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HomeMy WebLinkAboutAGMT - Lew Edwards Group (Assessment Advisory Services) T H E LEW EDWARDS GROUP AMENDMENT TO CONSULTING SERVICES AGREEMENT This constitutes a First Amendment to the Consulting Services Agreement between The Lew Edwards Group, a California Corporation ("Consultant"),and City of Seal Beach ("Client") that Agreement of which was effective March 7th, 2024. The aforementioned Agreement shall be amended as follows: 2. Services to be Performed. Beginning effective May 1, 2024 through August 30, 2024 Consultant shall,with consultation from Client,perform Task 2 Communications/Advisory Services: • Assist the City with Project Management in preparing for a potential November 2024 local funding measure. • Recommend and update preparation and project plan and timeline. • Develop text copy for informational materials. • Recommend strategies to disseminate information, consistent with the City's practices and advise on additional communications avenues to disseminate its information, such as use of its website and other Internet, paid digital, and traditional communications approaches as appropriate. • Provide text copy for the Internet, traditional Earned Media and/or Social Media. • Work with the City to provide clarifying or correct information to the public on a rapid response basis as needed. (Consultant does not function as a spokesperson for the City) • Provide ongoing advice as needed, including added value to the development of staff reports, City resolutions, and ballot materials. 3. Fees and Expenses. Consultant's fee for its May through August 2024 services shall be a discounted rate of Twenty-Two Thousand Dollars ($22,000) due and payable in increments of Five Thousand, Five Hundred Dollars ($5,500) per payment on the last business day of each month commencing May 31st, 2024 and ending on August 30, 2024. Professional fees do not include other project expenses such as graphic design, printing, postage, mailhouse, or social/digital media advertising. All Other provisions of the March 7th Agreement not revised in this Amendment shall remain in full force and effect. EXECUTION PAGE FOLLOWS THE LEW EDWARDS GROUP CITY OF SEAL BEACH By CATHERINE LEW, President Jill Ingram,City Manager May 14, 2024 Dated: T H E LEW EDWARDS G R 0 1' P AGREEMENT FOR ASSESSMENT AND ADVISORY SERVICES This Agreement is made between The Lew Edwards Group, a California Corporation ("Consultant"), and the City of Seal Beach ("Client"). The parties agree as follows: 1. Services to be Performed. Consultant shall, with consultation from Client, provide initial Task I Assessment and Advisory services: • Confer with the City on current constituent environment and 2024 Orange County trends • Conduct audit of all City issues/media coverage in the public arena over past twelve months • Review institutional archives of past client project with City and similar 2024 Orange County/small community projects • Facilitate design of updated Community Study by City's designated public opinion research professional • Independently analyze survey results • Provide strategic recommendations for the balance of the project, and update City staff on findings and recommendations 2. Fees and Expenses. Consultant's fees and expenses for these initial Task 1 services shall not exceed Sixteen Thousand, Two Hundred and Fifty Dollars($16,250)payable as follows: • Three Thousand, Two Hundred and Fifty Dollars ($3,250) upon invoice by Consultant for preparatory work; and • Two payments of Six Thousand, Five Hundred Dollars ($6,500) per payment due and payable on March 31st and April 30th, 2024. Expenses for conducting any public opinion research is in addition to Consultant's fee, through the City's direct contract with its opinion researcher. 3. Indemnification. With the exception of any action that one party may have against the other for harm caused to the other party arising from the willful misconduct or gross negligence of the other, Consultant shall hold Client, its agents, City Council and employees, harmless from any and all liability arising from or related to the performance of this Agreement, including third party legal actions caused by the acts or omissions of Consultant's agents or employees. 4. Notice. All notices, requests, demands or other communications under this Agreement shall be in writing. Notices shall be sufficiently given for all purposes as follows: Personal Delivery; First-Class Mail: Certified Mail; Overnight Delivery. 5. Severability If any term or provision of this Agreement shall be found illegal or unenforceable, then, notwithstanding, this Agreement shall remain in full force and effect and such term or provision shall be deemed stricken. 6. Entire Agreement. This Agreement supersedes any and all other agreements, whether oral or in writing, between the parties with respect to the subject of this Agreement. No other agreement,statement or promise not contained herein shall be valid or binding. 7.City Insurance Requirements. Consultant shall comply with insurance requirements attached hereto as Appendix A. Executed this_day of_ _ , 2024 at Seal Beach, California. CITY gra: # i I By r NglYaleitYl Jill Ing . , City Manager 211 Eighth Street Seal Beach,CA 90740 Executed this 7th day of March 2024 at Oakland, California. THE LEW EDWARDS GROUP Catherine Lew, President P.O. Box 21215 Oakland,CA 94620 APPENDIX A CITY INSURANCE REQUIREMENTS 1.1. General Requirements. Consultant shall not commence work under this Agreement until it has provided evidence satisfactory to City that Consultant has secured all insurance required under this Section. 1.2. Minimum Scope and Limits of Insurance. Consultant shall, at its sole cost and expense, procure, maintain and keep in full force and effect for the duration of the Agreement, insurance against claims for injuries to persons or damages to property that may arise from or in connection with the performance of this Agreement, as follows: 17.2.1. Commercial General Liability Insurance: Consultant shall maintain limits no less than $1,000,000 per occurrence for bodily injury, death, personal injury and property damage; and if Commercial General Liability Insurance or other form with a general aggregate limit is used,either the general aggregate limit shall apply separately to this Agreement/location or the general aggregate limit shall be twice the required occurrence limit: Coverage shall be at least as broad as the latest version of Insurance Services Office Commercial General Liability coverage(occurrence form CG 0001). If Consultant is a limited liability company,the commercial general liability coverage shall be amended so that Consultant and its managers, affiliates,employees, agents, servants,and other persons necessary or incidental to its operation are insureds. 17.2.2. Automobile Liability Insurance: Consultant shall maintain limits no less than $1,000,000 per accident for bodily injury and property damage.Coverage shall be at least as broad as Automobile Liability: Insurance Services Office Business Auto Coverage form number CA 0001, code 1 (any auto). 17.2.3. Workers' Compensation Insurance in the amount required by law;and Employer's Liability Insurance: with limits of at least$1,000,000 per accident and in the aggregate for bodily injury or disease. 17.2.4. Professional Liability(or Errors and Omissions Liability) Insurance:Consultant shall maintain professional liability(or errors and omissions liability)insurance that covers the Services to be performed in connection with this Agreement, with limits minimum limits no less than $1,000,000 per claim/aggregate. Any policy inception date,continuity date, or retroactive date must be before the effective date of this Agreement. If a"claims made" policy is provided, then the policy shall be endorsed to provide an extended reporting period of not less than three years. 1.3. Acceptability of Insurers. The Insurance policies required under this Section shall be placed with insurers with a current A.M. Best's rating no less than A:VIII, licensed to do business in California, and satisfactory to City. • 1.4. Additional Insureds. 17.4.1. For general liability insurance,City, its elected and appointed officials,officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials shall be covered as additional insureds with respect to the services or operations performed by or on behalf of the Consultant, including materials, parts or equipment furnished in connection with such work. 17.4.2. For automobile liability insurance, City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials, shall be covered as additional insureds with respect to the ownership,operation, maintenance, use, loading or unloading of any auto owned, leased, hired or borrowed by the Consultant or for which the Consultant is responsible. 17.4.3. These additional insured provisions shall also apply to any excess/umbrella liability policies. 1.5. Cancellations or Modifications to Coverage. The insurance policies shall contain the following provisions, or Consultant shall provide endorsements on forms supplied or approved by City to state: (i) coverage shall not be suspended, voided, reduced or canceled except after 30 days (or ten days for nonpayment) prior written notice by certified mail, return receipt requested, has been given to City; (ii) any failure to comply with reporting or other provisions of the policies, including breaches of warranties, shall not affect coverage provided to City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials; 1.6. Primary and Non-Contributing. Coverage shall be primary insurance as respects City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials, or if excess, shall stand in an unbroken chain of coverage excess of the Consultant's scheduled underlying coverage and that any insurance or self- insurance maintained by City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials, shall be excess of the Consultant's insurance and shall not be called upon to contribute with it; 1.7. Separation of Insureds. Each insurance policy shall contain standard separation of insureds provisions and shall not contain any special limitations on the scope of protection afforded to City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials. 1.8. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions shall be declared to and approved by City. Consultant guarantees that, at the option of City, either: (i) the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials; or(ii) Consultant shall procure a bond guaranteeing payment of losses and related investigation costs,claims and administrative and defense expenses. 1.9. Waiver of Subrogation. Each insurance policy required by this Agreement shall expressly waive the insurer's right of subrogation against City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials. Consultant hereby waives its own right of recovery and all rights of subrogation against City; and shall require similar express written waivers from any subcontractor. 1.10. Enforcement of Agreement Provisions(Non-Estoppel). Consultant acknowledges and agrees that any actual or alleged failure on City's part to inform Consultant of non-compliance with any insurance requirement does not impose additional obligations on City, nor does it waive any rights hereunder. 1.11. City Remedy for Noncompliance. If Consultant does not maintain the policies of insurance required under this Section in full force and effect during the term of this Agreement, or in the event any of Consultant's policies do not comply with the requirements under this Section, City may either immediately terminate this Agreement or, if insurance is available at a reasonable cost, City may, but has no duty to, take out the necessary insurance and pay, at Consultant's expense, the premium thereon. Consultant shall promptly reimburse City for any premium paid by City or City may withhold amounts sufficient to pay the premiums from payments due to Consultant. 1.12. Evidence of Insurance. Prior to the performance of Services under this Agreement, Consultant shall furnish City with original certificates of insurance and all original endorsements evidencing and effecting the coverages required under this Section on forms satisfactory to and approved by City. The certificates and endorsements for each insurance policy shall be signed by a person authorized by that insurer to bind coverage on its behalf, and shall be on forms provided by City if requested. Consultant may provide complete, certified copies of all required insurance policies to City. Consultant shall maintain current endorsements on file with City's Risk Manager. All certificates and endorsements shall be received and approved by City before work commences. City also reserves the right to require complete, certified copies of all required insurance policies, at any time. Consultant shall also provide proof to City that insurance policies expiring during the term of this Agreement have been renewed or replaced with other policies providing at least the same coverage. Consultant shall furnish such proof at least two weeks prior to the expiration of the coverages. 1.13. Insurance Requirements Not Limiting. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage,or a waiver of any type. 1.14. Broader Coverage/Higher limits. No representation is made that the minimum insurance requirements of this Agreement are sufficient to cover the obligations of Consultant under this Agreement. Consultant may also procure and maintain, at its own cost and expense, any additional kinds of insurance, which in its own judgment may be necessary for its proper protection and prosecution of the Services. If Consultant maintains broader coverage and/or higher limits than the minimums required above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Consultant. 1.15. Subcontractor Insurance Requirements/Pass-Through Clause. Consultant shall require each of its subconsultants and/or subcontractors`that perform Services under this Agreement to maintain insurance coverage that meets all of the requirements of this Section. Consultant agrees to monitor and review all such coverages and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this Section. Consultant agrees to submit all agreements with consultants, subcontractors, and others engaged in the Services upon City's request. 1.16. Timely Notice of Claims. Contractor shall give City prompt and timely notice of demands or claims made or suits instituted that arise out of or result from Contractor's performance under this Agreement, and that involve or may involve coverage under any of the required insurance policies. Form Wig Request for Taxpayer Give Form to the (Aw October MO Identification Number and Certification requester. Do not Deoartrrtre of the Trams, j send to the IRS. Interne Revenue Sees, ►Go to www.irager/FormW9 W9 for instructions and the latest information. 1 I I Name(as shown on yaut"Coma tax felon*Nene Is regrow]c-:r s are ]o not ease:-s -t^an. 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Cat No total Form W-0•Rat• 10 2018t �....11 LEWEDWA-01 GHODGES A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE 3/4/20�24 ) 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 License#OK07568 FAlACT Gail Hodges Cumbre Insurance Services,LLC PHONE Fax 3110 E.Guasti Road lac,No,Est),(707)992-3743 (A/c,No):(909)484-2491 Suite 500 istikss hodgesg@cumbreins.com Ontario,CA 91761 INSURER(S)AFFORDING COVERAGE NAIL e INSURER A:Underwriters at Lloyd's,London 15792 INSURED INSURER B:California Automobile Insurance Company 38342 Lew Edwards Group INSURER c:Republic Indemnity Company of America 22179 2301 Mastlands Drive INSURER 0:Hiscox Insurance Company Inc. 10200 Oakland,CA 94611 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. INSR TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF POUCY EXP LIMITS LTR INSD WYD IMM/DD/YYYYI IMM/DD/YYYY1 A X COMMERCIAL GENERAL UABIUTY 2,000,000 EACH OCCURRENCE S CLAIMS MADE X OCCUR X X CIP448878001 TO RNTE 2/6/2024 2/6/2025 PREMISES EaEo rrDence/ $ 100.000 MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLES PER GENERAL AGGREGATE $ 2.000.000 X_POLICY jka LOC PRODUCTS•COMP/OP AGG S OTHER: $ B AUTOMOBILE LUIBIUTY COMBINED SINGLE LIMIT 1,000,000 _� (Ea accident!___ S ----- ------ X •ANY AUTO X X BA040000069701 9/1/2023 9/1/2024 BODILYINJURY�rerperson) S OWNED SCHEDULED . _..._. _._ . AUTOS ONLY AUTOS BODILY INJURY Ter accident; S EF NpN.py�►�Ep -_..-- X AUTOS ONLY X.AUTOS ONLY `Peer MT ID S S UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE. AGGREGATE S DED RETENTIONS S C AND EMPLOYERS'UABILITY Y/N ATION X STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE 16644919 9/21/2023 9/21/2024 1,000,000 MFFICEROMEM EXCLUDED? Y N/A E.L.EACH ACCIDENT S andatory in NH) 1,000,000 E L DISEASE-EA EMPLOYEE S 'I ye&desT under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Errors&Omissions MPL5174394.23 9/30/2023 9/30/2024 Per Claim 2,000,000 D Claims Made MPL5174394.23 9/30/2023 9/3012024 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) The City of Seal Beach,its elected and appointed officials,officers,employees,agents,servants and voluenteers and those City agents serving as independent contractors in the role of City Officials are named as additional insured's per AF 00 859 07 23,coverage is Primary 8 Non-Contributory per AF 001 397 09 16 and Waiver of Subrogation applies per CG 24 04 05 09. Automobile Additional Insured,Primary and Non-Contributory and Waiver of Subrogation per MCA 85100817. Worker's Compensation Waiver of Subrogation per WC 00 03 13 04 84. 30 day Notice of Cancellation with the exception of a 10 day notice for non-payment of Premium CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sea)Beach City Eighth Street ACCORDANCE WITH THE POLICY PROVISIONS. 211Seal Beach,CA 90740 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) CO 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 FORM SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations ANY PERSON OR ORGANIZATION AS REQUIRED BY WRITTEN CONTRACT WITH THE NSURED 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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 A persons or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or"property damage" for which the"additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement Finished Operations or Work "Bodily injury" or"property damage" occurring after (1) 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 (2) 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 Negligence of Additional Insured "Bodily injury" or"property damage" directly caused by or resulting from the negligence of the"additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy) Policy Number: CIP448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective date AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 1 07f 2012 with its perm ission ENDORSEMENT This Endorsement Changes the Policy-Please Read it Carefully PRIMARY AND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV-Commercial General Liability Conditions, Paragraph 4: Section IV Commercial General Liability Conditions 4. Other Insurance: d. Specifically and solely for the Third-Party shown below, notwithstanding the provisions of sub-paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any Suit'Where the damages are caused by the insureds sole negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third-Party to whom this endorsement applies is: ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES: AT A SPECIFIED PROJECT SET FORTH IN A WRITTEN CONTRACT,THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY SEEKING COVERAGE UNDER THIS ENDORSEMENT, AND (2) HAS BEEN ENTERED INTO BEFORE ANY LOSS HAS OCCURRED. Any coverage provided pursuant to this endorsement shall be subject to all other terms,conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number: C1P448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective Date AF001397(09/16) Page 1 of 1 POLICY NUMBER: CIP448878001 COMMERCIAL GENERAL LIABILITY C G 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 Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS Information required to complete this Schedule,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 against 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 24 04 05 09 Insurance Services Office,Inc., 2008 Page 1 of 1 POLICY#BA040000069701 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY(BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V. SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR—DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM,SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO—COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 1 of 6 BUSINESS AUTO COVERAGE FORM NEWLY ACQUIRED OR FORMED ENTITY(Broad Form Named Insured) SECTION II-LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: d. Any business entity newly acquired or formed by you during the policy period provided you own 50%or more of the business entity and the business entity is not separately insured for Business Auto Coverage.Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Coverage does not apply to an "accident"which occurred before you acquired or formed the organization. II. EMPLOYEES AS INSUREDS SECTION II-LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: e. Any"employee"of yours is an"insured"while using a covered"auto"you don't own,hire or borrow in your business or your personal affairs. • III. AUTOMATIC ADDITIONAL INSURED SECTION II-LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the"bodily injury"or"property damage"occurs and that is in effect during the policy period is an"insured"for Liability Coverage,but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an"insured"under the Who Is An Insured provision contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II-LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: g. An"employee"of yours is an"insured"while operating an "auto" hired or rented under a contract or agreement in that"employee's"name,with your permission, while performing duties related to the conduct of your business. V. SUPPLEMENTARY PAYMENTS SECTION II—LIABILITY COVERAGE,A.Coverage,2.Coverage Extensions,a.Supplementary Payments,Subparagraphs(2)and(4)are replaced by the following: (2) Up to$3,000 for cost of bail bonds(including bonds for related traffic law violations)required because of an "accident"we cover. We are not obligated to furnish these bonds. (4) All reasonable expenses incurred by the"insured"at our request, including actual loss of earnings up to$500 a day because of time off from work. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with Its Permission Page 2 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II—LIABILITY COVERAGE,B.Exclusions,5. Fellow Employee This exclusion does not apply if you have workers'compensation insurance in-force covering all of your"employees". Coverage is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III-PHYSICAL DAMAGE COVERAGE,A.Coverage,4.Coverage Extensions,a.Transportation Expenses,is replaced with the following: We will pay up to$50 per day to a maximum of$1000 for temporary transportation expense incurred by you because of the total theft of a covered"auto"of the private passenger type.We will pay only for those covered"autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage.We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending,regardless of the policy's expiration,when the covered "auto"is returned to use or we pay for its"loss". If your business shown in the Declarations is other than an auto dealership,we will also pay up to$1,000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III—PHYSICAL DAMAGE COVERAGE,A.Coverage,4.Coverage Extensions,the following is added: c. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis and Comprehensive,Specified Causes of Loss,or Collision coverages are provided under this coverage form for any"auto"you own,then the Physical Damage Coverages provided are extended to"autos"you hire,subject to the following limit: (1) The most we will pay for"loss"to any hired"auto"is$50,000 or Actual Cash Value or Cost of Repair,whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to"loss"caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered"auto"you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III-PHYSICAL DAMAGE COVERAGE, B. Exclusions,3.a.,is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 3 of 6 X. LOAN/LEASE GAP COVERAGE SECTION III-PHYSICAL DAMAGE COVERAGE C.Limit of Insurance,the following is added: 4. In the event of a"total loss"to a covered"auto"shown in the schedule or declarations for which Collision and Comprehensive Coverage apply,we will pay any unpaid amount due on the lease or loan for that covered"auto,"less: a. The amount paid under the Physical Damage Coverage Section of the policy;and b. Any: (1) Overdue lease/loan payments at the time of the"loss"; (2) Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insurance purchased with the loan or lease;and (5) Carry-over balances from previous loans or leases. The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25%of the actual cash value of that insured auto at the time of the loss. Xl. GLASS REPAIR—DEDUCTIBLE WAIVER SECTION III-PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION III-PHYSICAL DAMAGE COVERAGE,D.Deductible,the following is added: If two or more"company"policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived;or 2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible;or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement"company"means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS,A.Loss Conditions,2.Duties In The Event Of Accident,Claim,Suit,Or Loss,a.,In the event of"accident",you must notify us of an "accident"applies only when the"accident" is known to: (1) You,if you are an individual; (2) A partner,if you are a partnership; (3) A member, if you are a limited liability company;or (4) An executive officer or insurance manager,if you are a corporation. Copyright 2017 Mercury Insurance Services,U.C. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 4 of 6 XIV. WAIVER OF SUBROGATION SECTION IV-BUSINESS AUTO CONDITIONS,A.Loss Conditions,5.Transfer of Rights Of Recovery Against Others To Us,section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any"accident"or "loss", provided that the"accident"or"loss"arises out of the operations contemplated by such contract.The waiver applies only to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR,OMISSION,OR FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, B.General Conditions, 2.Concealment, Misrepresentation,or Fraud,the following is added: Any unintentional omission of or error in information given by you,or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However,you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV—BUSINESS AUTO CONDITIONS, B.General Conditions,5.Other Insurance,b.For Hired Auto Physical Damage Coverage,is replaced by the following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos"you own: 1. Any covered"auto"you lease, hire, rent or borrow;and 2. Any covered"auto"hired or rented by your"employee"under a contract in that individual"employee's"name,with your permission,while performing duties related to the conduct of your business. However,any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV—BUSINESS AUTO CONDITIONS,B.General Conditions,5.Other Insurance,the following is added and supersedes any provision to the contrary: e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance;and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 5 of 6 XVIII. HIRED AUTO-COVERAGE TERRITORY SECTION IV-BUSINESS AUTO CONDITIONS, B.General Conditions, 7. Policy Period, Coverage Territory, e.Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less;and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico,or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V—DEFINITIONS,C. "Bodily Injury" is amended by adding the following: "Bodily injury"also includes mental anguish but only when the mental anguish arises from other bodily injury,sickness, or disease. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 6 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule State Person or Organization Job Description California City of Seal Beach All California operations 211 Eighth Street performed by the Named Insured Seal Beach, CA 90740 on behalf of the Certificate Holder The premium charge for this endorsement shall be$250. This charge will be billed at the final audit. WC 00 03 13 1 of 2 (Ed. 04-84) Insured Copy ©1983 National Council on Compensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Republic Indemnity Company of America Company Number 19739 Insured Lew Edwards Group Policy Number 166449-19 Endorsement Number 42 Endorsement Effective September 21, 2023 Printed On March 01,2024 Countersigned by : WC 00 03 13 2 of 2 (Ed. 04-84) Insured Copy j 1983 National Council on Compensation Insurance. T H E LEW EDWARDS GROUP AGREEMENT FOR ASSESSMENT AND ADVISORY SERVICES This Agreement is made between The Lew Edwards Group, a California Corporation ("Consultant"), and the City of Seal Beach("Client"). The parties agree as follows: 1. Services to be Performed. Consultant shall, with consultation from Client, provide initial Task 1 Assessment and Advisory services: • Confer with the City on current constituent environment and 2024 Orange County trends • Conduct audit of all City issues/media coverage in the public arena over past twelve months • Review institutional archives of past client project with City and similar 2024 Orange County/small community projects • Facilitate design of updated Community Study by City's designated public opinion research professional • Independently analyze survey results • Provide strategic recommendations for the balance of the project, and update City staff on findings and recommendations 2. Fees and Expenses. Consultant's fees and expenses for these initial Task 1 services shall not exceed Sixteen Thousand, Two Hundred and Fifty Dollars ($16,250)payable as follows: • Three Thousand, Two Hundred and Fifty Dollars ($3,250) upon invoice by Consultant for preparatory work; and • Two payments of Six Thousand, Five Hundred Dollars ($6,500) per payment due and payable on March 31 st and April 30th, 2024. Expenses for conducting any public opinion research is in addition to Consultant's fee,through the City's direct contract with its opinion researcher. 3.Indemnification. With the exception of any action that one party may have against the other for harm caused to the other party arising from the willful misconduct or gross negligence of the other, Consultant shall hold Client, its agents, City Council and employees, harmless from any and all liability arising from or related to the performance of this Agreement, including third party legal actions caused by the acts or omissions of Consultant's agents or employees. 4. Notice. All notices, requests, demands or other communications under this Agreement shall be in writing. Notices shall be sufficiently given for all purposes as follows: Personal Delivery; First-Class Mail; Certified Mail; Overnight Delivery. 5. Severability If any term or provision of this Agreement shall be found illegal or unenforceable, then, notwithstanding, this Agreement shall remain in full force and effect and such term or provision shall be deemed stricken. 6. Entire Agreement. This Agreement supersedes any and all other agreements, whether oral or in writing, between the parties with respect to the subject of this Agreement. No other agreement, statement or promise not contained herein shall be valid or binding. 7. City Insurance Requirements. Consultant shall comply with insurance requirements attached hereto as Appendix A. Executed this day of , 2024 at Seal Beach, California. CITY ' •l j � � H rtlarn. By 111 Jill Ing , City Manager 211 Eighth Street Seal Beach, CA 90740 Executed this 7th day of March 2024 at Oakland, California. THE LEW EDWARDS GROUP Catherine Lew, President P.O. Box 21215 Oakland, CA 94620 APPENDIX A CITY INSURANCE REQUIREMENTS 1.1. General Requirements. Consultant shall not commence work under this Agreement until it has provided evidence satisfactory to City that Consultant has secured all insurance required under this Section. 1.2. Minimum Scope and Limits of Insurance. Consultant shall, at its sole cost and expense, procure, maintain and keep in full force and effect for the duration of the Agreement, insurance against claims for injuries to persons or damages to property that may arise from or in connection with the performance of this Agreement, as follows: 17.2.1. Commercial General Liability Insurance: Consultant shall maintain limits no less than $1,000,000 per occurrence for bodily injury, death, personal injury and property damage; and if Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to this Agreement/location or the general aggregate limit shall be twice the required occurrence limit: Coverage shall be at least as broad as the latest version of Insurance Services Office Commercial General Liability coverage(occurrence form CG 0001). If Consultant is a limited liability company,the commercial general liability coverage shall be amended so that Consultant and its managers, affiliates, employees, agents, servants, and other persons necessary or incidental to its operation are insureds. 17.2.2. Automobile Liability Insurance: Consultant shall maintain limits no less than $1,000,000 per accident for bodily injury and property damage. Coverage shall be at least as broad as Automobile Liability: Insurance Services Office Business Auto Coverage form number CA 0001, code 1 (any auto). 17.2.3. Workers' Compensation Insurance in the amount required by law; and Employer's Liability Insurance: with limits of at least$1,000,000 per accident and in the aggregate for bodily injury or disease. 17.2.4. Professional Liability(or Errors and Omissions Liability) Insurance:Consultant shall maintain professional liability(or errors and omissions liability) insurance that covers the Services to be performed in connection with this Agreement, with limits minimum limits no less than $1,000,000 per claim/aggregate.Any policy inception date, continuity date, or retroactive date must be before the effective date of this Agreement. If a"claims made"policy is provided,then the policy shall be endorsed to provide an extended reporting period of not less than three years. 1.3. Acceptability of Insurers. The Insurance policies required under this Section shall be placed with insurers with a current A.M. Best's rating no less than A:VIII, licensed to do business in California, and satisfactory to City. • 1.4. Additional Insureds. 17.4.1. For general liability insurance, City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials shall be covered as additional insureds with respect to the services or operations performed by or on behalf of the Consultant, including materials, parts or equipment furnished in connection with such work. 17.4.2. For automobile liability insurance, City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials, shall be covered as additional insureds with respect to the ownership, operation, maintenance, use, loading or unloading of any auto owned, leased, hired or borrowed by the Consultant or for which the Consultant is responsible. 17.4.3. These additional insured provisions shall also apply to any excess/umbrella liability policies. 1.5. Cancellations or Modifications to Coverage. The insurance policies shall contain the following provisions, or Consultant shall provide endorsements on forms supplied or approved by City to state: (i) coverage shall not be suspended, voided, reduced or canceled except after 30 days (or ten days for nonpayment) prior written notice by certified mail, return receipt requested, has been given to City; (ii) any failure to comply with reporting or other provisions of the policies, including breaches of warranties, shall not affect coverage provided to City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials; 1.6. Primary and Non-Contributing. Coverage shall be primary insurance as respects City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials, or if excess, shall stand in an unbroken chain of coverage excess of the Consultant's scheduled underlying coverage and that any insurance or self- insurance maintained by City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials, shall be excess of the Consultant's insurance and shall not be called upon to contribute with it; 1.7. Separation of Insureds. Each insurance policy shall contain standard separation of insureds provisions and shall not contain any special limitations on the scope of protection afforded to City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials. 1.8. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions shall be declared to and approved by City. Consultant guarantees that, at the option of City, either: (i) the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials; or (ii) Consultant shall procure a bond guaranteeing payment of losses and related investigation costs,claims and administrative and defense expenses. 1.9. Waiver of Subrogation. Each insurance policy required by this Agreement shall expressly waive the insurer's right of subrogation against City, its elected and appointed officials, officers, employees, agents, servants, volunteers, and those City agents serving as independent contractors in the role of City officials. Consultant hereby waives its own right of recovery and all rights of subrogation against City; and shall require similar express written waivers from any subcontractor. 1.10. Enforcement of Agreement Provisions (Non-Estoppel). Consultant acknowledges and agrees that any actual or alleged failure on City's part to inform Consultant of non-compliance with any insurance requirement does not impose additional obligations on City, nor does it waive any rights hereunder. 1.11. City Remedy for Noncompliance. If Consultant does not maintain the policies of insurance required under this Section in full force and effect during the term of this Agreement, or in the event any of Consultant's policies do not comply with the requirements under this Section, City may either immediately terminate this Agreement or, if insurance is available at a reasonable cost, City may, but has no duty to, take out the necessary insurance and pay, at Consultant's expense, the premium thereon. Consultant shall promptly reimburse City for any premium paid by City or City may withhold amounts sufficient to pay the premiums from payments due to Consultant. 1.12. Evidence of Insurance. Prior to the performance of Services under this Agreement, Consultant shall furnish City with original certificates of insurance and all original endorsements evidencing and effecting the coverages required under this Section on forms satisfactory to and approved by City. The certificates and endorsements for each insurance policy shall be signed by a person authorized by that insurer to bind coverage on its behalf, and shall be on forms provided by City if requested. Consultant may provide complete, certified copies of all required insurance policies to City. Consultant shall maintain current endorsements on file with City's Risk Manager. All certificates and endorsements shall be received and approved by City before work commences. City also reserves the right to require complete, certified copies of all required insurance policies, at any time. Consultant shall also provide proof to City that insurance policies expiring during the term of this Agreement have been renewed or replaced with other policies providing at least the same coverage. Consultant shall furnish such proof at least two weeks prior to the expiration of the coverages. 1.13. Insurance Requirements Not Limiting. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. 1.14. Broader Coverage/Higher Limits. No representation is made that the minimum insurance requirements of this Agreement are sufficient to cover the obligations of Consultant under this Agreement. Consultant may also procure and maintain, at its own cost and expense, any additional kinds of insurance, which in its own judgment may be necessary for its proper protection and prosecution of the Services. If Consultant maintains broader coverage and/or higher limits than the minimums required above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Consultant. 1.15. Subcontractor Insurance Requirements/Pass-Through Clause. Consultant shall require each of its subconsultants and/or subcontractors that perform Services under this Agreement to maintain insurance coverage that meets all of the requirements of this Section. Consultant agrees to monitor and review all such coverages and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this Section. Consultant agrees to submit all agreements with consultants, subcontractors, and others engaged in the Services upon City's request. 1.16. Timely Notice of Claims. Contractor shall give City prompt and timely notice of demands or claims made or suits instituted that arise out of or result from Contractor's performance under this Agreement, and that involve or may involve coverage under any of the required insurance policies. Form IN-9 Request for Taxpayer Give Form to the (Pev Uctubrr;o,zf Identification Number and Certification requester. Do not Decarrnentot toe 7.easury send to the IRS. Internal Re:eiue Sevice le Go to www.irs.gov/Form W9 for instructions and the latest information. I Name(as shown on your Income tax return).Name 1_ 5 lire.so ro' ea,e t^s The Lew Edwards Group 2 Bt.s"^ess name/disregarded entity name,r'diuerent from above 3 Chock approor ate sox for federal tax classification of the person whose name is entered on fine 1.Check ony one o'the 4 Exemptions(codes apply only to ronoveng seven boxes certain entities.not individuals:see a '��tI instructions on page 31: 6 u kriti,Juo'x,le Isupriatar rx C C Corporat.on C C Corporal on Elr of catty 'rue:reetate Im �4qr single member LWEzemp7 payee code{,t artyl ❑ m Limited liability coplany.Enter the tax ctassiScahon 1C=C corporation.S=S corporation,P.Pertnerah p)► is" c Note:Cheek the appfopnale box in the line above for the lax classification of the single member owner Do not check Exemption f•om FATCA repo'hnq w LLC A the LLC ciarsi'ied as a single-member LLC that a disregarded'tor the owner un'egs the owner or the LLC is e annthar t.LC treat ie not dsregarded'rem:he owner for U.S.federal tax purposes Otherwise.a single-member LLC that code i'7 any) a r etsregarded rrom the owner shoakt check the appropnale box for the tax Cassi'iCa1 on o'its owner L_.1 ()me(see,nslrucsons1► :+cc:Mr>-o:..rn ramnr..+n�rvi.fie u Gi tav rn 5 Address(number,chexT^d apt or suite no I See instructions. Requester's name and address iopt,onal) c' 5454 Broadway 6 City,state.and ZIP coot Oakland,CA 94618 t 7 List account Norberto)here(optionall Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided mu.-1 -latch the name given on line t to avoid I Seelig eewrlty number backup withholding.For Individuals.this Is generally your social security number(SSN).However.for a resident alien,sole proprietor,re disregarded entity,see the instructions for Part I.later.For other - - entities,it Is your employer idehtificcatlon number(EIN),II you do not have a number,see How to get a _ TIN,later. or Note:If the account is in more than one name,see the Instructions for line 1.Also see What Name and Employer identification number ) Number To Give Pro Requester for guidelines on whose number to enter. 9 4 - 3 3 3 2 2 0 1 Part II Certificatiofl Under penalties of perjury.I certify than 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me):and 2.I am not subject to backup Withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends.or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.I am a U.S.citizen or other U.S.person(defined below):and 4.the FATCA code(s)entered'on this form(if any)Indicating that I am exempt from FATCA reporting is correct. Certification Instructions.You must cross out item 2 above it you have been notated by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions.Item 2 does not apply.For mortoape interest paid. acquisition or abandonment of lecured properly,cancellation of debt,contributions to an ndvidual retirement arrangement(IRA),and generally,payments other than interest,lid eividprdr.. 'ire not required to sign the certification,but st provide your correct TIN.See the it.li actions for Part II.later. Sign Signature of 1 iSi �3Here U.S.person► Uate► General Instructions •Form 1099-DIV iui'viaends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various typos of income,prizes,awards,dr gross noted. proceeds) Future developments.For t latest information about developments •Form 1099-B(stock or mutest funs rnleie arwl CMain rythe, related to Form w-9 and its instructions.such as legislation erecter transactions by brokers) after they were published,go tp wow IrS,g01lFormW9. •Form 1099-5(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant caro and third party network transactions) An Individual or entity(Form W-9 requester)who is requires to tile an •Form 1098(home mortgage interest), I0)98-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN which may be your social security number •Form 1099-C(canceled aebt) (SSN),individual taxpayer identification number(ITIN).adoption •Form 1099-A(aequ.sitwn or abandonment 01 secured property) taxpayer identification number(ATINI.or employer ioentifrcaticn number (ON).to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S person(including a resident amount reoortable on an information return.Examples of information alien),10 provide your correct TIN. returns include,but are not I-ruled to,the following. If you do not return Form W-9 to the regi.ester with a TIN,you might •Form 1099-INT(interest vd'rivd 9r paid) be subject to backup withholding.See What Is backup witnholatng, later. Cat No 10231X Form W-9(Rev 10 20181 LEWEDWA-01 GHODGES '4CoRo_ CERTIFICATE OF LIABILITY INSURANCE DAT3/4/2024 ) 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 License#0K07568 NQNTACT Gail Hodges Cumbre Insurance Services,LLC PHONE Fax 3110 E.Guasti Road (@DRE A.M/C,No,Ext):(707)992-3743 (A/C,No):(909)484-2491 Suite 500 MASS:hodgesg@cumbreins.com Ontario,CA 91761 INSURER(S)AFFORDING COVERAGE _ NAIC# INSURER A:Underwriters at Lloyd's,London 15792 INSURED INSURER B:California Automobile Insurance Company 38342 Lew Edwards Group INSURER C:Republic Indemnity Company of America 22179 2301 Mastlands Drive INSURER D:Hiscox Insurance Company Inc. 10200 Oakland,CA 94611 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMMIDDIYYYYI (MMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X I OCCUR X x CIP448878001 2/6/2024 2/6/2025 PAMAGE TO REMISES(EaENTED occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 - ---- X POLICY Fief LOC PRODUCTS-COMP/OP AGG $ OTHER: $ B AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) E - X ANY AUTO X X BA040000069701 9/1/2023 9/1/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSRE�ONLY AUTOS WN D BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS ONLY (Perr acadent)AMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION X STATUTE _ ERH- AND EMPLOYERS'LIABILITY YIN 116644919 9/21/2023 9/21/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ WFFICER/MEMBEREXCLUDED? Y NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Errors&Omissions MPL5174394.23 9/30/2023 9/30/2024 Per Claim 2,000,000 D Claims Made MPL5174394.23 9/30/2023 9/30/2024 Aggregate 1,000,000 iI DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) The City of Seal Beach,its elected and appointed officials,officers,employees,agents,servants and voluenteers and those City agents serving as independent contractors in the role of City Officials are named as additional insured's per AF 00 859 07 23,coverage is Primary&Non-Contributory per AF 001 397 09 16 and Waiver of Subrogation applies per CG 24 04 05 09. Automobile Additional Insured,Primary and Non-Contributory and Waiver of Subrogation per MCA 85100817. Worker's Compensation Waiver of Subrogation per WC 00 03 13 04 84. 30 day Notice of Cancellation with the exception of a 10 day notice for non-payment of Premium CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Seal Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 211 Eighth Street Seal Beach,CA 90740 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 FORM SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations ANY PERSON OR ORGANIZATION AS REQUIRED BY WRITTEN CONTRACT WITH THE INSURED 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person§or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or"property damage" for which the"additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work "Bodily injury" or"property damage" occurring after: (1) 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 (2) 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. Negligence of Additional Insured "Bodily injury" or"property damage" directly caused by or resulting from the negligence of the"additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Policy Number: CIP448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 1 07/2012 with its perm ission ENDORSEMENT This Endorsement Changes the Policy-Please Read it Carefully PRIMARY AND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV-Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Specifically and solely for the Third-Party shown below, notwithstanding the provisions of sub-paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any tuit"where the damages are caused by the insured§sole negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third-Party to whom this endorsement applies is: ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES, AT A SPECIFIED PROJECT SET FORTH IN A WRITTEN CONTRACT, THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY SEEKING COVERAGE UNDER THIS ENDORSEMENT; AND (2) HAS BEEN ENTERED INTO BEFORE ANY LOSS HAS OCCURRED. Any coverage provided pursuant to this endorsement shall be subject to all other terms, conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number: CIP448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective Date: AF001397 (09/16) Page 1 of 1 POLICY NUMBER: CIP448878001 COMMERCIAL GENERAL LIABILITY CG24040509 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 Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS Information required to complete this Schedule, 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 against 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 24 04 05 09 Insurance Services Office, Inc_,2008 Page 1 of 1 POLICY#BA040000069701 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V, SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR—DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO—COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 1 of 6 BUSINESS AUTO COVERAGE FORM NEWLY ACQUIRED OR FORMED ENTITY(Broad Form Named Insured) SECTION II -LIABILITY COVERAGE,A. Coverage, 1. Who Is An Insured,the following is added: d. Any business entity newly acquired or formed by you during the policy period provided you own 50%or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Coverage does not apply to an "accident"which occurred before you acquired or formed the organization. II. EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: e. Any"employee"of yours is an "insured"while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs. III. AUTOMATIC ADDITIONAL INSURED SECTION II - LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the"bodily injury"or"property damage" occurs and that is in effect during the policy period is an "insured"for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II -LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: g. An "employee"of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that"employee's" name,with your permission, while performing duties related to the conduct of your business. V. SUPPLEMENTARY PAYMENTS SECTION II—LIABILITY COVERAGE,A.Coverage, 2. Coverage Extensions, a.Supplementary Payments,Subparagraphs (2) and (4) are replaced by the following: (2) Up to$3,000 for cost of bail bonds(including bonds for related traffic law violations) required because of an "accident"we cover. We are not obligated to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to$500 a day because of time off from work. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 2 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II—LIABILITY COVERAGE, B. Exclusions,5. Fellow Employee This exclusion does not apply if you have workers' compensation insurance in-force covering all of your"employees". Coverage is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III -PHYSICAL DAMAGE COVERAGE,A. Coverage,4.Coverage Extensions,a.Transportation Expenses, is replaced with the following: We will pay up to$50 per day to a maximum of$1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto"of the private passenger type. We will pay only for those covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage.We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its"loss". If your business shown in the Declarations is other than an auto dealership,we will also pay up to$1,000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III—PHYSICAL DAMAGE COVERAGE,A. Coverage,4.Coverage Extensions,the following is added: c. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis and Comprehensive,Specified Causes of Loss,or Collision coverages are provided under this coverage form for any"auto"you own,then the Physical Damage Coverages provided are extended to "autos"you hire,subject to the following limit: (1) The most we will pay for"loss"to any hired "auto" is$50,000 or Actual Cash Value or Cost of Repair,whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to"loss"caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered "auto"you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE, B. Exclusions,3.a., is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 3 of 6 X. LOAN/LEASE GAP COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE C. Limit of Insurance,the following is added: 4. In the event of a "total loss"to a covered "auto" shown in the schedule or declarations for which Collision and Comprehensive Coverage apply,we will pay any unpaid amount due on the lease or loan for that covered "auto," less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease/loan payments at the time of the"loss"; (2) Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health,Accident or Disability Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25%of the actual cash value of that insured auto at the time of the loss. Xl. GLASS REPAIR—DEDUCTIBLE WAIVER SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION III-PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: If two or more "company" policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived;or 2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible;or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement"company" means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS,A. Loss Conditions, 2. Duties In The Event Of Accident, Claim,Suit, Or Loss, a., In the event of"accident", you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company;or (4) An executive officer or insurance manager, if you are a corporation. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 4 of 6 XIV. WAIVER OF SUBROGATION SECTION IV- BUSINESS AUTO CONDITIONS,A. Loss Conditions, 5.Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any"accident" or "loss", provided that the "accident" or"loss"arises out of the operations contemplated by such contract.The waiver applies only to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR,OMISSION,OR FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, B.General Conditions, 2.Concealment, Misrepresentation, or Fraud,the following is added: Any unintentional omission of or error in information given by you, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However,you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV—BUSINESS AUTO CONDITIONS, B.General Conditions, 5.Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos" you own: 1. Any covered "auto"you lease, hire, rent or borrow;and 2. Any covered "auto" hired or rented by your"employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However,any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV—BUSINESS AUTO CONDITIONS, B.General Conditions,5. Other Insurance,the following is added and supersedes any provision to the contrary: e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 5 of 6 XVIII. HIRED AUTO-COVERAGE TERRITORY SECTION IV-BUSINESS AUTO CONDITIONS, B. General Conditions,7. Policy Period, Coverage Territory, e.Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less;and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America,the territories and possessions of the United States of America, Puerto Rico,or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V—DEFINITIONS, C. "Bodily Injury" is amended by adding the following: "Bodily injury"also includes mental anguish but only when the mental anguish arises from other bodily injury,sickness, or disease. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 6 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule State Person or Organization Job Description California City of Seal Beach All California operations 211 Eighth Street performed by the Named Insured Seal Beach, CA 90740 on behalf of the Certificate Holder The premium charge for this endorsement shall be$250. This charge will be billed at the final audit. WC 00 03 13 1 of 2 (Ed. 04-84) Insured Copy ©1983 National Council on Compensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Republic Indemnity Company of America Company Number 19739 Insured Lew Edwards Group Policy Number 166449-19 Endorsement Number 42 Endorsement Effective September 21, 2023 Printed On March 01, 2024 Countersigned by : WC 00 03 13 2 of 2 (Ed. 04-84) Insured Copy 1983 National Council on Compensation Insurance. ------"'"IN LEWEDWA-01 GHODGES ACORCP DATE(MM/DD/YYYY) ii.......---- CERTIFICATE OF LIABILITY INSURANCE 4/18/2024 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 Gail Hodges Acrisure Southwest Partners Insuran e I tiee/a+ VE� PHONE 707 992-3743 FAX 909 484-2491 4000 Westerly Place CG�V G (A/C, Ed):( ) (A/c,No):( ) Suite 110 IL ADDRESS:ghodges@acrisure.com Newport Beach,CA 92660 i r L) 5 7024 INSURER(S)AFFORDING COVERAGE NAIL# t. INSURER A:Underwriters at Lloyd's, London (IL) 15792 INSURED CITY CLL" ,.iC INSURER B:California Automobile Insurance Company 38342 CITY OF SEAL BEAC't�+� Lew Edwards Group INSURER C:Republic Indemnity Company of America 22179 2301 Mastlands Drive INSURER D:Hiscox Insurance Company Inc. 10200 Oakland,CA 94611 INSURER E: INSURER F: I 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY1 LIMITS _ A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR X X 'CIP448878001 2/6/2024 2/6/2025 pREMISEsO(EaEoccurrence) _ $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY S& LOC PRODUCTS-COMP/OP AGG, $ OTHER: $ B ,_AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X X BA040000069701 9/1/2023 . 9/1/2024 BODILY INJURY(Per person) . $ OWNED SCHEDULED AUTOS ONLY AUTOS yy Ep BODILY INJURY(Per accident) $ X AUTOS ONLY X AUUTOS ONNLY (Perr PROPERTY $ $ -UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION X STATUTE I I OER TH- AND EMPLOYERS'LIABILITY Y 1 N 1 664491 9 9/21/2023 9/21/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? T N I A 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Co Errors&Omissions MPL5174394.23 9/30/2023 9/30/2024 Per Claim 1,000,000 D Claims Made MPL5174394.23 9/30/2023 9/30/2024 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Seal Beach,its elected and appointed officials,officers,employees,agents,servants and voluenteers and those City agents serving as independent contractors in the role of City Officials are named as additional insured's per AF 00 859 07 23,coverage is Primary&Non-Contributory per AF 001 397 09 16 and Waiver of Subrogation applies per CG 24 04 05 09. Automobile Additional Insured,Primary and Non-Contributory and Waiver of Subrogation per MCA 85100817. Worker's Compensation Waiver of Subrogation per WC 00 03 13 04 84. 30 day Notice of Cancellation with the exception of a 10 day notice for non-payment of Premium CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, City of Seal Beach ACCORDANCE WITH THE POLICY PROVISIONSCE WILL BE DELIVERED IN 211 Eighth Street Seal Beach,CA 90740 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 FORM SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations ANY PERSON OR ORGANIZATION AS REQUIRED BY WRITTEN CONTRACT WITH THE INSURED 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person§or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or"property damage" for which the"additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work "Bodily injury" or"property damage" occurring after: (1) 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 (2) 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. Negligence of Additional Insured "Bodily injury" or"property damage" directly caused by or resulting from the negligence of the"additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Policy Number: CIP448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 1 07/2012 with its permission ENDORSEMENT This Endorsement Changes the Policy-Please Read it Carefully PRIMARY AND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV-Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Specifically and solely for the Third-Party shown below, notwithstanding the provisions of sub-paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any tuit'where the damages are caused by the insuredt sole negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third-Party to whom this endorsement applies is: ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES, AT A SPECIFIED PROJECT SET FORTH IN A WRITTEN CONTRACT,THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY SEEKING COVERAGE UNDER THIS ENDORSEMENT; AND (2) HAS BEEN ENTERED INTO BEFORE ANY LOSS HAS OCCURRED. Any coverage provided pursuant to this endorsement shall be subject to all other terms, conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number: CIP448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective Date: AF001397(09/16) Page 1 of 1 POLICY NUMBER: CIP448878001 COMM ERCIAL 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 Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS Information required to complete this Schedule, 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- Cond itions: We waive any right of recovery we may have against 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 24 04 05 09 Insurance Services Office, Inc.,2008 Page 1 of 1 POLICY #BA040000069701 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V. SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR—DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO—COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH Copyright 2017 Mercury Insurance Services,LLC All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 1 of 6 BUSINESS AUTO COVERAGE FORM NEWLY ACQUIRED OR FORMED ENTITY(Broad Form Named Insured) SECTION II -LIABILITY COVERAGE,A. Coverage, 1. Who Is An Insured,the following is added: d. Any business entity newly acquired or formed by you during the policy period provided you own 50%or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Coverage does not apply to an "accident"which occurred before you acquired or formed the organization. II. EMPLOYEES AS INSUREDS SECTION II-LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: e. Any"employee"of yours is an "insured"while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs. III. AUTOMATIC ADDITIONAL INSURED SECTION II -LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily injury"or"property damage"occurs and that is in effect during the policy period is an "insured"for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II -LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: g. An "employee"of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name,with your permission, while performing duties related to the conduct of your business. V. SUPPLEMENTARY PAYMENTS SECTION II—LIABILITY COVERAGE,A. Coverage, 2.Coverage Extensions, a.Supplementary Payments,Subparagraphs(2) and (4) are replaced by the following: (2) Up to$3,000 for cost of bail bonds(including bonds for related traffic law violations) required because of an "accident"we cover. We are not obligated to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to$500 a day because of time off from work. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 2 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II—LIABILITY COVERAGE, B. Exclusions,5. Fellow Employee This exclusion does not apply if you have workers'compensation insurance in-force covering all of your"employees". Coverage is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses, is replaced with the following: We will pay up to$50 per day to a maximum of$1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage.We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its"loss". If your business shown in the Declarations is other than an auto dealership, we will also pay up to $1,000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III—PHYSICAL DAMAGE COVERAGE,A.Coverage,4.Coverage Extensions,the following is added: c. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis and Comprehensive,Specified Causes of Loss,or Collision coverages are provided under this coverage form for any"auto" you own,then the Physical Damage Coverages provided are extended to "autos"you hire, subject to the following limit: (1) The most we will pay for"loss"to any hired "auto" is$50,000 or Actual Cash Value or Cost of Repair, whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to "loss"caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions,3.a., is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 3 of 6 X. LOAN/LEASE GAP COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE C. Limit of Insurance,the following is added: 4. In the event of a "total loss"to a covered "auto" shown in the schedule or declarations for which Collision and Comprehensive Coverage apply,we will pay any unpaid amount due on the lease or loan for that covered "auto," less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease/loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties,Credit Life Insurance, Health,Accident or Disability Insurance purchased with the loan or lease;and (5) Carry-over balances from previous loans or leases. The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25%of the actual cash value of that insured auto at the time of the loss. Xl. GLASS REPAIR—DEDUCTIBLE WAIVER SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: If two or more "company" policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived; or 2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible;or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement"company" means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident,Claim,Suit,Or Loss, a., In the event of"accident", you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company;or (4) An executive officer or insurance manager, if you are a corporation. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 4 of 6 XIV. WAIVER OF SUBROGATION SECTION IV- BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5.Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any"accident" or "loss", provided that the "accident"or"loss" arises out of the operations contemplated by such contract.The waiver applies only to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR,OMISSION,OR FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, B.General Conditions, 2.Concealment, Misrepresentation, or Fraud,the following is added: Any unintentional omission of or error in information given by you, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However,you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV—BUSINESS AUTO CONDITIONS, B.General Conditions, 5.Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos" you own: 1. Any covered "auto"you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your"employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However,any"auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV—BUSINESS AUTO CONDITIONS, B. General Conditions, 5.Other Insurance,the following is added and supersedes any provision to the contrary: e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 5 of 6 XVIII. HIRED AUTO-COVERAGE TERRITORY SECTION IV-BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period,Coverage Territory, e.Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less;and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America,the territories and possessions of the United States of America, Puerto Rico,or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V—DEFINITIONS, C. "Bodily Injury" is amended by adding the following: "Bodily injury"also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 6 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule State Person or Organization Job Description California City of Seal Beach All California operations 211 Eighth Street performed by the Named Insured Seal Beach, CA 90740 on behalf of the Certificate Holder The premium charge for this endorsement shall be $250. This charge will be billed at the final audit. WC 00 03 13 1 of 2 (Ed. 04-84) Insured Copy WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Republic Indemnity Company of America Company Number 19739 Insured Lew Edwards Group Policy Number 166449-19 Endorsement Number 42 Endorsement Effective September 21, 2023 Printed On March 01, 2024 Countersigned by : WC000313 2of2 (Ed. 04-84) Insured Copy �...,,,i, LEWEDWA-01 GHODGES ACORO DATE(MMIDDIYYYY) 4.--o-- CERTIFICATE OF LIABILITY INSURANCE 9/23/2024 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 Gail Hodges Acrisure Southwest Partners Insurance Services, LLC PHONEN ,N ,Ext):(707)992-3743 I FAX No):(909)484-2491 4000 Westerly Place — Suite 110 ADDRESS:ghodges@acrisure.com Newport Beach,CA 92660 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Underwriters at Lloyd's,London(IL) 15792 INSURED INSURER B:California Automobile Insurance Company 38342 Lew Edwards Group INSURER c:Republic Indemnity Company of America 22179 2301 Mastlands Drive INSURER 0:Hiscox Insurance Company Inc. 10200 Oakland,CA 94611 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POUCY EFF POUCY EXP LIMITS LTRINSD WVD IMMIDD/YYYY1 IMMIDDIYYYYI A X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE S 2,000,000 CLAIMS-MADE X OCCUR X X CIP448878001 2/6/2024 2/6/2025 PREMISES EaEocccTuErrencel $ 100,000 MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S GEL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY jPa LOC PRODUCTS-COMP/OPAGG S OTHER: S B AUTOMOBILE U ABILITY (EOMaaBIident)SINGLE LIMIT S 1,000,000 X ANY AUTO X X BA040000069701 9/1/2024 9/1/2025 BODILY INJURY(Per person) S AUTOSUTE ONLY SCHEDULED BODILY INJURY(Per accident) $ X AUTOS ONLY X maw Y ( raER remAGE S S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE ,S DED RETENTION S S C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN 16644921 9/21/2024 9/21/2025 STATUTE ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L._EACH ACCIDENT S MFFICER/MEMBER EXCLUDED? Y NIA andatory in NH) 1,000,000 E.L.DISEASE-EA EMPLOYEE S _ If Yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S D E&O MLP5174394-24 9/30/2024 9/30/2025 Per Claim 1,000,000 D Claims Made MLP5174394-24 9/30/2024 9/30/2025 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Seal Beach,its elected and appointed officials,officers,employees,agents,servants and voluenteers and those City agents serving as independent contractors in the role of City Officials are named as additional insured's per AF 00 859 07 23,coverage is Primary&Non-Contributory per AF 001 397 09 16 and Waiver of Subrogation applies per CG 24 04 05 09. Automobile Additional Insured,Primary and Non-Contributory and Waiver of Subrogation per MCA 85100817. Worker's Compensation Waiver of Subrogation per WC 00 03 13 04 84. 30 day Notice of Cancellation with the exception of a 10 day notice for non-payment of Premium CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Seal Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 211 Eighth Street Seal Beach,CA 90740 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 FORM SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations ANY PERSON OR ORGANIZATION AS REQUIRED BY WRITTEN CONTRACT WITH THE NSURED 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person's or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability " Bodily injury" or"property damage" for which the"additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work Bodily injury" or"property damage" occurring after: (1) 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 (2) 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 Negligence of Additional Insured "Bodily injury" or"property damage" directly caused by or resulting from the negligence of the"additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Policy Number: CIP448878001 Named Insured LEW EDWARDS GROUP Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 1 07/2012 with its pens ission ENDORSEMENT This Endorsement Changes the Policy-Please Read it Carefully PRIMARY AND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV-Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Specifically and solely for the Third-Party shown below, notwithstanding the provisions of sub-paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any 5uit'Where the damages are caused by the insured sole negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third-Party to whom this endorsement applies is: ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES, AT A SPECIFIED PROJECT SET FORTH IN A WRITTEN CONTRACT,THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY SEEKING COVERAGE UNDER THIS ENDORSEMENT; AND (2) HAS BEEN ENTERED INTO BEFORE ANY LOSS HAS OCCURRED. Any coverage provided pursuant to this endorsement shall be subject to all other terms,conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number: C1P448878001 Named Insured: LEW EDWARDS GROUP Endorsement Effective Date: AF001397(09/16) Page 1 of 1 POLICY NUMBER: CIP448878001 COMMERCIAL GENERAL LIABILITY CG24040509 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/COM PLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS Information required to complete this Schedule, rf 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 against 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 24 04 05 09 Insurance Services Office. Inc., 2008 Page 1 of 1 POLICY#BA040000069701 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY(BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V. SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR—DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO—COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 1 of 6 BUSINESS AUTO COVERAGE FORM NEWLY ACQUIRED OR FORMED ENTITY(Broad Form Named Insured) SECTION II-LIABILITY COVERAGE,A.Coverage, 1. Who Is An Insured,the following is added: d. Any business entity newly acquired or formed by you during the policy period provided you own 50%or more of the business entity and the business entity is not separately insured for Business Auto Coverage.Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Coverage does not apply to an "accident" which occurred before you acquired or formed the organization. II. EMPLOYEES AS INSUREDS SECTION II- LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: e. Any"employee"of yours is an "insured"while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs. III. AUTOMATIC ADDITIONAL INSURED SECTION II -LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the"bodily injury"or"property damage"occurs and that is in effect during the policy period is an "insured"for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II-LIABILITY COVERAGE,A.Coverage, 1.Who Is An Insured,the following is added: g. An "employee"of yours is an "insured"while operating an "auto" hired or rented under a contract or agreement in that"employee's" name,with your permission, while performing duties related to the conduct of your business. V. SUPPLEMENTARY PAYMENTS SECTION II—LIABILITY COVERAGE,A.Coverage, 2.Coverage Extensions, a.Supplementary Payments,Subparagraphs(2)and(4)are replaced by the following: (2) Up to$3,000 for cost of bail bonds(including bonds for related traffic law violations) required because of an "accident"we cover. We are not obligated to furnish these bonds. (4) All reasonable expenses incurred by the"insured"at our request, including actual loss of earnings up to$500 a day because of time off from work. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 2 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II—LIABILITY COVERAGE, B.Exclusions,5. Fellow Employee This exclusion does not apply if you have workers'compensation insurance in-force covering all of your"employees". Coverage is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III- PHYSICAL DAMAGE COVERAGE, A. Coverage,4.Coverage Extensions,a.Transportation Expenses, is replaced with the following: We will pay up to$50 per day to a maximum of$1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type.We will pay only for those covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage.We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto"is returned to use or we pay for its"loss". If your business shown in the Declarations is other than an auto dealership,we will also pay up to$1,000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III—PHYSICAL DAMAGE COVERAGE,A.Coverage,4.Coverage Extensions,the following is added: c. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis and Comprehensive,Specified Causes of Loss,or Collision coverages are provided under this coverage form for any"auto"you own,then the Physical Damage Coverages provided are extended to "autos"you hire,subject to the following limit: (1) The most we will pay for"loss"to any hired"auto" is$50,000 or Actual Cash Value or Cost of Repair,whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to "loss"caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered"auto" you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE, B. Exclusions,3.a., is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 3 of 6 X. LOAN/LEASE GAP COVERAGE SECTION III -PHYSICAL DAMAGE COVERAGE C. Limit of Insurance,the following is added: 4. In the event of a "total loss"to a covered"auto"shown in the schedule or declarations for which Collision and Comprehensive Coverage apply,we will pay any unpaid amount due on the lease or loan for that covered"auto," less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease/loan payments at the time of the"loss"; (2) Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties,Credit Life Insurance, Health,Accident or Disability Insurance purchased with the loan or lease;and (5) Carry-over balances from previous loans or leases. The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25%of the actual cash value of that insured auto at the time of the loss. XI. GLASS REPAIR—DEDUCTIBLE WAIVER SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added: If two or more"company"policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived; or 2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible;or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement"company"means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS,A. Loss Conditions, 2.Duties In The Event Of Accident,Claim,Suit,Or Loss,a.,In the event of"accident", you must notify us of an "accident"applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company;or (4) An executive officer or insurance manager, if you are a corporation. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 4 of 6 XIV. WAIVER OF SUBROGATION SECTION IV-BUSINESS AUTO CONDITIONS,A. Loss Conditions, 5.Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any"accident" or "loss", provided that the "accident"or"loss"arises out of the operations contemplated by such contract.The waiver applies only to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR,OMISSION,OR FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, B.General Conditions, 2.Concealment, Misrepresentation,or Fraud,the following is added: Any unintentional omission of or error in information given by you,or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However,you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV—BUSINESS AUTO CONDITIONS, B.General Conditions,5.Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos" you own: 1. Any covered "auto"you lease, hire, rent or borrow;and 2. Any covered "auto" hired or rented by your"employee" under a contract in that individual "employee's" name, with your permission,while performing duties related to the conduct of your business. However,any"auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV—BUSINESS AUTO CONDITIONS, B. General Conditions, 5.Other Insurance,the following is added and supersedes any provision to the contrary: e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance;and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 5 of 6 XVIII. HIRED AUTO-COVERAGE TERRITORY SECTION IV-BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period, Coverage Territory,e.Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less;and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico,or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V—DEFINITIONS, C. "Bodily Injury" is amended by adding the following: "Bodily injury" also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease. Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 6 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule State Person or Organization Job Description California All persons or organizations All jobs whom the Named whom the Named Insured has Insured has agreed by written agreed by written contract to contract to furnish this waiver. furnish this waiver. The charge for this endorsement shall be 3% of total manual premium, subject to a minimum premium of$100. This charge will be billed on your next invoice based on current manual premium, and the final charge will be calculated and billed at the final audit. WC 00 03 13 1 of 2 (Ed. 04-84) ©1983 National Council on Compensation Insurance.