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PROOF OF INSURANCE (2018 - 2018) CLOSED III CERTIFICATE OF LIABILITY INSURANCE °11/21/2017 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(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 certificato holder In Ileu of such o'ndorsement'(s). PRODUCER CONTACT John McComb Trinity Insurance services,Incgip.Earl; 818-773-0079 lAc,l(��;,�18-773-0059 - 22048 Sherman way,Suite 201 °E,M , Canoga Park,California 91303 APPR�-- .•..•.•. . P"00 ER ..........°... ,,,.,._................._........., LN-SU RUt1IB AFFORDING COVERAGE NNC P INSURED •..... - Ins Co Mobile Illumination,Inc INSURER B: 21817 Plummer St STE C -°— Chatsworth, CA 91311 INSURER c hNsuRmo AIG-National Union Fire T.. ' '+.e.OR1,��°^ pensat i Ins......Fund I....... ....... _.......... .. . NSU 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. -IIDBR - ...""�Ni'II't,'a'L`StIBR .......�..._.W. tYLHC'Y EFF' ., ...-- — Lm TYPE OF INSURANCE POLICY NUMBER MmOD1YYYYp 1 LIMITS GENERAL LIABILITY ........................ .�....... E .�&��„•_'UroRREENNWC•I:ED .....^?T- sS „3,.000,000 CCMMERCIALGrNEmAm .aArp9aY E 100,000 ..•.•..., CLAIMS-MADE ZIOCCR 5,000A X X 101GL0054665-01 35/09/17 05/09/18 PERSONAL ADVHJURY 3,000,000 " ..�.•. ................----.... GENERAL AGGREGATE _$ 4,000,000 GENIAGGREGATE LIMIT'.APPLIES PER: NPRODUCTS,.-.C...O....M.._P./OP AGG S 4'.0....0...0.�,000 POLICY I01 Lr $ , AUTOMOBILE LIABLITY )SINGLE ANY AUTO _ (Ea acd0erd B NED SINGL S - •�� BODILY INJURY(Per person) 'S _ ALL OWNED AUTOS -- ,.,., ... .. BODILY INJURY(Per accident) S SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNEDAUTOS S UMBRELLA LI11B AGGREGATE2,0'0"0,00000 mm EXCESS LIAR CLAIMS�IADE OCCURAC�P1 C7CCY„!Rmk...._................... E' DEDUCTIBLE X EBU051521686 05/19/17 05/09/18 gym• F --_ E _............._.. D E.�_. I O RETENTION, 5WORKERS .,.....�� m...�.•.•..v...°......�,•. E SATION ANY PROPRIETDRIPARTNER/EXECUTIVE 'STAT U- 07 FF E O�FMFIaOd CSj AND YMe�EHRNFxcLUD m II NIA X II9118139- 017 10/16/17 10/16/18 EL q0 s ER_ a•..••... 1,000,000 YIN Y CCI_EMPLOYEr;, Ifyyes,daacnl�eumdor _ E 1,000,000 U,SCRIPIION Or-OPERATIONS below V E.L...DISEASE..-POLICY LIMIT •...•.•.•.•., L E 1,000,000 b i a r d DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AdElUonel Rernarks Schedule,H more space is required) CERTIFICATE HOLDER CANCELLATION' N City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:City Cleric THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street Room 5 ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo,Ca.90245 I AUTHORIZED REPRESENTATIVE 01988-2009 AG"ORD CORPORATION, All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS— SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE s lrii�,Q peiii)hw n #pan(s (Additional Insured)-i—, AS DESiGNA1715DIN WRI*rTEN CONTRACT [AS—D—E'SIGI NXTED IN WRITTEN CONTRACT WTH THE NAMED INSURED WTH THE NAMED INSURED 'k I"a "r'aire-ed that this Insurance shail be Primary and Nion,Contribulory'IbUt only in the event of a Named Insured's sole negligence, I —, , , 'r � . . -.-," A. SECTION If—WHO 13 AN INSURED is amended to mOUCIC aS an additional Insured the person(s),or orgaivzoton(s)sha"in the SchodLile for whom you an-perion,ning operations when yoti and such person or organization have road m wn'Inq in a uontracl or agreement that Stich Person or organization be added as an additionat insurAd on your pof^cy, Such person or organwation ts an additional insured oriy yvith respect to l4bifty for'bactly injuq" 'fxaoetty dwlaae,"ur"personat and advWWrV 1n)U 'caused in whole or in pan, by 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations twTho additional insu"s)at the location(s)designated above. A Person's or orgaivzanon`s statua as an additional insured under this endorsement ends when your operations for thaladditional insured are cornpWted- & With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: lel nsurance does not apply W AddlSonal Insured ConVactual Liability 'Bodily inlury'or"property,domage'for vAich the addibonak mt�tired(s)are obligated to pay damages by reason of the assumption of liability in a contract or aqrceirent Finished Operations at Work *Bodily injury"or'property damage"occurring after. 1. AN work, including malionals, parts or eqLopoient furnished in connection with such wixU,an the prqect (other than service, maintenance or repaiirs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been comploited;or 2. That portion of'your worWout of which the injury or darnage woes has bow put to ft Intended use by any person or organization. Negligence of Additional Insured "Bodly Injury"or'property d~ adsirV directly or indirectly out of to negligence of the additional U158-0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 2 with Its Permission ENDT.0001 EFF:07=291 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endomementmodifies insurance provided under the following- COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART The fallg is added to Paragraph 8.Transhier Of Rights Of Recovery Against Other*To Us of$action IV-Conditions We waive any rights of rerovery we may have against any person or organization because of payments we rf iake for injury or darriage,resulWig ftorn your ongoing operations of"your Work"done under a contract with that person or organization and included In the"piroducts-compIated operations hazard" if a. you agreed to such waiver; b. the waiver is inciuded as part of a wi*en contract or lesse; and c. such written contract or lease was executed pritor to any loss to which this insurance applies, ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047-0310 Includes copyrighted matefial of ISO Properties, Inc , Page I of 1 with Its penintesion. INIU1•IICI flfll I�In CERTIFICATE OF INSURANCE SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. This certifies that: ® STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas,or ❑ STATE FARM INDEMNITY COMPANY of Bloomington, Illinois has coverage in force for the following Named Insured as shown below: NAMED INSURED: MOBILE ILLUMINATION, INC. ADDRESS OF NAMED INV'RED: 21817 PLUMMER ST. CHATSWORTH, CA 91311 POLICY NUMBER 592 9158-B21-75A 593 6305-C06-75 EFFECTIVE DATE OF POLICY 08/22/17-02/22/18 09/06/17-03/06/18 DESCRIPTION OF 2016 DODGE RAM 2017 FORD 5500 TRANSIT 250 VEHICLE(Including VIN) 3C7WRNAJ9GG224669 IFTYRZMlHKA75266 LIABILITY COVERAGE ® YES ❑ NO ®YES ❑ NO F❑YES ❑ NO ❑YES ❑ NO LIMITS OF LIABILITY a.Bodily Injury Each Person 1,000,000 110001000 Each Accident 1,000,000 1,000,000 b.Property Damage Each Accident 1,000,000 1,000,000 c. Bodily Injury& Property Damage Single Limit EachAcciderut $1,000,000 PHYSICAL DAMAGE COVERAGES ®YES ❑ NO ®YES ❑ NO ❑ YES ❑ NO ❑YES ❑ NO a.Co .................De,,,,,,Deductible rripretuenspr O Deductible O................. ®YES ❑ NO ®YES ❑Deductible a 1e YES ° ❑ NO ❑YES ❑ NO b.Collision $ 500.00 Deductible $500.oo Deductible $ Deductible $ Deductible EMPLOYERS NON-OWNED CAR ❑ NO ❑YES ❑ NO ❑YES ❑ NO [:1 YES ❑ NCAR LIABILITY COVERAGE ❑ ..— HIRED CAR LIABILITY ❑ YES ❑ NO ❑YES ElNO [71YES ❑ NO E]YES ❑ NO COVERAGE FLEET- �AAGE FOR M V IC LICENSED ❑YES ® NO ❑YES ❑ NO ❑YES ❑ NO ❑YES ❑ NO M. TOR VEHICL S AGENT 1484 11/22/2017 __allure of Autho ..............._.__ ..........._.... _.. Slg zed Representative Title Agent's Code Number Date Name and Address of Certificate Holder ._._... m Name and Address of Anent _. ................................ FCITY OF EL SEGUNDO STATE FARM INSURANCE COMPANIES ATTN: CITY CLERK JOHN MCCOMB, AGENT 350 MAIN STREET, ROOM 5 P.O. BOX 729 EL SEGUNDO, CA 90245 WOODLAND HILLS, CA 91365 PHONE: 818/225-1234 FAX: 818/225-1111 P .............. .. _.. INTERNAL STATE FARM USE ONLY: Request permanent Certificate of Insurance for liability coverage 122429,2 Rev.06-10-2004 ( Request Certificate Holder to be added as an Additional Insured. CIVK,CIYICN I AUKCCIVICIY 1 "%ofl%v"" ♦/Vr I WAIVER OF SUBROGATION REP 05 BLANKET' BASIS 9118139-17 RE IL YU ScNNEWAL HOME OFFICE 7-50-30-72 SAN FRANCISCO EFFECTIVE OCTOBER 16, 2017 AT 12.01 A.M. PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AND EXPIRING OCTOBER 16, 2018 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME MOBILE ILLUMINATION, INC 21817 PLUMMER ST STE C CHATSWORTH, CA 91311 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: OCTOBER 17, 2017 r 2572 AI341?FIIZb RI P11E, EIT IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.7-1014) OLD DP 477