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PROOF OF INSURANCE (2014) CLOSEDACCItR CERTIFICATE OF LIABILITY INSURANCE CE DATE(MM /DDIYYYY) 10/17/2013 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER InterWest Insurance Services PHONE Mlcjje Gdx/lrt � ........... License #0601094 MQ >EXsiaS 0.1 1.Q0 (aA +c,r��).y1- Y303 ...... 222 Court Street �oaRESS: dgpy Woodland CA 95695 INSURER(S)AFFORDING COVERAGE. � NAIC # INSURED USH EA -1 U.S. Healthworks Holding Company, Inc. 25124 Springfield Ct., Ste 200 Valencia CA 91355 COVERAGES CERTIFICATE NUMBER: 1A1AAr,7Ad7 REVISION NUMBER: 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 INSURAN.�.� .......... "...m ...J'AbbLfg, .R, .. ... ....� POLICY E , — GP,OLtCttYYYY ............... ......... ... ..... .,IMI,T ,S ........ ......... ...... ........ .. ....° L.TR IN SR WVD POLICY NUMBER MMADD/YYYX POL4CY EXP LIMITS C GENERAL LIABILITY Y P0647613600 /1/2013 /1/2014 EACH OCCURRENCE $1,000,000 X` COMMERCIAL GENERAL LIABILITY P'RM9S:xe o�€uxa"arlce - - -.. $1,000,000 CLAIMS -MADE KI OCCUR MED EXP (Anyone person) $10,000 PERSONAL & ADV INJURY $1,000,000 .° ................................................................................................ .............................., GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ,.,..,. i POLICY I....,, „ PRO �X .,.,. LOC $ C AUTOMOBILE LIABILITY CP0647613600 /1/2013 /1/2014 '777rM (Ea ac den $1 „0000 000, X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED { SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X..__.., HIREDAUTOS :X _. AUUTOSWNED Or„ae,Lall ,A.IuRAG.F' ... $..... ...... ......................... A UMBRELLA LIAB X OCCUR XLS0089886 /1/2013 /1/2014 EACH OCCURRENCE $15,000,000 X EXCESS LIAB CLAIMS -MADE A GGREGATE $15,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN DC4042721 /1/2013 /1/2014 X WC STATU- I OTH "'"""" 'TORY " "' "U"T"19" °d"""'B"" A. I f A E L EACH A, 1 n,dato1 In, NH EXCLUDED? NIA (MF E L DISEASECIEA EMPLOYEE 1,000,000 $,1,7900,000 DESCRIPTION OF OPERATIONS below E L DISEASE . POLICY LIMIT $1,00'0"0­0'0' DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate holder is included as additional insured as required by written contract per the attached endorsement Re: 390 North Sepulveda Blvd, El Segundo, CA City of El Segundo, its officials, 4ploys 350 Main Street, Room 5 El Segundo CA 90245 -3813 GANG 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 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD U.S. Healthworks Holding Company, Inc. Policy No. CP0647613600 09/01/13 -14 General Liability Supplemental Coverage .Endorsement ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following changes apply to this Coverage Part. However, endorsements attached to this Coverage Part will supersede any provisions to the contrary in this General Liability Supplemental Coverage Endorsement. A. Broadened Named Insured 1. The following is added to Section Il —Who Is An Insured: Any organization of yours, other than a partnership or joint venture, which is not shown in the Declarations, and over which you maintain an ownership interest of more than 50% of such organizatlon as of the effective date of this Coverage Part, will qualify as a Named Insured. However, such organization will not qualify as a Named Insured under this provision if it: a. Is newly acquired or formed during the policy period; b. Is also an insured under another policy, other than a policy written to apply specifically in excess of this Coverage Part; or C. Would be an insured under another policy but for its termination or the exhaustion of its limits of insurance. Each such organization remains qualified as a Named Insured only while you maintain an ownership interest of more than 50% in the organization during the policy period. 2. The last paragraph of Section II — Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision. B. Newly Acquired or Formed Organizations as Named Insureds 1. Paragraph 3, of Section II — Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form during the policy period, other than a partnership or joint venture, and over which you maintain an ownership interest of more than 50% of such organization, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. 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. Coverage A does not apply to "bodily injury' or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. An additional premium will apply in accordance with our rules and rates in effect on the date you acquired or formed the organization. Includes copyrighted material of Insurance Services Office, Inc., with its permisslcn. U- GL- 1345 -A (09/08) Page 1 of 13 2. The last paragraph of Section II — Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision. C. Insured Status — Employees Paragraph 2.a.(1) of Section II — Who Is An Insured is replaced by the following; 2. Each of the following is also an insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees ", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury ": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co- "employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However: Paragraphs (1)(a) and (1)(d) do not apply to your "employees" or "volunteer workers ", who are not employed by you or volunteering for you as health care professionals, for "bodily injury" arising out of "Good Samaritan Acts" while the "employee" or "volunteer worker" is performing duties related to the conduct of your business. "Good Samaritan Acts" mean any assistance of a medical nature rendered or provided in an emergency situation for which no remuneration is demanded or received. Paragraphs (1)(a), (b) and (c) do not apply to any "employee" designated as a supervisor or higher in rank, with respect to "bodily injury" to co-"employees". As used in this provision, "employees" designated as a supervisor or higher in rank means only "employees" who are authorized by you to exercise direct or indirect supervision or control over "employees" or "volunteer workers" and the manner in which work is performed. D. Additional Insureds — Lessees of Premises Section II — Who Is An Insured is amended to include as an insured any person or organization who leases or rents a part of the premises you own or manage who you are required to add as an additional insured on this policy under a written contract or written agreement, but only with respect to liability arising out of your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or occupancy of such person or organization or any other tenant or lessee. This provision does not apply: (1) To liability arising out of such person's or organization's sole negligence; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- GL•1345 -A (09108) Page 2 of 13 (2) After the person or organization ceases to lease or rent premises from you. E, Additional Insured —Vendors The following change applies if this Coverage Part provides insurance to you for "bodily injury" and "property damage" included in the "products- completed operations hazard ": Section II — Who Is An Insured is amended to include as an insured any person or organization (referred to below as vendor) who you have agreed in a written contract or written agreement, prior to loss, to name as an additional insured, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional provisions: 1. The insurance afforded the vendor does not apply to: a. Bodily injury" or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; C. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 3. This insurance does not apply to any of "your products" for which coverage is excluded under this Coverage Part. N BJAdditional Insured — Managers, Lessors or Governmental Entity Section II — Who Is An Insured is amended to include as an insured any person or organization who is a manager, lessor or governmental entity who you are required to add as an additional insured on this policy under a written contract, written agreement or permit, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by; Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- GL- 1345 -A (09/08) Page 3 of 13 a. Your acts or omissions; or b. The acts or omission of those acting on your behalf; and resulting directly from: a. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit; b. Ownership, maintenance, occupancy or use of premises by you; or c. Maintenance, operation or use by you of equipment leased to you by such person or organization. This provision does not apply; a. Unless the written contract or written agreement has been executed, or the permit has been issued, prior to the "bodily injury ", "property damage" or offense that caused "personal and advertising injury "; b. To any person or organization: (1) For "bodily injury ", "property damage" or "personal and advertising injury" arising out of its sole negligence; (2) Included as an insured under Paragraph 3. of Section II — Who Is An Insured; c. To any lessor of equipment if the "occurrence" or offense takes place after the equipment lease expires; d. To any: (1) Owners or other interests from whom land has been leased by you; or (2) Managers or lessors of premises, if; (a) The "occurrence" or offense takes place after the expiration of the lease or you cease to be a tenant in that premises; (b) The "bodily injury ", "property damage" or "personal and advertising injury" arises out of the structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or (c) The premises are excluded under this Coverage Part. G. Damage to Premises Rented or Occupied by You 1. The last paragraph under Paragraph 2., Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner, A separate Damage to Premises Rented To You Limit of Insurance applies to this coverage as described in Section III — Limits Of Insurance. 2. Paragraph 6. of Section Ill — Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises while rented to you, or in the case of damage by one or more "specific perils" to any one premises, while rented to you or temporarily occupied by you with permission of the owner. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U -GL- 1345 -A (09/08) Page 4 of 13 H. Broadened Contractual Liability Definition 9. in Section V — Definitions is replaced by the following: 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract "; b. A sidetrack agreement; C. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury ", "property damage ", or "personal and advertising injury" arising out of the offenses of false arrest, detention or imprisonment, to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. I. Definition -- Specific Perils The following definition is added to Section V — Definitions: "Specific perils" mean: a. Fire; b. Lightning; c. Explosion; d. Windstorm or hail; e. Smoke; f. Aircraft or vehicles; g. Vandalism; h. Weight of snow, ice or sleet; i. Leakage from fire extinguishing equipment, including sprinklers; or Includes copyrighted material of Insurance Services Office, Inc., with its permission, U- GL- 1345 -A (09108) Page 5of13 j. Accidental discharge or leakage of water or steam from any part of a system or appliance containing water or steam. J. Limited Contractual Liability Coverage — Personal and Advertising Injury 1. Exclusion e. of Section I —Coverage B —Personal And Advertising Injury Liability is replaced by the following: 2. Exclusions This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to: (1) Liability for damages that the insured would have in the absence of the contract or agreement; or (2) Liability for "personal and advertising injury" if: (a) The "personal and advertising injury" arises out of the offenses of false arrest, detention or imprisonment; (b) The liability pertains to your business and is assumed in a written contract or written agreement in which you assume the tort liability of another. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement; and (c) The "personal and advertising injury" occurs subsequent to the execution of the written contractor written agreement. Solely for purposes of liability so assumed in such written contract or written agreement, reasonable attorney fees and necessary litigation expenses Incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury" described in Paragraph (a) above, provided: (1) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same written contract or written agreement; and (ii) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 2. Paragraph 2.d. of Section I — Supplementary Payments — Coverages A And B is replaced by the following: d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the lndemnitee; 3. The following is added to the paragraph directly following Paragraph 2.f. of Section I — Supplementary Payments -- Coverages A And B: Notwithstanding the provisions of Paragraph 2.e.(2) of Section I — Coverage B — Personal And Advertising Injury Liability, such payments will not be deemed to be damages for "personal and advertising injury" and will not reduce the limits of insurance. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- GL- 1345 -A (09108) Page 6 of 13 K. Supplementary Payments The following changes apply to Supplementary Payments — Coverages A and B; Paragraphs 1.b. and 1.d. are replaced by the following: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit ", including actual loss of earnings up to $500 a day because of time off from work. L. Broadened Property Damage 1. Property Damage to Contents of Premises Rented Short -Term The paragraph directly following Paragraph (6) in Exclusion j. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following; Paragrophs (1), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage by "specific perils "), including "property damage" to the contents of such premises, rented to you under a rental agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to Premises Rented to You as described in Section III — Limits Of Insurance. 2. Elevator Property Damage a. The following is added to Exclusion j. of Section I — Coverage A — Bodily Injury And Property Damage Liability: Paragraphs (3) and (4) of this exclusion do not apply to "property damage" arising out of the use of an elevator at premises you own, rent or occupy. b. The following is added to Section III — Limits Of Insurance: Subject to Paragraphs 2., 3. and 5. above, the most we will pay under Coverage A for damages because of "property damage" to property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy is $25,000 per "occurrence ". 3. Property Damage to Borrowed Equipment a. The following is added to Exclusion j. of Section I -- Coverage A — Bodily Injury And Property Damage Liability: Paragraph (4) of this exclusion does not apply to "property damage" to equipment you borrow from others at a jobsite. b. The following is added to Section III — Limits Of Insurance: Subject to Paragraphs 2., 3. and 5. above, the most we will pay under Coverage A for damages because of "property damage" to equipment you borrow from others at a jobsite is $25,000 per "occurrence ". M. Expected or Intended Injury or Damage Exclusion a. of Section I — Coverage A— Bodily Injury And Property Damage Liability is replaced by the following: Includes copyrighted material of Insurance Services Office, Inc., with its permission. U -GL- 1345 -A (09108) Page 7 of 13 a. Expected Or Intended Injury Or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. N, Definition — Bodily Injury Definition 3. in Section V — Definitions is replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death sustained by that person which results from that bodily injury, sickness or disease. O. Insured Status — Amateur Athletic Participants Section II — Who Is An Insured is amended to include as an insured any person you sponsor while participating in amateur athletic activities. However, no such person is an insured for: a. 'Bodily injury" to: (1) Your "employee ", "volunteer worker" or any person you sponsor while participating in such amateur athletic activities; or (2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company) while participating in such amateur athletic activities; or b. "Property damage" to property owned by, occupied or used by, rented to, in the care, custody or control of, or over which the physical control is being exercised for any purpose by: (1) Your "employee ", "volunteer worker" or any person you sponsor; or (2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). P. Non -Owned Aircraft and Watercraft Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading ". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and Includes copyrighted material of Insurance Services Office, Inc., with its permission, U- GL- 1345 -A (09108) Page 8 of 13 (b) Not being used to carry persons for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5) An aircraft that is hired or chartered by you or loaned to you, with a paid and licensed crew, and is not owned in whole or in part by an insured; or (6) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f,(2) or f.(3) of the definition of "mobile equipment ". Q. Definitions — Leased Worker, Temporary Worker and Labor Leasing Firm 1. Definitions 10. and 19. in Section V-- Definitions are replaced by the following: 10. "Leased worker" means a person leased to you by a "labor leasing firm" under a written agreement between you and the "labor leasing firm ", to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker ". 19. "Temporary worker" means a person who is furnished to you to support or supplement your work force during "employee" absences, temporary skill shortages, upturns or downturns in business or to meet seasonal or short -term workload conditions. 'Temporary worker" does not include a "leased worker ". 2. The following definition is added to Section V —Definitions: "Labor leasing firm" means any person or organization who hires out workers to others, including any: a. Employment agency, contractor or services; b. Professional employer organization; or C. Temporary help service. R. Definition — Mobile Equipment Paragraph f. of Definition 12. in Section V -- Definitions is replaced by the following: f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self - propelled vehicles with the following types of permanently attached equipment, exceeding a combined gross vehicle weight of 1000 pounds, are not "mobile equipment" but will be considered "autos ": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; Includes copyrighted material of Insurance Services Office, Inc., with its permission. U -GL- 1345 -A (09/08) Page 9 of 13 (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. S. Definitions — Your Product and Your Work Definitions 21. and 22. in Section V — Definitions are replaced by the following: 21. "Your product ": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your product "; and (2) The providing of or failure to provide warnings or instructions. C. Does not include vending machines or other property rented to or located for the use of others but not sold. 22. "Your work ": a. Means: (1) Work, services or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work, services or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your work "; and (2) The providing of or failure to provide warnings or instructions. T. Priority Condition The following paragraph is added to Section III — Limits Of Insurance: In the event a claim is made or "suit" is brought against more than one insured seeking damages because of "bodily injury" or "property damage" caused by the same "occurrence" or "personal and advertising injury" caused by the same offense, we will apply the Limits of Insurance in the following order: Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- 0 L- 1345 -A (09108) Page 10 of 13 (a) You; (b) Your "executive officers ", partners, directors, stockholders, members, managers (if you are a limited liability company) or "employees "; and (c) Any other insured in any order that we choose. U. Duties in the Event of Occurrence, Offense, Claim or Suit Condition The following paragraphs are added to Paragraph 2., Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions: Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or "suit" shall be given to us as soon as practicable after knowledge of the "occurrence ", offense, claim or "suit" has been reported to any insured listed under Paragraph 1, of Section 11 -- Who Is An Insured or an "employee" authorized by you to give or receive such notice. Knowledge by other "employees" of an "occurrence ", offense, claim or "suit" does not imply that you also have such knowledge. In the event that an insured reports an "occurrence" to the workers compensation carrier of the Named Insured and this "occurrence" later develops into a General Liability claim, covered by this Coverage Part, the insured's failure to report such "occurrence" to us at the time of the "occurrence' shall not be deemed to be a violation of this Condition. You must, however, give us notice as soon as practicable after being made aware that the particular claim is a General Liability rather than a Workers Compensation claim. V. Other Insurance Condition Paragraphs 4.a. and 4.b.(1) of the Other Insurance Condition of Section IV— Commercial General Liability Conditions are replaced by the following: 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. This insurance is primary insurance as respects our coverage to the additional insured person or organization where the written contract or written agreement requires that this insurance be primary and non - contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. Other insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (1) That is property insurance, Builder's Risk, Installation Risk or similar coverage for "your work "; (ii) That is property insurance purchased by you (including any deductible or self insurance portion thereof) to cover premises rented to you or temporarily occupied by you with permission of the owner; Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- GL- 1345 -A (09/08) Page 11 of 13 (iii) That is insurance purchased by you (including any deductible or self insurance portion thereof) to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (iv) If the joss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability; or (v) That is property insurance (including any deductible or self insurance portion thereof) purchased by you to cover damage to: Equipment you borrow from others at a jobsite; or Property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy. (b) Any other primary insurance (including any deductible or self insurance portion thereof) available to the insured covering liability for damages arising out of the premises, operations, products, work or services for which the insured has been granted additional insured status either by policy provision or attachment of any endorsement. Other primary insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities, (c) Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence ", claim or "sult ". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. W. Unintentional Failure to Disclose All Hazards Paragraph 6. Representations of Section IV — Commercial General liability Conditions is replaced by the following: 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and C. We have issued this policy in reliance upon your representations, Coverage will continue to apply if you unintentionally: Fail to disclose all hazards existing at the inception of this policy; or b. Make an error, omission or improper description of premises or other statement of information stated in this policy. You must notify us in writing as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to inception of this Coverage Part. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- GL- 1345 -A (09108) Page 12 of 13 X. Waiver of Right of Subrogation Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Commercial General Liability Conditions is replaced by the following: B. Transfer Of Rights Of Recovery Against Others To Us a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b. if the insured waives its right to recover payments for injury or damage from another person or organization in a written contract executed prior to a loss, we waive any right of recovery we may have against such person or organization because of any payment we have made under this Coverage Part. The written contract will be considered execrated when the insured °s performance begins, or when it Is signed, whichever happens first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. Y. Liberalization Condition The following condition is added to Section IV — Commercial General Liability Conditions: Liberalization Clause If we revise this Coverage Part to broaden coverage without an additional premium charge, your policy will automatically provide the additional coverage as of the day the revislon is effective in the state shown in the mailing address of your policy. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U- GL- 1345 -A (09/08) Page 13 of 13 CERTIFICATE OF LIABILITY INSURANCE I °�Tn`n "An° °`Y"YY' 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 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 Ileu of such endorselnentlsl. PRODUCER WN IA'C'r NAME: lnterWest Insurance Services PJIOO l License #01301094 _ AI.�- tlll..rt t f�dkl L� 222 Court Street ApDRr s r Woodland CA 95695 GENERAL ...... ..��.-w._ ...�_ m.., ...,. � ...... .............................__ _.,_,,.,, .INSURER A: INSURED USHEA -1 INSURER B; U.S. HeaEtliworks Holding Company, Inc. INSURERc 26124 Springfield Ct., Ste 200 INSURER D: Valencia CA 91355 rn� COMMERCIAL GENERAL LIABILITY Y INSURER E: COVERAGES CERTIFICATE NUMBER: 1555389311 REVISION NUMBER: 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. I... ...._... O-FF PO LICY.EXP LTR E TYPE OF INSURANCE POLIO fi MMD® _,. _ ...... .,. r... w. LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY Y A1v N "TO ITEM pS�C1J��,(S�sr�n�l g CLAIMS -MADE OCCUR MED EXP An one person _ _� .................. ................. PERSONAL & ADV INJURY � .... .... -..�� GENERAL AGGREG. ATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPIOP AGO PROF +; POLICY LOC _.�..�..�... S AUTOMOBILE LIABILITY COMUMED SIN= 091Y ffA.Y ?. J9L_. A. _ ._. .. ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS RODILY INJURY P (eraccidenl ) $ NON -OWNED DAMACa "% E $ HIRED AUTOS AUTOS P s Inc .. .... S UMBRELLALIAB OCCUR EACHOCCURRENCE $ EXCESS LIAS CLAIMS-MADE AGGREGATE S $ DED RETENTIONS WORKERS COMPENSATION SA 0 AND EMPLOYERS'LIABILITY YIN AC x ANY PRO RIETOR E ECUTIVE EXCLUDED? N/A E.L. EA H ACCIDEN T - $ . . - (Mandatory In NH) E.L. E L DISEASE - EA EMPLOYEE $ , d"wibe under p CR$PTiONOFOPERATIONSbellow E.L.DISEASE -POL CY LIMIT $ A Medlwl Malpract$0a 069727 1112013 11120`14 Aggregate 33 „000,000 Professional LlabIlily Limit $1,000 „0001 Deductible $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Altach ACORD 101, Additional Roma rks Schedule, [I more space Is required) Loc #14063001 , LAX VCR r l(•1VH 1 r- nVLL r-M 4ANUt:LL.A I LUN' 14063001 U. S. HealthWorks, Ipb. i 390N. Se ulveda, Suite 1000 El SegundpD, CA 90245 '+x, 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 -2090 ACORD CORPORATION. All rights reserved. ACORD 25 (2090/05) The ACORD name and logo are registered marks of ACORD