PROOF OF INSURANCE (2025 - 2025) CLOSEDTDATE(MWDDfYYYY)
ACCOR" LIABILITY INSURANCE 10 0
CERTIFICATE OF LIA 1 Of/202Y4
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 endorsementils).
WMAU1,
PRODUCER t1A . . ........... . . ...
Certificates
Orr & Associates Insurance Services PHONE
FAx
1
28780 Single Oak Dr E-MAIL . .... ...... .
Ste 255 ACDREWj�g!:!�.Q�
Temecula CA 92590 INSURER AFfOR01 E qE
INSURED SOUTCOA-04 wsugeEi M. AmGuard
South Coast Painting Inc. IaIsIw R.
28364 S Western Ave. #465
Rancho Palos Verdes CA 90275 An --- — ----
COVERAGES CERTIFICATE NUMBER: 325170463 REVISION NUMBER: I
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE tNSURE0 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.
... . ........ ...............
TYPEOFINSURANOE -an rvdvn
I F-01.10y NUMM"
9 1rATfflULNTTTXJ --
- - F
A X COMMERCIAL GENERAL LIABILITY Y I Y
U24AC87006-09
5/112024 511/2025
EACH OCCURRENCE $- — ----- - -
CLAIMS -MADE X OCCUR
. . . ...... .
S 1,000,000 ADV INJURY
[2E[t�RAL Aq1ZETE-Arg S.
GEN1 AGGREGAT5 LIMIT APPLIES PER:
PR'-
POLICY' LOG
—, JECT
i. OTHER:
—B AUTOMOBILE LIABILITY Y Y
SOAU545707
4/2612024 4/26/2025
$11000,000
L 11111211411 Nllf='� If
ANY AUTO
BODILY INJURY Per $ ?erwn)
OWNED SCHEDULED
BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
X HIRED x NON -OWNED
AUTOSONLY AUTOS ONLY
—1
$
A UMBRELLALIAB OCCUR
7j- EXCESS LIAB 01 —CIC-I Iul M
U24AC87006-09
5/1/2024 511)2025 EA -H 00 URRENCE, $ 1,0�00 000
AGGREGATE 001000.
pp
DES d RETENTIONS
I WORKERS COIWIPENSATI ON
WE
EMPLOYERS.LIABILITY YIN
F
�A..E.R
A RIX11PARTNrA�EXECUTIVP NIA�
OFMCS
RNAEMsEREXCLUDED" (Mandatory in NHJ
. .... .. . . . ........ ...
DESCRIPTION OF OPERATIONS/ LOCATIONS) VEHICLES IACORD101, Additional Remarks Schedule, may be attached if more space is required)
Certificate is subject to policy limits, conditions and exclusions.
City of El Segundo is named as Additional Insured as per attached endorsement form(s).
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of El Segundo
150 Illinois Street AUTHORIZED REPRESENTATIVE
El Segundo, CA 90245 UI
0 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
COMMERCIAL AUTO
BA 99 02 09 08
BLANKET WAIVER OF SUBROGATION
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply
unless modified by the endorsement.
SECTION N - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of
Recovery Against Others To Us is amended by adding the following:
We waive any right of recovery we may have against any person or organization with whom you have a
written contract that requires such waiver because of payments we make for damages under this
Coverage Form.
BA 99 02 09 08 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
COMMERCIAL AUTO
BA 99 04 0618
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This provision does not apply in regard to any ownership, maintenance or use of the additional insured's "autos."
Additional Insured When Required by Contract
(1) Paragraph A.I. — WHO IS AN INSURED —
of Section 11 — Liability Coverage is
amended to add:
d. When you have agreed, in a written
contract or written agreement, that a
person or organization be added as an
additional insured on your business auto
policy, such person or organization is an
"insured', but only to the extent such
person or organization is liable for
"bodily injury' or "property damage"
caused by the conduct of an "insured"
under paragraphs a. or b. of Who Is An
Insured with regard to the ownership,
maintenance or use of a covered "auto"
The insurance afforded to any such
additional insured applies only if the
"bodily injury" or "property damage"
occurs:
(1) During the policy period, and
(2) Subsequent to the execution of such
written contract, and
(3) Prior to the expiration of the period
of time that the written contract
requires such insurance be provided
to the additional insured.
(2) How Limits Apply
If you have agreed in a written contract
or written agreement that another
person or organization be added as an
additional insured on your policy, the
most we will pay on behalf of such
additional insured is the lesser of:
(a) The limits of insurance specified in
the written contract or written
agreement; or
(b) The Limits of Insurance shown in
the Declarations.
Such amount shall be a part of and not
in addition to Limits of Insurance shown
in the Declarations and described in this
Section.
(3) Additional Insureds Other Insurance
If we cover a claim or "suit" under this
Coverage Part that may also be covered
by other insurance available to an
additional insured, such additional
insured must submit such claim or "suit"
to the other insurer for defense and
indemnity.
However, this provision does not apply
to the extent that you have agreed in a
written contract or written agreement
that the insurance is primary and non-
contributory with the additional insured's
own insurance.
(4) Duties in The Event Of Accident, Claim,
Suit or Loss
If another person or organization is
added as an additional insured on your
policy, the additional insured shall be
required to comply with the provisions in
A Loss Conditions 2. — Duties In The
Event Of Accident, Claim, Suit Or
Loss — of SECTION IV — BUSINESS
AUTO CONDITIONS, in the same
manner as the Named Insured.
BA 99 04 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
POLICY NUMBER: U24AC87006-09
COMMERCIAL GENERAL LIABILITY
CG 2010 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY..
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON O
ORGANIZATION
This endorsement modifies insurance provided under the following..
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Oraanization(s): I Location(s) Of Covered Operations
Any person or organization for whom you are performing
operations during the policy period when you and such
person or organization have agreed in writing in a contract
or agreement that such person or organization be added
as an additional insured on your policy.
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
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
1. All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by or
on behalf of the additional insured(s) at the
location of the covered operations has been
completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 E3l
POLICY NUMBER: U24AC87006-09
COMMERCIAL GENERAL LIABILITY
CG 20 37 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES O
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) I Location And Description Of Completed I
'
Or Organization(s): operations
Any person or organization, when you and such parties
have agreed in writing in a contract or agreement
pertaining to "your work" performed during the policy
period. This additional insured coverage does not apply
to "excluded residential construction". "Excluded
residential construction" means:
a) the ground -up construction of any building
whose units will be individually owned and
titled; and,
b) "your work" performed on the conversion of any
building into a condominium or townhome.
Information required to complete this Schedule, if not shown above will be shown in the Declarations.
Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with
respect to liability for "bodily injury" or "property
damage" caused, in whole or in part, by "your work"
at the location designated and described in the
schedule of this endorsement performed for that
additional insured and included in the "products -
completed operations hazard".
CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13
POLICY NUMBER: U24AC87006-09
COMMERCIAL GENERAL LIABILITY
HCS 040 06 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY AND BLANKET
WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
A. PRIMARY AND NON-CONTRIBUTORY TO
OTHERINSURANCE
Wdh respect to any person or organization that is
an additional insured under this Coverage Part,
the following is added to paragraph 4. of
SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
If you have agreed in writing in a contract or
agreement that this insurance is primary and non-
contributory relative to an additional insured's own
insurance, then this insurance is primary and we
will not seek contribution from that other
insurance. For the purpose of this endorsement,
the additional insured's own insurance means
insurance on which the additional insured is a
Named Insured.
When this endorsement is attached to the policy it
supersedes all other insurance conditions within.
HCS 040 06 10 13
B. WAIVER OF SUBROGATION — BLANKET
Under SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS, The Transfer Of
Rights Of Recovery Against Others To Us
Condition is amended by the addition of the
following:
We waive any right of recovery we may have
against any person or organization because of
payments we make for injury or damage arising
out of:
a. Your ongoing operations; or
b. "Your work" included in the "products -
completed operations hazard".
However, this waiver applies only when you have
agreed in writing to waive such rights of recovery
in a, contract or agreement, and only if the contract
or agreement:
a. Is in effect or becomes effective during the
term of this policy; and
b. Was executed prior to loss.
Includes copyrighted material of insurance Services Office, Inc., with its permission.
Page 1 of 1
POLICY NUMBER: U24AC87006-09 COMMERCIAL GENERAL LIABILITY
HCS 040 0211 12
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL AGGREGATE LIMIT PER PROJECT WITH A
OVERALL GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project(s): All Projects
ired to complete this Schedule, if not shown above, will be shown in the
A. For all sums which the insured becomes legally
3. Any payments made under Coverage A for
obligated to pay as damages caused by more
damages or under Coverage C for me6c'al
than one 'occurrence" under Section I —
expenses shall reduce the Designated
Coverage A, and for all medical expenses
Construction Project General Aggregate
caused by accidents under Section I —
Limit for that designated construction
Coverage C, which can be attributed only to
project. Such payments small not reduce the
ongoing operations at a single designated
General Aggregate Limit shown in the
construction project shown in the Schedule
Declarations nor shall they reduce any other
above:
Designated Construction Project General
1. A separate Designated Construction Project.
Aggregate Limit for any other designated
construction project shown in the Schedule
General Aggregate Limit applies to each
above.
designated construction project, and that,
limit is equal to the amount of the General
4. The limits shown in the Declarations for
Aggregate Limit shown in the Declarations,
Each Occurrence, Damage To Premises
Subject to the applications of the General
Rented To You and Medical Expense
Aggregate Limit to each of your projects, the
continue to apply. However, instead of being
maximum amount we will pay under the
subject to the General Aggregate Limit
General Aggregate Limit for all claims
shown in the Declarations„ such limits will
arising from all projects is $10,000,000 00.
be subject to the applicable Designated
2 The Designated Construction Project
Construction Project General Aggregate
General Aggregate Limit is the mostwe will
Limit.
pay for the sure of all damages under
Coverage A, except damages because of
"bodily injury" or "property damage"
included in the "products -completed
operations hazard", and for medical
expenses under Coverage C regardless of
the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims
or bringing "suits".
HCS 040 02 11 12 Page 1 of 2
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
B. For all sums which the insured becomes legally
obligated to pay as damages caused by an
"occurrence" under Section I — Coverage A,
and for all medical expenses caused by
accidents under Section I — Coverage C, which
cannot be attributed only to ongoing operations
at a single designated construction project
shown in the Schedule above:
1. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the amount available
under the General Aggregate Limit or the
Products -completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any
Designated Construction Project General
Aggregate Limit.
C. When coverage for liability arising out of the
""products -completed operations hazard" is
provided„ any payments for damages because
of "bodily injury" or "property damage" included
in the "products -completed operations hazard"
will reduce the Products -completed Operations
Aggregate Limit, and not reduce the General.
Aggregate Limit nor the Designated
Construction Project General Aggregate Limit,
D. If the applicable designated construction project
has been abandoned, delayed, or abandoned
and then restarted, or if the authorized
contracting parties deviate from plans,
blueprints„ designs, specifications ortimetables,
the project will still be deemed to be the same
construction project.
E. The provisions of Section III — Limits Of
Insurance not otherwise modified by this
endorsement shall continue to apply as
stipulated.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED
HCS 040 02 11 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Page 2 of 2
ACCIl EP CERTIFICATE OF LIABILITY INSURANCEDATEYYYY)
AA....: sas8�t 611/202/1/2024
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
REPRESENTATIVEOR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED pT'o0dions or be endorsed. If
SUBROGATION IS WAIVED, subject to the terms and conditiOA of the policy, certain Policies may require an endorsement. A statement on this
cerdfPcatp does not conferright's to the cemt"dfcate bo4der in lieu of such andorsemantlst.
PRODUCER
USI Insurance Services, LLC
2502 N Rocky Point Drive
Tampa, FL 33607
INSURED
SOUTH COAST PAINTING INC
28364 South Western Avenue #465,
Rancho Palos Verdes, CA 90275
COVERAGES CERTIFICATE NUMBER -
844-290-4908
Ace American Insurance
2207
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE -SEEN ISSUED TO THE INSU11 R11 ED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. N07WPITHSTANDING AW RE+CUIREMEW, TERM OR CONDITION OF ANY CONTRAC'T''OR OTHER DOCUM04T WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE ENSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND OONDITIONS OF SUCH POLICIES, LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
11LTR4 TYPE OF INSURANCE OL Ll,cy Nyi..tl6p16R, '204r''P POLIGY 6XP UMR5
COMWAOAU.. GENERA„ UAMUTY
EACHOCCURRENCE
�.9
_..v..�..m.. ........_.
CLAIMS -MADE OCCUR
rndrrc7.
5
MED E%P,",; fAny we Person! , ,
5
I
..
PERSONALBADV INJURY
....._
S
OEIa"LAGGREO
ATE LIMITAPPLIES PER!
GENERAL AGGREGATE
5
PRO-
POLICY JECT LOC
PRODUCTS-COMP/OP AGG
""'....".."""'"...."
$
' OTNE'SC.
5
AUTOMOBILE UABIurY
COPAWNE6 SINGLELIMR
S
ANY.
BODILY INJURY (Per person)
..._ ...._..""""""'"
S
OWNED
AUTOS ONLYHSCHEDUIED
AUTOS
BODILY INJURY Per acddenl
( Ii
$
HIRED NON -OWNED
PROPERTY DAMAGE O
S
AUTOS ONLY AUTOS ONLY
... .. ,
5 I
BRELLA UAB
OCCUR
EACH OCGURRENC'E
m_IT
' S
�7,u,Em[)
EXCESS UAe
OLAIMS-MADEAGGREGATE
$
RETENTION S
S
WOPR4CE'R3 CONFENBAT4DN
X TE' -.. -
ANO EMPLOYERS" LIABILITY Y J N
ANY'PROPAI-^rOrfPARTI4ERfrX'ECUI"CUE
E.L. EACH ACCIDENT
5 2,000,000
A
OFFICERN.M REXCLUDED? ' �'I,..,.
N/A .
C-55625979
611 J2024
V112025
F-L,DISFASE-EAEMPL2MEE
$ 2,000,O110
(Mand'a racy IRNN)
poti damdpPlyd under
CA IFTION OF OPERATIONS" e?Aw
E.L DISEASE- POLICY LIMIT
13 2,000,WD
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addklorml Remarks Seh.&d.. may be attached It —spate. is recpdred)
Pail,tate = CA
SOUTH COAST PAINTING` INC
2836430 astBrTIAWBPsue 4455
Rancho erdes, CA 90276
SHOULD ANY OF THE ABOVE DE5'C'.WSED POLICPSS BE CANCELLED BEFORE
THE EXPIRATION DATE r"4AROF., NOTICE WILL BE DELIVERED
IN ACCORDANCE W4TN THE POUC'Y FROVISIDNS..
I
Aw
ACORD 25 (2016103) The ACORD name and logo are r nw ks o f A o RD
g registered