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PROOF OF INSURANCE (2025 - 2026) CLOSEDb DATE (MM/DD/YYYY) ACDOREIII CERTIFICATE OF LIABILITY INSURANCE 11/07/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION', ONLY AND CONFERS NO RIGHTS UPON THIN 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°, It the certificate holder is an ADDITIONAL INSURED, the polic)I(ies) must have ADDITIONAL INSURED provisions or be endorsed. It SUBROGATION IS WAIVED, subject to the terns 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). CONTACT PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX HOME OFFICE: BOX 328 •M mm TERcFED1NS COM �664 HOME O OFFICE: E: P.O..O. B D/C, No,ExIl 888-333-4949 _ (A/c No) 507-44 DRESS CLIENTCONTACTCEN INSURERS AFFORDINGCOVERAGE VERAGE NAIC # INSURERA.FEDERATED MUTUAL N INSURANCE COMPANY 13935 _. ...... ..._ _..... INSURED INSURER B: ____ C J CONCRETE CONSTRUCTION, INC. 10142 SHOEMAKER AVE INSURER c: SANTA FE SPRINGS, CA 90670-3404 INSURER D: INSURER E __ ....,m.......,,,., ........ .........� ..... INSURER F COVERAGES CERTIFICATE NUMBER: 196 REVISION NUMBER: 0 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 rDL SK'/BR "-""-POLICY NUMBER LTR dNSR 1NYV0 Y EFF w, POLICY EX'P S POLIO- LIMIT (MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE .,_ ITITITIT $1,000,000 .......... DAMAGE TO RENTED PREMISES $100,000 CLAIMS -MADE X OCCUR (Ea occurrence) _.... ._............. .._........... MED EXP (Any one person) $10,000 A Y Y 1845023 11/12/2025 11/12/2026 PERSONAL & ADV INJURY $1 000I000 GEN L AGGREGATE LIMIT APPLIES FE.R�.... """""" ""' GENERAL AGGREGATE _ $2 000,000 POLICY - LOC � �.... O DUCTS & COMPIOP ACC PR... $2 00O 000 r-.mm EC• OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1 O00 OOO X ANY AUTO BODILY INJURY (Per Person) .... . A OWNED AUTOS ONLY]SO-LDULED Y Y 1845023 11/12/2025 11/12/2026 BODILY INJURY (Per Accident) AU ros AUTOS ONLYNI 11691 11d 1CT A7.lTd5: OM11.."/ PPRQ PAECRRTY'SAMAOE .I�._._..." ......_.. .......HIRED ._._ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE ..� ..... $8 000,000 _._.. A EXCESS LIAR CLAIti1S-MADE Y Y 1845025 11/12/2025 11/12/2026 AGGREGATE .� ....- .. ...,,,,�, $8 00 OOO OOO .... OED RETENTION WORKERS COMPENSATION PER STATUTE THER AND EMPLOYERS' LIABILITY YIN ---- "- ANY PROPRIETORIPARTNERI EXECUTIVE E.L EACH ACCIDENT -OFFICER IMEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE EA EMPLOYEE 11 yes, describe under .DESCRIPTION OF OPERATIONS below ........_. E.L DISEASE • POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY CLERK CITY OF EL SEGUNDO 196 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 350 MAIN ST EL SEGUNDO, CA 90245-3813 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID LOC # -•-''" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 ._,.. ........._.... .. ._....._.. _..._�.. .. .............. _. NAMED INSED ......,...,, IAGENCY FEDERATED MUTUAL INSURANCE COMPANY C J CONCRETE CONSTRUCTION, INC. POLICY NUMeERa�......._,..............�.�.� —� w....................., ,.. 10142 SHOEMAKER AVE SANTA FE SPRINGS, CA 90670-3404 SEE CERTIFICATE # 196.0 ..CAR RIE..,...-......�........................�....... ....... ....,,,_. .. ._.�_-. .... ....... ..... R NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 1960 CERTIFICATE # 196.0 SEE CERTI._ _ _. _._._ ..........- ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: C9,RTIFIC_.,IEEPE,,,,,,,I, A I_I 1.X IN.$WRANCE PROJECT *25-10 RE: FY25-26 CONCRETE IMRPOVEMENTS PROJECT, EL SEGUNDO, CA 90245-3813 CONTRACTUAL LIABILITY COVERAGE FOR LIABILITY FOR DAMAGES ASSUMED IN A CONTRACT OR AGREEMENT THAT IS AN "INSURED CONTRACT" IS PROVIDED PER THE CO 00 01, COMMERCIAL GENERAL LIABILITY COVERAGE FORM. SUBJECT TO THE TERMS ,AND CONDITIONS OF THE POLICY,, ADDITIONAL INSUREDS ALSO INCLUDES THE CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY, WAIVER OF SUBROGATION ALSO INCLUDES < > 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 GENERAL LIABILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED OWNER'S, LESSEES,, OR CONTRACTORS - COMPLETED OPERATIONS ENDORSEMENT. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. INSURANCE PROVIDED BY THE BUSINESS AUTO LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. GENERAL LIABILITY CONTAINS A WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC ENDORSEMENT BUSINESS AUTO LIABILITY CONTAINS A WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER SUBJECT TO THE CONDITIONS OF THE BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY ENDORSEMENT. GENERAL LIABILITY COVERAGE CONTAINS CG 25 03 DESIGNATED CONSTRUCTION GENERAL AGGREGATE LIMIT ENDORSEMENT APPLICABLE TO EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. ACORD 101 (2008l01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION 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 01 12 19 Policy Number: 1845023 Transaction Effective Date: 11/12/2025 COMMERCIAL GENERAL LIABILITY CG 24 53 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 2453 12 19 Policy Number: 1845023 Transaction Effective Date: 11/12/2025 POLICY NUMBER: 1845023 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Each construction project as required by written contract or written agreement. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I - Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I - Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate Limit. expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally C. obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical D. expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General E. Aggregate Limit. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 Federated Mutual Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED AMENDMENT OF CANCELLATION PROVISIONS All Coverage Parts included in this policy are subject to the following conditions: If we cancel this policy, we will mail advance notice to the person(s) or organization(s) as shown in the Schedule. SCHEDULE Insured: C J Concrete Construction, Inc. 10142 Shoemaker Ave Santa Fe Springs, CA 90670-3404 Includes copyrighted material of Insurance Services Office, Inc., with its permission. IL-F-50 (04-13) Policy Number: 1845023 Transaction Effective Date: 11/12/2025 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION 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". © Insurance Services Office, Inc., 2016 Page 1 of 1 CA 04 49 11 16 Policy Number: 1845023 Transaction Effective Date: 11/12/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto" with your permission. However, this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss" which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented "auto" or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-127 (03-03) Policy Number: 1845023 Transaction Effective Date: 11 /12/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. In the event of any payment for a loss under this Business Auto Coverage Part arising out of your ongoing operations, we agree to waive our rights under the TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US condition against any person or organization, its subsidiaries, directors, agents or employees, for which you have agreed by written contract, prior to the occurrence of any loss, to waive such rights, except when the payment results from the sole negligence of that person or organization, its subsidiaries, directors, agents or employees. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-128 (03-03) Policy Number: 1845023 Transaction Effective Date: 11/12/2025 " — - @p DATE (MM/DD/YYYY) ACC► " CERTIFICATE OF LIABILITY INSURANCE 11/6/2025 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 CONTACI NAME: Behr Insurance Services Inc. A/c No, Ext : 888-988-2347 _ (AIC, No)! AG DRESS. scrvicc(cc(bchrins.eom 1420 E Los Angeles Ave #203 INSURER(S) AFFORDING COVERAGE NAIC # Simi Valley CA 93065 INSURER A : COREPOINTE INS CO 10499 INSURED INSURER B r CJ Concrete Construction Inc INSURER C : 10142 SHOEMAKER AVE INSURER D : INSURER E ; INSURER F o SANTA FE SPRINGS CA 90670-3404 COVERAGES CERTIFICATE NUMBER: REVISION NUMIitK: 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. LTR TYPE OF INSURANCE 1NSD WVD POLICY NUMBER (MMIDD(YYYY) MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ (CLAIMS -MADE DOCCUR PREMISES IE.aocrur'rencc: $ MED EXP (Any one person) $ '.. PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ mm GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG � $ PRO- POLICY ❑ J;E''O_ ❑ LOC ''.OTHER: I $ AUTOMOBILE LIABILITY _ (', �, , ac�clddrnR.S X 'LE UMI $ BODILY INJURY Per person) $ ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY - (Pker avccidrsnM1�,''II"1 .. $ ..... $ I LIAR OCCUR EACH OCCURRENCE $ ''.EXCESSLIAB CLAIMS -MADE AGGREGATE $ rUMBRELLA —.1DED RETENTION $ $ ORKERS COMPENSATION ND EMPLOYERS' LIABILITY NY PROPRIETOR/PARTNER/EXECUTIVE �Y / N A OFFICER/MEMBER EXCLUDED? L ` N / A Y CTP1003801 05/08/2025 05/08/2026 :Mandatory in NH) '-'w' X .STATUTE ER E.L EACH ACCIDENT Is -' E.L. DISEASE - EA EMPLOYEE $ 1,000,000 1,000,000 I yes, describe under )ESCRIPTION OF OPERATIONS below E..L.. DISEASE -POLICY LIMIT $ 1,000,000 ---- DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project Full Name: FY25-26 CONCRETE IMRPOVEMENTS PROJECT Waiver of subrogation (WC 04 03 06) applies to workers compensation only if an executed written contract explicitly requires these specific endorsements. Coverage subject to policy terms and exclusions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ofEl Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE J&-4h a_ Bzkr El Segundo, CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD a I DATE (MM/DD/YYYY) A,;CC",,,"'�" CERTIFICATE OF LIABILITY INSURANCE 11/5/2025 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 prllicy(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 NAMEt Behr Insurance Services Inc. PHONE No Ex1 a 888-988-2347 (A1C, NoY, 1420 E Los Angeles Ave #203 ADDRESS s irv'ice@,behrins-co m INSURER(S) AFFORDING COVERAGE NAIC # Simi Valley CA 93065 INSURER A: COREPOINTE INS CO 10499 INSURED INSURER B : CJ Concrete Construction Inc INSURER C : 10142 SHOEMAKER AVE INSURER D : INSURER E : SANTA FE SPRINGS CA 90670-3404 INSURER F ......._.... _ «...."..»..,......«.mm-� .,,,...,�.,. RFVICIr1N NI IIMVfRf.�° -. STED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS PTO CERTIFY" THAT THE POLICIES OF INSURANCE E , LISTED 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. —POLICY EFF N TYPE OF INSURANCE INN WVD POLICY NUMBER IfnM owyYYY) (MMdOOdYYYY) LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISE'S (Ea oc Wreirr.0) $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ POLICY JPE LOC AUTOMOBILE LIABILITY Ea acdden4) I $ ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) -°^^•�^^'^' ( Pir accbdcwott) YVV $ $ OWNED 'SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED .AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE ''. $ AGGREGATE $ 'EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ UARERS COMPENSATION X STATI iTE', ER A AND EMPLOYERS' LIABILITY Y / N lVYf'F^OPRVE'TORIPAR'tNERPEXFCUTIVE FFIC£R)MEMBER EXCLUDED? �Y (Mandatory In NH)and ttl yyes, describe under DESCRIPTION OF OPERATIONS below N / A Y CTP1003801 05/08/2025 05/08/2026 E.L.EACHACCIDENT $ 1,000,000 $ 1,000,000 � EL. DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of subrogation (WC 04 03 06) applies to workers compensation only if an executed written contract explicitly requires these specific endorsements. Coverage subject to policy terms and exclusions. CERTIFICATE HOLDER UAINLAZLL 11 i4. M 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 Jo..afk&- Be,r El Segundo, CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Any person or organization as required by written contract Job Description Notes: 1. This endorsement may be used to waive the company's right of subrogation against named third parties who may be responsible for an injury. 2. The sentence in ( ) is optional with the company. It limits the endorsement to apply only to specific jobs of the insured, and only to the extent that the insured is required to obtain this waiver. 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 Policy No. Endorsement No. Insured Insurance Company Countersigned By