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PROOF OF INSURANCE (2014) CLOSED'. DATE(MMIDD/YYYY) ACORDM CERTIFICATE OF LIABILITY INSURANCE IATE(M3 /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 pollcy(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 lieu of such endorsement(s), PRODUCER CONTACT Ken Noden NAME: Wi more Insurance Agency, Inc. P "o" .714.979.6543 m gm 9 9 y Ala N.1mEx f ........ IAIC N�): 714.549.2943 2970 Harbor Blvd. #215 ADDRESS: commercial @wi moreins.com _ ........ . .....................INSURER(S) AFFORDING COVE License #0811959 RAGE NAIL# Costa Mesa, CA 92626 .... Mutua l . .WSURER.....mmm......NdtlOrlWlde Insurance Co 23787 INSURED'° "Steven Enterprises, Inc. INSURER B: AMCO 19100 Sky wsURERC: Security National Insurance 17952 Sk Park Cir # E ante Co 19879 Irvine, CA 92614 -4420 INSURE - RDt INSURER E: COVERAGES CERTIFICATE NUMBER: 565185 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED IISTED BELOW HAVE BEEN IS UED 70 -THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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 REDUCED BY PAID CLAIMS. .. . �,.�.MMIUDD�. ..................... .... .... ........... .............................__ ...... ..............TYPE .. ..,'INSDR OF INSURANCE.. LNTR VWD POLICY NUMBER MIDI LIMITS GENERAL LIABILITY ACPBA780593297 02/14/2013 02/14/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY cperson) e 300,00( CLAMS- MADEXmOCCUR 5,00 A mmmmmm, ... X mMEDEIP(An PERSONAL & ADV INJURY ..................... ,$ $ 1,000,00( . ...........- GENERAL AGGREGATE—— $ 2,000,00( GEN' LMAGGREGA"„. TE LIMIT A PPLIES COMP /OP AGG $ 2 , 000, 00 LPER:PRODUCTS POLICY PRO- JECfT ....... .............................__ $ AUTOMOBILE LIABILITY ACPBPW780593297 02/14/2013 02/14/2014 GUN (Ea accident'l $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED ...... ..........�................. BODILY INJURY (Per accident) $ MONO- -OWNED . °"'�TAMALOE ".... $ HIR DSAUTOS Pura cid )( UMBRELLA LIAB X OCCUR ACPCAA780593297 02/14/2013 02/14/2014 EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE AGGREGATE $ 5,000,000 $ DED X I RETENTION $ 0 wRKERS COMPENSATION SWC101 945 02/14/2013 02/14/2014 - O AND M C RRK' T9V`ANYPROPRIE'l'OR /PARTJEE IM RE EXCLUDED? NIA X EL EACH ACCIDENT mm $. 1m,m000,00RM .. (Mandatory In NH) E . DISEASE EA EMPLOYEE $ 1 , 000 , 00 If yes, descr be under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) ERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED. FANCELLATION NOTICE IS 10 DAYS IN THE EVENT OF NON PAYMENT OF PREMIUM. <.GR I If -I<rM 1 G 1'7VLV CR -" I.M IY IiCLLN I IVIY ( SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF EL SEGUNDO AUTHORIZED REPRESENTATIVE ,e'f 350 MAIN STREET ELISEGUNDO, CA 90245 Timothv Wiamore /K140 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD lma 0 BUSINESSOWNERS PB 60 72 0711 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT TO OTHER INSURANCE CLAUSE FOR ADDITIONAL INSUREDS - PRIMARY AND NOW CONTRIBUTORY WHEN REQUIRED IN A WRITTEN AGREEMENT OR CONTRACT- ITH YOU This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITION' Only with respect to any additional insured, in the COMMON POLICY CONDITIONS, form PB 00 09, under condition H. OTHER INSURANCE, paragraph 2.a. is replaced by the following: H. OTHER INSURANCE 2. Under any liability coverage provided by this policy, a. If for injury or loss we cover, there is other valid and collectible insurance available to any additional insured under another policy, our obligations are limited as follows: (1) Issued by another insurer, or if there is self insurance or similar risk retention that applies to a loss covered by this policy, then this insurance provided by us shall be excess over such other insurance, unless you have agreed in a written contract or written agreement signed prior to the loss that this insurance shall be primary: (a) Then this insurance is primary. If other insurance is also primary, we will share with all that other insurance as described in d. below; and (b) The coverage afforded by this insurance is non - contributory with the additional insured's own insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured to any other person or organization's policy.; or (2) Issued by us or any of our affiliate companies, that applies to a loss covered by this policy, then only the highest applicable Limit of Insurance shall apply to such loss. This condition does not apply to any policy Issued by us that is designed to provide Excess or Umbrella liability insurance. All terms and conditions of this policy apply unless modified by this endorsement. PB 60 72 07 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ACP SPIN 7605932976 INSURED COPY 78 00842 PB 00 06 04 11 5. Automatic Additional Insureds Any of the following persons or organizations are automatically insureds when you and such person or organization have agreed in a written contract or agreement that such person or organization be added as an additional insured on your policy providing general liability coverage. a. Co- Owners of Insured Premises Any person or organization with whom you co -own a premises insured under this policy is an additional insured, but only with respect to their liability as the co- owner of such premises. HOWEVER, their status as additional insured under this policy ends when you cease to co -own such premises with that person or organization. b. Controlling Interest Any person or organization that has a controlling interest in you is an additional insured, but only with respect to liability arising out of: (1) Their financial control of you; or (2) Their ownership, maintenance or control of premises you lease or occupy; subject to the following additional exclusion: This insurance, including any duty we have to defend "suits ", does not apply to structural alterations, new construction or demolition operations performed by or for such person or organization. HOWEVER, their status as additional insured under this policy ends when they cease to have such controlling interest in you. Grantor of Franchise or License Any person or organization that has granted you a franchise or license by written contractor agreement is an additional insured, but only with respect to their liability as the grantor of a franchise or license to you. HOWEVER, their status as additional insured under this policy ends when their contractor agreement with you granting the franchise or license ends. d. Lessors of Leased Equipment Any person or organization from whom you lease equipment by written contract or agreement is an additional insured, but Page 16 of 22 only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of the equipment leased to you by that person or organization, subject to the following additional exclusion: This insurance, including any duty we have to defend "suits ", does not apply to "bodily injury" or "property damage" arising out of, in whole or in part, or results from, in whole of in part, the active negligence of such person or organization. HOWEVER, their status as additional insured under this policy ends when their contract or agreement with you for such leased equipment ends. e. Managers or Lessors of Leased Premises Any person or organization from whom you lease premises is an additional insured, but only with respect to their liability arising out of your use of that part of the premises leased to you, subject to the following additional exclusion: This insurance, including any duty we have to defend "suits ", does not apply to structural alterations, new construction or demolition operations performed by or for such person or organization. HOWEVER, their status as additional insured under this policy ends when you cease to be a tenant of such premises. f. Mortgagee, Assignee or Receiver Any person or organization who has status as mortgagee, assignee or receiver of your property is an additional insured, but only with respect to their liability as mortgagee, assignee or receiver arising out of your ownership, maintenance, or use of such premises, subject to the following additional exclusion: This insurance, including any duty we have to defend "suits ", does not apply to structural alterations, new construction or demolition operations performed by or for such person or organization. HOWEVER, their status as additional insured under this policy ends when their status as mortgagee, assignee or receiver ends. Includes copyrighted material of Insurance Services Office, Inc., with its permission. PB 00 06 04 11 ACP BPW 7805932976 INSURED COPY 78 01528 PB 00 06 04 11 g. Owners or Other Interest from Whom b. Damages under COVERAGE A, except Land has been Leased damages because of "bodily injury" or Any person or organization from whom you property damage" included in the "; lease premises is an additional insured, but 'products - completed operations hazard only with respect to their liability arising out and of your maintenance or use of that part of c. Damages under COVERAGE B. the land leased to you, subject to the The General Aggregate Limit applies following additional exclusion: separately to each of your described This insurance, including any duty we premises. For the purposes of this provision, have to defend "suits ", does not apply to premises means involving the same or structural alterations, new construction or connecting lots, or premises whose demolition operations performed by or for connection is interrupted only by a public such person or organization. street, roadway or waterway, or railroad right - HOWEVER, their status as additional of -way. Insured under this policy ends when you 3. Products - Completed Operations cease to lease that land. Aggregate Limit of Insurance h. State or Political Subdivisions - The Products - Completed Operations Permits Relating to Premises Aggregate Limit is the most we will pay under Any state or political subdivision which COVERAGE A for damages because of has issued a permit in connection with "bodily injury" and "property damage" premises insured by this policy which you included in the "products- completed own, rent, or control is an additional operations hazard ". insured, but only with respect to the 4. Personal and Advertising Injury Limit of following hazards: Insurance (1) The existence, maintenance, repair, Subject to paragraph 2. above, the Personal construction, erection, or removal of and Advertising Injury Limit is the most we will advertising signs, awnings, canopies, pay under COVERAGE B for the sum of all cellar entrances, coal holes, damages because of all "personal and driveways, manholes, marquees, advertising injury" sustained by any one hoistaway openings, sidewalk vaults, person or organization. street banners, or decoration and 5. Each Occurrence Limit of Insurance similar exposures; Subject to paragraph 2. or 3. above, (2) The construction, erection, or whichever applies, the Each Occurrence Limit removal of elevators; or is the most we will pay for the sum of: (3) The ownership, maintenance, or use a. Damages under COVERAGE A; and of any elevators covered by this in in p b. Medical expenses under COVERAGE C surance. HOWEVER, their status as additional because of all "bodily injury" and "property insured under this policy ends when the damage" arising out of any one 'occurrence ". permit ends. 6. Tenants Property Damage Legal Liability III. LIMITS OF INSURANCE AND DEDUCTIBLE Limit of Insurance 1. The Limits of Insurance shown in the Subject to paragraph 5. above, the Tenants Property Damage Legal Liability Limit is the Declarations and the rules below fix the most twe will pay under COVERAGE A for we will pay regardless of the number of: damages because of all "property damage" to a. Insureds; premises, while rented to you or temporarily b. Claims made or "suits" brought; or occupied by you with permission of the c. Persons or organizations making claims owner, arising out of any one 'occurrence ". or bringing "suits ". 7. Medical Payments Limit of Insurance 2. General Aggregate Limit of Insurance (Other than Products - Completed Operations) The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under COVERAGE C; PB 00 06 04 11 Includes copyrighted material of Insure Subject to paragraph 5. above, the Medical Payments Limit is the most we will pay under COVERAGE C for all medical expenses because of 'bodily injury" sustained by any one person. nice Services Office, Inc., with its permission. Page 17 of 22 ACP BPW 7805932976 INSURED COPY 78 01529 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 covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization City of El Segundo El Segundo, CA 90245 Job Description All CA Operations This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated, Endorsement Effective 2/14/2013 Policy No, SWC1019456 Endorsement No. WC040306 Insured Steven Enterprises. Inc. (a Corp) Premium $ 10309 Insurance Company Security National Insurance Company Countersigned by