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PROOF OF INSURANCE (2024 - 2026)DATE (MM/DD/YY. ..,.,.., CERTIFICATE OF LIABILITY INSURANCE "Y' .. ...zs THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVE LY 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 ADD ITIONAL I NSU RED, the olic ies must have ADDITIONALINSUREDprovisionsorbeendorsed.IfSUBROGATIONISWAIVED,su p y(' ) bject to the terms and conditions ofthe policy, certain policies may require an endorsement. Astatement on this certificate does not confer rig htsto the certificate holder in lieu of such endorsement(s). .-..-.--...... .,... �.�,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,m.m,,,....., ....�.................,.................. ......... ......� ,,....... .-...AAA...., -- PRODUCER CONTACT NAME: GARETH NICKERSON Gareth Nickerson(993039V) PHONE FAX 27194 Baseline St Ste C NO EXT) 909 365 3200 I (A/c NO) 909 839 4372 E-MAIL Highland CA 92346-3197 ADDREss: gnickerson@farmersagent.com INSURER(S) AFFORDING COVERAGE NAIC# _...... ....... INSURE „.ER INSURERA NOR THFIELD INSURANCE 279 L.. INSURERB ---------------- SALE 38920 IWA TD NC ............ ��.. INSURERC MID CENTURY COMPANY 21687 12 GOODYEAR SUITE 130 INSURERD TRUCK INSURANCE EXCHANGE 21709 IRVINE CA 92618 INS URERE INSURERF COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE. LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDPCATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTI FICATE MAY BE ISSUED OR MAY PERTAIN, TH E INSU RANCE 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. I N S R LTR TYPE NSURANCE ADDTL INSD SUBR WVD POLICYNUMBER l POLICY (MM/DD/YYYY) POLICY (MM/DD/YYYY) LIMITS GENERAL LIABILITY j COMMERCIAL GE. ,,, ILI xI J .... .. .............. ... , . .......... ...,,,,, „ �. OCCURRENCE J 1 000 000. CLAIMS -MADE X OCCUR .A ..... PRMAGETORENTEDrence) I$ �$ 100 000 person) P ....... _.- I Y WH008318 10/27/2024 10/27/2025 PERSONAL ONALSADVINJURY is 1,000000„ ..., .. GENT AGGREGATEMITAIPLIES PER: L......„ I GENERAL�AGGREGATE $$ 2,000,000 ,000,000 POLICY PROJECIL_J LOC � PRODUCTSCOMP/OP AGO Is 2,000 000 OTHER . .......... ..... .. -- ...... 1$ QMBISINGLE NED Caccident) .. 10AUTOMOBILELIABILITY 0000 ANYAUTO INJURv(Perpersan) BODILY..-. $ O . OWNED AUTOS i� ONLY SCHEDULED , AUTOS Y 605861543 09/04I2024 09/04/2025 BODILY INJURYA' (Peraccident) $ i..# N YDAUTOS ONLY /� AUTOSSONLY DAMAGE $ -_ , (Peraccden t�....... ,.... f $ ........ x UMBRELLA LIAB X� OCCUR ..,�,.,,..�., EA cHoceuRRENCE �$ 5000000� E ExcessuA6 CLAIMS -MADE 01002925201___ 10/27/2024 1 10/27/2025 AGGREGATE $ 000 000� 5,000,000 N_ DED RETENTION$ l $ w_ .... ,,...,, _,, WORKERS COMPENSATION .. �„_.. ,,,,,,,,, ��--_._._-.-.-...- .. � .....m.,,,,.,....... , .�.. PIER OTHER $ .! ...... , DPROV r ANYPROPRIETOR/PARY/N CFiACC1DEN.T..r $ 1-,000000 C EMBERft OFFICER/MEMBER EXECUTI(Mandatory Y N/A A09505451 02/15/2025 02/15/2026 ,.E-;L.EA DISEASE � EXCLUDED? to Manda ) I If yes, deOribeunrDESCRIPTIONOF O� S el w i E,L ISEASE -POLICY LMIT is 1,000,000 .... PERATIONS/LOCATIONS/VEHICLES(ACORD101,Additional Schedule maybe attachedi DESCRIPTION OF O ifmore space is required) l CERTIFICATE HOLDER CANCELLATION .....-.-..- ......,.....IWATERINC........ .... ........... .......,.. ................................. ,,,,........ry. ... ..SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELL...ED,.................IR ,.., BEFORETHEEXPIRATION 12 GOODYEAR SUITE 130 ACCORDANCE �r i� PROVISIONS. DATE THEREOF NOTICE WILL BE DELIVERED IN ACCORDANCE WIT T EPOLICY, IRVINE CA92618 j AUTHORIZED REPRESENTATIVE �� ACORD 25 (2016/03) @1988-2015 ACORD CORPORATION. All Rights Reserved 31-1769 11-15 The ACORD name and logo are registered marks of ACORD POLICY NUMBER: WH008318 COMMERCIAL GENERAL LIABILITY CG20100413 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) Location(s) Of Covered Operations City of El Segundo, 350 Main Street, El Segundo, CA 90245 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. 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. 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 04 13 Copyright, Insurance Services Office, Inc., 2012 Page 1 of 2 C. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 Copyright, Insurance Services Office, Inc., 2012 Page 2 of 2 DD AC CERTIFICATE OF LIABILITY INSURANCE DATE /09/20 YYYY) 10/09/2023 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 Fred Dean NAME; Premier One Insurance Services PHONPc. (949) 727-2025 , Na (949) 727-9219 �1 V 100 Pacifica Ste 480 �n�A-11, Ffed.Dean(,,ot' Premier0ile.conl INSURER( NAIC # Irvine CA 92618 INSURERA: Beazley Insurance Company 37540 INSURED WSURfR B iWater, Inc. INSURER C q 12 Goodyear #130 INSURER D INSURER E,. Irvine CA 92618 INSURER F CI 93Q9R19100 RFVIRIAN NIIMRFR, 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. 4NSR' LTR'� TYPE OF INSURANCE WVD POLICY NUMBER MM/DDY F MMIDDPOL Y EXP .. LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ $ CLAIMS -MADE E OCCUR PREMISES Esoccung" _ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ PRODUCTS-COMPIOPAGG $ ❑ JIRO- ECT LOG POLICY JEGT OTHER: tlNW E LghtgT $ AUTOMOBILE LIABILITY 1" ou^cl@deq,) ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMA�GL. Pei , dent' $ AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB=0CCUREACH OCCURRENCE AGGREGATE $ EXCESS LIAB $ DED RETENTION $ OTH WORKERS COMPENSATION ER AND EMPLOYERS'LIABILITYPARTNER YIN PROPRIETOR/PARTNER/EXECUTIVE ID 7EACH OFFICER/MEMBER EXCLUDED?(Mandatory NIAIDENT in NH) EMPLOYEE $ANY Ifyes, describe underDESCRIPTION OF OPERATIONS below POLICY LIMIT $OCC $2,000,000 A Professional Liability IV1307D231201 10/04/2023 10/04/2024 DEDUCTIBLE $15,000 RETRO DATE 08-04-2011 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245 V 1!J0tf-ZU10A1,VKu t-VKt-VKAIIUnI. All rlyms I6 VINFuu. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD