268-24-43-G 11 t9/2024 11,,9�202� OTR- LTURE � 9E.. .--- E-L ACCIDENT s I M0.000 OFFICERIMEMBER EXCLUDED? EN] (Mandatory In NH) NIA CH EL DISEASE- EA EMPLOYEE, $000 11,es ge, 0 ORIPTION OF OPERATIONS below alle under M -no I EI-DISEASE POLICY UMIT S 1a0 00 1000 , Arch&Eng Prof N 0313-5950 11,9(2024 11/9/2025 PerClainy$1,000,000 17 Aggregate:$1000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RF- Fire plan review senwes CA%, QfEI Seq.undo' its officials and eniployees are mckided as A(khttong] In accoTclalire %vilb The prq°wisions ofthe Getlerid Liabihh" Automobile Ltalafilv arad Umbrella Liabifit; policies, The 0 ieneral Liabdiiy� Automobile habdir), and Umbrella Liability policipi, oidenced herein ase Pnmary and Non- 0:mtribulon, to othin msur=e, autilable to an Additional Insured, hod ozilt in arcordimce with die Inovutons of the poficies Seo the next page- - 19811079 City of El Squado Attention: Nicole Pesqueira 350.VI"141 Street El Segundo, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED F BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE SENTATNE (D ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD TION. All rights reserved. CONTINUATION DESCRIPTION OF OPERAiIONSILOCAiIONSNEHICLES[EXCLUSIONS ADDED BY ENDORSEMENiISPECIAL PROVISIONS (Use only if more space is required) 'Aaiw e;r of abrogation is granted III flavor of City of Eli Segundo in accordance with, the policy provisions of (lie.Workers' Compensation policy, Policle� include 0-days' utotice ofcalticcllall (except 10�"days for non-payineut of premitan) sand the provisioDs of each policy govern flow police of cancellation may be delivered to Certificate Holder. Umbrella Liability follows fol lu over General Liability, Auto Liability and Employers Liability as per the policy language. ACORD 2512016M) Certificate Holder ID: 19811079 Attachment Code: D604165 Master ID: 1506116, Certificate ID: 19811079 Policy P-630-Al 178471 -TIL-24 COMMERCIAL GENERAL LIABILITY Effective1l/9/2024 to 11/9/2025 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 LIABILITYCOVERAGE 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 "persona 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 dama a is caused by acts or omissions of you or (1) Any "bodily injury", "property damage" "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. 9 your subcontractor in the performance of "your (2) Any "bodily injury" or "property damage" work" to which the written contract or agreement caused by "your work" and included in the applies. Such person or organization does not "products -completed operations hazard" qualify as an additional insured with respect to the unless the written contract or agreement independent acts or omissions of such person or specifically requires you to provide such organization coverage for that additional insured during the The insurance provided to such additional insured is policy period. subject to the following provisions c. The additional insured must comply with the 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 additionalinsured willbe 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 additiona insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance 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" oroffense. b. The insurance provided to such additional insured (2) If a claim is made or "suit" is brought against does not apply to the additionalinsured: CG D2 46 04 119 0 2018 The Travelers Indemnity CompanyAll rights reserved Page 1 of 2 Attachment Code: D604165 Master ID: 1505166. Certificate ID: 19811079 COMM ERCIALG ENERALLIABI LITY Policy P-630-Al 178471 -TI L-24 Effective 11/9/2024to 11/9/2025 (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 ofthe claim or "suit" as soon as practicable (3) ImmedWely sendus copies of all le a papers r fted' n connection with he ccfaim si '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„defy se and inda ni{� of any suet 7o any provider of other claim or insurance which would coversuch additional insured for a loss we cover. However, this condition does not affect whetherthe insurance provided to such additional insured is primary to other insurance available to such additionalinsured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. CG D2 46 0419 Attachment Code: 00041asMaster ID: /nuu6.Certificate ID: /uo1mr COMMERCIAL GENERAL LIABILITY Effective 11/9/2024 to 11/9/2025 x. Method Of Sharing If all ofthe other insurance permits contribution byequal shares, wewill follow this method also. Under this approach each insurer contributes equal amounts until it has paid ie*appl{mab&xlimit mfinsurance ornone oythe loss remains, whichever comes first. |fany ofthe other insurance does not permit contribution byequal shares, wewill contribute bylimits. Under this method, each insurer's share isbased nnthe ratio mfits applicable limit cfinsurance 0othe total applicable limits of insurance ufall insurers. d.Primary And Non -Contributory Insurance |f Required ByWritten Contract |fyou specifically agree inowritten contract or agreement that the insurance afforded hman insured under this Coverage Part must apply on aprimary basis, uroprimary and noncontributory basis, this insurance isprimary tmother insurance that ioavailable tnsuch insured which, covers such insured as o named insuped, and vvowill not share with that other insurance, provided that: (1)The "bodily injury" or"property damage" for which coverage, iosought occurs; and (2) The "permona|and advertising injury" for which coverage issought iscaused byan offense that lsnmmmitted: subsequent to the signing of that contract or agreement by you. 5.Prem|um Audit a. We will. compute all premiums for this Coverage Part in accordance with our rules and rates. b.Premium shown inthis Coverage Part es advance premium is a deposit premium only, /m the close oieach audit period mmwill compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums iothe date shown oe the due date onthe bill. |fthe sum ufthe advance and audit premiums paid for the policy period is greater than the earned premium, mewill return the excess oothe first Named Insured. o.The first Named Insured must keep records of the information wmneed for premium computation, and send uscopies otsuch times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b, Those statements are based upon representations, you made tmus; and, o.Wehave: issued this policy inreliance upon your representations. The unintentional omission of, o,unintentional error in, any information provided byyou which werelied upon, inissuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right Uocollect additional premium or0u exercise our rights ufcancellation ornunnenowa|in accordance with applicable insurance laws nr regulations. 7. Separation Of Insureds Except with respect tothe Limits ofInsurance, and any rights m*duties specifically assigned inthis Coverage Part tothe first Named Insured, this insurance applies: a.AsNeach Named Insured were the only Named Insured; and b.Separately tveach insured against whom claim ismade or^ouiriabrought. 8'Transfer OfRights Of Recovery Against Others To Us |fthe insured has rights torecover all orpart ufany payment we have made under this Coverage Part, those rights are transferred tuus. The insured must dunothing after loss bmimpair them. p4our request, the insured will bring ~mud.ortransfer those rights to us and help us enforce them. 9. When We Do Not Renew If wedecide not \o renew this Coverage Part, wmwill mail urdeliver hmthe first Named Insured shown in the Declarations written notice ofthe nonenowm|not less than 30days before the expiration date. Mnotice is mailed, proof ofmailing will besufficient proof of notice. SECTION V--DEFINITIONS 1.^Ad,erUsamont"means anotice that isbroadcast o, published h,the general public orspouifiomarket segments about your goods, products o,services for the purpose ufattracting nu000memor supporters. For the purposes cf this definition: o. Notices that are published include material placed onthe Internet n,onsimilar electronic means ofcommunication; and b.Regarding wmbsivao.only that part ofowmbsim, that isabout your goods, products n,services for the purposes of ou,ocunn customers or ' ' - supporters isconsidered anadvertisement. Page 1aof21Q 2017The Travelers Indemnity Company- All rights reserved. CG T1 00 0219 Attach i 1 06mae 2ID: 19811079TIL- Efre ct::l.ve 1.1/9/2024 to 1.1/9/2025 COMMERCIAL GENERAL LIABILITY occupational therapist or occupational therapy assistant, physical therapist or speech -language pathologist; 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". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the violation of a penal statute or ordinance relating to the sale of 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. 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 5. 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 8., 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, but only for payments we make because of: 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — a. "Bodily injury" or "property damage" that COMMERCIAL GENERAL LIABILITY occurs; or CONDITIONS: b. "Personal and advertising injury" caused by This insurance is excess over any valid and an offense that is committed; collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement. CG D3 79 02 19 ® 2017 The Travelers IndemnityCompany. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Attachment Code: D603994 Master ID: 1506116, Certificate ID: 19811079 P011.1CYNUJMBER P-630-A1:1.787'71 T !7 2i4 ISSUE DATE: 10-21-24 V:::FF ECTIVE: :1.1/9l2.024 1.1l9l2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. IL T4 05 05 19 0 2019 The Travelers Indemnity Company. All rights reserved Page 1 of 1 Attachment Code: D603995 Nlaster ID: 1506116, Certificate : 19811079 POLICYNUMBER: 810-A1161741-24-43-G COMMERCIAL AUTO Effective 11/9/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph AA.c., 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 between you and that person or organization, 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 2fo.IloTwhineg 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 the first named insured when the written contract or agreement between you and that person or organization, 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 74 02 16 ® 2016 The Travelers Indemnity Company. All rights reserved Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Atta ID&?1 ip Code k�?69p�g ster : @, C4jj ,6 Certificate ID: 19811079 'lvESS cM1 1a EXfFNSIONGLr 'S"EMENT POLIC'T NUMBER. 810 A1.161.741-24 43--G EfEec1rive 11/9/2024 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 AA.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 The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and 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: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident' or 'loss", provided that the "accident' or "loss' arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. CA T3 53 02 15 0 2015 The Travelers Indemnity Company. All rights reserved_ Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Attachment Code: D603996 Master : 1506116, Certificate : 19811079 POLICY'NUMBER: 810-A1161741-24-43-G Effective 11/9/2024 ISSUE DATE. 10/21/24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. IL T4 05 05 19 m 2019 The Travelers Indemnity Company. All rights reserved Page 1 of 1 Attachment Code: D656212 Master ID: 1506116, Certificate ID: 19811079 POLICY NUMBER: CUP-sY11211s-24-43 ISSUE DATE: 10/21/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 PERSON OR ORGANIZATION: A PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM You TO US. PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. IL T4 05 0519 0 2019 The Travelers indemnity Company_ All rights reserved_ Page 1 of 1 TRAVELERS ONE TOWER SQUARE HARTFORU CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) - NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX —CONDITIONS: Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation. .wF4J 1I Name and Address of Designated Persons or Organizations: I Number of Days Notickt� ANY PERSON OR ORGANIZATIONWHOM YOU HALVE. + WRITTEN CONTRACT•:. CANCELLATIONBE GIVEN 30 1 BUT ONLY IF: 1, YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDIN G THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION O F THIS POLICY;AND 2, WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEM ENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRIT TEN REQUEST FROM YOU TO US. All other terms and conditions of this policy remain unchanged. 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 11/9/2024 Policy No. UB-8Y032268-24-43-G Endorsement No. Insurance Company Countersigned by _. ........ Travelers Property Casualty Company of America a 9 e o DATE OF ISSUE: 10-21-24 ST ASSIGN: 0 2013 The Travelers Indemnity Company_ All rights reserved. Attachment Code: D604007 Master ID: 1506116, Certificate ID: 19811079 ENDORSEMENT NO. AMEND SUBROGATION CLAUSE; WAIVER OF SUBROGATION FOR CLIENTS AND THIRD PARTIES This Endorsement, effective at 12:01 a.m. on November 9, 2024, forms part of Policy No. 0313-5950 Issued to Willdan Group, Inc. Issued by Allied World Surplus Lines Insurance Company In consideration of the premium charged, it is hereby agreed that Section Vill. CONDITIONS, Subsection N. is deleted in its entirety and replaced as follows: N. SUBROGATION In the event of any payment under this Policy, the Company shall be subrogated to all the Insured's rights of recovery against any person or organization and the Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured shall do nothing to prejudice such rights. The Company agrees to waive its right of subrogation against any client of the Insured or any other person or entity for a Claim which is covered by this Policy where the Insured agreed to waive any such rights in writing prior to the date the Wrongful Act giving rise to such Claim first occurred. Any recoveries shall be applied first to subrogation expenses, second to Damages and Defense Expenses paid by the Company, and third in satisfaction of the Policy Deductible shown in Item 4. of the Declarations. Any additional amounts recovered shall be paid to the First Named Insured. All other terms, conditions and limitations of this Policy shall remain unchanged_ Authorized representative AE 00062 (08/21) Attachment Code: D604005 Master ID: 1506116. Certificate ID: 19811079 ENDORSEMENT NO, ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED LIMITED TO E-MAIL NOTIFICATION This Endorsement, effective at 12:01 a.m. on November 9, 2024, forms part of Policy No. 0313-5950 Issued to Willdan Engineering Issued by Allied World Surplus Lines Insurance Company In consideration of the premium charged, it is hereby agreed that: In the event that the Company cancels this Policy for any reason other than nonpayment of premium, and the cancellation effective date is prior to this P o i u'" expiration date; 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this Policy is canceled (hereinafter, the "Certificate Holder(s)"); and has provided to the Company, either directly or through its broker of record, the email address of the contact at such entity; and 3. the Company receives this information after the First Named Insured receives notice of cancellation of this Policy and prior to this Policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Company; the Company will provide advice of cancellation (the "Advice") via e-mail to such Certificate Holders not later than thirty (30) days before the effective date of cancellation. Proof of the Company emailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Company has fully satisfied its obligations under this Endorsement. This Endorsement does not affect, in any way, coverage provided under this Policy or the cancellation of this Policy or the effective date thereof, nor shall this Endorsement invest any rights in any entity not insured under this Policy. Any failure on the insurer's part to deliver the Advice will not impose liability of any kind upon the Insurer or invalidate the cancellation. Any Certificate Holder is not an Insured or a Loss Payee under this Policy. No coverage will be available under this Policy for any Claim brought by or against any Certificate Holder. All other terms, conditions and limitations of this Policy shall remain unchanged. -7-6.11 %- ---- Authorized Representative AE 00025 00 (03/21) Attachment Code: D616078 Master ID: 1506116, Certificate ID: 19811079 Aw TRAVELERSJ ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 0313 (00) - POLICY NUMBER: UB-8Y032265-24-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. INCLUDING: ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH. THE INSURED HAS AGREED BY WRITTEN CONTRACT, EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. DATE OF ISSUE: 10-21-24 ST ASSIGN: PAGE 1 OF1