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PROOF OF INSURANCE (2026 - 2026)N DATE (MM/DONYYY) A `CIR& CERTIFICATE IFICATE OF LIABIUTY INSURANCE 06/26/2025 THISCERTIFICATE: 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 pollcy(Ias) 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 endorsemerlt(s). CONTACT PRODUCER NAME: CLIENT CONTACT CENTER � FEDERATED MUTUAL INSURANCE COMPANY 6WHE_.. HOME OFFICE: P.O. BOX 328 (A/C, No, Ext):888-333-4949 (AIC, No): 5074464664 AIL OWATONNA, MN 55060 ADDRESS: CLIENTCONTAC'TCENTER( .FEDINS.COM INSURERS AFFORDING COVERAGE _ NAIC II INSURERA:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: WATERLINE TECHNOLOGIES INC INSURERC: 620 N SANTIAGO ST SANTA ANA, CA 92701-3942 INSURER D: INSURER E: INSURER F: 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVV POLICY NUMBER MMIDDIyYYY MMIDOtYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 RENTED PREMISES $100,000 CLAIMS -MADE gnw ....... a rTO MED EXP (Any one person) EXCLUDED A Y N 0623485 08/15/2025 08/15/2026 PERSONAL & ADV INJURY $1 OOO OOO OEN1. AOGREGATE (LIMIT APPLIES PER, GENERAL AGGREGATE $2 OOO OOO X POLICY [3ERC LOC PRODUCTS & COMP/OP ACC $2,000,000 OTHER: (E acciiddentSINGLE LIMIT $1,000,000 AUTOMOBILE LIABILITY BODILY INJURY (Per Person) X ANY AUTO BODILY INJURY (Per Accident) A OWNED AUTOS ONLY "C RU'LED Y N 0623485 08/15/2025 08/15/2026 IROPE AMAGE AU' HIRED AUTOS ONLY AUTL X UMBRELLA LIAB X',.00CUR EACH OCCURRENCE $10,000,000 A EXCESS LIAB CLAIMS -MADE N N 0623486 08/15/2025 08/15/2026 AGGREGATE $10,000,000 DIED RETENTION WORKERS COMPENSATION PER STATUTE THER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERI EXECUTIVE E.L EACH ACCIDENT FICERnrMEMBER EXCLUDED OFFICER (Mandatory ) N/A E.L DISEASE -EA EMPLOYEE E.L DISEASE •POLICY LIMIT H yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY OF EL SEGUNDO 2170 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST EL SEGUNDO, CA 90245-3813 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O INS-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: " LOC ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED - FEDERATED MUTUAL INSURANCE COMPANY WATERLINE TECHNOLOGIES INC 620 N SANTIAGO ST POLICY NUMBER SANTA ANA, CA 92701-3942 SEE CERTIFICATE ## 217.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE ## 217.0 SEE CERTIFICATE ## 217.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: ALL OPERATIONS TO VARIOUS LOCATIONS IN CA. CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED UNDER THE GENERAL LIABILITY ON A PRIMARY AND NON-CONTRIBUTORY BASIS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION ENDORSEMENT. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON BUSINESS AUTO LIABILITY SUBJECT TO THE CONDITIONS OF THE BUSINESS AUTO ADDITIONAL INSURED ENDORSEMENT ACORD 101 (2008101) 0 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE 0/246/24/2DIYYYY) ,. /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 endorsements . PRODUCER CO ACT Certificate Department _. PHONE 415 754-3635 FAX a.. Newfront Insurance Services, LLC (AQAQ,AxtL_ ( ).... __.... ) .- 777 Mariners Island Blvd E-MAIL gEs corts neWiront COrru... _.._. — Suite 250 1gffEE$J AFEgRltaN!G COVEFRAG mmm NAIc a San MateoSURCA 94404 .._� INsuREtx fx ; Service American IndemnityIndemnityCompany 39152 INED� INSURERS [ ....., ,_._.-.... ___ ........ -_.............., .......�...,w,w.............. Waterline Technologies Inc. 620 N Santiago St Santa Ana CA 92701 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, S. INTaEXCLUSIONSTMPDoCONDITIONS �NCE mOF SUCH POLICIES. ULIMITS SHOWN c MAYHAVEBEEN REDUCED BY PAID C mm m � �Llmlrs mmmm COMMERCIAL GENERAL LIABILITY - µ EACH OCCURRENCE _ S .... CLAIMS -MADE OCCUR .k'h'�E.'d s_ES(E4necaarrmer ........ MED FJCP Attl one Pernon & AD PERSONAL.........,, V INJURY'.,, $ ,..m,.... ...._......�� GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ._ . _. .,,. POLICY 0 JEO,T � LOC 'PRODUCTS C ^� COMP/OP AGC3 �+ .... .. .. $...,,,..a OTHER; COMBINED SINGLE LIMIT . $ AUTOMOBILE LIABILITY Ea awrar,( _...... ANY AUTO ,BODILY INJURY (P ) ...mm (Per person $ � . OWNED SCHEDULED BODILY INJURY (Per accident) $ ONLY AUTOS D.... . .. ... E AMAGE ....... ,,.. .._,_.-. AUTOS ONLY ........ .HIRED...... AUTOS ONLNON-OWNEY .. UMBRELLA LIAB OCCUR EACHQJCIJRFBENCE' ,...._......_. $..—m ...._._......._—_wwm,W EXCESS LIAB CLAIMS -MADE AGGREGATE ........ ..._,.. _$�...... .... _....... OCT)RETENTION$ p R OTM- WORKERS COMPENSATION ST.r1°U(,,._ DR AND EMPLOYERS' LIABILITY Y N N H A 1,000,000 E.L. EACCCIDENT 5A ANYPROPRIETOR/PARTNER/EXECUTIVE OFF ICER/MEMBEREXCLUDED? Li NIA SAMTWC0031505 07/01/2025 07/01/2026. •• - ­ DISEASE EA EMPLOYEE S 1,000,000 (Mandatory in NH) _E.L, Ues descAbounder OP C PEFW'IONS b0ow E.L. DISEASE-ICYL,IMI"T 5 1,000,000 POLSCRIPTION DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Evidence of Coverage. Lwi C 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 ' AUTHo&'tl ESEr:TATIVE 350 Main St I ElSegundo CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 0623485 COMMERCIAL AUTO CA 20 48 1013 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 this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Auto Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Waterline Technologies Inc Endorsement Effective: 08/15/2025 SCHEDULE Name of Person(s) Or Organization(s): City of El Segundo 350 Main St El Segundo, CA 90245 Information required to complete this 'Schedule, if not shown above„ will be shown in the Declarations. 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 Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 1013 © Insurance Services Office, Inc., 2011 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. fisqu#k. ., • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance 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. © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 0112 19 Policy Number: 0623485 Transaction Effective Date: 08/15/2025 POLICY NUMBER: 0623485 COMMERCIAL GENERAL LIABILITY CG 2010 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INS • � � � � •�» • I I 11 • - Z. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization(): Location(s) Of Covered Operations City of EI Segundo Any Coverage Provided by This Endorsement 350 Main St Applies Only With Respect to Named Insured's El Segundo, CA 90245 Delivery of Products to Certificate Holder. Additional Insureds Also Include: City of El Segundo, its Officers, Officials, Employees and Volunteers. Information required to c zm late this Schedule if not shown above, will be shown in the Declarations. 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 additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the in the performance of your ongoing operations for location of the covered operations has been the additional insured(s) at the location(s) completed; or designated above. 2. That portion of "your work" out of which the However: injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. 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. © Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 10 12 19 Policy Number: 0623485 Transaction Effective Date: 08/15/2025 C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Insured: Waterline Technologies Inc 620 N Santiago St Santa Ana, CA 92701-3942 Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 Policy Number: 0623485 Transaction Effective Date: 08/15/2025