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PROOF OF INSURANCE (2018 - 2019) CLOSED .;^•,r;.v,".'+":.4'r+vr•wY✓:trY,Y'r'�4Y'�.4'+M.'::',': •3�,i�ir:r:„•:�S�.;�r,+C�:,,?tM'i�dCdc.•C�'".k�~r<:•✓rG<:YC'Cd�iS.::d�rk.:�$ii:,•.3: �- �r •..'''�k',�.'�'�,,..'i.. ':•�•+t.vr�,..Y�°.,�k"',✓^,..�k'✓•S.r•,.✓?'?�.rccw,�°;'�::tw'�„k �.r�...,�•.�,¢,".°'c3•d:'.:;'ivr':'�•:r.;'c:c��: � acfi;;:3adr.r>.`',).+.E•,�a;• :�'::,s:.k.'b•;1�•::;r�t'','?%at:;�A.��.'''rf"GSv'°��'":;'k;�:;.'°',;;��'�Ef;".�o s ��?<'<t•Eid'3:;i3�a F• >''•,..S.'".tEE"�_.Et::��f.fle1;.'•.;3'•. '':.S:.':;s�cS6r::ati i{'coca':,�n¢:ao-,r::.r,:c:},:✓,":�1i,r'.3''S''i<:xa.nt"�,�`."a�"..''„;;,;,:;•:',>✓3M1r,.�.;.� ., ISSUE r°ti4D'iA?�Ti'E^:(MMI;aD,,ar<D/'a.4y�ffl : 0 5 0 8 18 !lull* (Y tY !0' fciv" 3 .wr'1i ns>t. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Hanen Insurance Services, Inc. CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE 22231 Mulholland Hwy.. #209-A POLICIES BELOW. Calabasas CA 91302 COMPANIES AFFORDING COVERAGE (818) 222-9080 COMPANY A LETTER National Interstate Ins. Co. COMPANY B INSURED LETTER Insurance Company of The West Van Lingen Body Shop, Inc. COMPANY C dba: Van Lingen Towing LE TER 2755 Lomita Blvd. COMPANY D Torrance CA 90503 LETTER (310) 370-4533 I COMPANY I» dr "'...:7,�.M,.c.t•,.,i �.".';;d'::•>•.„?at;JS.�5'�:,':.�'."r�3.�:,•�9..,,.1,�.:•+,..c.rrq.„:.•�r,f�,�.N't.:.wr.,.:•,�r.,:.,r:F 5+1t.��r+,',."6..Y+4..a'c✓'ri c n<.'.�.�r,<.yf•..''>,r1 '�,!,i;,'.ra''rr,a::'+,:A':•r:S;.,x,.Jwr'rYra.a:'::•r�G�:v.•::•:i':..�•�nke,':;C d.' LnE��T•rrTEr"rR .000 ,,.:).�.�,,a,..sir>. >..x�.,'"...,.,,.•�.,.:'y^.::,;,r.<'.,�r.'ala,4.�n"�✓'r.,.�,.:,,.,,,.x.a'.5r•.:".,.i,r�I,*i,»�.->,mac5�:,„.+qt,I-,G.,f,.!rf:.:°,.:tc>'.'c..•r.L.: 2„flnit.:V:,Ef:�a Fj tbl�di.�...:������.�'r<v<.YfE.,....'-�.rf>•r.�4•r'.$3.Ir•,l'�,:r,3.. 8bk.cr'_Ai:.nqr.,�^-c•,:3,,�h:r.�3;:,::,P�Ir:';'.C. , r W�ku •G•r.�ot7.flkt,��:-.....k...i-...,rtd:ce..33Sa:'..a�".i��.�,�aa.r.,r••3.•�...”.��'�ra5�•S:anov'r4•.✓."k`eev,tn,,�w::.v.,,a,,,.-..,✓r.o-x+i.”:��n�.�,:•;rwtn<:..ewr,^�•��'.':;i�I�'�.,a:.,. �.•,�nn�...r•:tra��,:at'„" •4....,r?.^.'�,:v...r,••a.... 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. CO TYPE OF INSURANCE POUCYNUMBER POUCYEFF'ECTIVE POUCYEXPIRATION LIMITS !LTR' DATE(MM/DD/YY) DATE(MWDD/YY) a GENERAL U A131UTY GENERAL AGGREGATE 10 000, 000 COMMERCIAL GENERAL LIABILITY U PRODUCTS-COMP/OP AGO. T3, 000, 000 CLAIMS MADEX]occua TPC-4400004-00 10/15/17 11/01/18 ”PERSONAL&ADV.INJURY S1, 000, 000 OWNER'S s CONTRACTOR'S PROT. EACH OCCURRENCE $1, 000, 000 FIRE DAMAGE(Any one nre) $ 100, 000 MEMEXPENSE(Anyoneperson) $ 5, 000 A AUTOMOBILE UABIUTY COMBINED SINGLE S ANY AUTO LIMIT 1, 000, 000 _ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS TPC-4400004-00 10/15/17 11/01/18 'SODILYINJURY NON-OWNED AUTOS (Per accident) S GARAGE LIABILITY PROPERTY DAMAGE S A EXCESS uABIuTY EACH OCCURRENCE S1, 000, 000 x1,uMBRELLAFORM TPC-4400004-00 10/15/17 11/01/18 'AGGREGATE X83, 000, 000 OTHER THAN UMBRELLA FORM B I STATUTORY OMITS WORKEWS COMPENSATION WVE-5021332-06 04/01/18 04/01/19 EACH ACCIDENT �S1, 000, 000 AND EMPLOYERS'UABIUTY DISEASE—POLICY UMIT L$1,, 000, 000 DISEASE—EACH EMPLOYEE L$1, 000, 000 ]� OTHER On-Hook $ 200, 000 Garage Keepers TPC-4400004-00 10/15/17 11/01/18 $ 500, 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS 'he City of El Segundo, its officers, officials, employees, agent and volunteers are additional insureds f ,•tv.Wyss ':s':w��`��""k: �,. c:;!c ,>t .Sc, 'a I ,•..,r•y r' ',^,;; `,+;f✓+;•.:.::.s'�I'„v,-,,;.,rc°,17<r”; °%+',i;,s,;iiuo,:;S�;'. sa,y,', o- rx.k;,&'�,3, .•a�,ao . ":••: •,:1'. 3� tc.v>�' t•,.a•.< •I s,Jc.,•.:r,t�"r"•;:✓8+.'S;� •,:r>r 'S:•,s '.,?•::... �I... �,rA�3•'t:Y .f3 c.. ...t .f r .f: ..na. .''r ..+>. 'P., ` .� '4•P.~,�:':...:::a•t ,:•6c _ `�r F ra, .c s .,1.4. ..>. :'•i; rr•� i�.:• 'Mrt.' `�1'N,pl�,.` :'$'hd'•:<>¢:'�:•r•' ? ..?�?,. �S�t�'•>:• ..a.... �.�!l,: •:•5";;,>r -' ��:,�,•C>�. •. ..�" .,r:M•Ii�a,•c'�.•t� a.'>:,;..:.,r~:,.r�.,•�:.r.,:,,:v;�w;. r,�cc�',.e.,,+y�..;.�.?;�,,1.4x.. �S�:k .�',.,:�,,.,..'C .,�,.,.,.E„�'VaIE,rn. �RE'i ,I��t•:r,.�..,,�e.,s,�>� ac1'tr:tr":'�IS3FfEr3Er4�'r,�F.r.,�.il8sa�+�;;•,:r�::,' ;s$3;'""�:3e`v:;.,.4..,,r.:,33;.:x.;. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE amity Of El Segundo EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Public Works Dept. MAIL 10 DAYS WRITTEN NOTICE T TR CE TIFICATE HOLDER NAMED TO THE 350 Main St. LEFT, BUT FAILURE TO MAIL SU N'0' LL IMPOSE NO OBLIGATION OR E1 Segundo CA 90245 a= LIABILITY OF ANY KIND UPON T CO ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE yq ...,,.r••,,.•.:"M„•r.•rw•,•,N,,,,r :::.,,•r•:r,,,,r,,,••.r.,":.. .•..•:,, :.:'r ,•r•n r•,••.,,,:,,r,r ,..,.: •.r r.,r.,.•....,;,r�:•. :,,.i�'� •.•,,,.:,<�,�•„•.�..:•:: •,•::.:,, ,:. i ,..r. ., „• du, , .. �, ..a. t,. .�. ..r. .•.. u, ....... .r....:.;.,.,;r;r;r,�,.,.... .::�,R;r's•x•r°'•......�r.m �,t�n.',4a,;.,,.;•::�r.•,.,•,,,...tr.. Fav'� G X�,n.•,.�FdryS.;:; ..ff J:,: !.p ,�.c;, y r3.c..,,•,f`¢”" tip.. L;,CY.,..r�., ri. a•: .toss.tw.1::71.;;,f:..,U rtr,:.:::,.M:p.A�,. ,p •.r�4k•.. � �.•:-r� ; ,, v, M.,. ,.r:•. .r i' ,•;il:"s:''' ar• ;s+ . }.�.... , POLICY NUMBER:TPC440000400 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONL I S ' E - DESIGNATED PERSONORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): The City of EI Segundo, Its Officers, Officials, Employees,Agent&Volunteers Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for"bodily injury", "property If coverage provided to the additional insured is damage" or "personal and advertising injury' required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. In the performance of your ongoing operations; 1. Required by the contractor agreement; or or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the Declarations. 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. CG 20 26 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 dr VNATIONAL GENERAL LIABILITY CluvERAGE PART -17-7 INTERSTATE Policy Number FromPolicy Period TO NATIONAL INTERSTATE INSURANCE COMPANY 32§PTER%ff LIDR 001 1"100 281-9000 TPC 4400004 00 10/15/2017 11/01/2018 ' 9 12:01 AA StwWatd Time at tho doscdW kioation ITEM ONE: Transaction POLICY DECLARATION Named Insured VAN LINGEN BODY SHOP, INC. Insured's Name and Address(continued) Agent and Address DBA VAN LINGEN TOWING HANEN INSURANCE, SERVICE, INC 2755 LOMITA BLVD 22231 MULHOLLAND HWY STE 209-A TORRANCE CA 90505 AS,AS CA 91302 Telephone: 818-222-9080 Agent#: 4110069 Business Description Type of Business Audit Period TOWING AND RECOVERY OPER. CORPORATION NON AUDITABLE IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE Each Occurrence Limit $ 1,000,000 Personal and Advertising injury Limit $ 1,000,000 General Aggregate Limit(Other then Products-Completed Operations) $ 3,000,000 Products-Completed Operations Aggregate Limit $ 3,000,000 Medical Expense Limit,any one person $ 5,000 Damage to Premises Rented to You Limit,any one premises $ 100,000 CLASSIFICATIONS Refer to attached schedule TOTAL PREMIUM FOR THIS COVERAGE PART $ 18,492 AUDIT PERIOD F-1 ANNUAL NON-AUDITABLE F1 OTHER Forms and Endorsements Ap9licable to this Policy See Attached Schedule ExwV in this Declaration,when we use the word*Declarations"in this Coverage Part,we mean this"Declarations"of the"' ommon Policy Declarations". Issued Date: 12/07/203.7 INS Page 1 of I GLDEC NIC6000f 0101 COMMERCIAL GENERAL LIABILITY CG 00 01 04 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. (2) The "bodily injury" or "property dam- Read the entire policy carefully to determine rights, age" occurs during the policy period; duties and what is and Is not covered. and Throu hout this policy the words"you"'and "your" (3) Prior to the policy period, no insured refer ?o the Named Insured shown In the Dec- listed under Paragraph 1. of Section 11 laxations, and any other person or organization — Who Is An Insured and no qualifying as a Named Insured under this policy. "employee" authorized by you to give The words "we", "us!' and "our" refer o the or receive notice of an "occurrence"or company providing this insurance. claim, knew that the "bodily Injury" or The word "insured" means any person or organiza- "prof". damage" had occurred, in tion qualifying as such under Section 11 — Who Is who(e or in part. If such a listed insured An Insured. or authorized "employee" knew, prior to the policy period, that the "bodily Other words and phrases that appear in quotation Injury" or "property damage" occurred, marks have special meaning. Refer to Section V then any continuation, change or re- -Definitions. sumption of such "bodily injury" or SECTION I—COVERAGES property damage" during or after the COVERAGE A— BODILY INJURY AND PROPERTY policy period will be deemed to have DAMAGE LIABILITY been known prior to the policy period. 1. Insuring Agreement c. "Bodily injury" or"property damage"which occurs during the policy period and was a. We will pay those sums that the insured not, prior to the policy period, known to becomes legally obligated to pay as have occurred by any Insured listed under damages because of "bodliv injury" or Paragraph 1. of Section if — Who Is An "property damage" to which this Insurance Insured or any "employee" authorized by applies. We will have the right and duty to you to give or receive notice of an "occurr- defend the insured against any "suit" ence" or claim, includes an continuation, seeking those damages,. However, we will change or resumption 0? that "bodily have no duty to defend the insured against injury" or "property damage" after the end any "suit" seeking damages for "bodily of the policy period. injury" or "property damageo to which this d. "Bodily Injury" or "property damage" will in- surance does not apply. We may,at our discretion, Investigate any ""occurrence" be deemed to have been known to have occurred at the earliest time when any and settle any claim or suit that may insured listed under Paragraph I. of result, But: Section 11 — Who Is An Insured or any (1) The amount we will pay for damages is employee" authorized by you to give or limited as described in Section III — receive notice of an"occurrence"or claim: Limits Of Insurance;and (1) Reports all, or any part, of the "bodily (2) Our right and duty to defend ends injury" or "property damage" to us or when we have used up the applicable any other insurer; e limit of Insurance in the payment of (2) Receives a written or verbal demand or Judgments or settlements under Cov- claim for damages because of the erages A or s or medical expenses "bodily injury" or "property damage"; under Coverage C. or No other obligation or liability to pay sums (3) Becomes aware by any other means or perform acts or services is covered that "bodily Injury" or "'property dam- unless explicitly provided for under Supple- age" has occurred or has begun to ment,iry Payments—Coverages A and S. occur. b. This insurance, applies to "bodily injury" e. Damages because of"bodily injury" include and"property damage"only if: damages claimed by an� person or organ- (1) The "bodily injury" or "property dam- ization for care, loss 0 services or death age" is caused by an "occurrence" that resulting at any time from the "bodily takes place in the"coverage territory"; injury". CG 00 01 04 13 0 Insurance Services Office, Inc.,2012 Page I of 16 Wolters Kluwer Financial Services I Uniform Forms TM POLICY NUMBER:TPC 4400004 00 COMMERCIAL AUTO CA 99 37 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GARAGEKEEPERS COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: VAN LIN EN BODY SHOP INC. DBA VAN LINGEN TOWING` Endorsement Effective Date: SCHEDULE Location Number Address Where You Conduct Garage Operations(Main Location) 00001 2755 LOMITA BLVD TORRANCE CA 90505 Coveraaes Limit Of Insurance And Deductible Premium Comprehensive $ 500,000 Limit Of Insurance $ 274 $ 500 Deductible For Each Customer's Auto For Loss Caused By Theft Or Mischief Or Vandalism $ 2,500 Maximum Deductible For Loss Caused By'Theft Or Mischief Or Vandalism In Anv One Event OR $ Limit Of Insurance $ Deductible For All Perils For Each Customer's Auto $ Maximum Deductible For All Loss In Anv One Event CA 99 3710 13 ©Insurance Services Office, Inc., 2011 Page 1 of 6 Wolters Kluwer Financial Services I Uniform Formem Specified $ Limit Of Insurance $ ' Causes Of Loss $ Deductible For Each Customer's Auto For Loss Caused By Theft Or Mischief Or Vandalism $ Maximum Deductible For Loss Caused By Theft Or Mischief Or Vandalism In Any One Event OR $ Limit Of Insurance $ Deductible For All Perils For Each Customer's Auto Is Maximum Deductible For All Loss In Any One Event Collision $ 500,000 Limit Of Insurance $ 408 i $ 500 Deductible For Each Customer's Auto Location Number Address Whore You Conduct Oara verautions 00002 20621 EARL ST TORRANCE CA 90503 Coverages Limit Of Insurance And Deductible Premium Comprehensive 1$ 500,000 Limit Of Insurance $ 274 $ 500 Deductible For Each Customer's Auto For Loss Caused By Theft Or Mischief Or Vandalism $ 2,500 Maximum Deductible For Loss Caused By Theft Or Mischief Or Vandalism In Any One Event OR $ Limit Of Insurance $ Deductible For All Perils For Each Customer's Auto $ Maximum Deductible For All Loss In Any One Event Specified $ Limit Of insurance $ Causes Of Loss $ Deductible For Each Customer's Auto For Loss Caused By Theft Or Mischief Or Vandalism $ Maximum Deductible For Loss Caused By Theft Or Mischief Or Vandalism In Any One Event OR $ Limit Of Insurance $ Deductible For All Perils For Each Customer's Auto $ Maximum Deductible For All Lass In An One ne Event .. Page 2 of 6 0 Insurance Services Office, Inc., 2011 CA 99 37 1013 sr Direct Coverage Options Indicate below with an "X"which, if any, Direct Coverage Option is selected. ❑Excess Insurance If this box is checked, Garagekeepers Coverage remains applicable on a legal liability basis. However, coverage also applies without regard to your or any other"Insured"'s" legal liability for"loss"to a "Customer''s auto"on an excess basis over any other collectible Insurance regardless of whether the other Insurance covers your or any other"Insured's"Interest or the interest of the"customer's auto"s" owner. Primary Insurance If this box is checked,Garagekeepers Coverage is changed to apply without regard to your or any other "insured's"legal liability for"loss"to a"customer's auto and is primary insurance. A. This endorsement provides only those 2. We will have the right and duty to defend coverages: any "Insured" against a "suit' asking for 1. Where a Limit Of Insurance and a premium these damages. However, we(have no duty are shower for that coverage in the to defend any "insured" apinst a "suit' Schedule; and seeking damages for "loss to which this 2. For the location shown in the Schedule. insurance does not apply. We may investigate and settle any claim or"suit"' as B. Coverage we consider appropriate. Our duty to 1. We will pay all sums the "insured" legally defend or settle ends for a coverage when must pay as damages for "loss" to a the Limit of Insurance for that coverage has "customer's auto" or "customer's auto" been exhausted by payment of judgments equipment left in the "Insured's" care while or settlements. the "insured" is attending, , servicing, 3. Who Is An Insured repairing, parking or storing It in your The following are "insureds"" for "loss" to ""garage operations""under: "customer's autos" and "customer's auto" a. Comprehensive Coverage equipment: From any cause except: a. You. (1) The "customer's auto's" collision b. Your partners and their spouses, if you with another object; or are a partnership, but only with respect (2) The"customer's auto's"overturn. to the conduct of your "'garage operations". b. Specified Causes Of Loss Coverage C. Your members, if you are a limited Caused by: liability company, but only with respect (1) Fire, lightning or explosion; to the conduct of your "garage oper- ations Your managers are also (2) Theft; or "insureds", but only with respect to (3) Mischief or vandalism. their duties as your managers. C. Collision Coverage d. Your "executive officers" and directors, Caused by: if you are an organization other than a (1) The "customer's auto's" collisionpartnership or limited liability company" with another object; or but only with respect to their duties a your officers or directors. Your stock- (2) The "customer's auto's"overturn. holden are also "insureds", but only with respect to their liability as stockholders. v Page 4 of 6 ©Insurance Services Office, Inc., 2011 `CA 99 37 10 13 a. Your "employees", other than either d. Faulty Work your "executive officers" (If you are an Faulty"work you performed" organization other than a partnership or limited liability company or your man- 2. we will not pay for "loss" to any of the agers (if you �Imlted liability following: company), but only for acts within the a. Tape decks or other sound-reproducing scope of employment by you or while equipment unless permanently installed performin their duties related to the in a"oustomer's auto". conduct oil your"garage operations", b. Tapes, records or other sound- 4. Coverage Extensions reproducing devices designed for use The following applies as Supplementary with sound-reproducing equipment. Payments.We will pay for the"Insured": c. Sound-receiving equipment designed a. All expenses we incur. for use as a citizens band radio, b. The costs of bonds to release attach- two-way mobile radio or telephone or scanninmonitor recr, its ments, In any "suit" against an antennasg and other ams oriels, unless "Insured" we defend, but only for bond permanently installed in the dash or amounts within our Limit of Insurance. console opening normally used by the c. Ali reasonable expenses incurred by the "customer's auto" manufacturer for the "insured" at our request, Including installation of a radio. actual loss of earnings up to $250 a d. Any device designed or used to detect day because of time off from work. speed-measuring equipment, such as d. All court costs taxed against the radar or laser detectors and any "insured" in any "suit' against an jamming apparatus intended to elude or "insured"" we defend. However, these disrupt speed-measuring equipment. payments do not Include attorneys" 3. We will not pay for "loss" caused, by or fees or attorneys' expenses taxed from the following. Such "loss" is against the"insured", = regardless of any other 'cause or e. All interest on the full amount of any event that contributes concurrently or in judgment that accrues after entry of the any sequence to the"lose: judgment In any "SUrit' against an a. War,including undeclared or civil war; "insured" we defend; but our duty to b. Warlike action by a military force, In- offered ends when we have paid, chiding action in hindering or defending offyored to pay, or deposited in court the part of the judgment that is within against an actual or exp6cted attack, by our Limit of Insurance. any government, sovereign or other authority using military personnel or These payments will not reduce the Limit other agents; or of Insurance. c. Insurrection, rebellion, revolution, C. Exclusions usurped power or action taken by 1. This insurance does not apply to any of the governmental authority in hindering or following: defending against any of these. a. Contractual D. Umits Of Insurance And Deductibles Liability resulting from any contract or 1 Regardless of the number of "customer's .,agreement by which the "insured" autos"", "insureds"', premiums paid, claims accepts responsibility for "loss". But made or suits" brought, the most we will this exclusion does not apply to liability pay for each "loss" at each location is'the for "loss"' that the "insured" would Garagekeepers Coverage Limit Of Insurance have in the absence of the contract or shown In the Schedule for that location. agreement. Prior to the application of this limit, the b.. Theft damages for "loss" that would otherwise be payable will be reduced by the "Loss" due to theft or conversion applicable deductibles for"loss"caused by: caused in any way by you, your a. Collision;or "employees"or by your stockholders. c. Defective Parts Defective parts or materials. CA 99 37 10 13 0 insurance Services Office, Inc.,2011 Page 5 of 6 b. With respect to Caragekeepers Cover- 2. "Loss" means direct and accidental loss or age Comprehensive or Specified Causes damage and includes any resulting loss of Of Loss Coverage: use. (1) Theft or mischief or vandalism;or 3. "Garage operations" means the ownership, {2} All perils. maintenance or use of locations for the 2. The maximum deductible stated In the purpose of a business of selling, servicing„ repairing, parking or storing "customer's Schedule for Oaragekeepers Coverage autos" and that portion of the roads or Comprehensive or Specified Causes Of other accesses that adjoin these locations. Loss Coverage is the most that will be "Garage operations"" also Includes all deducted for all "loss" in any one event operations necessary or incidental to the caused by: performance of garage operations. a. Theft or mischief or vandalism;or 4. "Worst you performed"includes: b. All perils. a. Work that someone performed on your 3. To settle a claim or "suit", we may ay all behalf;and or any part of the decuctible. if this b. The providing of or failure to provide happens you must reimburse us for the warnings or instructions. deductible or that part of the deductible that we paid. E. Additional Definitions As used in this endorsement: I. "Customer's auto"' means a land motor vehicle, "trailer" or semitrailer lawfully within your possession for service, repair, storage or safekeeping, with or without the vehicle owner's knowledge or consent. A, "customer's auto" also includes any such vehicle left in your care by your "ernployeee" and members of their house- holds who pay for services performed. Page 6 of 6 a insurance Services Office, Inc.,2011 'CA 99 37 10 13 M w WORKERS COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY—INFORMATION PAGE INSURER: POLICY NO: WVE 5021332 06 INSURANCE COMPANY OF THE WEST REAL OF: NSA 5021332 05 NCCI Company No: 19593 Account No: RISK ID #3246803 N.J.Taxpayer Identification No. ITEM 1. NAMED INSURED AND MAILING ADDRESS: PRODUCER NAME AND ADDRESS: VAN LINGEN BODY SHOP INC ARTHUR J GALLAGHLR b CO INS 2755 LOMITA BLVD P.O. BOX 7419 TORRANCE CA 90505 THOUSAND OAKS CA 91359 PRODUCER NO.: 0010249 LEGAL ENTITY: CORPORATION OTHER WORKPLACES NOT SHOWN ABOVE: (See Workers Compensation Classification Schedule) ITEM 2 POLICY PERIOD: From: 04-01-2018 To: 04-01-2019 Effective 12:01 A.M. Standard Time at the Insured's mailing address. ITEM 3. COVERAGE: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: CA B. Employers' Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident: $ 1,000, 000 each accident Bodily Injury by Disease: $ 1,000, 000 policy limit Bodily Injury by Disease: $ 1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AL AX AZ AR CO CT DE' DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC OK OR PA RI SC SD TN TX UT VT VA WV WI D. This Policy includes these Endorsements and Schedules: See Schedule of Forms and Endorsements. ITEM 4. PREMIUM: The premium for this Policy will be determined by our Manuals of Rules,Classifications,Rates and Bating Plans. All Information required on the Workers Compensation Classification Schedule is subject to verification and change by audit. Total Estimated Minimum Premium: $ 1,050 Annual Premium: $ 78,203 Audit Period:MONTHLY Issued At: Ventura, CA Date: 04-05-18 Countersigned by WC 00 00 01 A CopyrtgM 1987 Natiomi Council on Compersatlon Irsumme A (Ed.9.06) INSURED s WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed.8.00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-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). The additional premum for this endorsement shall be 3%of the total California Workers'Compensation premium otherwise due. Schedule Person or Organization Job Description ANY PERSON OR ALL CA OPERATIONS ORGANIZATION WEEN REQUIRED BY WRITTEN CONTRACT This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The informatlon below Is required only when this ends,Q;. � :Is issued subsequent to preparation of ttie poky.) Endorsement Effective 04/0112018 Policy No.WVE 5021332 06 Endorsement No. Insured VAN LINGEN BODY SHOP INC Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed.8.00) INSURED