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PROOF OF INSURANCE (2025 - 2026)C 01I2712025 Y) CERTIFICATE OF LIABILITY INSURANCE DATE (MM2025 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 Certificate Department NAME. PHONE (949) 261-5335 c No Arc Na E t (949) 261-1911 Assured Partners of California 1300 Dove Street, Suite 300 E-MAILcertificates.nb@assuredpartners.com ADDRESS! Lic# OM07762 INSURER(S) AFFORDING COVERAGE NAIC # Newport Beach CA 92660 INSURERA: Middlesex Insurance Company 23434 ..................................... INSURED INSURER B : Insurance Company of the West 27847 NKS Mechanical Contracting Inc INSURER C: 2971 E. White Star Avenue INSURER D: INSURER E : Anaheim CA 92806 INSURER F f: COVERAGES CERTIFICATE NUMBER: 24-25 WC 25-26 GL,BA,XS REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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., POLICY EFF MMIDD/YYYY P MIDf E.Xt" PdYdIMP'DiD;PVYYY'� _ LIMITS .. �_ MHSR LTR TYPE OF INSURANCE INgp yyVD POLICY NUMBER X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A --""""' PREMISES Ea occurrence 500,000 $ CLAIMS -MADE FXOCCUR MED EXP (Any one Person) $ 15,000 A Y Y A0165544004 02/06/2025 02/06/2026 PERSONAL& ADV INJURY $ 1,000.000 G.EN C AGGREGATE L OIM..:ITAPPILIES PER: GENERAL AGGREGATE...... ...$ 3,000,000 PtiJ.: POt (CY JEC•r LO' PRODUCTS - COMPIOP ASS $ 2,000,000 OTHE:R:. AUTOMOBILE LIABILITY COMBINED SINGLE LIIwMtli :Ea arcirlent $ 1,000,000 X ANYAUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED Y Y A0165544001 02/06/2025 02/06/2026 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPt:R"fY'OAMAGE $ AUTOS ONLY AUTOS ONLY Per accidart X UMBRELLALIAB X OCCUR ....._._ ......... ., EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE A0165544005 02I06I2025 02/06/2026 AGGREGATE $ 5,000,000 DED RETENTION $ —FIR $ WORKERS COMPENSATION �/ PER STATUTE ER AND EMPLOYERS' LIABILITY YIN 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA Y WSD505087905 10/01/2024 10I01/2025 E.L. EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? t� (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below _............... E.L. DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: PW 23-03 City Hall HVAC Replacement Project The City, its officers, officials, employees, agents, and volunteers are named GL additional insureds with Primary Non Contributory and Waiver of Subrogation per CG7125 0622. Automobile Additional Insured per CA7601 06/15 including Primary Non Contributory, Waiver of Subrogation per CA0444 10/13. Workers' Compensation Waiver of Subrogation per WC990634. City of El Segundo 350 Main Street 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 REPRESENTATIVE CA 90245 d N r ElSegundo rr" U 1y6t1-ZUIO AGUKU GUKI'UKAI IUIV. All rignis reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 7125 06 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS BLANKET ADDITIONAL INSUREDS, PRIMARY & NONCONTRIBLITORY, WAIVER OF SU ROGATION This endorsement modifies the coverage provided under the following Coverage Form(s): COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Coverage enhancements are listed below. For details of each coverage, please read the corresponding policy provisions in the body of this endorsement. 1 Additional Insureds - Autom ......_. ..... a.titic Status for 13 Additional Insured Types A. Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You B. Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) C. State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations D. Lessor of Leased Equipment E. Owners or Other Interests From Whom Land Has Been Leased F. Manager or Lessor of Premise G. Mortgagee, Assignee, or Receiver H. Controlling Interest I. Co-owner Of Insured Premises J. Executors, Administrators, Trustees Or Beneficiaries K. State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises L. Vendors M. Grantor of Franchise 2. Primary and Noncontributory - Other Insurance Condition 3. Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 1. Additional Insureds - Automatic Status for 13 Additional Insured Types Section II - Who Is An Insured is amended to include the following as additional insureds when you have agreed to add that person or organization as an Additional Insured on your policy in a written contract or written agreement with that person or organization, or because of a permit issued by a state or political subdivision; provided the injury or damage occurs subsequent to the execution of the contract or agreement or issuance of the permit and while the contract, agreement or permit remains in effect. A. Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You 1) A person or organization with respect to liability for "bodily injury", "property damage" or ",personal and advertising injurycaused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. CG 7125 06 22 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 5 A0165544 with its permission. Middlesex Insurance Company A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. 2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. b. "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. B. Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) 1) Any person(s) or organization(s) with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed for that additional insured and included in the "products -completed operations hazard", but only when that portion of the "products -completed operations hazard" is not excluded by endorsement. 2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, 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, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, subject to the following provisions: 1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. 2) This insurance does not apply to: Page 2 of 5 Includes copyrighted material of Insurance Services Office, Inc., CG 71 25 06 22 A0165544 with its permission. Middlesex Insurance Company a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". D. Lessor of Leased Equipment 1) Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). 2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. E. Owners or Other Interests From Whom Land Has Been Leased 1) Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you by the additional insured person(s) or organization(s). 2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to lease that land; b. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured person(s) or organization(s). F. Manager or Lessor of Premise Any personi(s) or organization(s) with respect. to liability for "bodily injury" "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you by the additional insured person(s) or organization(s), subject to the following additional exclusions: This insurance does not apply to: 1) Any "occurrence" which takes place after you cease to be a tenant: in that premises. 2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. G. Mortgagee, Assignee, or Receiver Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of a premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured) person(s) or organization(s). H. Controlling Interest 1) Any person(s) or organization(s) with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. 2) This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. I. Co-owner Of Insured Premises Any person(s) or organization(s) with respect to their liability as co-owner of a premises co -owned by you and covered under this insurance. J. Executors, Administrators, Trustees Or Beneficiaries Any executor, administrator, trustee or beneficiary of your estate or living trust while acting within the scope of their duties as such. CG 7125 06 22 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5 A0165544 with its permission. Middlesex Insurance Company K. State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or political subdivision, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: 1) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or 2) The construction, erection or removal of elevators; or 3) The ownership, maintenance or use of any elevators covered by this insurance. L. Vendors 1) Any person(s) or organization(s) (referred to throughout this endorsement as vendor), but only with respect to liability for "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However: a. The insurance afforded to such vendor only applies to the extent permitted by law; and b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2) With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. The insurance afforded the vendor does not apply to: 1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2) Any express warranty unauthorized by you; 3) Any physical or chemical change in the product made intentionally by the vendor; 4) Repackaging, except when unpacked solely for the purpose of inspection„ demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; 5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; 6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7) Products which, after distribution or sale y you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or 8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or Page 4 of 5 Includes copyrighted material of Insurance Services Office, Inc., CG 7125 06 22 A0165544 with its permission. Middlesex Insurance Company (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. M. Grantor of Franchise Any person(s) or organization(s) with respect to their liability as grantor of a franchise to you. However: 1. The insurance afforded to such additional insureds only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. If there is any difference in coverage afforded to an additional insured in this endorsement and that provided under another additional insured endorsement attached to this policy, the broader coverage will apply to that additional insured. 2. Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 3. Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. CIS 7125 06 22 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 5 A0165544 with its permission. Middlesex Insurance Company POLICY NUMBER: A0165544001 COMMERCIAL AUTO CA 76 01 0615 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: NKS Mechanical Contracting Inc Endorsement Effective Date: 02/06/2025 SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "'insured" under the Who Is An Insured provision contained in: (1) Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. B. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1) The person or organization is a Named Insured under such other insurance; and (2) Prior to the "accident" you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the person or organization. CA 76 01 06 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 A0165544 with its permission. Middlesex Insurance Company POLICY NUMBER: A0165544001 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER R OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. ..........W... _ ......._ ....... Named Insured NKS Mechanical Contracting Inc Endorsement Effective Date: 02/06/2025 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 4410 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 A0165544 Middlesex Insurance Company WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER 2 % of the total California Workers' Compensation premium Schedule Job Description ALL CA OPERATIONS 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 10/01/2024 Policy No. WSD 5050879 05 Endorsement No. Insured N K S MECHANICAL CONTRACTING Premium $ INCL . Insurance Company INSURANCE COMPANY OF THE WEST WC 99 06 34 (Ed. 8-00) Countersigned By INSURED