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PROOF OF INSURANCE (2019 - 2019) CLOSEDDATE (MM/DD/YYYY) .4,CCOR" CERTIFICATE OF LIABILITY INSURANCE 5114/2019 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 Patriot Risk & Insurance Services CONTACT 2415 Campus Drive, Suite #200 ice" � ctl (9a9) 486 -7900......_ .................................................. FAX p ..__ (/VC,No1: (949)486-7950 Irvine, CA 92612 E-MAIL QLRgAg� www.patrisk.com OK07568 _........... . INSURED Superior Pavement Markings, Inc. 5312 Cypress S't. Cypress CA 90630 INSURER(S) AFFORDING COVERAGE INSURER A: Wesco Insurance Company INSURER B: Great American Insurance Company . ..................................... INSURER C: Security National Insurance Company INSURER D INSURER E NAIC # 25011 16691 19879 INSURER F: COVERAGES CERTIFICATE NUMBER: 48670518 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 'AID CLAIMS. .--._._.._._._--_- _— ILTR TYPE OF INSURANCE N n —....,__POLICY NUMBER IMM' DDYrY ' ) POLICY EXP I LIMITS p„„�nr iMMrDDnfYwYl A y+'' COMMERCIAL GENERAL LIABILITY / / WPP158316101 9/18/2018 9/18/2019 EACH OCCURRENCE I $ 1 000 000 '_DAMAGE TO RENTED-'-'-_� CLAIMS -MADE ,� OCCUR PREMISE,S_tI,F,�aorcu,Lrenc„g ) $300,000 a, ............................ MED EXP (Any one person) I $ 5,000 PERSONAL & ADV INJURY 1$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: EI Segundo, CA — Class III Bike Route, PW # 19-03 / SPM Job #6541 EI Segundo Public Works is named as Additional Insured as respects to General Liability includes Waiver of subrogation applicable to GL and WC and in favor of the additional insureds per endorsements attached as required by written contract. "30 -day notice of cancellation / 10 -days for non-payment of premium. CERTIFICATE HOLDER EI Segundo Public Works 350 Main Street EI Segundo CA 90245 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „ Dave Jacobson ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 48670516 116/19 GL/AO/UKB/WC I Annette Romero 15/14/2019 4:43:49 PM (POT) I Page 1 of 11 This certificate cancels and supersedes ALL previously issued certificates. E PRO ❑ POLICY JECT LOC COMBINED SINGLE UNUT $ IEn accidenO 1,000,000 OTHER: A AUTOMOBILE LIABILITY WPP158316101 M,r ANY AUTO OWNED SCHEDULED EACH OCCURRENCE $ g 000,000 AUTOS ONLY AUTOS $ HIRED '- NON -OWNED 1 STATUTE I OTH AUTOS ONLY AUTOS ONLY B / UMBRELLA LIAB / OCCUR ._... TUE 2191315 01 EXCEISIISLIAB CLAIMS -MADE .......,m �.�� DED V RETENTI ON$ C WORKERS COMPENSATION `/ SWC1197018 AND EMPLOYERS' LIABILITY Y / N ANYP ROPR I ETOR/PARTN E R/EX EC UTI V E OFFICER/MEMBER EXCLUDED? [7Y NIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: EI Segundo, CA — Class III Bike Route, PW # 19-03 / SPM Job #6541 EI Segundo Public Works is named as Additional Insured as respects to General Liability includes Waiver of subrogation applicable to GL and WC and in favor of the additional insureds per endorsements attached as required by written contract. "30 -day notice of cancellation / 10 -days for non-payment of premium. CERTIFICATE HOLDER EI Segundo Public Works 350 Main Street EI Segundo CA 90245 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „ Dave Jacobson ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 48670516 116/19 GL/AO/UKB/WC I Annette Romero 15/14/2019 4:43:49 PM (POT) I Page 1 of 11 This certificate cancels and supersedes ALL previously issued certificates. Q PRODUCTS -COMP/OP,AGG $2,000,000 9/18/2018 9/18/2019 COMBINED SINGLE UNUT $ IEn accidenO 1,000,000 BODILY INJURY ( Per arson) $ P BODILY INJURY (Per accident) $ PROPERTY DAMAGE, $ ........ .. 9/18/2018 9/18/2019 EACH OCCURRENCE $ g 000,000 AGGREGATE $9,0001000 $ 6/1/2018 6/1/2019 1 STATUTE I OTH LEACH EACH ACCIDENT $1,000,000 -E E.L. DISEASE - EA EMPLOYEE;I $ 1.000.000 E.L. DISEASE - POLICY LIMIT I $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: EI Segundo, CA — Class III Bike Route, PW # 19-03 / SPM Job #6541 EI Segundo Public Works is named as Additional Insured as respects to General Liability includes Waiver of subrogation applicable to GL and WC and in favor of the additional insureds per endorsements attached as required by written contract. "30 -day notice of cancellation / 10 -days for non-payment of premium. CERTIFICATE HOLDER EI Segundo Public Works 350 Main Street EI Segundo CA 90245 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „ Dave Jacobson ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 48670516 116/19 GL/AO/UKB/WC I Annette Romero 15/14/2019 4:43:49 PM (POT) I Page 1 of 11 This certificate cancels and supersedes ALL previously issued certificates. POLICY NUMBER: WPP158316101 Superior Pavement Markings, Inc. COMMERCIAL GENERAL LIABILITY CG 2010 0413 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 Name Of Additional Insured Person(s) Or Organization(s) Blanket as required by written contract. SCHEDULE Location(s) Of Covered Operations Blanket as required by written contract. Information required ulred to complete re this Schedule, If not shown above, well be shown in the Declarations. A. Section -II — Who -Is An -Insured -is -amended -to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 required—by —the—contractor agreementto provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after. 2. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or That portion of "your work" out of which the Injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project will not be broader than that which you are CG 2010 0413 O Insurance Services Office, Inc., 2012 48670518 1 18/19 GL/AU/UMB/WC I Annette Romero 1 5/14/2015 4:43:49 PM (PDT) I Page 2 of 11 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ® Insurance Services Office, Inc., 2012 48570518 1 18119 GL/AU/UMB/WC I Annette Romero 15/14/2019 4:43;49 PM (PDT) I Page 3 of 11 This certificate cancels and supersedes ALL previously issued certificates CG 2010 0413 Superior Pavement Markings, Inc. POLICY NUMBER: WPP158316101 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 Oanization(s1 Location An rp „ d Description Of Completed Operations Blanket as required by written contract. Blanket as required by written contract. 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However. I. 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. CO 20 37 0413 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 48670518 i 19/19 GL/AU/UMH/WC I Annette Romero 1 5/14/2019 4:43:49 PM (PDT) I Page 4 of 11 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 Superior Pavement Markings, Inc. WPP158316101 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. PROPERTY DAMAGE TO BORROWED EQUIPMENT Paragraph (1), of j. Damage To Property, under 2. Exclusions, of SECTION I — COVERAGES COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY is amended to add the following: Paragraphs (3) and (4) of this exclusion do not apply to tools or equipment loaned to you, provided that they are not being used to perform operations at the time of the loss. With respect to "property damage" to borrowed equipment the following additional provisions apply: 1. The most we will pay for "property damage" to borrowed equipment is $100,000 for any and all such losses regardless of the number of: a. Insureds; b. Claims or "suits" brought; or c. Persons or organizations bringing claims or "suits". B. NON -OWNED WATERCRAFT EXTENSION Subparagraph (2) of g. Aircraft, Auto Or Watercraft, under 2. Exclusions, of SECTION I — COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced with the following: This exclusion does not apply to: (2) a watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge. C. DAMAGE TO PREMISES RENTED TO YOU The last paragraph of 2. Exclusions of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced with the following: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: 1. Fire; 2. Explosion; GL90076 Page 1 of 6 Ed 0912 49670510 110/19 GL/AU/UMb/WC I Annette Romero 15/14/2019 4:43:49 PM (PDT) I Page 5 of 11 This certificate cancels and supersedes ALL previously issued certificates. 3. Lightning; 4. Smoke resulting from such fire, explosion or lightning; or 5. Water. A separate limit of insurance applies to this coverage as described in Section III Limits of Insurance. This insurance does not apply to damage to premises rented to you, or temporarily occupied by you, with permission of the owner caused by: 1. Rupture, bursting, or operation of pressure relief devices; 2. Rupture or bursting due to expansion or swelling of structural components or the contents of any building or structure, caused by or resulting from water; 3. Explosion of steam boilers, steam pipes, steam engines or steam turbines. Paragraph 6. of SECTION III LIMITS OF INSURANCE is d eleted and replaced w i t h the following: Subject to paragraph 5. of SECTION III — LIMITS OF INSURANCE, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY. for the sum of all damages because of "property damage" to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: fire; explosion; lightning; smoke resulting from such fire, explosion , or lightning; or water. The Damage To Premises Rented To You Limit will apply at all "property damage" proximately caused by the same "occurrence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented to You Limit will be the higher of: a. $300,000; or b. The amount shown on the Declarations for Damage To Premises Rented To You Limit. Paragraph a. of 9. "Insured Contract', under SECTION V — DEFINITIONS, is deleted and replaced with the following: An "Insured contract' means a contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: fire: explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water, is not an "insured contract". D. PROPERTY DAMAGE COVERAGE FOR PERSONAL PROPERTY WHILE IN YOUR POSSESSION Sub -paragraphs (3) and (4) of Paragraph j. Damage To Property, of 2. Exclusions. of SECTION I — COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY do not apply to "property damage" to the property of others while in your possession. With respect to the insurance provided by this section of the endorsement, the following provisions apply: The limit of this coverage is $25,000 per "occurrence" and $25,000 aggregate in any annual policy period starting with the beginning of the policy period in the Declarations, regardless of the number of: a. Insureds; GL90076 Page 2 of 6 Ed 0912 48576518 1 18/19 GL/AU/UMB/WC I Annette Romero 15/14/2819 4:43:49 PM (PUT) I Page 6 of 11 This certificate cancels and supersedes ALL previously issued certificates, Claims or "suits" brought; or C. Persons or organizations bringing claims or "suits". We will pay for damages on your behalf, only to the amount of damages for each "occurrence" on your behalf applies only to the amount of damages for each "occurrence" which are in excess of a $1,000 deductible. We may pay any part, or all of the deductible amount, to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount, as has been paid by us. E. PROPERTY DAMAGE COVERAGE FOR TENANTS — REAL PROPERTY Sub -paragraph j. (5) Damage To Property, of 2. Exclusions of SECTION I — COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced with the following: While under your care, custody or control we will pay for "property damage" to property of others arising out of operations incidental to your business when: Damage is caused by the insured; Damage occurs while in the insured's possession The most we will pay under this provision for loss or damage during the policy period is $25,000 per ..occurrence" and $25,000 aggregate in any annual policy period starting with the beginning of the policy period in the Declarations. We will pay damages on your behalf, only to the amount of damages for each "occurrence" which are in excess of a $1,000 deductible. The limits of insurance will not be reduced by the application of such deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us; or SUPPLEMENTARY PAYMENTS Paragraphs 1.b. and 1d. under SUPPLEMENTARY PAYMENTS — COVERAGES A AND B of SECTION I is amended as follows: a. In paragraph 1.b., the amount we will pay for the cost of bail bond is increased to $2,500 b. In paragraph 1.d., the amount we will pay for loss of earnings is increased to $500 a day, G. NEWLY ACQUIRED OR FORMED ORGANIZATIONS Paragraph 3.a. of SECTION II — WHO IS AN INSURED is deleted and replaced with the following: Coverage under this provision is afforded until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. H. PAST PARTNERSHIPS AND JOINT VENTURES The following is added to SECTION II — WHO IS AN INSURED: GL990078 Page 3 of 6 Ed 0912 48670518 1 18/19 GL/AU/UMB/WC I Annette Romero 15/14/2019 4:43:49 PM (PDT) I Page 7 of 11 This certificate cancels and supersedes ALL previously issued certificates. If you are an insured, as shown in the Declarations, you are an insured for your interest in a partnership or joint venture that ended prior to this policy -period. This insurance applies: Only to the extent of your interest in the partnership or joint venture. b. Only if no other similar insurance is available to you for your interest in the joint venture or partnership. The last paragraph of SECTION II — WHO IS AN INSURED is deleted and replaced with the following: Except as provided in H. PAST PARTNERSHIPS AND JOINT VENTURES, no person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. ADDITIONAL INSURED The following is added to SECTION II — WHO IS AN INSURED: Any person or organization with whom or with which you have agreed in writing in a contract or agreement that such person(s) or organization(s) shall be included as an additional insured on your policy is an additional insured. The contract must be executed before the "bodily injury or "property damage" occurs or the "personal injury' or "advertising injury' offense is committed, to name such person or organization as an additional insured, but only with respect to liability arising out any tenancy operation or use of equipment leased to you by such an additional insured. The following provisions apply to such additional insured: a. The limits of insurance afforded to the additional insured shall be the limits which you agreed to provide in the written contract, or the limits shown on the Declarations, whichever is less. b. The insurance afforded to the additional insured does not apply to: i. A ny "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury' caused by an offense which is committed, after you cease to be a tenant in that premises; ii. Liability arising out of any premises for which coverage is excluded by endorsement; or iability arising out of structural alterations, new construction or demolition operations performed by or on behalf of such additional insured(s) The insurance afforded to the additional insured is excess over any valid and collectible insurance available to the insured, unless you have agreed in the written contract that this insurance must be primary or non-contributory with such other insurance. BROADENED NAMED INSURED Paragraph 1.d. of SECTION II — WHO IS AN INSURED is deleted and replaced with the following: The person or organization named in the Declarations, and any organization, other than a partnership, joint venture or limited liability company, of which you maintain ownership or in which you maintain the majority interest on the effective date of the policy. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. However, coverage for any such additional organization will cease as of the date, if any, during the policy GL90076 Page 4 of 6 Ed 0912 48670518 1 18/19 GL/AU/UM®/WC I Annette Romero 1 5/14/2019 4:43:49 PM (PDT) I Page 8 of 11 This certificate cancels and supersedes ALL previously issued certificates. period, that you no longer maintain ownership of, or the majority interest in, such organization. K. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to paragraph 6. Representations of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: Based on our reliance on your representations as to existing hazards, if you unintentionally fail to disclose any such hazards prior to the beginning of the policy period of this coverage part, we shall not deny coverage under this coverage part because of such failure. However, the provision does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws, codes or regulations. L. BROADENED NOTICE OF OCCURRENCE The following is added to paragraph 2 Duties in the Event of Occurrence, Offense, Claim or Suit of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: Notice of an "occurrence" or of an offense which may result in a claim covered by this policy, the failure to report such "occurrence" to us at the time of the "occurrence shall not be deemed a violation of this condition unless such "occurrence" or offense becomes known to. you, or one of the following if designated by you to give such notice: your "executive officers" (if you are a corporation), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited liability company), or an "employee" (such as an insurance, loss control or risk manager or administrator)., However, you or your designated representative must give us notice as soon as practicable after being made aware that the particular claim. b. Knowledge by any other "employee" of an "occurrence" or offense does not imply that you also have such knowledge. c. This provision does not apply as respects the specific number of days within which you are required to notify us in writing of the abrupt commencement of a discharge, release or escape of "pollutants" that causes "bodily injury" or "property damage" which may otherwise be covered under this policy. M. WAIVER OF SUBROGATION The following is added to paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under contract with that person or organization; "your work"; or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury' offense is committed. N. BROADENED CONTRACTUAL LIABILITY —WORK WITHIN 50' OF RAILROAD PROPERTY Paragraph 9.c. of the definition "Insured Contract" under SECTION V — DEFINITIONS is deleted and replaced with the following: "Insured contract" means any easement or license agreement in connection with construction or demolition operations on or within 50 feet of a railroad. GL990078 Page 5 of 6 Ed 0912 46670516 I 1B/19 GL/AU/UMB/WC I Annette Romero 15/14/2019 4:43:49 PM (PDT) I Page 9 of 11 This certificate cancels and supersedes ALL previously issued certificates. Paragraph f.(1) of 9. "Insured contract' under SECTION V — DEFINITIONS is deleted. O. BODILY INJURY DEFINITION The definition of "bodily injury" in paragraph 3. of SECTION V — DEFINITIONS is deleted and replaced with the following: "Bodily injury" means bodily injury, mental anguish, mental shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. GL990078 e 6 of 6 Ed 0912 48670519 118/19 GL/AU/IIM9/WC I Annette Romero 15/14/2019 4:43:49 PM (PDT) I Page 10 of 11 This certificate cancels and supersedes ALL previously issued certificates. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 O6 I (Ed. 4-84) 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 2.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract This endorsement changes the policy to which it Is attached and is effective on the date issued unless otherwise stated. Endorsement Effective 6/1/2018 Policy No. swcl 197018 Endorsement No. Insured Superior Pavement Markings, Inc. Premium $ Insurance Company security National Insurance Company Countersigned by 48670518 1 18/19 GL/AU/UM&/WC I Annette Romero 1 5/14/2019 4:43:49 PM (PDT) I Page 11 of 11 This certificate cancels and supersedes ALL previously issued certificates