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PROOF OF INSURANCE (2018 - 2018) CLOSED Client#: 396700 WESCOSIG ACORD,., CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/11/2017 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 endorsement(s). PRODUCER (;ONT,Acl j Marina Tutunian . NAME„ USI Insurance Services LLC-SCL PlIONId 949-790-9295 )uA gMG No,Exit: - Lic#01311911 FWAIL marina.tutul't'ian rr tb i.com 21700 Oxnard Street,Suite 1200 ADLrtar $. 1 INSURER(S)AFFORDING COVERAGE NAIC# WoodlandHills CA 91367 ........................................................................................................................................................................................................................................................................................ INSURER A;Ohio Security Insurance Company 24082 .-- ......... ............. ......... .............-.. INSURED INSURER B:American Fire 8r Casualty Compan 24066 Signco, Inc. Dba: Wesco Signs INSURER C: I Wesco Signs, Inc. INSURER D 2413 Amsler Street INSURER E. Torrance, CA 90505 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 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 INSR TYPE OF INSURANCE ADDL'SUBR POLICY EFF POLICY EXP LT,R f�l„ R.,,W!W[� POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) LIMITS A COMMERCIAL GENERAL LIABILITY BKS56469691 04/15/2017 04/15/2018 EACH OCCURRENCE $1,000,000 +l i' Irli t;lurp u„ I,CLAIMS-MADE [ X�OCCUR P tn.brry4'�) is 1 i S500,000 ., .,, ., ...., ..,.. MED EXP,(Any one person) 15,00.0„ PERSONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s2,000,000 El JECT X ��LOC PRODUCTS-COMP/OPAGG 52,000,000 OTHERPRO- ............... � � �. ..._..u._. A L $ AUTOMOBILE LIABILITY UUMUINED SINGLE LIMI BAS56469691 04115/2017 0411512018,O=aarcidentl 51,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED HX SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED HIRED AUTOS AUTOS I(i a t.q r Iltr�MT+.V' , �yYi ua)I S B UMBRELLA LIAB X OCCUR ESA56469691 34115/2017 04/15/2018 EACH OCCURRENCE 55,000,000 X EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000 . WORKERS.0 OMP ENSATIONN ROcOO ... ... .... .... .... S �PS i ... AND EMPLOYERS'LIABILITY YIN FIR-�- -�-�----------� ---- ANY Pf'L i':'�"iIIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT S OFFICfi po ,HM N:MBER EXCLUDED? ❑ NIA (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: El Segundo Fire Department/348 Main Street, El Segundo, CA 90245 City of El Segundo-Public Works Department its Officials and Employees are included as Additional Insured's per attached form#CG8810(04/13). General Liability policy is Primary and Non-Contributory. CERTIFICATE HOLDER CANCELLATION City of El Segundo-Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S20484519/M20346832 MXTJB COMMERCIAL GENERAL LIABILITY CG 88 62 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - BLANKET VENDORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured any person(s) or organiza- tion(s) (referred to throughout this endorsement as vendor) whom you have agreed to add as an additional insured in a written contract or written agreement, 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. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these vendors, the following exclusions apply: 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 agree- ment; 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, test- ing 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. C. 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. © 2013 Liberty Mutual Insurance CG 88 62 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission, Page 1 of 1 spy N DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE I 05/11/2017 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()es) 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 NAME: Justin Benhoor Brookhurst Insurance Services LLC PHONE t), (818)465-7860 FAX No); (818)465-7856 16260 Ventura Blvd.Ste 720 6 0 E-MAIL Uslin brookhur'st,corn a0rs�r��s�, j. � INSURER(S)AFFORDING COVERAGE NAIC# Encino CA 91436 INSURER A: INSURED INSURER B WESCO SIGNS INC I INSURERC: 2413 AMSLER STREET INSURER D: Midwest Employers Casualty Company 23612 TORRANCE,CA 90505 INSURER E 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 'ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 'OLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, iLTR TYPE OF IN 11DCD 5ueri POLICY EFF POLICY YY tTR INSD wVD POLICY NUMBER IMMIDDIYYYY! (MMIDDIYVVI/) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ .........................Y CLAIMS-MADE r............� OCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ . .............. .PERSONAL&ADVINJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO F—]ECT LOG PRODUCTS-COMP/OP AGG $ 1 OTHER: J $ AUTOMOBILE LIABILITY COlABRgED�,',1NGLE LIMIT $ (Es accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ........... AUTOS NON-OWNED VG.'Y'AMAu"3Im $ HIRED AUTOS .... AUTOS (Pc I,acddevil) .,,.... UMBRELLA LIAB CLAIMS-MA ELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS DE AGGREGATE $ UM .... .. ,,,,,,.... DED I I RETENTION$ $ AND EMPLOYERS'LIABILITY YIN E L�,,,,,3T TIAITF ID,,,,T,Ep D OFFICER/MEMBER IEXCLUDED?ECUTIVE Dy NIA BNUWC013511501 02/07/2017 02/07/2018 .X....EACH"CC ll EN 1 R WORKERS COMPENSATION I! S A $ 1,000,000 (Mandatory in NH) E L,DISEASE-EA EMPLOYEE, $ 1,000,000 under If DESCRIPTI describe OF OPERATIONS below E L DISEASE-...POLICY..LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:El Segundo Fire Department-314 Main Street,El Segundo,CA 90245 Project No. PW 17-18 Waiver of subrogation in regards to Workers Compensation in favor of The City,its officials,and employees. CERTIFICATE HOLDER CANCELLATION 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 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo,CA 90245 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BNUWC0135115 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA(Blanket) 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 2.0000 % of the California workers'compensation premium otherwise due on such remuneration. Schedule State Description CA Any party with whom the insured agrees to waive subrogation in a written contract. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information belowis required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 02/01/2017 Policy Number: BNUWC0135115 Endorsement No.: Insured Name: Signco,Inc. Insurance Company: Midwest Employers Casualty Company Countersigned By �„�.