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PROOF OF INSURANCE (2019 - 2019) CLOSED WESTN-1 OE IDO KQ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 0312112018 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 have ADDITIONAL INSURED provisions or be endorsed. V 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). StockddSallef 02 1 1 rsfield) 6ti1-843-1546 Pp VCT �,661-843^1546 FAX ay.661-327-3321 PO Box 10269 N6 Ext )'661 A 6. _r nc( stockdalelnsurance.com Bakersfield,CA 93389-0269 (( INst�BRls)nFFORo)NG.,covEn,cE LLa,Ir„n,,.....,. Hadley Littlewood INSURER A� p y AIX Specialty Insurance Co 12833 .... .... .... ..... ...... 15542 Chemical Lane Huntington Beach,CA 92649 INSURER Travelers !?e e 18445 INSURED Westnet Inc H Insurance oInsurance INSURER13: y 250 046 Company 54 INSURER D. . „ ..... .... .... .............., INSURER E:Granite State Insurance 23809 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, QTR TYPE OF INSURANCE INSD SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS �,VD rMMIOOlWYY1 fMMIDDIVYVYI -A X COMMERCIAL GENERAL LIABILITY LAIJII�a'' JPN'I_IfJ� p. q, 1,000,000 X LIKA876342-02 03/15/2018 03115/2019 +I+In` °°°' 0 Y L s IA I „l 1 r ill'.urtl 50 00.... 5,000 ;I,aIIr+.J (;, ,u:wurcJ,ll.11r, p 1,000,000 r�;c I � ,IIIII III IIInIIIIII 1"IIS _ 2,000,000 u - 11 1.11.1 I III J ..� ,000,000 X AUTOMOBILE I+INM IIViVy V U+t rYVrulhfi + 1... 1,000,000 0.0 C AUT ,000 0 Y BA-1 C324039 07130/2017 07/30/2018 1 ANI II 0 I II r �� IIII VDI II k I', XX a olu,ll I rcl III ui1 IIII, wrl,Y IiJ s!! ....... X BR IAB X 2,000,000 B Exc ssLIABu 1 ml I:Inln EBU019230157 03/1512018 03/15/2019 ' 2,000,000 L"I'l I XII 1r1 II1011 1'I'f 0 E DEMRS IDN V S7H..III'�T ,IIII I',I.L1,,.4.9,11 1; ....,....' E WORKERS COMPENSATION Y I N 065-25-7102 CA 04/0112018 0410112019 TIF 1,000,000 ANN�!�Iru,uutPLovEUI2S LIABILITY LT��dJl 065-25-7101 AOS 04/01/2018 04/0112019 L„I_',u ,,.I .Ii,.l 1,r111 ,r11 L, ,u 1,000,000 �I.IIIII IIII (� I n1 +I�IIII I.n I� 1III,r11 ( ) Oo IVII�II+,VIII' NTA (AOS) V VI Y^i V',li �l'II`II II'Itlll I,I h,+,Viwm F1 lul',,,dI,11',11„ 111,111k 11P,II IIP,II111 �$ 1,000,00 li+;�' '111�n Ips+ 1 „ ” a D P1'ofesslonal EMT 12165 6 08108/2017 0810812018 ,aggregate 2,000,000 Occurence 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) EI Segundo Fire Department,,City, its officials, and employees are named as additional insulr'ed as re 'uired by written contract per the attached lalanket endorsements(GL&ALI.This 'insurance is primary and non'-contributory, CERTIFICATE H LDER CANCELLATION CITYELS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EI Segundo Fire Department ACCORDANCE WITH THE POLICY PROVISIONS. City of EI Segundo canderson@elsegundo.org AUTHORIZED REPRESENTATIVE 314 Main Street -" B Seaundo.CA 90245 ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: LIKA876342 02 GDMMERCIAL GENERAL LIABILITY CG 2D 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART L,.,,. A. Section 11--Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or agreement that such person or organization be 1. "Bodily injury",, "proPertYdame eor"personal onal added as an additional insured on your policy. and advertising injury" arising out of the Such person or organization is an additional rendering of, or the failure to render, any insured only with respect to ilabllity for "bodily professional architectural, engineering or Injury' "property damage" or "personal and surveying services,including: advertising injury"caused,in whole or in part,by, a. The preparing, approving, or failing to 1. Your acts or omissions;or prepare or approve, maps, shop drawings, on our opinions, reports, surveys, field orders, 2. The acts or omissions of those acting y change orders or drawings and behalf; specifications;or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims against additional insured: any insured allege negligence or other wrongdoing 1. Only applies to the extent permitted by law; in the supervision, hiring, employment, training or and monitoring of others by that insured, If the 2. Will not be broader than that which you are "occurrence" which caused the "bodily injury" or required by the contract or agreement to "property damage", or the offense which caused provide for such additional insured. the"personal and advertising injue, involved the Bison's or organization's status as an rendering of or the failure to render any A P 9 professional architectural, engineering or additional insured under this endorsement ends surveying services. when your operations for that additional insured are completed. CG 20 33 0413 0 Insurance Services Office,Inc.,2012 Pagel of 2 2. "Bodily injury" or "property damage" occurring C. With respect to the insurance afforded,to these after additional insureds, the following is added to a. All work, including materials, parts or Section III—Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1, Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured: insured(s) at the location of the covered or operations has been completed;or 2. Available under the applicable Limits of b. That portion of"your work"out of which the Insurance shown in the Declarations; injury or damage arises has been put to its whichever is less. intended use by any person or organization other than another contractor or This endorsement shall not increase the subcontractor engaged in performing applicable Limits of Insurance shown in the operations for a principal as a part of the Declarations. same project. Page 2 of 2 ©Insurance Services Office, Inc.,2012 CG 20 33 04 13 POLICY NUMBER: LIKA876342 02 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Location And Description Of Completed Operations Where required in a written contract or agreement, provided the written contract or agreement is executed prior to the date of any loss. Information reouired to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section 11--Who Is An Insured is amended to S. 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" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we 'your worl?' at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and includedin the "products-completed operations 1. Required by the contract or agreement;or hazard', 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law;and Limits of Insurance shown in the Declarations. 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 37 0413 iso Insurance Services Office, Inc.,2012 Pagel of 1 POLICY NUMBER: LIKA876342 02 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Or anization: 'V'�►-iere reclOr cl in a writ en contract or agreement, provided the written contract or agreement is executed prior to the date of any loss. Information regurect to complete thisSchedule, if not shown above,will be shown in the Declarations. 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 againstJ"�, 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_ CG 2404 05 09 0Insurance Services Office, Inc.,2008 Page 1 of 1 ❑ POLICY NUMBER= L.IKA876342-02 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. PRIMARY NON-CONTRIBUTORY ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART When required by written contract or agreement,the insurance provided by endorsement *See Below is primary insurance and we will not seek contribution from any other insurance available to the person or organization covered as additional insured hereunder unless the other insurance is provided by a contractor, other than you,for the same operations and job location.Then we will share that other insurance by the method described in SECTION IV—CONDITIONS,Paragraph 4.Other Insurance subparagraph c. Method Sharing. ALL OTHER TERMS,CONDITIONS,AND EXCLUSIONS REMAIN UNCHANGED. CG2033, CG2037&CG2404 801-0073 06 13 Includes copyrighted material of Insurance Services Office,Inc.,with Its permission Page 1 of i POLICY NUMBER: BA-1C324039 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO EQUIPMENT—INCREASED LIMIT C. EMPLOYEES AS INSURED I. WAIVER OF DEDUCTIBLE—GLASS D. SUPPLEMENTARY PAYMENTS — INCREASED J. PERSONAL EFFECTS LIMITS K. AIRBAGS E. TRAILERS—INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP F. HIRED AUTO PHYSICAL DAMAGE M, BLANKET WAIVER OF SUBROGATION G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT A. BLANKET ADDITIONAL INSURED performing duties related to the conduct of The following is added to Paragraph A.1., Who Is your business. An Insured, of SECTION II — LIABILITY COV- 2. The following replaces Paragraph b. in B.S., ERAGE: Other Insurance, of SECTION IV — BUSI- Any person or organization who is required under NESS AUTO CONDITIONS: a written contract or agreement between you and b. For Hired Auto Physical Damage Cover- that person or organization, that is signed and age, the following are deemed to be cov- executed by you before the "bodily injury" or ered"autos"you own: "property damage" occurs and that is in effect (1) Any covered "auto" you lease, hire, during the policy period, to be named as an addi- rent or borrow;and tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance (2) Any covered "auto" hired or rented by applies and only to the extent that person or or- your "employee" under a contract in ganization qualifies as an "insured" under the that individual "employee's" name, Who Is An Insured provision contained in Section with your permission, while perform- IL ing duties related to the conduct of B. EMPLOYEE HIRED AUTO your business. However, any "auto"that is leased, hired, 1. The following is added to Paragraph A.1., rented or borrowed with a driver is not a Who is An Insured, of SECTION II — LI- covered"auto". ABILITY COVERAGE: An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is under a contract or agreement in that "em- An Insured, of SECTION 11 — LIABILITY COV- ployee's" name, with your permission, while ERAGE: CA T4 20 07 10 ©2010 The Travelers Indemnity Company.All rights reserved. Page I of 3 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO Any "employee" of yours is an "insured"while us- (3) If a repair or replacement results in better ing a covered "auto"you don't own, hire or borrow than like kind or quality, we will not pay for the in your business or your personal affairs. amount of betterment. D. SUPPLEMENTARY PAYMENTS — INCREASED (4) A deductible equal to the highest Physical LIMITS Damage deductible applicable to any owned 1. The following replaces Paragraph A.2.a.(2) of covered "auto". SECTION 11—LIABILITY COVERAGE: (5) This Coverage Extension does not apply to: (2) Up to $3,000 for cost of bail bonds (in- (a) Any "auto" that is hired, rented or bor- cluding bonds for related traffic law viola- rowed with a driver; or tions) required because of an "accident" (b) Any "auto" that is hired, rented or bor- we cover. We do not have to furnish rowed from your"employee". these bonds. G. PHYSICAL DAMAGE — TRANSPORTATION 2. The following replaces Paragraph A.2.a.(4) of EXPENSES—INCREASED LIMIT SECTION 11—LIABILITY COVERAGE: (4) All reasonable expenses incurred by the The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of Para- " insured" at our request, including actual SECTION III — PHYSICAL DAMAGE COVER- loss of earnings up to $500 a day be- AGE: COVER- cause of time off from work. E. TRAILERS--INCREASED LOAD CAPACITY We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- The following replaces Paragraph CA. of SEC- curred by you because of the total theft of a cov- TION I—COVERED AUTOS: ered "auto"of the private passenger type. 1. "Trailers" with a load capacity of 3,000 H. AUDIO, VISUAL AND DATA ELECTRONIC pounds or less designed primarily for travel EQUIPMENT—INCREASED LIMIT on public roads. Paragraph C.2.. Limit Of Insurance, of SEC- F. HIRED AUTO PHYSICAL DAMAGE TION III — PHYSICAL DAMAGE COVERAGE is The following is added to Paragraph AA., Cover- deleted. age Extensions, of SECTION 111 — PHYSICAL I. WAIVER OF DEDUCTIBLE—GLASS DAMAGE COVERAGE: The following is added to Paragraph D., Deducti- Hired Auto Physical Damage Coverage ble, of SECTION III — PHYSICAL DAMAGE If hired "autos" are covered "autos" for Liability COVERAGE: Coverage but not covered "autos" for Physical No deductible for a covered "auto" will apply to Damage Coverage, and this policy also provides glass damage if the glass is repaired rather than Physical Damage Coverage for an owned "auto", replaced. then the Physical Damage Coverage is,extended J. PERSONAL EFFECTS to "autos" that you hire, rent or borrow subject to the following: The following is added to Paragraph AA., Cover- (1) The most we will pay for "loss" in any one age Extensions, of SECTION III — PHYSICAL "accident" to a hired, rented or, borrowed DAMAGE COVERAGE: "auto"is the lesser of: Personal Effects Coverage (a) $50,000; We will pay up to $400 for "loss" to wearing ap- (b) The actual cash value of the damaged or parel and other personal effects which are: stolen property as of the time of the (1) Owned by an"insured"; and "loss";or (2) In or on your covered"auto". (c) The cost of repairing or replacing the This coverage only applies in the event of a total damaged or stolen property with other theft of your covered"auto". property of like kind and quality. No deductibles apply to Personal Effects cover- (2) An adjustment for depreciation and physical age. condition will be made in determining actual cash value in the event of a total"loss". Page 2 of 3 ©2010 The Travelers indemnity Company.All rights reserved. CA T4 20 07 10 Includes copyrighted material of Insurance Services Office,Inc.w th its permission. COMMERCIAL AUTO K. AIRBAGS (2) Any: The following is added to Paragraph B.3., Exclu- (a) Overdue lease or loan payments at the sions, of SECTION III — PHYSICAL DAMAGE time of the"loss'; COVERAGE: (b) Financial penalties imposed under a Exclusion 3.a. does not apply to "loss" to one or lease for excessive use, abnormal wear more airbags in a covered "auto"you own that in- and tear or high mileage; flate due to a cause other than a cause of"loss" (c) Security deposits not returned by the les- set forth in Paragraphs A.1.b. and A.1.c., but sor; only; (d) Costs for extended warranties, Credit Life a. If that "auto" is a covered "auto" for Compre- Insurance, Health, Accident or Disability hensive Coverage under this policy; insurance purchased with the loan or b. The airbags are not covered under any war- lease; and ranty; and (e) Carry-over balances from previous loans c. The airbags were not intentionally inflated. or leases. We will pay up to a maximum of $1,000 for any M. BLANKET WAIVER OF SUBROGATION one"loss". The following replaces Paragraph A.5., Transfer L. AUTO LOAN LEASE GAP Of Rights Of Recovery Against Others To Us, The following is added to Paragraph A.4., Cover- of SECTION IV — BUSINESS AUTO CONDI- age Extensions, of SECTION III — PHYSICAL TIONS: DAMAGE COVERAGE: S. Transfer Of Rights Of Recovery Against Auto Loan Lease Gap Coverage for Private Others To Us Passenger Type Vehicles We waive any right of recovery we may have In the event of a total"loss"to a covered"auto"of against any person or organization to the ex- the private passenger type shown in the Schedule tent required of you by a written contract exe- or Declarations for which Physical Damage Cov- cuted prior to any "accident" or "loss", pro- erage is provided, we will pay any unpaid amount vided that the"accident"or"loss"arises out of due on the lease or loan for such covered "auto" the operations contemplated by such con- less the following: tract. The waiver applies only to the person or (1) The amount paid under the Physical Damage organization designated in such contract. Coverage Section of the policy for that"auto"; and CA T4 20 07 10 @2010 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of insurance Services Office,Inc.with its permission_ BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 04/01/2018 forms a part of Policy No. WC 065-25-7102 Issued to WESTNET, INC. By GRANITE STATE INSURANCE COMPANY We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy. WC 04 03 61 Countersigned by (Ed. 11190) Authorized Representative