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PROOF OF INSURANCE (2026 - 2026)DATE (MMIDD/YYYY) A4C7C>RV>< CERTIFICATE OF LIABILITY INSURANCE 01 /26/2026 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 Jackl n Yahla an Summit Partners Insurance Services 818-916-50......... 1 _... -- f'1ioIE Y Y ' NAME 95 �� �..�AX 818-484-3005 ..��..a_ �...,� rArd^. nrna: 2270 Douglas Blvd Suite 212 Roseville, CA 90815 INSURED GEM Construction Inc 6510 E Spring St Suite 941 Long Beach, CA 90815 dl= ICUTATC d11111A00O• air ss myanlay/anrow_summilagems,nel R1=VIRIr1NI 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. .. tt DDL:�u��, INSR.i ... ...... .................... ..L ......... POLICY.N ... ....._ffMMIDD.IYEFF LTR 4 .. ^. TYPE OF INSURANCE UMBER .PO ..................... .. __...... LIM......... POLICY EFF POLICY IE7CP MMI'DO�IYYYY � ITS COMMERCIAL GENE LIABILITY X RA L OCCURRENCE $ 000 EACH 1 000 .. ..._. — CLAIMS MADE OCCUR-,PREM Y5 rt I e5 I 0 SES,(Ea,occu,rrencej $ 0 5,0000......... MED EXP (Any one person) $ A Y Y GL202400016529 07/12/2025 07/12/2026 PERSONAL a ADV INJURY Is 2,000,000 ._ TE LIMIT APPLIES PER: GENERAL,AGGRELATE $ 2,000,000 GEN'LAGGREGA,,,,,,,,,,,,,,,,,,,,,,,,,,P PRO- LOC POLICY (iC JECT ,,...,.,. _ o........... ...____ ---._.. PRODUCTS -COMP/OP AGG $ 000 i 2 000 ...........,, ----- .......... ..COPW4'B1PWE'D OTHER AUTOMOBILE LIABILITY ' SINGLE: LIMIT 1 ar,,cidenl . $ 1,000,000 i ANY AUTO �XY ( person) i BODILY INJURY Per erson $ B I OWNED SCHEDULED Y J BA040000055182 AUTOS ONLY I X, AUTOS 10/07/2025 10/07/2026 BODILY INJURY (Per accident) $ -------- ...... HIRED CE AUTOS ONLY AUTOS ONELYrlAAAAac gip) $ UMBRELLA LIAB X OCCUR ff I EACH OCCURRENCE .$ 000 . C X EXCESS LIAR CLAIMS -MADE{ 1 � EZXS3122862 07/12/2025 07/12/2026 1,000,000 ATE $_ 1 AGGREGATE..", DEC RETENTION $ i r $ WORKERS COMPENSATION '" ' X PER 1 OTH Eft, D AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N MaOFFICER/MEMBER EXCLUDED? Mandatory in NH I NIA Y 9351480-2023 12/28/2025 12/28/2026 _ _STATUTE _ _ E.L. EACH ACCIDENT $ 1,000,000 EMPLOYEE�000 . 1,_E.L. f yes, describe under DESCRIPTION OF OPERATIONS below DISEASE- POLICY LIMIT $ 1,000 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "The City of El Segundo, its elected and appointed officials, employees, and volunteers as additional insureds." The City of El Segundo will receive thirty (30) days written notice in the event of cancellation, nonrenewed or reduction." CERTIFICA City of El Segundo 350 Main Street El Segundo, CA 90245 ILLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 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 (2016103) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Policy Number: GL202300016529 Endorsement Effective: 07/12/2025 12:01 a.m. Named Insured Countersigned By: GEM CONSTRUCTION INC W 4f a 4, -1 SCHEDULE Name of Person or Organization: Blanket where required by written contract Location: VARIOUS LOCATIONS THROUGHOUT CALIFORNIA (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions 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 site 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. C. The words "you" and "your" refer to the Named Insured shown in the Declarations. D. "Your work" means work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. 49-0108 07 11 May Include Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 1 Used with permission If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-insurance maintained by the above additional insured(s) shall be excess of the insurance afforded to the named insured and shall not contribute to it. Waiver If required by written contract or agreement: We waive any right of recovery we may have against an entity that is an additional insured per the terms of this endorsement because of payments we snake for injury or damage arising out of "your work" done under a contract with that person or organization. Page 2 of 2 © ISO Properties, Inc., 2000 49-0108 07 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Policy# GL2024400016529 COMMERCIAL GENERAL LIABILITY COVERAGE PART Insured: GEM Construction Inc SCHEDULE Name of_..�.���_ ..........�... �........�. �.._ ...._..,_ ......���.. ..�_�___ Additional Insured Persons or Organization(s) (Additional Insured): _ Location(s) of Coveredm.O reratigns cAll ontract personsor ororganizations as required by a writtenm Locations as required by a written contract or agreement with the named insured agreement with the named insured. 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations at Work "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. Negligence of Additional Insured "bodily injury" or "property damage" arising directly or indirectly out of the negligence of the additional insured(s). U156A-0313 Includes copyrighted material of ISO Properties, Inc., Page 1 of 2 with its permission. C. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance is amended and the following added: The insurance afforded by this Coverage Part for the additional insured required by a written contract or agreement with the named insured is primary insurance and we will not seek contribution from any other insurance available to that additional insured. D. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer Of Rights Of Recovery Against Others To Us is amended and the following added: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" if: a. you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED,. U156A-0313 Includes copyrighted material of ISO Properties, Inc., Page 2 of 2 with its permission.