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PROOF OF INSURANCE (2019 - 2020) CLOSEDA ` R V CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) k* '11 8/1/2019 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 ... 'CONTACT Dealey, Renton & Associates PHONE� _ FAX P. O. Box 12675 J9l tds� aa1L._510-465-3090 I,Nc,""No : 510-452-2193 Oakland CA 94604-2675 ADoREss: certlficalestct dealeyrenton.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER American Casualty Company of Reading PA 20427 _...........__......_...................................�.............. _...........___. INSURED CANNOCORP INSURER B : Transportation Insurance COmT.ap / 20494 Cannon Corporation INSURER Continental Insurance Company 35289 1050 Southwood Drive ---•� San Luis Obispo CA 93401 INSURER D: Hartford Fire Ins. Co. 19682 INSURER E : Beazley Insurance Company, Inc. 37540 INSURER F: COVERAGES CERTIFICATE NUMBER: 577163979 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. IiN R A .0kk ..�. POLICY TEFF f'OUCY EXP TYPE OF INSURANCE .17L1Cn POLICY NUMBER IMM/OD/YYYY1 imMPODNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 2058094931 9/1/2018 9/1/2019 EACH OCCURRENCE $1.000.000 CLAIMS -MADE X �, OCCUR DAMAGE 1'0 RENTED PREMISES Lga oocurromm,l $ 1,000,000 MED EXP (Any one person) $ 15,000 PERSONA& ADV INJURY $ 1,000,000 `G'EN'LAGGREGATELIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 POLICY, w EOTX...� LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER'. $ B AUTOMOBILE LIABILITY Y Y 2058094976 9/1/2018 9/1/2019 COMBINED SINGLE LIMIT $1,000,000 — dran�tl X ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLYAUTOS ............ HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per'accidontli .,..$,,,,,,,,,,,,,,,,,,,,,,., C UMBRELLA LIAB X OCCUR Y Y 6043414103 9/1/2018 9/1/2019 EACH OCCURRENCE $9,000,000 X EXCESS LIAB ��� CLAIMS -MADE AGGREGATE $ 9,000,000 DED I I RETENTION $ $ D WORKERS COMPENSATION Y 51WEAA5OF4 9/1/2018 9/1/2019PER AND CER/MEMBEREXTNE E F N/A STATUTE IERH ACH ACCIDENT $ 1,000,000 OFFICER/ME BE PARTNERIEXECUTIVE E.L......................................................... (Mandatory ) DISEASE - EA EMPLOYEE $1,000,000 ........................................................................................... If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Professional V27737190101 6/8/2019 9/1/2020 Limit 2,000,000 Liability Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project Number/Name: #190638 / City of EI Segundo Water Yard Improvements City of EI Segundo, its officials, and employees are named as Additional Insured as respects General and Auto Liability as required per written contract or agreement. General Liability and Auto Li'abilit'y are Primary/Non-Contributory per policy form wording. 30 Days Notice of Cancellation NI_ C'ERTIF'ICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of EI Segundo 350 Main St.AUTHO REPRESENTATIVE EI Segundo CA 90245 FRIZED i ©1988-2015 ACORD CORPORATION. All rights reserved„ ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: v COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or B. additional insured coverage with "arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Policy No: 2058094931 Page 1 of 2 Endorsement No: 8 AMERICAN CASUALTY CO OF READING, PA Effective Date: 09/01/2018 Insured Name: CANNON CORPORATION Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Primary and Noncontributory Insurance CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (10-16) Page 2 of 2 AMERICAN CASUALTY CO OF READING,PA Insured Name: CANNON CORPORATION Policy No: 2058094931 Endorsement No: 8 Effective Date: 09/01/2018 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Business Auto Policy CNAPolicy Endorsement I d v� I tl I r V M I A I I , I 11 dl I I Y I� V AI I M 1 11 I I l 6 1 IIII I u .II l I YI I I I 1 � I I Y l I I YII I IIY � I I I I I A I II I I n I u I I 1 I l I I a l fl I u I I Y 1 I II I 1 1 l � I III I I I I I I VIIIII 11„li �^�, IIIIIIII I I i I I. � � pp 1 1 1 �I 1� m I� V �I�I��II li a�I1111I . IIII a II�II� �I I I ,I I � I I I II I I � I Y II VIII I I 11 I, I � I I� 1 I 1111111 III I111,�,� 1 �I I V I I 1 I I Y i I I 1 1 1 � I i IVI VIII I,. IIII I I. cul 1 IIIIIIII (� I ��ul 11 u,,��, 1�a1,W u,....�����.I Illll�u uu V. v ,. i III I� II 1111 I I rvo�l Ill IIV,ulwll,�ul �I �,IIII� I II 11111 SII uI II�,,I �I�III 1,1�� I I IN�I � IIII hVl, 11. 111111 SII u�l� ��i�WWWWWWIIIIIV..�M�VNIY,���,.'�V,VIVu'.IU'�W� IIIMIAIIO i�u,!I �N V L1. UIV41I, v� UV „i� IIIIh� 14111,I�.a���I��'V/k, l .,yU,B,,,ll � �.M, 11,,1,,,1„iI Viill N„dl,'��,I�,I, WI, I .IIIIxhCiR IP1II�uNd1Y,Yy,L„ll IV ,. „V„I����� I����m14NYW�Vr�YM�ial�IY�Y� Iv�iuhVowvIMPl�ll,�l�ly,�,lr�ll�a)Itiill�„ �� �Iv„u�dillml,�,�1 I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. For a covered "auto” licensed or principally garaged in, or "auto dealer operations” conducted in, California, 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. A. The term "spouse” is replaced by the following: Spouse or registered domestic partner under California law. B. The following are added to the Other Insurance Condition in the AUTO DEALERS and BUSINESS AUTO COVERAGE FORMS and the Other Insurance — Primary And Excess Insurance Provisions Condition in the MOTOR CARRIER COVERAGE FORM and supersede any provisions to the contrary: 1. When this Coverage Form and any other Coverage Form or policy providing liability coverage apply to an "auto” and: a. One provides coverage to a Named Insured engaged in the business of selling, repairing, servicing, delivering, testing or road-testing "autos"; and b. The other provides coverage to a person not engaged in that business; and c. At the time of an "accident", a person described in Paragraph 1.b. is operating an "auto" owned by the business described in Paragraph 1.a., then that person's liability coverage is primary and the Coverage Form issued to a business described in Paragraph 1.a. is excess over any coverage available to that person. 2. When this Coverage Form and any other Coverage Form or policy providing liability coverage apply to an "auto" and: a. One provides coverage to a Named Insured engaged in the business of selling, repairing, servicing, delivering, testing or road-testing "autos"; and b. The other provides coverage to a person not engaged in that business; and c. At the time of an "accident", an "insured" under the Coverage Form described in Paragraph 2.a. is operating an "auto" owned by a person described in Paragraph 2.b., then the Coverage Form issued to the business described in Paragraph 2.a. is primary and the liability coverage issued to a person described in Paragraph 2.b. is excess over any coverage available to the business. 3. When this Coverage Form and any other Coverage Form or policy providing liability coverage apply to a "commercial vehicle” and: a. One provides coverage to a Named Insured, who in the course of business, rents or leases "commercial vehicles” without operators; and b. The other provides coverage to a person other than as described in Paragraph 3.a.; and Form No: CA 01 43 10 13 Policy No: BUA 2058094976 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 09/01/2018 Endorsement No: 1; Page: 1 of 2 Policy Page: 44 of 170 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 © Copyright Insurance Services Office, Inc., 2012 Business Auto Policy Policy Endorsement c. At the time of an "accident", a person who is not the Named Insured of the policy described in Paragraph 3.a., and who is not the agent or "employee" of such Named Insured, is operating a "commercial vehicle" provided by the business covered by the Coverage Form or policy described in Paragraph 3.a., then the liability coverage provided by the Coverage Form or policy described in Paragraph 3.b. is primary, and the liability coverage provided by the Coverage Form or policy described in Paragraph 3.a. is excess over any coverage available to that person. 4. Notwithstanding Paragraph 13.3., when this Coverage Form and any other Coverage Form or policy providing liability coverage apply to a power unit and any connected "trailer" or "trailers" and: a. One provides coverage to a Named Insured engaged in the business of transporting property by "auto" for hire; and b. The other provides coverage to a Named Insured not engaged in that business; and c. At the time of an "accident', a power unit is being operated by a person insured under the Coverage Form or policy described in Paragraph 4.a., then that Coverage Form or policy is primary for both the power unit and any connected "trailer" or "trailers" and the Coverage Form or policy described in Paragraph 4.b. is excess over any other coverage available to such power unit and attached "trailer" or "trailers". C. As used in this endorsement: "Commercial vehicle" means an "auto" subject to registration or identification under California law which is: 1. Used or maintained for the transportation of persons for hire, compensation or profit; 2. Designed, used or maintained primarily for the transportation of property; or 3. Leased for a period of six months or more. Form No: CA 01 43 10 13 Policy No: BUA 2058094976 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 09/01/2018 Endorsement No: 1; Page: 2 of 2 Policy Page: 45 of 170 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 Copyright Insurance Services Office, Inc., 2012 Business Auto Policy Policy Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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: CANNON CORPORATION Endorsement Effective Date: 09/01/2018 SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR T--- ..................................................................................................................................................................................................................................................................................................................................._.......................................... 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. Form No: CA 04 44 10 13 Policy No: BUA 2058094976 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 09/01 /2018 Endorsement No: 6; Page: 1 of 1 Policy Page: 54 of 170 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 Copyright Insurance Services Office, Inc., 2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 51WEAA5OF4 Endorsement Number: Effective Date: 09/01/2018 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: Cannon Corporation 1050 Southwood Drive 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 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by Form WC 04 03 06 (1) Printed in U.S.A. Authorized Representative Policy Expiration Date: 09/01/2019