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PROOF OF INSURANCE (2017 - 2017) CLOSEDA CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD /YYYY) 02/08/2015 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(les) 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 Ilou of such ondorsement(s). N ACT PRODUCER 877.804.7916 877.337.5209 NF Thomas Ed+lfrt 877,24.963" Contractor's Edge Insurance Services PHONu R77 f304 7910 �n ..gib 877 .4 __..�_. � _ ArC,ua�i 8 77 7mm 0 501 N. El Camino Real Ste. 200 PRODUCER as ceinurnmm@iT! #cn1. _ ..... San (✓IEfI'12I7te CA 92672 GE NAIL q INSURERISI AFFORDING COVERAGE .- w...°......°........__ „_... INSURED �. �w .. m INSURER A: Preferred Contractors Insurance Company 'Nationwide Signs, Inc. lnc. g INSURERS KemnPr SDPC � ialty Insurance CO. Yan Minkovitch INSURER C. 21133 Victory Blvd, Suite 203 INSURER D: Canoga Park, CA 91303 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER; 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. m INSR 0 b l�#9'Y r rn TYPE OF INSURANCE '. uco unm POLICY NUMBER ... �_... .......w- ,._...... �M,.,.,.,..,.- ..- .,_..... — ..._ POLIICY EFF POLICY EXP ITS � 4WWMd�, �,DFM�„"�,,,yk'Y'I. MMd'DgiYYYY GENERAL LIABILITY _ / OCCU OCCURRENCE s 1 nnn nnn D Y A ( OMFs4EFtCV�V. GFNEr^FAL LIABILITY AGE- T'O"R'E'NTE _ PRF MI5F5 rFa ocaurencel 5 5(00 mm CV.941kd�' =MAOG”. 4 � OCCUR EXP (Anv one person) S s nnn MOH ...,.mm.IT.mm.. _�.,_.- .m...., -. �..;�_M..,. ............... ... p cic5009- P cacm558251 01/25/16 01/25/17 PERSONAL aAD�V INJURY s 1 nnn Ono .. - �� -� GENERAL AGGREGATE S 9 nnn nnn �_ .... , .�e�.. ......a,.,a .._....._...._.,., . __......._... GEN'L AGGREGATE LIMIT APPLIES PER PRO DUCTS - COMP /OP AGG S Z „ -_ MP /OP G _ ,.,000 0O... _ww ZI hOLIC'Y _.__- Prd,'OW E- LOC S� AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANYAUTO _... _._. . ............ ._.... .. ..... .,.�..- _,....,,. BODILY INJURY (Per person) S ALL OWNED AUTOS B 3766445 02/05/16 02/05/17 BODILY INJURY (Per accident) S SCHEDULED AUTOS ��- $ PROPERTY DAMAGE - -...5. HIRED AUTOS (Per accident) NON -OWNED AUTOS S 5 UMBRELLA AB OCCUR EACH RENCE S - � EXCESSLIAB CLAIMS-MADE AGGREGATE S _ DEDUCTIBLE S RFTFNTION S WORKERS COMPENSATION S I rIPV I ATU- OTH AND EMPLOYERS' LIABILITY Y� T°�* p"^ "!'Tc ANY PROPRIETOR/PARTNEFLEXECUTIVE E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? NIA """�"`�""�"``- """" " """` " " " "" -mm.--------- (Mandatory In NH) E.L. DISEASE - EA EMPLOYE S _ _W., . ..._.._mm- .._...�,._...._.... I! yyes, deschbo under F L., DISEASE - POLICY LIMIT E DESCRPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of El Segundo is named as additional insured, CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD 1'mFv%rvd C"uwrs wa — ltrsurdatco 4 ompotiy, RRG ENDORSEMENT TO POLICY NO. 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREFERRED CONTRACTORS INSURANCE COMPANY RISK RETENTION GROUP LLC. COMMERCIAL GENERAL LIABILITY POLICY BLANKET ADDITIONAL INSURED INCLUDING PRIMARY COVERAGE AND WAIVER OF SUBROGATION The section of the policy entitled III. — WHO IS AN INSURED is amended to include as an additional insured any person or organization 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. The coverage afforded by this endorsement is only; (1) with respect to liability of the Additional Insured in connection with the original Member's or Named Insured's ongoing operations performed for said Additional Insured; and (2) only if the Additional Insured performs all obligations required under the Policy. The coverage afforded to an Additional Insured is limited to a claim made for a Covered Loss not covered by other insurance available to an Additional Insured, and is limited by V. — COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, b., of the policy, which provision applies equally to an Additional Insured and is made a part of this Endorsement. Other than as expressly modified herein, coverage for the Additional Insured is governed by the terms and conditions of this policy, including the insuring agreement. No coverage is afforded under the "products- completed operations hazard" for an Additional Insured pursuant to this endorsement. The coverage afforded to an Additional Insured under this endorsement ends as of the date of completion, abandonment or termination of the work of the original Named Insured at any jobsite, project or structure. The "work" of the original Named Insured will be deemed completed as of the date 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 when 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, including another contractor or subcontractor engaged in performing operations as part of the same project. The coverage provided for the Additional Insured is only to the extent that the additional insured is held liable for the negligence or strict liability of the Named Insured. No coverage is provided for liability based upon the acts, errors and omissions of the Additional Insured. No coverage is provided to an Additional Insured for damages because of "bodily injury" to an employee of the original Named Insured, whether suit is brought or claim is made by the employee or the parent, spouse, child or sibling of such employee, or any entity seeking damages because of injury to such employee. If required by written contract: the insurance afforded by the policy to the Additional Insured shall be primary insurance, and any insurance or self - insurance maintained by the above Additional Insured shall be excess of the insurance afforded to the Named Insured and shall not contribute to it. 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 make for injury or damage arising out of "your work" done under a contract with that person or organization. Except as set forth above, all of the terms, conditions and exclusions of this policy apply and remain in effect. Policy No.: PCIC5009- PCACM558251 Preferred Contractors Insurance Company Risk Retention Group, LLC Date: 1/25/2016 27 North 27th Street, Suite 1900 Billings, Montana 59101 Time: 12:01 a.m. By: Authorizcd epresentative V 09 12 END 10 -1 of 1 Exhibit B To whom It may concern. a ern A This is to advise you that as per the California State Contractors License Board a Self Employed individual such as myself does not need to purchase workman's comp insurance rf T Page 1 of 1 21133 Victory Blvd #203 Woodland Hills CA 91303 1- 888 - 854 -1944 CSLB complaint disclosure Is restricted by law (B&P 7124.6) If this entity Is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action Information. Per B&P 7071.17 , only construction related civil judgments reported to the 0SLI3 are disclosed. Arbilrations are not listed unless the contractor falls to comply with the terms of the arbitration. Due to workload, there may be relevant Information that has not yet been entered onto the Board's license database. This license is current and active. All information below should be reviewed. 'x"�45 - ELECTRICAL SIGNS Business Information NATIONWIDE SIGNS INC 21133 VICTORY BLVD #203 WOODLAND HILLS, CA 91303 Business Phone Number:(323) 864-7001 Entity Corporation Issue Date 09/09/2014 Expire Date 0913012016 License Status Rogdina Infomiation Contractors Bond fiii's-ic-e-n-s-e-flted a- —Con—trac-to-e-s, -Sand with—SURE'T"EC—IN-"D-""E-,M--N-)T-,Y-C,-,O--m,-P A-N- Y_..W.- _.......__ Bond Number: 124584 Bond Amount: $15,000 Effective Date: 01/0112016 Contractor's Bond 1-0slory Bond of Qualifying Individual stoct-Jequfty of the corporation. A bond of qualifying individual Is not required. Ive Date: 09/09/2014 fi-f, -se-is-e-ie' m-p-,t"f-,r-o"m-,h-a--vi,-n,g-w"-or-ke-rs co-i-n-p-e-nz-a-lion insurance; they, certified ftt I,h-e-,y--h-,a--v"e-"n-,o,-,-em-�p-l-o-y-ees at thistime, Effective Date: 06/0512014 Expire Date: None. .. . .... ..... . . . .. . .. . ...... Personnel listed on this license (current or disassociated) are listed on other licenses. --11- -- :----TTfF 1 /,%I Pint