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PROOF OF INSURANCE (2019) CLOSED 304363 DATE(MMIDD/YYYY) Amo,Rai CERTIFICATE OF LIABILITY INSURANCE 6/27/2018 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 have ADDITIONAL INSURED provisions or 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 I CONTACT NAME: Jonathan Allen Commercial Lines-213-253-6700 PHONE 213-337-6350 FAX 610-537-2253 (A/C,No.Ext). (AIC,No): USI Insurance Services National, Inc.-CA Lic#:OD08408 I E-MAIL ADDRESS: jonathan.allen@usi.com 777 South Figueora St,Ste 2100 I INSURER(S)AFFORDING COVERAGE NAIC# Los Angeles, CA 90017 I INSURER A: Nautilus Insurance Company 17370 INSURED INSURER B: Great Divide Insurance Company 25224 Ocean Blue Environmental Services., Inc. INSURER C 925 West Esther Street I INSURER D: INSURER E: Long Beach,CA 90813 I INSURER F: COVERAGES CERTIFICATE NUMBER: 13234001 REVISION NUMBER: See below 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY X ECP2018650-12 07/01/2018 07/01/2019 EACH OCCURRENCE S 1.000.000 RETE CLAIMS-MADE � OCCUR PREM SESDAMAGEO(Ea occur ence) $ 100.000 MED EXP(Any one person) S 5.000 PERSONAL&ADV INJURY S 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2.000.000 PRO- POLICY� ECT El LOC PRODUCTS-COMP/OP AGG S 2.000.000 X OTHER SIR:$20.000 S B AUTOMOBILE LIABILITY BAP2018652-12 07/01/2018 07/01/2019 COMB NED idem)SINGLE LIMIT $ 1.000.000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) x MCS-90 $ A UMBRELLALIAB OCCUR FFX2018651-12 07/01/2018 07/01/2019 EACH OCCURRENCE $ 9.000.000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 9.000.000 DED I I RETENTION$ S SIR-N/A PER B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X WCA2018653-12 07/01/2018 07/01/2019 X ( STATUTE ( X I EORH USL&H ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E L EACH ACCIDENT $ 1.000.000 OFFICER/MEMBER EXCLUDED? C NIA (Mandatory in NH) E L DISEASE-EA EMPLOYEE S 1.000.000 If yes,describe under 1.000.000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ A Pollution Liability ECP2018650-12 0710112018 07/01/2019 Limits:$1.000.000 Each Occurrence Ded:$20.000:Occurence Form DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is named as additional insured as it relates to general liability&waiver of subrogation is granted as it relates to general liability in accordance with the terms and conditions of the policies. Umbrella follows form as it relates to additional insureds.The above coverage is primary and noncontributory where required by written contract. CERTIFICATE HOLDER CANCELLATION City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN its officials,and employees ACCORDANCE WITH THE POLICY PROVISIONS. City Clerk 350 Main Street, Room 5 AUTHORIZED REPRESENTATIVE EI Segundo, CA 90245 The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) Client Code: 304363 SID: 13234001 Certificate ®f insurance (Con't) OTHER Coverage INSR TYPE OF INSURANCE ADDL WVD POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMIT LTR INSR SUBR (MM/DD/YY) (MM/DD/YY) A Professional Liability ECP2018650-12 07/01/2018 07/01/2019 Limits:$1.000.000 Each occurrence $2.000.000 Aggregate re ate Ded:$20.000:Claims Made Certificate of Insurance-Coni Named Insured:Ocean Blue Environmental Services,Inc. Policy Number:ECP2018650-12 Effective Date:7/7/2018 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. WAIVER OF SUBROGATION It is agreed that the Company, in the event of any payment under this policy,waives its right of recovery against any Principal, but only at the specific written request of the Named Insured either before or after loss,wherein such waiver has been included before loss as part of a contractual undertaking by the Named Insured. This waiver shall apply only with respect to losses occurring due to operations undertaken as per the specific contract existing between the Named Insured and such Principal and shall not be construed to be a waiver with respect to other operations of such Principal in which the Named Insured has no contractual interest. No waiver of subrogation shall directly or indirectly apply to any employee,employees or agents of either the Named Insured or of the Principal,and the Company reserves its right or lien to be reimbursed from any recovery funds obtained by any injured employee. This waiver does not apply in any jurisdiction or situation where such waiver is held to be illegal or against public policy or in any situation wherein the Principal against whom subrogation is to be waived is found to be solely negligent. ©2006 by Berkley Specialty Underwriting Managers LLC,an affiliate of Nautilus Insurance Company and Great Divide Insurance Company.Al rights reserved. ©1985-2006 by Insurance Services Office,Inc.,material used by permission. ENV 2004 09 06 Page 1 of 1 Named Insured:Ocean Blue Environmental Services, Inc. Policy Number: ECP2018650-12 Effective Date:7/1/2018 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED-BLANKET This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY In consideration of the premium charged and notwithstanding anything contained in this policy to the contrary,it is hereby agreed and understood that this endorsement shall apply only to the Coverage Part(s)corresponding with the box or boxes marked below. ® COVERAGES A AND B—GENERAL LIABILITY ® COVERAGE D—CONTRACTORS POLLUTION LIABILITY SECTION III—WHO IS AN INSURED is amended to include as an insured,with respect to Coverage A, B and D,any person(s)or organization(s)when you and such person(s)or organization(s)have agreed in a written contract or written agreement that such person(s)or organization(s)be added as an additional insured on your policy. Such written contract or written agreement must be in effect prior to the performance of your work which is the subject of such written contract or written agreement. Such additional insured status applies only: 1. Under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY for claims or suits resulting from: a. Your work performed for such person(s)or organization(s) in the performance of your ongoing operations for the additional insured; or b. Your work performed for such person(s)or organizations(s)and included in the products-completed operations hazard. 2. Under COVERAGE D CONTRACTORS POLLUTION LIABILITY for claims or suits arising out of pollution conditions that are the result of: a. Your work performed for such person(s)or organizations) in the performance of your ongoing operations for the additional insured; or b. Your work performed for such person(s)or organizations(s)and included in the products-completed operations hazard. With respect to damages caused by your work,as described above,the coverage provided hereunder shall be primary and not contributing with any other insurance available to those person(s)or organization(s)with which you have so agreed in a written contract or written agreement. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ©2006 by Berkley Specialty Underwriting Managers LLC,an affiliate of Nautilus Insurance Company and Great Divide Insurance Company.All rights reserved- 0 1985-2006 by Insurance Services Office,Inc.,material used by permission. ECP 1004 04 10 Page 1 of 1 Named Insured:Ocean Blue Environmental Services, Inc. Policy Number:ECP2018650-12 Effective Date:7/1/2018 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED- BLANKET-OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Who is An Insured(Section II) is amended to include as an insured any person(s)or organization(s)for whom you are performing operations when you and such person(s)or organization(s)have agreed in writing in a contract or written agreement that such person(s)or organization(s)be added as an additional insured on your policy, but Only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by: 1. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured; or 2. Your work performed for such person(s)or organizations(s)and included in the products-completed operations hazard,only when required by the written contract or written agreement. With respect to damages caused by your work,as described above,the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above, but only when required by written contract or agreement. C 2006 by Berkley Specialty Underwriting Managers LLC,an affiliate of Nautilus Insurance Company and Great Divide Insurance Company.All rights reserved. ®19852006 by Insurance Services Office,Inc.,material used by permission. ENV 2154 A 09 06 Page 1 of 1 Named Insured:Ocean Blue Environmental Services, Inc. Policy Number:ECP2018650-12 Effective Date:7/1/2018 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT In consideration of the premium charged and notwithstanding anything contained in this policy to the contrary, it is hereby agreed and understood that this endorsement shall apply only to the Coverage Part(s)corresponding with the box or boxes marked below. ® COVERAGES PARTS A AND B ❑ COVERAGE PART D Name Of Additional Insured Person(s)Or Organization(s) Any person or organization with whom the Named Insured executes a written contract prior to the lease of equipment and is shown on a certificate of insurance issued by an authorized representative prior to the lease of the equipment. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. 1. SECTION III—WHO IS AN INSURED is amended to include as an insured the person(s)or organization(s)shown in the schedule above, but only with respect to their liability arising out the maintenance,operation or use by you of equipment leased to you by such person(s)or organization(s). 2. With respect to the insurance afforded to the person(s)or organization(s)scheduled above,their status as an insured ends when their contract or agreement with you for such leased equipment ends. 3. The coverage provided by this endorsement shall not apply to: a. Claims or suits based upon or arising from an actual or alleged act,error or omission in the performance of professional services of the person(s)or organization(s)shown in the schedule above. b. Any occurrence which takes place after the equipment lease expires. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ©2006 by Berkley Specialty Underwriting Managers LLC,an affiliate of Nautilus Insurance Company and Great Divide Insurance Company.All rights reserved. ©1988-2006 by Insurance Services Office,Inc.,material used by permission. ECP 1058 12 07 Page 1 of 1 POLICY NUMBER: BAP2018652-12 COMMERCIAL AUTO CA 04 4410 13 '"II'll'AIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM 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: Ocean Blue Environmental Services,Inc. Endorsement Effective Date: 07/01/2018 II SCHEDULE Name(s)Of Person(s)Or Organization(s): Any Principal wherein such waiver has been included before loss as part of a contractual undertaking by the Named Insured Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident"or the 'loss" under a contract with that person or organization. CA 04 44 10 13 ©Insurance Services Office,Inc.,2011 Page 1 of 1 Named Insured:Ocean Blue Environmental Services.Inc. Policy Number:BAP2018652-12 Effective Date:7/1/2018 BSUM CA 06 02 13 ENDORSEMENT This endorsement forms a part of the policy to which it is attached.Please read it carefully. Business Auto -Additional Insured When Required by Contract or Agreement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section 11—Liability Coverage A.—Coverage,1.Who is an Insured,is amended to add: d. Any person or organization to whom you become obligated to include as an additional insured under this policy,as a result of any contract or agreement you enter into,excluding contracts or agreements for professional services,which requires you to furnish insurance to that person or organization of the type provided by this policy,but only with respect to liability arising out of your operations or premises owned by or rented to you.However,the insurance provided will not exceed the lesser of: 1. The coverage and/or limits of this policy;or 2. The coverage and/or limits required by said contract or agreement. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. Includes copyrighted material of Insurance Services Office,Inc.,used by permission BSUM CA 06 02 13 Page 1 of 1 POLICY NUMBER:BAP2018652-12 COMMERCIAL AUTO CA 20 01 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM 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: Ocean Blue Environmental Services,Inc. Endorsement Effective Date: 07/01/2018 SCHEDULE Insurance Company: Great Divide Insurance Company Policy Number: BAP2018652-12 Effective Date: 07/01/2018 Expiration Date: 07/01/2019 Named Insured: Ocean Blue Environmental Services, Inc. Address: 925 West Esther Street,Long Beach,CA 90813 Additional Insured(Lessor): As required by those entities with whom the Named Insured executes a written contract for a`leased auto"and on file with the underwriter submitted at binding on a Business Auto Acord application or on an Acord Business Auto Policy Change Request form prior to loss. Address: Designation Or Description Of"Leased Autos": CA 20 01 10 13 0 Insurance Services Office,Inc.,2011 Page 1 of 2 Coverages Limit Of Insurance Covered Autos Liability $SEE SCHEDULE Each"Accident' Comprehensive Actual Cash Value Or Cost Of Repair Whichever Is Less,Minus $SEE SCHEDULE Deductible For Each Covered"Leased Auto" Collision Actual Cash Value Or Cost Of Repair Whichever Is Less,Minus $SEE SCHEDULE Deductible For Each Covered"Leased Auto' Specified Actual Cash Value Or Cost Of Repair Whichever Is Less,Minus Causes Of Loss $N/A Deductible For Each Covered"Leased Auto' Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Coverage 2. The insurance covers the interest of the 1. Any 'leased auto' designated or described in lessor unless the "loss" results from the Schedule will be considered a covered fraudulent acts or omissions on your part. "auto" you own and not a covered "auto' you 3. If we make any payment to the lessor, we will hire or borrow. obtain his or her rights against any other 2. For a 'leased auto' designated or described party. in the Schedule, the Who Is An Insured C. Cancellation provision under Covered Autos Liability 1. If we cancel the policy, we will mail notice to Coverage is changed to include as an the lessor in accordance with the "insured" the lessor named in the Schedule. Cancellation Common Policy Condition. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting 2. If you cancel the policy, we will mail notice to from the acts or omissions by: the lessor. a. You; 3. Cancellation ends this agreement. b. Any of your"employees" or agents; or D. The lessor is not liable for payment of your c. An premiums. Any person, except the lessor or any "employee" or agent of the lessor, E. Additional Definition operating a "leased auto" with the As used in this endorsement: permission of any of the above. "Leased auto'means an"auto"leased or rented to 3. The coverages provided under this you,including any substitute,replacement or extra endorsement apply to any 'leased auto' "auto'needed to meet seasonal or other needs, described in the Schedule until the expiration under a leasing or rental agreement that requires you date shown in the Schedule, or when the to provide direct primary insurance for the lessor. lessor or his or her agent takes possession of the 'leased auto', whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss"to a "leased auto'. Page 2 of 2 ©Insurance Services Office, Inc.,2011 CA 20 01 10 13 FORM MCS-90 Revised 01/05/2017 OMB No.:2128-0008 Expiration:01/31/2020 i - - US DOT Number: Date Received: A Federal Agency may not conduct or sponsor,and a person is not required to respond to,nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.The OMB Control Number for this information collection is 2126-0008.Public reporting for this collection of information is estimated to be approximately 2 minutes per response,including the time for reviewing instructions,gathering the data needed,and completing and reviewing the collection of information.Al responses to this collection of information are mandatory.Send comments regarding this burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden to:Information Collection Clearance Officer,Federal Motor Carrier Safety Administration,MC-RRA,Washington,D.C.20590. Vnftdstat"D4partmantOf onsprsftAtfoh F"ArMt NOW"111lK:arfYty AditdnitrtntltiM Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FLIM MCS-90 Issued to Ocean Blue Environmental Service, Inc. of 925 West Esther Street,Long Beach,CA 90813 (Motor Carrier name) (Motor Carrier state or province) Dated at Two Ravinia,Drive,Atlanta,GA 30346 on this 01 day of July,2018 Amending Policy Number: BAP2018652-12 Effective Date: July 1,2018 Name of Insurance Company: Great Divide Insurance Company Countersigned by: (authorized company representative) The policy to which this endorsement is attached provides primary or excess insurance,as indicated for the limits shown(check only one): D This insurance is primary and the company shall not be liable for amounts in excess of$ 1,000,000 for each accident. ❑ This insurance is excess and the company shall not be liable for amounts in excess of$ for each accident in excess of the underlying limit of$ for each accident. Whenever required by the Federal Motor Carrier Safety Administration(FMCSA),the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements.The company also agrees,upon telephone request by an authorized representative of the FMCSA,to verify that the policy is in force as of a particular date.The telephone number to call is:404-443-2118_ Cancellation of this endorsement may be effected by the company of the Insured by giving(1)thirty-five(35)days notice in writing to the other party(said 35 days notice to commence from the date the notice is mailed,proof of mailing shall be sufficient proof of notice),and (2)if the insured is subject to the FMCSNs registration requirements under ,by providing thirty(30)days notice to the FMCSA(said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington,DC). Filings must be transmitted online via the Internet at (continued on next page) FORM MCS-90 Page 1 of 3 FORM MCS-90 Revised 01/05/2017 OMB No.:2126-0008 Expiration:01/31/2020 DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to Environmental Restoration means restitution for the loss, conditions or which results in bodily injury,property damage,or damage,or destruction of natural resources arising out of the environmental damage which the Insured neither expected nor accidental discharge,dispersal,release or escape into or upon intended. the land,atmosphere,watercourse,or body of water,of any Motor Vehicle means a land vehicle,machine,truck,tractor, commodity transported by a motor carrier.This shall include the cost of removal and the cost of necessary measures taken trailer,or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property,or any to minimize mitigate damage to human health,the natural environment,,fish,shellfish,and wildlife. combination thereof. Bodily Injury means injury to the body,sickness,or disease to Public Liability means liability for bodily injury,property damage,and environmental restoration. any person,including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. The insurance policy to which this endorsement is attached company from liability or from the payment of any final judgment, provides automobile liability insurance and is amended to assure within the limits of liability herein described,irrespective of the compliance by the insured,within the limits stated herein,as a financial condition,insolvency or bankruptcy of the insured. motor carrier of property,with Sections 29 and 30 of the Motor However,all terms,conditions and limitations in the policy to Carrier Act of 1980 and the rules and regulations of the Federal which the endorsement is attached shall remain in full force and Motor Carrier Safety Administration(FMCSA). effect as binding between the insured and the company.The In consideration of the premium stated in the policy to which this insured agrees to reimburse the company for any payment made endorsement is attached,the insurer(the company)agrees to by the company on account of any accident,claim,or suit pay,within the limits of liability described herein,any final involving a breach of the terms of the policy,and for any judgment recovered against the insured for public liability payment that the company would not have been obligated to resulting from negligence in the operation,maintenance or use of make under the provisions of the policy except for the agreement motor vehicles subject to financial responsibility requirements of contained in this endorsement. Sections 29 and 30 of the Motor Carrier Act of 1980 regardless It is further understood and agreed that,upon failure of the of whether or not each motor vehicle is specifically described in company to pay any final judgment recovered against the the policy and whether or not such negligence occurs on any insured as provided herein,the judgment creditor may maintain route or in any territory authorized to be served by the insured or an action in any court of competent jurisdiction against the elsewhere.Such insurance as is afforded,for public liability, company to compel such payment. does not apply to injury to or death of the insured's employees The limits of the company's liability for the amounts prescribed in while engaged in the course of their employment,or property this endorsement apply separately to each accident and any transported by the insured,designated as cargo.It is understood payment under the policy because of any one accident shall not and agreed that no condition,provision,stipulation,or limitation operate to reduce the liability of the company for the payment of contained in the policy,this endorsement,or any other final judgments resulting from any other accident. endorsement thereon,or violation thereof,shall relieve the (continued on next page) FORM MCS-90 Page 2 of 3 FORM MCS-90 Revised 01/05/2017 OMB No.:2126-0008 Expiration:01/31/2020 SCHEDULE OF LIMITS - PUBLIC LIABILITY Type of carriage Commodity transported January 1,1985 (1) For-hire(in interstate or foreign Property(nonhazardous) commerce,with a gross vehicle $750,000 weight rating of 10,000 or more pounds). (2) For-hire and Private(in interstate, Hazardous substances,as defined in transported in $5,000,000 foreign,or intrastate commerce,with a cargo tanks,portable tanks,or hopper-type vehicles with capacities gross vehicle weight rating of 10,000 in excess of 3,500 water gallons;or in bulk Division 1.1,1.2,and 1.3 or more pounds). materials,Division 2.3,Hazard Zone A,or Division 6.1,Packing Group 1,Hazard Zone A material;in bulk Division 2.1 or 2.2;or highway route controlled quantities of a Class 7 material,as defined in (3) For-hire and Private(in interstate or Oil listed in ;hazardous waste,hazardous $1,000,000 foreign commerce,in any quantity;or materials,and hazardous substances defined in and In Intrastate commerce,In bulk only; listed in but not mentioned in(2)above or(4) with a gross vehicle weight rating of below. 10,000 or more pounds). (4) For-hire and Private(In interstate or Any quantity of Division 1.1,1.2 or 1.3 material;any quantity of a $5,000,000 foreign commerce,with a gross Division 2.3,Hazard Zone A,or Division 6.1,Packing Group 1, vehicle weight rating of less than Hazard Zone A material;or highway route controlled quantities of a 10,000 pounds). Class 7 material as defined in 'The schedule of limits shown does not provide coverage.The limits shown in the schedule are for information purposes only. FORM MCS-90 Page 3 of 3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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,_0.00_,_„%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any Principal wherein such waiver has Been included before loss as part of a contractual Undertaking by the Named Insured. Notes: 1. This endorsement may be used to waive the company's right of subrogation against named third parties who may be responsible for an injury. 2. The sentence in( )Is optional with the company.It limits the endorsement to apply only to specific jobs of the Insured,and only to the extent that the insured is required to obtain this waiver. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 711!2018 Policy No.WCA201BW3-12 Endorsement No. Insured: Insurance Company:Great Divide Ins.Co. Ocean Blue Environmental Services,Inc. Countersigned By