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PROOF OF INSURANCE (2026)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY ) 3/13/2025 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 Burnham WGB Insurance Solutions CA Insurance License OF69771 15901 Red Hill Avenue Tustin CA 92780 INSURED Clinical Lab of San Bernardino Geo-Monitor, Inc. PO Box 329 San Bernardino CA 92402 COVERAGES CLINI-2 CERTIFICATE NUMBER:929189912 Hernandez REVISION NUMBER: 20427 20443 20494 42625 34630 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR... TYPE OF INSURANCE AOGdE. SU--. .....-- w.,.__,."". _ TC1 ..W.,._.......- .... .... .........-_-.._._----....--- BR POLICY EFF POLICY RXP LTR, POLICYNUMBER MLAM iYYYY. MFDDdYYYY' LIMITS A X COMMERCIAL GENERAL LIABILITY 6072997663 2/1/2025 2/1/2026 EACH OCCURRENCE $ 1,000,000 [ CLAIMS -MADE OCCUR PREMI",Lq,,aiprrencm $ 100,000 .---� MED FRCP (And one person) .. $ 1'0,'000IT - —------ .m PERSONAL & ADV INJURY ......_. $ 1,000,000 IT GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 000 2_,OOQ000ITIT , POLICY q - -..� PRO� X LOC PRODUCTS - COMP/OP AGG �_...-_" "_""...... ......................�..�.._. _$ $ 2,000,000 OTHER $ C AUTOMOBILE LIABILITY 7036574348 2/1/2025 2/1/2026 E LE.LIMIT a COMBINED ISINGL (PA.AmL I ...... $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED ...._'. SCHEDULED BODILY INJURY (Per accident) i.. $ AUTOS ONLY .,m AUTOS X HIRED ...X NON -OWNED PROPERTYDAMAG'E $ AUTOS ONLY _ AUTOS ONLY "" pw .am,4031,. ............ -...--...... --......-----�.,-. $ D X UMBRELLALIAB X OCCUR CUE6076281162 2/1/2025 2/1/2026 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE' ......,..�................_ AGGREGATE ..� ..�.._......_...m......................�._..............�,. $ 5,000,000 DED X RETENTION $ 10 opn $ E WORKERS COMPENSATION CLWC666456 2/1/2025 2/1/2026 X PER OTH $Tt,TEiU—_ ER AND EMPLOYERS' LIABILI Y YIN 11101,,,,,,_ ............ITITITITIT"„ ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N / A """ '""1 "" Mandato in (Mandatory ) E.L,.DISEASE- EA $1,000,000 "mmmmm�"ITIT�ITITITmmmITm If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE -POLICY LIMIT $ 1,000,000 B Environmental Professional Liabil EEH276170923 2/1/2025 2/1/2026 Per Claim 4,000,000 Claims Made Coverage Aggregate 4,000,000 Deductible: $1•00,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of El Segundo, its directors, officials, employees, agents and volunteers named as additional insured on the General Liability per attached CNA75081XX(1-15) as required by written contract subject to the terms and conditions of the policy. Waiver of Subrogation applies to the General Liability per attached CNA75008XX(1-15). Waiver of Subrogation applies to the Workers' Compensation per attached WC040306. City of El Segundo 400 Lomita Street El Segundo CA 90245 UANL; 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this Coverage Part; including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. bodily Injury, property damage, or personal and advertising injury to the extent caused by: 1. the Named Insured's acts or omissions; or 2. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations specified in the written contract; or B. bodily injury or property damage to the extent caused by your work specified in the written contract and included in the products -completed operations hazard, and only if 1. the written contract requires the Named Insured to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: a A. acts or omissions of the additional insured, or of anyone acting on the additional insured's behalf; or B. 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, w field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or C. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: CNA75081 XX (1-15) Policy No: 6072997663 Page 1 of 2 Endorsement No: 8 AMERICAN CASUALTY CO OF READING, PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNAAII Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; S. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 4 does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. The bodily Injury or property damage; or 2. The offense that caused the personal and advertising Injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75081 XX (1-15) Policy No: 6072997663 Page 2 of 2 Endorsement No: 8 AMERICAN CASUALTY CO OF READING, PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services Office, Ina, with its permission. CNA CNA PARAMOUNT Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or ANY PERSON OR ORGANIZATION WHOM THE NAMED INSURED HAS AGREED IN WRITING IN A CONTRACT OR AGREEMENT TO WAIVE SUCH RIGHTS OF RECOVERY, BUT ONLY IF SUCH CONTRACT OR AGREEMENT: 1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND 2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY GIVING RISE TO THE CLAIM, (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products -completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy,. CNA75008XX (10-16) Page 1 of 1 AMERICAN CASUALTY CO OF READING,PA Policy No: 6072997663 Endorsement No: 11 Effective Date: 0 2/ 01 / 2 0 2 5 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNAAII Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Business Auto Policy CNAPolicy Endorsement �f THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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. Named Insured: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Endorsement Effective Date: 02/01 /2025 SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS. 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. _..m..... ,.... Form No: CA 04 44 10 13 Policy No: BUA 7036574348 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 02/01 /2025 Endorsement No: 4; Page: 1 of 1 Policy Page: 19 of 38 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 ° Copyright Insurance Services office, Inc., zU 1 -i CNA CNA PARAMOUNT Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. the additional insured is a named insured under such other insurance; and b. the Named Insured has 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. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy, CNA74987XX (1-15) Policy No: 6072997663 Page 1 of 1 Endorsement No: 10 AMERICAN CASUALTY CO OF READING,PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Indudes copyrighted material of Insurance SerAces Offioe, Inc., with its permission. Professional Liability and Pollution Incident Liability Insurance CNAPolicy Design defect circumstance means a circumstance arising out of a design defect for which the Insured has requested reimbursement of a rectification expense from the Insurer. Disciplinary proceeding means any pending matter, including an initial inquiry, before a state or federal licensing board or a peer review committee to investigate charges alleging a violation of any rule of professional conduct in the performance of professional services. Domestic partner means any person qualifying as such under any federal, state or local laws or under the Insured's employee benefit plans. Emergency response means an action taken by the Insured to rectify a design defect that prevents imminent bodily injury and/or material physical injury to, or destruction of, tangible property due to that design defect, which is otherwise insured under this Policy. Extended reporting period means the period of time after the end of the policy term for reporting claims to the Insurer that are first made against the Insured during the applicable extended reporting period arising out of: 1. a wrongful act that took place prior to the end of the policy term that is otherwise covered by this Policy; or 2. activities that took place prior to the end of the policy term that result in a pollution incident that is otherwise covered by this Policy. Fungi means any form of fungus including but not limited to yeast, mold, mildew, rust, smut or mushroom, and including any spores, mycotoxins, odors, or any other substances, products, or byproducts produced by, released by, or arising out of the current or past presence of fungus. Hostile fire means a fire that becomes uncontrollable or breaks out from where it was intended to be. Insured means the Named Insured, a newly acquired subsidiary and: 1. any current partner, officer, director, member, stockholder or employee of the Named Insured or newly acquired subsidiary during the policy term, but only while acting within the scope of their duties for the Named Insured or newly acquired subsidiary; 2. any current leased or contracted personnel, but only while acting within the scope of their duties for the Named Insured or newly acquired subsidiary; 3. any retired or past partner, officer, director, member, stockholder or employee or leased or contracted personnel of the Named Insured or newly acquired subsidiary, but only for professional services or activities performed for or on behalf of, at the request of, and for the benefit of the Named Insured or newly acquired subsidiary; and 4. solely with respect to Insuring Agreement A.2., Pollution Incident Liability, any client or project owner for whom the Named Insured performs activities, provided that: a. a written contract or agreement is in effect between the Named Insured and a client or project owner under which the Named Insured assumes the tort liability of the client or project owner to pay compensatory damages to a third party for a pollution incident; b. such pollution incident is caused by the Named Insured's activities, or the activities of any person or entity for whom the Named Insured is liable; and c. such written contract or agreement is executed prior to the pollution incident, and: L incorporates an enforceable indemnity provision pertinent to the pollution incident; or ii. requires such client or project owner to be made an additional insured under the Policy that insures the Named Insured against pollution incidents. For purposes of this definition only, "tort liability" means liability for a civil or private wrong imposed by Form No: CNA79034XX (11-2022) Policy No: EEH276170923 Policy Page 5 of 17 Policy Effective Date: 02/01/2025 Underwriting Company: Continental Casualty Company Policy Page: 14 of 30 151 North Franklin Street, Chicago, IL 60606