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PROOF OF INSURANCE (2025)DATE (MM/DDNYYY) 1 -1 CERTIFICATE OF LIABILITY INSURANCE 12/31/2025 12112()24 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(les) 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 endersernerlt s . PRODUCER Lockton Companies, LLC NCT NAME _...... — 444 W. 47th St., Ste. 900 F PHONE FA C No Kansas City MO 64112-1906 E Ib1AIL (816) 960-9000 AD�s�: ..�...._. ,......,__� ..... _ �..._. kcasu@lockton.com ----------- INSURERIS AFFORDING COVERAGE NAIC # ` _— .ation 15105 INSURERA Safe National Ca ual Corpolat,mm-_ _ _ FORNIA, INC. UNITED SITE SERVICES OF CALIFORNIA, ...._._..- __ Specialty Insurance C pad] 37885 INSURER BITIT 1507679 118 FLANDERS ROAD, SUITE 1000 nce Com&l1 LU,XL INSURER C : Allied World AssuraS.lnc. 19489 WESTBOROUGH MA 01581 INSURER D : National Union Fire Ins Co Pitts. P_ ..............._._...._ A 19445 INSURER e : ..... ..._. - —... _.... ....... .._� INSURER F : COVERAGES CERTIFICATE NUMBER: 18424196 KtzVI UN NUMIseI<: AAAAAA.A. 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. °--_._ .. ......... ......... .........,,,,,m. ........ LTR ....... YNSR TYPE OF INSURANCE DL SUB POLICY NUMBER MMf0DP EFF MM/DD EXP LIMITS AX COMMERCIAL GENERAL LIABILITY Y N GL4057787 12/31/2024 12/31/2025 EACH OCCURRENCE $ 2000000 CLAIMS -MADE 1xx1 OCCUR Ea nccprref� U1_... $ 1.000.000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000, O00 ❑ ,PRODUCTS COMP/O,P AGG $ 4 000 OOO ', POLICY PRO- LOC PRO- OTHER:' A AUTOMOBILE LIABILITY Y N CA6675838 12/31/2024 12/31/2025 a woLl &INC3LE. L.prw�)T Ear �n $ 3 000 000 91 ANY AUTO BODILY INJURY (Per person) $XXXXXXX AUTOS ONLY AUTOS -••-------� HIRED � NON -OWNED � �aE � �AMAGEacadent) $ XXXXXXX SCHEDULED BODILY INJURY (Per AUTOS ONLY AUTOS ONLY XXXXXXX . ...... $ XXX3O{XX B UMBRELLA LIAB R N N US00076933LI24A 12/31/2024 12/31/2025 EACH OCCURRENCE _$ 10 000 000 D _ Excess LWe 20597768 12/31/2024 12/31/2025 AGGREGATE $10000000 JZS-MADE ....- ....-.am.:...a-- - DED X RETENTION $ 10,000 $ XX WORKERS COMPENSATION PER OTH A AND EMPLOYERS' LIABILITY N LDS4047370 12/31/2024 12/31/2025 X STATuTE . ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N NIA E L EACH ACCIDENT $ 1000.QQ0 OFFICER/MEMBER EXCLUDED? N . (Mandatory In NH) E L DISEASE - EA EMPLOYEE. $ 1.000.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ I 0 0 00 C ENVIRON. SITE LIAB & Y N 0311-5276 9/19/2024 9/19/2027 $3,000,000 EACH INCIDENT; CONTRACTORS $6,000,000 AGGREGATE POLLUTION LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CITY OF EL SEGUNDO, ITS ELECTED AND APPOINTED OFFICIALS, EMPLOYEES, AND VOLUNTEERS ARE ADDITIONAL INSURED ON GENERAL LIABILITY, AUTOMOBILE LIABILITY, AND POLLUTION LIABILITY, IF REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 18424196 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF EL SEGUNDO 350 MAIN STREET AUTHORIZED REEPRESENTAT.. EL SEGUNDO CA ?90245 t ©1988(1015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Attachment Code: D608659 Certificate ID: 18424196 POLICY NUMBER: GL 4057787 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Or Or anization s O erations As required by written contract or ocation(s) of operations as per written agreement when such written contract or contract or agreement between you and agreement is executed prior to an the Additional Insured. occurrence, offense or loss to which this endorsement applies, but only for the limits agreed to in such contract or the Limits of Liability provided by this policy, whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. Information required to corn lete this Schedule if not shown above will be shown in the A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products -completed operations 1. Required by the contract or agreement; hazard". or However: 3. Available under the applicable limits of 1. The insurance afforded to such additional insurance; insured only applies to the extent permitted whichever is less. by law; and This endorsement shall not increase the 2. If coverage provided to the additional insured is applicable limits of insurance. 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. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Attachment Code: D608142 Certificate ID: 18424196 POLICY NUMBER: GL4057787 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations As required by written contract or agreement when such Location(s) of operations as per written written contract or agreement is executed prior to an contract or agreement between you and the occurrence, offense or loss to which this endorsement Additional Insured. applies, but only for the limits agreed to in such contract or the Limits of Liability provided by this policy, whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. Information required to com lets 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. However: 1. The insurance afforded to such additional insured 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. CG20101219 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: 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 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. Attachment Code: D607880 Certificate ID: 18424196 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART SCHEDULE r.songsi or Organization(s) as required by written contract. Any individually scheduled Designated Additional Insured shall not be construed to override nor negate this blanket Designated Additional Insured. CHANGE The person(s) or organization(s) shown in the Schedule above with whom you have agreed in a written contract to provide insurance such as is afforded under this Coverage Form, is included as an Additional Insured subject to the below: (1) Insurance for such Additional Insured(s) scheduled above shall be afforded only to the extent that such Additional Insured is liable for "bodily injury" or "property damage" arising out of your operations and resulting from the ownership, maintenance or use of covered "autos" by you while the covered "autos" are on premises owned or leased by the above scheduled Additional Insured(s). (2) The insurance afforded under this Coverage Form to such Additional Insured(s) applies only: (a) If the "accident' takes place subsequent to the execution and effective date of such written contract: and, (b) While such written contract is in force, or until the end of the policy period, which ever occurs first. (22) How Limits Apply to Additional Insured(s) The most we will pay on behalf of the Additional Insured(s) scheduled above is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or, (b) The Limits of Insurance provided by the Coverage Form. SNCA 026 10 13 Safety National Casualty Corporation Page 1 of 2 Attachment Code: D607880 Certificate ID: 18424196 The amount we will pay on behalf of such Additional Insured(s) shall be a part of, and not in addition to, the Limits of Insurance shown in the Coverage Form Declarations and described in this section. Such amount will thus not increase the Limits of Insurance shown for the Coverage Form. (4) Exclusions (a) This endorsement does not apply to liability of the Additional Insured which arises out of the ownership of transportation operating rights granted to the Additional Insured by public authority. (b) This endorsement does not apply to the liability of the owner or anyone else from whom you hire or borrow a covered auto. (5) Obligations at the Additional Insured's Own Cost No Additional Insured will, except at their own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. The Additional Insured(s) scheduled above shall be subject to all other conditions set forth in the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. 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 12 / 31 / 2 0 2 4 Policy No. CA 6675838 Endorsement No. Named Insured UNITED SITE SERVICES, INC. Premium $ Included Insurance Company Safety National Casualty Corporation Countersigned By Page 2 of 2 Safety National Casualty Corporation SNCA 026 10 13 Attachment Code: D608139 Certificate ID: 18424196 Endorsement No: 2 This endorsement, effective: September 19, 2024 (at 12:01 A.M. standard time at the address of the Named Insured as shown in Item 1. of the Declarations) forms a part of Policy No: 0311-5276 Issued to: USS Ultimate Holdings, Inc. by: Allied World Assurance Company (U.S.) Inc. ADDITIONAL INSURED- WHERE REQUIRED BY WRITTEN CONTRACT It is hereby agreed that solely with respect to insurance that may be afforded under SECTION I - INSURING AGREEMENTS, 1. Pre-existing Conditions Coverage and 2. New Conditions Coverage, each of the following is an additional insured, but only to the extent provided below. 1. Each additional insured identified below is deemed an insured, but only: a. With respect to such person's or organization's liability arising out of a named insured's ownership, operation, maintenance or use of a scheduled location; and b. If and while such person or organization is a co-defendant in a lawsuit brought and maintained against a named insured, alleging that such person or organization is liable on a basis described in clause a. above. ADDITIONAL INSUREDS Any person or organization that a named insured has agreed in a written contract or written agreement to add such person or organization as an additional insured on this policy prior to a pollution incident. All other terms and conditions of this policy remain unchanged. By: Joseph Cellura Title: President, North American Casualty Division Date: September 30, 2024 ENV-SPL2 00006 00 (09/14) Page 1 of 1