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PROOF OF INSURANCE (2019 - 2020) CLOSED0 DATE iMMIDDNWV) CERTIFICATE OF LIABILITY INSURANCE 110/15/2018 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(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(sl. PRODUCER CONTACT .doe Van Dyke NAp,1Ca.',,,� Tailored Insurance Services Inc PaeezE r' 8'22-3 ext 801 �.CAaAX1r..8ro'a2IT3 23785 EI Toro Rd, #267 0sa'_8t .. Joe ' MyTalloredirIs,cbm Lake Forest, CA 92630 "P.�'a ssa l 9TDMER ID $�__.....Y.........w....................... INSURERISI AFFORDING COVERAGE NAIC #........... INSURED INSURERA: WeSCO Insurance ComDanv rr ALOHA DOORS INC INSURERS: Interstate Fire & Casualty Comps 214 MAIN STREET #119 • AmGuard Insurance Comm any_ INSURER C „ . EL SEGUNDO, CA 90245 I I j u00" INSURER D MXC07011969 9/15/2018 9/15/2019 __._0 �� INSURER E : 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. ......................................_ IPOLIC R NUMBER MMIGD YMW"pTYPE OF INSURANCE LIMITS GENERAL LIABILITY 1.000,000 ✓JI I. I II I II I $ 50.000 I I j u00" MXC07011969 9/15/2018 9/15/2019 __._0 �� , " I $...! . .III �„ I I I s 2.Q00.000 000.000 ...................m............... _. a I. r....ww...... $1.000 000 I AUTOMOBILE LIABILITY $ 1,D00,DD0 I I....., C i ALAU951133 10/18!16 10!18/19777 71"I „ I °... I I II I I 1 UMBRELLA LIAB �4 EXCESS AB r I II II II, VILA i WORKERS GVN911rW.,AT10N Ar�uua u ll %NA Il�oaw L'IwSuIl�Sllll rlfN''.,r " vIP r! tliPVl F c ;�i'IIt1= NIA IL. rE' I rVande or, rn NHl l,l'I;,1 5 Ih 4M5 ,I•; v, u;rllfJ :"WI'Ir4h1' .'�,I 6`ttl4"'IR>r4,)F I'll �F RA. IUWS he luvv DI I,' ,I. "' I I�' „ DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (Atmch ACORD 101, Addllional Remarks Schedule, IF more space is required) City of EI Segundo are named as additional insureds in regards to the general liability policy. CERTIFICATE HOLDER CANCELLATION CI}�� of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE �7 9 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORlrZEDREPRESiI ("a � 01988-2099A RD CORPORATION„ .All rights reserved. ACORD 25 (2009109) The ACORD name and logo are. d marks of CO Allianz (@ 3250 Grey Hawk Ct, Unit Z • Carlsbad, CA 92010 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTERSTATE FIRE & CASUALTY COMPANY COMMERCIAL GENERAL LIABILITY POLICY ADDITIONAL INSURED ENDORSEMENT INCLUDING PRIMARY COVERAGE AND WAIVER OF SUBROGATION. The section of the policy entitled III. — WHO IS AN INSURED is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in a legally enforceable written contract or agreement entered into before your work commenced, that such person or organization be added as an additional insured on your policy. The coverage afforded by this endorsement is only (l) with respect to liability in connection with the original Named Insured's ongoing operations performed for said Additional Insured during the term of this policy, and (2) only if the Additional Insured performs all obligations required under this policy. The coverage afforded to an Additional Insured is limited to a claim made for a Covered Loss not covered by other insurance available to an Additional Insured, and is limited by the provisions of the Insuring Agreement, Exclusions, Conditions set forth in the pollcy and all endorsements thereto. No coverage is afforded under the "products -completed operations hazard" for an Additional Insured pursuant to this endorsement. The coverage afforded to an Additional Insured under this endorsement ends as of the date of completion, abandonment, or termination of the work of the Named Insured at any jobsite, project, or structure. There is no coverage hereunder for any Additional Insured in connection with any claim or suit involving any claim for damage that takes place or is alleged to take place following completion of the Named Insured's work. The "work" of the Named Insured will be deemed completed as of the date all work, including materials, parts or equipment furnished in connection with such work, on the project or any structure therein (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 when 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, including another contractor or subcontractor engaged in performing operations as part of the same project, whichever is earlier. The coverage provided for the Additional Insured is only to the extent that the additional insured is held liable for the negligence or strict liability of the Named Insured, and is only to the extent of and in the proportion Additional Insured is held liable for the negligence or strict liability/conduct/acts of the Named Insured_ No coverage is provided for liability based upon the acts, errors or omissions of the Additional Insured. If expressly required by a written and legally enforceable contract entered into by the Named Insured prior to commencement of work by the Named Insured for the Additional Insured, then the insurance afforded by the policy to the Additional Insured shall be primary insurance, and any insurance or self-insurance maintained by the above Additional Insured shall be excess of the insurance afforded to the Named Insured and shall not contribute to it. If expressly required by a written and legally enforceable contract entered into by the Named Insured prior to commencement of work by the Named Insured for the Additional Insured, then we waive any right of subrogation we may have against an entity that is an Additional Insured per the terms of this endorsement because of payments we make for injury or damage arising out of "your work" performed under such written and legally enforceable contract with that Additional Insured. Except as set forth above, all of the terms, conditions and exclusions of the policy apply and remain in effect. Policy No.: MXC07011969 Interstate Fire & Casualty Company 3250 Grey Hawk Ct, Ste. Z Date: 09/15/2018 Cirlsbad. �,J„2010 By: Time: 12:01 a.m. .•* Ali ,,I,t'�Kz d Representative V ALZ AIE OPWS 00 01 0318 Page 1 of 1 ALOHDOO-01 POSORNIO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)7/12/2019 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. ............_wwwwwwww................................WW......... 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 C NTACT 25550 HawthorInsurance e Blvd SService to 2103 Inc. _ N I; 3„10)„"373-uncan.com INC, Nol`t310)' 378-5336 Torrance, CA 90505 APORESS.ins@olisonduncan.com INSURERF: : h ............... - ......... ....._..� COVERAGES _C 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIMS. INSR TYPE OF INSURANCE IADDL SUBR POLICY NUMBER III POLICY EFF POLIICDY�i LIMITS _ LTR _ .....................„{NSD WD MMIOD/YYYYI„ A X COMMERCIAL GENERAL LIABILITY1,000,000' EACH OCCURRENCE $ CLAIMS -MADE X � occuR � AMW0024357 OAMAGE TO RFNTFD 3/14/2019 3/14/2020 5 mm . 6,000 ....... MED EXP (Any one person) $ _ A RY ............................................................ ........PE.............�.�....., GEN -1. AGGRE LIMITAPPLIESLOC AGREGATEDV GENERAPERSONL $......................��,..2,000,OOOI �IFR _PATE.......,,,„p JET ❑ PRODUCTS ,W,$'000,000 �.......................... O�H AUT OMOBILE LIABILITY COMBINED SINGLE UNiff _.EX_iSRX:d9�lAl�____.,.�..............�.�......_...�.. $ ANY AUTO O ONLY A(CH�EDU ED aCcidenl BODILY INJU,RY..iP.ef.......... � ...�.................... FOES _..._ AUTOS ALDTO�t POPERTY MAGE ............. ONLY OCCUR AGHEGC�ALRR0 $EXCESSLIABHCLAIMS-MADE,� GGRTE A� � $UMBRELLALIAB ............... ,.,........ DED ANDREMPLOYERS'LABIILITYN$ ON PEA f X..L.,�?�T.U�T�F,,..L.........!,.C� YIN 9253994 ,13 5/15/2019 5115/2020 1'00 ..................... 0,000 ANY PROPRIETOR/PARTNER/EXECUTIVE � E;I $ FIC E.RIMiEMBER EXCLUDED? N / A �andaRolY Nn NH) ❑ „EAGN,AC„G,,,,IDENT DISEASE - EA EMPLOYEE .$.................................................0...,,,.__.. ,000,OOO If yes, describe under „E,L 1,00 DESCRIPTION OF OPERATIONS below E L DISEASE • POLICY LIMIT '000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CAACELIFAT” SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City EI 9 ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ALOHA DOORS, INC. 9253994-19 NEW SC 8-71-41-05 PAGE 1 OF 1 EFFECTIVE JULY 16, 2019 AT 12.01 A.M. AND EXPIRING MAY 15, 2020 AT 12.01 A.M. 214 MAIN ST EL SEGUNDO, CA 90245 d.. ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, ALOHA DOORS, INC.. IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JULY 18, 2019 AUTHORIZED REPRESENTIVE PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) 2570 OLD DP 217 BROKER COPY 9253994-19 NEW SC PLEASE KEEP THIS ENDORSEMENT WITH YOUR POLICY Dear Policyholder: These endorsements amend and are part of your policy. Please keep them with your documents for future reference. If you have any questions concerning these endorsements, Please contact your local State Fund office.