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PROOF OF INSURANCE (2017 - 2017) CLOSEDDATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE Ilw... 10/11/2016 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 SUBROGA'T'ION 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 NAME: Kim Foote Thomas Costello Insurance Agency pp : (805) 520 -4997 _.NI (805) 426 -8802 2775 Tapo St. #102 EA-nnR ss, klml costello assoc:com INSURERS) AFFORDING COVERAGE NAIC # Simi Valley CA 93063 INSURER A : FIRST MERCURY INSURANCE COMPANY 10657 _.__..., ....- ....... � ......... .. - - - - - -- . - -- - ........ m . .. .. ............ ... ...... -.._ INSURER B : TO _. ......- , ............m.............. ..... ... INSURED PA INS CO 18031 ADVANCED ACCESS CONTROLS, INC. INSURER c STATE COMPENSATION INSURANCE FUND 35076 ._ ... 13407 SATICOY STREET INSURER D : NATIONWIDE MUTUAL INSURANCE COMPANY 23787....._...... 11 ... ....... ...— ..H . ...... -- -. __. -.. NORTH HOLLYWOOD, CA 91605 INSURER E. SENTINEL INSURANCE COMPANY 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. tNSR _ — INSURANCE .... AFL S J IY POLICY NUMBER........ POLICY YYYFF POLICY Y EXP._.. _ ..... -- - _._._ --- LTR TYPE OF LOD0 yY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE /� .bAY�Ab9 T6 A9NTE15� _. � .. . - OCCUR ES (Ee occurrence)...... E- _50,000 PREMIS - DEDUCTIBLE $2 500 MED EXP (Any one person) $ 5,000 .. ...- - -- A SE -CGL- 0000051179 -02 01/17/2016 01/17/2017 PERSONAL &ADVINJURY $ INCLUDED _..... GEN AGGREGATE LIMIT APPLIES L AGGREGATE $ 2,000,000 ' _ _ _....___. POLICYv /� LOC PRODUC TS COMPIOPAGG $ 1,000,000 U1c' , .__. —.- OTHER! $ AUTOMOBILE LIABILITY COM81NE0 SINGLE LIMIT $ 1,000 000 yEs aar 00 _ .............. . ... . .... . ANY AUTO BODILY INJURY (Per person) $ D X ALL OWNED SCHEDULED � AUTO BODILY S AUTOS ACP 7864593214 08/26/2016 08/26/2017 INJURY (Per accident NON -OWNED k M OT"E TY DAMAGE ..... _ ...._.., ^a HIRED AUTOS X AUTOS PararcddoU $ ... ....... ._ —. s UMBRELLALIAS X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESSLIAB CLAIMS -MADE XL- 6602561 -05 01/17/2016 01/17/2017 AGGREGATE $ 5,000,000 _u. - -- DED RETENTION $ $ WORKERS COMPENSATION SErARTUTE ERH AND EMPLOYERS'LIABILITY Y/N ...R' .. --- - - - - -- - ------ ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? nN NIA 9126882-16 04/01 /2016 04101/2017 - ...... -._ _,_,,, (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 000 If es, describe under M.... .1,000 y DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 BUSINESS PERSONAL LIMIT: $ 200,000 E PROPERTY 72 SBA AK3924 01/17/2016 01/17/2017 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Renarks Schedule, maV be attached N more space Is required) CITY OF EL SEGUNDO, ITS OFFICIALS AND EMPLOYEES ARE LISTED AS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF EL SEGUNDO ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 'P�TIAZT*Fff IM MMY-11111110"s N1 WM4.1 ®r CG 20 33 07 04 C ISO Properties, Inc., 2004 Pagel of 1 ❑ This endorsement modifies insurance provided under the following: The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or " "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CIS 24 04 05 09 Oc, Insurance Services Office, Inc,, 2008 Page 1 of 1 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT SUBJECT TO A TOTAL POLICY AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: All alarm system installations performed pursuant to a written contract signed prior to an 'occurrence ". (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount shown in the Declarations of this policy. 2. Subject to the Total Policy Aggregate Limit, the Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury' or 'property damage" included in the "products - completed operations hazard," regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits." 3. Any payments made under COVERAGE A for damages shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Subject to the Policy Aggregate Limit, such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit and the Total Policy Aggregate Limit. FMIC -GL- 2017(01/2011) Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY PRIMARYAND NON - CONTRIBUTING INSURANCE lilliql 1 1111 Jill 11 11111 11, '1'' 1 1 COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART 4. Other Insurance If all of the other insurance permits contribution by equal shares, we will follow this method unless the insured is required by written contract signed by both parties, to provide insurance that is primary and non-contributory, and the "insured contract" is executed prior to any loss. Where required by a written contract signed by boll parties, this insurance will be pri irriary and non-contributing only when and to the extent as required by that contract, insurance ornoneof the loss remains, whichevercornes first. If any of the olher insurance does not permit contribution by equal shares, we will contribute by lirm.ts, Under this method, eaiJi insurees share is based or) the ratio of its appilicable limit of insuranGe to the total applicable limits of insurance of all Insurers, ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. This endorsement forms a part of the Policy to which at shed, effeLtive on the inception date of the Policy unless otherwise stated herein. (The foNowing information is required only when this endorsement sissued subsequent to preparation of the Policy.) Endorsement effective Policy No. SE-CGL-000005117T-oVsement No, 31IMMEMEM FMIC-GL-1002(1012012) ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS UKUKI=K UUF Y HOME OFFICE SAN FRANCISCO EFFECTIVE APRIL 1, 2016 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING APRIL 1, 2017 AT 12.01 A.M. AT 12.01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ADVANCED ACCESS CONTROLS INC 13407 SATICOY ST NORTH HOLLYWOOD, CA 91605 REP 01 9128882 -16 RENEWAL NA 3- 30 -70 -99 PAGE 1 OF 1 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED INSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO-. MARCH 8, 2016 AUTHORIZED REPRESENT NVE PRESIDENT AND CEO 2572