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PROOF OF INSURANCE (2026)
I 0 DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 712912025 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 pollcy(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 endorsement s PRODUCER CONTACT "E._. Jeanie Miller ..... Stephens Insurance, LLC rr I 1 (2.05) 847 3 8._. a N91..m........._ 111 Center Street, Suite 100 E-MAIL Little Rock, AR 72201 ApgR9=Rs „n, 0eanle rYill e _St9 ns.com INSURERS) AFFORDING COVERAGE NAIC # www.stephensinsurance.com _...................... INSURERA: Ashen Specialty Insurance Company -A (XV) 10717 .. _ INSURED INSURER Casualty and Surety Co of Amer -A- (XV) 31194 Knorr Systems Intl., LLC wsm;mm_Travelers 2221 Standard Avenue INSURERC ._ _._. Santa Ana CA 92707 INSURER D INSURER E INSURER F : .,.-..o-wµ».ww.:+�-e. a+crsa��xr»t�.-r� u��r�ec�o. „r.+..��*�.r,rw,, RFVICIr1N 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. ........... .. ".-_.. ".,-._ .mm..,,.............. .......... ...... .TYPE OF INSURANCE .-_........---- POLICYNUMBER INSR At SUM POLICY EFF POLICY EXP LIMITS TR NUMBER. . MlDD MMIO. /Yl'YY A wr' COMMERCIAL GENERAL LIABILITY �/ �/ ERACCC925 8/1/2025 8/1/2026 OCCURRENCE ". $ 1 000 OOO CLAIMS -MADE OCCUR EACH LtM64�`"i� ifs PR -twt gliggi a oca�rr�lr�cp,1 $ 300 000,.,. ....... MED EXP (Any one person) $ 25 000 PERSONAL & ADV INJURY ,-,,........._.. $ 1 000000 wwwmm_m, �.... ENL.AGGREGATE....., w___............ G LIMIT APPLIES PER: GENERALAGGREGATE N...............--...........,-......,..._—. $2,000,000 ..............,,,,,,,. RO POLICY ✓mm� .PVC � LOC PRODUCTS - COMP/OP AGG .,,._....... „ ......... $ 2 000 OOO a..,..._...._...... .�,.. ✓ ov-I'ER DED: 15 000 BI 6, PD $ B AUTOMOBILE LIABILITY ✓ 810-8W994744-25-43-G 8/1/2025 8/1/2026 FOaMrxalN} On 1sINGLE LIMrr $1,000,000 ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ ^� AUTOS ONLY AUTOS HIRED NON -OWNED PROPER'TYOAMFtCrE AUTOS ONLY AUTOS ONLY JRQL sa .21ph. A UMBRELLALIAB ,/ OCCUR EXACCCA25 8/1/2025 8/1/2026 EACH OCCURRENCE $ 3.000 000 wwwwwww_ , ✓ EXCESS LIAB CLAIMS -MADE AGGREGATE " ...... $ 3R000.000............IT„ OED ETENTION$0 $ B WORKERS COMPENSATION UB-9WO57283-25-43-G 8/1/2025 8/1/2026 OT ,� STATUTE ERH AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE Y f N H NA / E.L. EACH ACCIDENT -_. $ 1J'000,000 OFFICER/MEMBEREXCLUI , (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 OOO A General Pollution Liability ERACCC925 8/112025 8/1/2026 Each Incident -Contractors Poll (Ded $15K) $1,000,000 -On/Off Site Pollution (Ded $15K) $1,000,000 Professional Ded $15K 1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder„ its elected and ,appointed officials, employeesand volunteers are additional Insureds (except Workers Compensation) as their interests may appear until completion) of the job, where required by written contract. Umbralla policy sits excess of General (Liability, Auto Liability„ and Employers Liability. A Walver of Subrogation applies in favor of the additional insured on the Workers Compensation policy where required by written contract. Coverage is primary and others is non-contributory where required by written contract. 30 days Notice of Cancellation as required by written contract. ULK 111-I :A I t II VL-L LK +.tsuM+ i r rs I twim SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 150 Illinois St ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo CA 90245 AUTHORIZED REPRESENTATIVE Michael L. Wilson U 98SS-LU9b AGUKU GUK1-UKAI IUIV. AU rignis reserveu. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 06463991. I Maste.c 25 26 GLALEXWC Pot.l (4rorx Per Project I 7eanie Miller 1 7/99,r^2025 9:37:29 AM (CDT) I Page_ 1. of 1.5 This certi.Picate cancels and supersedes AI,I, previously issuers c.ert.i.kfica.tes. Policy #810-8W994744-25-43-G Policy Term: 08/01/2025 to08/01/2026 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE — INCREASED LIMIT C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: Any organization you newly acquire or form during the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS as an additional insured for Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSINESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: CA T3 53 0817 © 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 4 H46 )9l 1 Master Lys -26 Gf.ALEXWC Poll Knorr Per Prra)es. I uehnie. Mi1.le.r I 7(29M Oe9 9L 37.24 AM (CDT) I Page 2 aa£ 15 Th:ls certificate cancels and supcisedes AL6, pre+vioi4,;ly issued a.¢ rtific:ates., COMMERCIAL AUTO (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS The following replaces Subparagraph e. in Paragraph B.7., Policy Term, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDITIONS: e. Anywhere in the world, except any country or jurisdiction while any trade sanction, embargo, or similar regulation imposed by the United States of America applies to and prohibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (1) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (a) You must arrange to defend the "insured" against, and investigate or settle any such claim or "suit" and keep us advised of all proceedings and actions. (b) Neither you nor any other involved "insured" will make any settlement without our consent. (c) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (d) We will reimburse the "insured": (i) For sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "insured" pays with our consent, but only up to the limit described in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE; (ii) For the reasonable expenses incurred with our consent for your investigation of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (2) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess contingent or on any other basis. (3) This insurance is not a substitute for required or compulsory insurance in any country outside the United States, its Page 2 of 4 © 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission CA T3 53 08 17 85.46g 991 ( Master 25--26 GLALEXWC Poll Krco.r..r. PerPxojarr I 7�eanze Miller 1 7/29P2025 9:37.24 AM (CDT) I Page 3 of1.5 THs cerhif.icate cancels and supersedes ALL previously .issued certificates. territories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such country up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory insurance requirements. (4) It is understood that we are not an admitted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Canada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deductible, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Paragraph A.4.b., Loss Of Use Expenses, of SECTION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Paragraph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. J. PERSONAL EFFECTS The following is added to Paragraph A.4., Coverage Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: COMMERCIAL AUTO Personal Effects We will pay up to $400 for "loss" to wearing apparel and other personal effects which are: (1) Owned by an "insured'; and (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclusions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that inflate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Comprehensive Coverage under this policy; b. The airbags are not covered under any warranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representative prompt notice of the "accident" or "loss" applies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability company); (d) An executive officer, director or insurance manager (if you are a corporation or other organization); or (e) Any "employee" authorized by you to give notice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDITIONS: CA T3 53 08 17 © 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 3 of 4 B64F3997. 1 jAaster 25-26 GLALEXWC Poll Knorr. Per Pro�ler.at I �7eanie Miller 1 t(29d:16;7'- .9 37.24 AM (CDT) I Page 4 or :1.5 This certificate Cancels and supersedes ALL �vrr3vlratr�sl,y.. ®ss.jed c;ert ftoates. COMMERCIAL AUTO 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Concealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. However this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 © 2016 The Travelers Indemnity Company. All rights reserved. CA T3 53 08 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission 0646399:1. I Master 25-26 GLALEXWC P0.11 Krco.r..r. Per Pro�oct I Jeanie Miller 1 7(29/2025 9:37:24 AM (CDT) I Page 5 of 15 TMs certificate cancels and supersedes ALI, ire^vie�zsiy :issued cert.il:a,.oates. POLICY NUMBER: ISSUE DATE: I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • OF • OR •. PROVIDED This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: WHEN WE DO NOT RENEW (Nonrenewal): PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. Number of Days Notice: B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T3 20 051 ® 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 86463991 1 Master 25-26 GLALEXWC Poll Knorr Per Project I Jeacme Miller 17/29/iYC 5 9:37:24 AM (CDT) I Page 6 of 15 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: 10066448CA COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 011i ', ► • • 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. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". Page 1 of 1 86463991 1 Master 25-26 GLALEXWC Poll Knorr Per Project I ,Jeanie Miller 1 7/29f2025 9:37:24 AM (CDT) I Page 7 of 15 TM s certificate cancels and supersedes ALL previously issued certificates. PolicyNo.:ERACCC925 Oft A% Effective Date: 08/1 /2025 0..Azopun Endorsement No.: 29 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT — OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following coverages only: Section 1. COMMERCIAL GENERAL LIABILITY AND EMPLOYEE BENEFITS ADMINISTRATION Section 2 GENERAL POLLUTION LIABILITY Section 3 SITE POLLUTION INCIDENT LIABILITY SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations: Or Organization(s): Those required by written contract executed prior to a N/A loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section IV. 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, personal and advertising injury, environmental damage, emergency response cost, or clean-up cost 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to your work that is deemed completed in accordance with Section Vill. DEFINITIONS, paragraph 00. (Products -completed operations hazard). C. Notwithstanding Section VII. CONDITIONS, paragraph J. (Other Insurance), with respect to the insurance afforded to the additional insureds added by this Endorsement, this Policy shall be primary to, and non-contributory with, any other insurance available to that person or organization when required by written contract or agreement. All other terms and conditions of this Policy remain unchanged. ASPENV215 0917 2017 © Aspen Insurance U.S. Services Inc. All rights reserved. Page 1 of 1 86"'3991 1 Master 25-26 GLALEXWC Poll Knorr Per Proloct. I Jeanie Miller 1 7/29/202.: 9:37:24 AM (CDT) I Page 8 of 15 This certificate cancels and supersedes ALL ,prOWi USl.y issued certificates. Policy No.:ERACCC925 As pft 4 n Effective Date: 08/01/2025 Endorsement No.A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY NON-CONTRIBUTORY ENDORSEMENT It is hereby agreed that Policy is amended as follows: Schedule Name Of Additional Insured Person(s) Or Organization(s): Those required by written contract executed prior to a loss. Notwithstanding Section VII. CONDITIONS, J. Other Insurance, with respect to the insurance afforded to the additional insured(s) shown in the schedule above, this Policy shall be primary to, and non-contributory with, any other insurance available to that person or organization when required by written contract or agreement. This Endorsement shall not increase any applicable Limits of Liability shown in the Declarations. All other terms and conditions of this Policy remain unchanged. ASPENV219 0418 Page 1 of 1 2018 ©Aspen Insurance U.S. Services Inc. All rights reserved. Bl446,5991 I Master 25-26 GLALEXWC Poll Knorr Per Projeat I Jeanie Miller 1 7/29a""2(] 5 9:37:24 AM (CDT) I Page 9 of 15 This certificate cancels and supersedes ALL previously issued certificates. M�ru� I Policy No.: EIACCC925 Effective Date: 08/01/2025 Endorsement No.:14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADVICE OF CANCELLATION SCHEDULE ASPENV117GL1218A SCHEDULE Name & Mailing Address Of Person(s) Or Organization(s): ket where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Number of Days' Notice 30 day notice or 10 da s for non Payment of premium (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) If we cancel this policy for any reason, we will notify the persons or organizations shown in the Schedule above. We will send notice of cancellation to.the mailing address listed above at least the number of days listed above before the cancellation becomes effective. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date or negate cancellation of the policy. All other terms and conditions of this Policy remain unchanged ASPENV117 1117 2017 © Aspen Insurance U.S. Services Inc. All rights reserved, Page 1 of 1 86463991 1 Master 25-26 GLALEXWC Poll Knorr Per Projpct. I JaawnA e Miller 1 7/29/:2025 9:37:24 AM (CDT) I Page 10 of 15 This certificate cancels and supersedes ALL 'OreVic..au$ly issued certificates. PolicyNo.:ERACCC925 &Aspen Effective Date: 08/01 /2025 Endorsement No.: 26 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY ENDORSEMENT It is hereby agreed that the last sentence of Section VII. CONDITIONS, Paragraph O. Subrogation, is deleted in its entirety and replaced with the following: O. Subrogation However, if the insured has waived rights of recovery against any person or organization in a written contract or agreement prior to a loss, we also waive such right of recovery we may have under this Policy against such person or organization. All other terms and conditions of this Policy remain unchanged. ASPENV254 0917 Page 1 of 1 2017 © Aspen Insurance U.S. Services Inc. All rights reserved. B0,A i611991 I Master 25-26 GLALEXWC Poll Kivataarr Per Prop(=e„tl; I Jeanie Miller 1 7/291202144 9:37:24 AM (CDT) I Page 11 of 15 This, certificate cancels and supersedes ALL previous 1y issued certificates. WORKERS COMPENSATION �,LERS AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: UB-9W057283-25-43-G NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX - CONDITIONS: Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organiza- tion before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation. SCHEDULE Number of Name and Address of Designated Persons or Organizations: Days Notice As required by written contract 30 DATE OF ISSUE: - - ST ASSIGN: Page 1 of 3 © 2013 The Travelers Indemnity Company. All rights reserved. 86w463991 1 Master 25-26 GLALEXWC Poll Knorr Per Project II Jeanie Miller 1 7/29/2025 9:37:24 AM (CDT) I Page 12 of 15 This certificate cancels and supersedes ALL previously issued certificates. WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: Name and Address of Designated Persons or Organizations: DATE OF ISSUE: - - ST ASSIGN: © 2013 The Travelers Indemnity Company. All rights reserved. Number of Days Notice Page 2 of 3 86463991 1 Master 25-26 GLALEXWC Poll Knoi:.r Per Pro,�,iieCt I Jewi J.e Miller 1 7/29/2025 9:37:24 AM (CDT) I Page 13 of 15 This certificate cancels and supersedes ALL previously issued certificates. M � POLICY NUMBER: Name and Address of Designated Persons or Organizations: WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) Number of Days Notice All other terms and conditions of this policy remain unchanged. 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 Insured Insurance Company Policy No. DATE OF ISSUE: - - ST ASSIGN: 0 2013 The Travelers indemnity Company. All rights reserved. Countersigned by Endorsement No. Premium $ Page 3 of 3 86463991 1 Master 25-26 GLALEXWC Poll Knorr Per Project I Jeanie MLUar 1 7/2912025 9:37:24 AM (CDT) I Page 3.4 Of 15 This certificate cancels and supersedes ALL Oreviovsly issued certificates. �Y�°� WORKERS COMPENSATION �i AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 0313 (00)- POLICY NUMBER: UB-9W057283-25-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: DATE OF ISSUE: - - ST ASSIGN: B6461:991 I Master 25-26 GLALEXWC Poll I'4R'6orr Per Pro°pect I Jeanie Miller 17/29/2025 9:37:29 AM (CDT} I Page 15 of 15 T11is certificate cancels and supersedes ALL jg revaioU sly issued certificates.