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PROOF OF INSURANCE (2014) CLOSEDACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD,YYYY' 03/26/2013 THIS CERTIFICATE 15 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. I O TAN If Me Zertiftals 11000F G an ADDIT INSURED, the pOIICy(les) must be endorsed. It SUBR-06-A-Ti-o-N-i-s-vv-A-iVE-E)-, su )ect 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 NAME" Brennan 8t Associates 800.509.6452 _' No � : , �Iu 562.429.6313. License # 0649629 E ADDRESSs 5001 Airport Plaza Dr. ;#125 INSIIRER(S) AFFORDING COVERAGE Long Beach, CA 90815 I,NSMRERA, Everest Indemnity Insurance ~ Co C Nat a INSURED Krause ACT, Inc. INSURERS! Republic Underwiters Ins. Co. dba: Air Cleaning Technology INSURER c;, Peerless Insurance Company 411 Rowland Ave INSURER D: Santa Ana, CA 92707 INSURER E, .. .... INSURER F s COVERAGES CERTIFICATE NUMBER: 2013 -2,014 GL/Ex Renewal REVISION NUMBER: `I'H1 a IS TO CERTIFY THAT THE POLICIE S OF I S RANCE LISTED SE!LO AVE BEEN ISSUER TO THE INSU'REO NAMED ABOVE FOR POLICY PE IOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 REDUCER BY PAID CLAIMS, LTR TYPE OF INSURANCE INSR WVO POLICYNUMBER M p P NImebl'ti'Y LnnTS OENERAL LIABILITY EF4ML01$69 -13 03/3012013 0313012014' EACH OCCURRENCE $ 1,000q0 ,0 E I C1'NEN "il D .. �_. X COMMERCIAL GENERAL LIABILITY PREMISES Ea f39:C4�rian�p $ 5U, OOO CLAIMS MADE �X OCCUR MED EXP (Arty one Person) S 5 , 0O0 A m!ERSONAL 8 ADV INJURY GENERALAGGREGATE S 2,000,000' GEN'L AGGREGATE LIMIT APPLIES PER: POLCY X PRODUCTS - COMP /OP AGG S 2 0OO , O00 JprgOT.- LO,C _ a - AUTOMOBILE LIABILITY t acc(denl s ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY (Par accident) S AUTOS AUTOS WNEO -{ er ax ent { HIRED AUTO 6 g UMSREL.LA LIAR I X OCCUR EF EACH OCCURRENCE $ 41000,000 4C000190 -13 03/3012013 03130!2014 A X EXCESS LIAR CLAIMS MADE AGGREGATE S 4 000, 00 DED X !RETENTION$ IO�,OO. $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN L EACH ACCIDENT mm ER ANY PItOPRIETOIidP,�RTNERIEXECU�rIV ATW00179 0 0110112013 01/01/2014 X„ m �� B OFFICEWMEMBEREXCLUDED? � NIA E• 5 1.000.009 ll�andatorr In NH) -.-.- ..�._m_._...._ �... E.L. DISEASE - EA EMPLOYE S 1,000,000 III�ran dew1be under _ 0 SCRIPTIONOFOPERATIONShelow E.LDISEASE - POLICY LIMIT 5 1 000, 0100 Employee Dishonesty CBP811S437 02/01/2013 0210112014 250,000 Limit _.., C Coverage DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES Attach ACORD 101, Additional mm ( nal Rsmarka schedule, Irmoro space is required) E: El Segundo Fire Department, 314 Main Street, El Segundo, CA 90245. The City of El Segundo is included as Additional Insured with regard to General Liability per attached forms CG 20 10 07 04 and G 20 37 10 01. Waiver of Subrogation applies to Workers' Compensation per attached form WC 04 03 06. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ( THE E"IRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo �. Attn : City Clerk! AUTHORIZED REPRESENTATIVE Ilk 350 Main Street E1 Segundo, CA 90245 Greg Havill ®1050 -2010 ACORD CORPORATION. All rights ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: EF4ML01869 -131 COMMERCL4L GENERAL LIABILITY CG 20 37 10 01 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREPULJ_y. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies Insurance provided underthefollowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organlzatlon: Blanket where required by written contract. Location And Description of Completed Operations: Blanket where required by written contract Additional Premium: Included (if no entry appears above, Information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section Ii — Who Is An Insured Is amended to include as an Insured the person or organization shwvn in the Schedule, but only with respect to liability arise out of "your work "" at the lecallon designated and described in the schedule of this endorsement performed for that insured and Included in the "products- completed operations ha- zard". CG 20 3710 01 �A 0 r c. " 0 © ISO Properties, Inc., 2000 Page 1 of 1 0 POLICY NUMBER: EF4ML01869-131 COMMERCIAL GENERAL LIABILITY CG 20 10,07 04:-' ti THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT GAREFULLY, ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS -- SC "HEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or antatlon s : Blanket where required by written contract. this Schedule, If not Aµ Seftton Il — Who Is An Insured is amended to include as an additional insured the person(s) or organl ation(s) shown in the Schedule, but only with respect: to liability for "bodily Injury ". "property damage " or "personal and advertising Injur' 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) desig- nated above. CG 20 10 07 04 z, 10 Loll the Declarations. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily Injury" or "property damage" occurring after: 1. All work, including materials, part,, or equip. rnont furnished. In connection +with such worm,, on the project (other than service, maintenance or repairs) to be ' performed by or on behalf of tha additional Insured(s) at the location of the covered operatlons has`been completed; or Z That portion of " "your work "" out of which the Injury or damage arises has been put to its In- tended use. by any person or orgahl ation other than another contractor or subcontractor- an- gaged in perforrning operations for a principal as a part of t same project, © ISO Properties, Inc., 2004 Page 1 of 1 13 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4-84 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury coered 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 tb obtain this agreement, korn 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 2,5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation As respects to all CA jobs performed by the named insured during the policy period where by written contract a waiver of subrogation is required prior to the commencement of work. This endorsement changes the policy tow hick It Is attached and Is effective on the date t s red unisS otherwise stated (The Inform atlon be tow is required only when this endorsement I su "quent to preparation of the policy.) 1^ Endorsement Elf active 01 -01 -2013 Policy No. ATW 001779 -00 �t Endorsement No. 1 Insured Insurance Company Krause ACT, Inc. (A Corp) Republic Underwriters Insurance Company Countersigned By ©1998 by the Workers' Compensation Insurance Rating Bureau of California, All rights reserved. V °e r r 'm m n "? e M r K STATE FARM INSURANCE COMPANIES® 900 Old River Road Bakersfield CA 93311 -9501 130A AT1 23 001337 0093 CITY OF EL SEGUNDO ATTN: CITY CLERK 350 MAIN ST EL SEGUNDO CA 90245 -3895 A DATE OF NOTICE: MAR 20 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 391 3576 - 001 -75J COVERAGE: KRAUSE A C T YR /MAKE /MODEL: NONOWNED AUTO BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: $ 1 MIL 411 ROWLAND AVE AGENT NAME: JOHN MONSON $250 DED. COMP/COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE 6164DL 61650P MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This polioy shown above supersedes polioy# 3913576 -751. The policy includes a loss payable clause protecting the additional insured's interest in the desoribed oar to the e)dent of the insurance provided and subject to all policy provisions. The additional insured will be given 20 days notice if the policy Is terminated. Until suoh notice is provided, It shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void, FRT I& i; r m M com Fe vi I� u� o ^° ^• STATE FARM INSURANCE COMPANIES® IMfUPMCs 900 Old River Road Bakersfield CA 93311 -9501 80A AT1 23 001010 0093 CITY OF EL SEGUNDO ATTN: CITY CLERK 350 MAIN ST EL SEGUNDO CA 90245-3895 w # A DATE OF NOTICE: MAY 13 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 8186 -FA64M NAMED INSURED: POLICY NO: 391 3576- C01 -75K COVERAGE: T YR /MAKE /MODEL: NONOWNED AUTO BI AND PD LIABILITY DBA I R 01-EANING TECHNOLOGY VIN /CAMPER: $ 1 MIL 411 ROWLAND AVE AGENT NAME: JOHN MONSON $250 DED. COMP/COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE 6164DL 61650P APR 03 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 3913576 -75J. The policy includes a loss payable clause protecting the additional insured's interest In the described car to the extent of the insurance provided and subjeot to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT co 0 0 0 0 m 0 s L STATE FARM INSURANCE COMPANIES`9 44 900 Old River Road Bakersfield CA 93311 -9501 79A AT1 23 001033 0093 CITY OF EL SEGUNDO CITY CLEARK 350 MAIN ST x EEL SEGUNDO CA 90245 -3895 DATE OF NOTICE: JUL 03 2013 CODE: 84686 NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. ADDITIONAL INSU ED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 8186- FA64 -M NAMED INSURED: POLICY NO: 397 2175- C01.75E COVERAGE: o KRAUSE A C T YR /MAKE /MODEL: 2012 MERCEDES UTILITY BI AND PD LIABILITY N DBA AIR CLEANING TECHNOLOGY VINIXAMPER: WDAPF3CCOC9506211 $ 1 MIL 100 DED. COMP. .- 411 ROWLAND AVE AGENT NAME: JOHN MONSON 1000 DED. COLL. > SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE o JUN 12 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes polioyli' 3972175 -75D. R The policy inoludes a loss payable clause protecting the additional insured's interest in the described oar to the e)dent of the insurance provided and subjeot to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notoe is provided, it shall be presumed that the required renewal premiums have been paid. The additional Insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this polioy null and void. tn 0 M T FRT a °o N a m R_ ti 0 M T STATE FARM INSURANCE COMPANIES® IHfVP11MC 900 Old River Road Bakersfield CA 93311 -9501 91A AT1 23 000889 0093 CITY OF EL SEGUNDO CITY CLEARK 350 MAIN ST EL SEGUNDO CA 90245 -3895 A COVERAGE DATE OF NOTICE: JUL 01 2013 CODE: 84686 NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 8186- FA64•M NAMED INSURED: POLICY NO: 401 0032 - 001 -75F COVERAGE: KRAUSE A C T YR /MAKE/MODEL: 2004 DODGE UTILITY BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: WD1 PD444X45684798 $ 1 MIL $100 DED. COMP, 411 ROWLAND AVE AGENT NAME: JOHN MONSON $500 DED. COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE JUN 12 2013 UNTIL TERMINATED POLICY MESSAGES: This polloy shown above supersedes polioy* 4010032 -75E. The policy includes a loss payable clause protecting the additional insured's interest in the desoribed oar to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of Interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT 00 c� 0 0 cli 0 s et r m m o� Is w 0 M r A STATE FARM INSURANCE COMPANIES® 900 Old River Road Bakersfield CA 9331 1 -9501 52A ATE 23 000752 0093 CITY OF EL SEGUNDO ATTN: CITY CLERK 350 MAIN ST EL SEGUNDO CA 90245 -3895 A DATE OF NOTICE: JUL 15 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 8186- FA64•M NAMED INSURED: POLICY NO: 391 3576 - 001 -75L COVERAGE: KRAUSE A C T YR /MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: $ 1 MIL COMP/COLL. 411 ROWLAND AVE AGENT NAME: JOHN MONSON $250 DED. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE 6164DL 61650P SEP 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 3913576 -75K. The policy includes a loss payable clause protecting the additional insured's interest in the described oar to the extent of the insurance provided and subjeot to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT ACORDTM CERTIFICATE OF LIABILITY INSURANCE °09 /20/202' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION John Monson ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE State Farm Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 30131 Town Center Dr, Ste 275 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Laguna Niguel, CA 92677 INSURERS AFFORDING COVERAGE NAIC # ,... ..�.. .... ..,.._.. . _ , ..,,_...... INSURER A: State Farm Mutual .. ...... - °___ _...,........ .- - -.., .. INSURED al Automobile Insurance Company 25178 25178 Krause ACT DBA Air Cleaning Technology " "m "' 11 Rowland Ave, INSURER B: SantaAna, CA 92707 INSURER.. R .............. ...... _......................,..... w........,......................... ......... ---- . ........... _. '.... INSURER D: h '.. INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .............µ..,... -- ........... .... .,., ... ................... .......OLICY.i��'F'C'PdVE POLIC"lW7CF"IRATIY... YI-TR �D ,........... ......,w..,__ _ ......_ POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ - bAWA69- 'TOA#RTtG " ......... .m COMMERCIAL GENERA CO L LIABILITY PREMISE E e' L�9 enon�......$..,. $ CLAIMS MADE OCCUR n ''.. MED E A one ers ..._.... ._.._......... ............................... _..........,..,...,,,a.n,.,�..m PERSONAL & ADV INJURY ................... ....... ............................... GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG '.... $ .,. ... F'OL.IOY PRO- LOC X AUTOMOBILE LIABILITY 3090552- C01 -75G 09/0112012 09/01/2013 COMBINED SINGLE LIMIT 1,000,000.00 ANY AUTO 309 3182 -001 -75G �Ea.. accident) .... ..............---- ...--- - - - - - .$.............�__ - - -_ ....,_........ +� X ALL OWNED AUTOS 3791976- C01 -75B BODILY INJURY SCHEDULEDAUTOS 3835032 -001 -75B (Per person) $ HIRED AUTOS 391 3576- C01 -75C ...,..w...... ... LL _.. _._._. „, BODILY 401 0032- C01 -75A P accident) 266 5524- CO1 -75J r ........... .........................,..-._„,..._ ...- _. .............. ._.......... .'.....2843100'C01-75H PROPERTY DAMAGE $ (Per accident) GAt AOF UABIUTY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ -�.. - ,...��......_. AUTO ONLY: AGG $ EXCESSIUMBREL,LA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE ''. AGGREGATE '.. DEDUCTIBLE $ RETENTION $ $ WC STATU- 01H - WORKERS COMPENSATION AND .Tt,RXIMl,TS.. ...E.id.._ ........... EMPLOYERS' LIABILITY E.L. EACH ACCIDENT .. $ ANY PROPRIETOR/PARTNER/EXECUTIVE _ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE ... $� If yes, describe under ,........ .... .... ...... . ..................... ....,.... ....... .._. SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Comprehensive deductible: $100; Collision deductible: $500 City of El Segundo is named as additional insured City of El Segundo Attn: City Clerk 350 Main Street r EI Segundo, CA 90245 -0989 CANCELLATION SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE John Monson by Katherine B ACORD 25 (2001108) C ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) SrR� @dRM STATE FARM INSURANCE COMPANIES@ IK4UWAMf! ta 900 Old River Road Bakersfield CA 93311 -9501 108A AT1 23 A 009324 0093 CITY OF EL SEGUNDO, ATTN: CITY CLERK W1 350 MAIN ST EL SEGUNDO CA 90245 -3895 a g r m z m u�tiu� 0 DATE OF NOTICE: APR 17 2013 CODE: • �c c-r c r State Farm Mutual Automobile Insurance Company 8186- FA64.M NAMED INSURED: POLICY NO: 128 2942-.001 COVERAGE: KRAUSE A C T YR /MAKE /MODEL: 2005 DODGE VAN M AND PD LIANLITY DBA AIR CLEANING TECHNOLOGY VIN / CAMPER: W132PD644655750157 1 M@1Il_ 050 u��: 411 ROWLAND AVE AGENT NAME: JOHN MONSON 500 IA. ` a�� of fl) a::i"�d�.,i -. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE MAR 07 2013 UNTIL TERMINATED POLICY MESSAGES: This laodioy shown above supersedes polloy 1282942.75W. The pohoy Inoltades a loss payable claarse proteollng the acddlflonat Insured's Interest In the desorl'laed oar to the extent of the Insuranoe provided and subjeot to all podloy provisions. The additional Iasarred will be given 20 days nolloc If the polioy Is torn,llnated, Until such notice Is provided, it shall be presumed that the required renewal pren�unas have been Paid. The additional i noured nwet nohfy us within 10 days of ap y otaan a of lnte at or ownersltlp ooaxntra0 to dhein° akteu�honw Fall ure to do so will render this polloy nutll and void. 0 0 c� 0 0 ca s s ASTATE FARM INSURANCE COMPANIES@ 900 Old River Road Bakersfield CA 93311 -9501 166A AT1 23 A 001561 0093 CITY OF EL SEGUNDO ATTN: CITY CLERK MAIN ELOSEGUNDOTCA 90245 -3895 N <� j1 [oil o two DATE OF NOTICE: FEB 28 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 252 6913 - 001 -75P COVERAGE: KRAUSE A C T YR /MAKE /MODEL: 2006 DODGE STAKE BI AND PD LIABILITY DBA AIR CLEANING TH L VIN /CAMPER: WDXPD844965932054 $ 1 MIL $100 DED. COMP. 411 AVE AGENT NAME: JOHN MONSON $1000 DED. COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT (40: 6028BU POLICY EFFECTIVE MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 2526913 -750. The policy includes a loss payable clause protecting the additional insured's Interest in the described oar to the extent of the insurance provided and subject to all policy provisions. The additlonal insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. ,ADDITIONAL INSUREDS NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 3791976-C)01-75E COVERAGE: KRAUSE A C T DBA AIR CLEANING TENCHOLOGY 411 ROWLAND AVE SANTA ANA CA 92707 -3445 YR /MAKE /MODEL: 2011 MERCEDES UTILITY VIN /CAMPER: WDAPF3004B9478265 AGENT NAME: JOHN MONSON AGENTT PHQ1(E: (949)495.2515 ENDORSEMENT NO: 6028BU BI AND PD LIABILITY $ 1 MIL $100 DED. COMP. $1000 DED. COLL. POLICY EFFECTIVE MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 3791976 -75D. The policy includes a loss payable clause protecting the additional insured's Interest in the described oar to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. m ADDITIONAL INSU;R' Db'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 128 2942 - 001 -75W COVERAGE: KRAUSE A C T YR /MAKE/MODEL: 2005 DODGE VAN BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: WI)2P1 6"655750157 $ 1 MIL 411 ROWLAND AVE AGENT NAME: JOHN MONSON $100 DED. COMP. $500 DED. COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495.21115 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 1282942 -75V. The policy includes a loss payable clause protecting the additional Insured's interest in the described oar to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of 9 any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. MFFIT T °n• °• STATE FARM INSURANCE COMPANIES® INSUII�MCS 900 Old River Road Bakersfield CA 93311 -9501 163A AT1 23 A 001579 0093 CITY OF EL SEGUNDO ATTN: CITY CLARK cc-Wk MAIN PAK ELOSEGUNDOTCA 90245 -3895 8 0 Y H 0 0 DATE OF NOTICE: FEB 28 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 383 5032 - 001 -75E COVERAGE: KRAUSE A C T YR /MAKE/MODEL: 2001 FORD PICKUP BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: 1 FDWF36S91 EA78814 $ 1 MIL $100 DIED, COMP. 411 ROWLAND AVE, AGENT NAME: JOHN MONSON $500 DED. COLL, SANTA ANA CA. 9P707-3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes polioy# 3835032 -75D. The policy includes a loss payable clause protecting the additional insured's interest in the desoribed oar to the e)dent of the insurance provided and subject to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any ohange of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT 9 .tit V 0 r m m co P A co o r 900 Old River Road Bakersfield CA 93311 -9501 57A AT1 23 001147 0093 CITY OF EL SEGUNDO ATTN: CITY CLERK 350 MAIN ST EL SEGUNDO CA 90245 -3895 "j DATE OF NOTICE: NOV 06 2012 CODE: r,- .. 1110 . State Farm Mutual Automobile Insurance Company 8186 F4 6- NAMED INSURED: POLICY NO: 391 3576- COl -75F COVERAGE: KRAUSE A C T YR /MAKE /MODEL: NONOWNED AUTO BI AND PD LIABILITY $ 1 MIL DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: 411 ROWLAND AVE AGENT NAME: JOHN MONSON $250 DED. COMP/COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028AU POLICY EFFECTIVE 6164RR 6165AA NOV 01 2012 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 3913576 -75E. The policy includes a Noss payable clause protecting the additional insured's interest in the described car to the extent of the insurance provided and: subject to all policy pr °ovlsions4 The additional 'insured will be given 20 days rlotroe it the policy is terminated. Until such notice r, -wider, it shall be presumed that the requIred renewal premiums have been paid, The additional insured must nobly us within 10 days of autge of interest or ownership ooniirl0 to their attention.. Failure to do so will render this polloyd null and void, FRT STATE FARM INSURANCE COMPANIES® 900 Old River Road Bakersfield CA 93311 -9501 99A AT1 23 001307 0093 CITY OF EL SEGUNDO ATTN: CITY CLERK �;• 1 350 MAIN ST 1��5r�� EL SEGUNDO CA 90245 -3895 co 0 c� 0 0 s A DATE OF NOTICE: FEB 05 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. ADDITIONAL INSUREDS NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 391 3576 - 001 -75H COVERAGE: a BI AND PD LIABILITY o KRAUSE A C T YR /MAKE /MODEL: NONOWNED AUTO N DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: $ 1 MIL 411 ROWLAND AVE AGENT NAME: JOHN MONSON $250 DED. COMP/COLL. a SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO. 6028AU POLICY EFFECTIVE 6164RR 6165AA JAN 15 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy* 3913576 -75G. cA The policy includes a loss payable clause protecting the additional insured's interest in the described oar to the e)dent of the insurance n provided and subject to all policy provisions. The additional Insured will be given 20 days notice if the policy is terminated. Until such notice ai is provided, It shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of P4 any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. e FRT co 0 O 0 U) O STATE FARM INSURANCE COMPANIESQ' 900 Old River Road Bakersfield CA 93311 -9501 164A AT 1 23 A 001580 0093 CITY OF EL SEGUNDO ATTN: CITY CLEARK 350 MAIN ST EL SEGUNDO CA 90245 -3895 ji ADDITIONAL NOTICE DATE OF NOTICE: FEB 28 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. State Farm Mutual Automobile Insurance Company 81 136+416-M NAMED INSURED: POLICY NO: 397 2175- C0l -75D COVERAGE: KRAUSE A C T YR /MAKE /MODEL: 2012 MERCEDES UTILITY BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: WDAPF3000C9506211 $ 1 MIL $100 DED. COMP. 411 AVE AGENT NAME: JOHN MONSON $1000 DED. COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 3972175 -750. The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance provided and subjeot to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT I a °o ev r 'm a m cc ti o co r INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: i ! ! 401 0032- COl -75D El KRAUSE A C T YR /MAKE /MODEL: DATE OF NOTICE: NOV 06 2012 BI AND PD LIABILITY 900 Old River Road VIN /CAMPER: CODE: $ 1 MIL $100 DIED. COMP. Bakersfield CA 93311-9501 AGENT NAME: JOHN MONSON $500 DED. COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 58A AT1 23 A POLICY EFFECTIVE 001148 0093 CITY OF EL SEGUNDO \ NOTE: PLEASE NOTIFY STATE FARM AT THE ATTN : COUNTY CLERK ADDRESS LISTED AT THE TOP LEFT CORNER 350 MAIN ST OF THIS PAGE REGARDING ANY CHANGE OF EL SEGUNDO CA 90245- 3895 ADDRESS INFORMATION. I a °o ev r 'm a m cc ti o co r INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 8186- F416 -M NAMED INSURED: POLICY NO: 401 0032- COl -75D COVERAGE: KRAUSE A C T YR /MAKE /MODEL: 2004 DODGE UTILITY BI AND PD LIABILITY DBA AIR CLEANING TECHNOLOGY VIN /CAMPER: WDi PD444X45684798 $ 1 MIL $100 DIED. COMP. 411 ROWLAND AVE AGENT NAME: JOHN MONSON $500 DED. COLL. SANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT O: 6028AU POLICY EFFECTIVE NOV 01 2012 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes polioy# 4010032 -750. The policy inoludes a loss payable clause protecting the additional insured's Interest in the desoribed oar to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice is — avided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of ange of interest or ownership ooming to their attention. Failure to do to will render this policy null and void. FRT 8 0 s s ;1 R in N 0 ca • °' ^•� STATE FARM INSURANCE COMPANIES`W 900'Old River Road Bakersfield CA 93311 -9501 166A AT1 23 001502 0093 CITY OF EL SEGUNDO ATTN: COUNTY CLERK MAIN ELOSEGUNDOTCA 90245 -3895 A DATE OF NOTICE: FEB 28 2013 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. ADDITIONAL INSUR E "S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 81,86- F416 -M NAMED INSURED: POLICY NO: 401 0032- C01 -75E COVERAGE: KRAUSE A OT YR /MAKE/MODEL: 2004 DODGE UTILITY BI AND PD LIABILITY RA AIR CLEANING TECHNOLOGY VIN /CAMPER: WD1 PD444X445684798 $ 1 MIL C 411 ROWLAND AVE AGENT NAME: JOHN MONSON $100 DED. COMP. $500 DED. COLL. BANTA ANA CA 92707 -3445 AGENT PHONE: (949)495 -2515 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE MAR 01 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 4010032 -75D. The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT