Item 17 - Arc Flash Analysis and Safety Program Development

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A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/21/2021 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 eppndorsement(s). PRODUCER NAMEACT Aimee Guesno Cornerstone Specialty Insurance Services, Inc. q/C No Ext : (714) 731-7700 FAX (714) 731-7750 E-MAIL aimee@cornerstonespecialty.com ADDRESS: 14252 Culver Drive, A299 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: RLI Insurance Company 13056 Irvine CA 92604 INSURED INSURER B : INSURER C SMAART POWER INSURER D 24301 Rhona Drive INSURER E INSURER F Laguna Niguel CA 92677 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 CONTRACTOR 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 LTR TYPE OF INSURANCE ADDL INSD UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR ADDT'L INSURED / P & NC PSB0009703 08/31/2021 08/31/2022 EACH OCCURRENCE 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 $ X MED EXP (Any one person) $ 10,000 X BLNKT WVR OF SUBRO PERSONAL &ADV INJURY $ INCLUDED GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY � JECT PRO ❑ LOC OTHER: GENERALAGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PSB0009703 08/31/2021 08/31/2022 COMBINED SINGLE LIMIT $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per nrr. dent) $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSE0004848 12/14/2021 08/31/2022 EACH OCCURRENCE $ 3,000,000 X AGGREGATE $ 3,000,000 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A PER UTF OTH- STAT FIR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of coverage in force. Contractual insurance requirements will be addressed at the time the contract is awarded. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR PROPOSAL PURPOSES ONLY PLEASE CONTACT ACCORDANCE WITH THE POLICY PROVISIONS. CORNERSTONE SPECIALTY AUTHORIZED REPRESENTATIVE TO VERIFY COVERAGE IN FORCE @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks ofACORD