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HomeMy WebLinkAboutCALIFORNIA BARRICADE RENTALS, INC. (3)A-2022-013-02A MAYOR Valerie Amezcua MAYOR PRO TEM Thai Viet Phan COUNCILMEMBERS Phil Bacena Johnathan Ryan Hernandez Jessie Lopez David Penaloza Benjamin Vazquez INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANC EXPIRES 0/ D 1 ZS CITY CLERK DATE: NOV 2 7 2024 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza . P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.io November 14, 2024 0TWA(2) Robyn Lmitj n(4(0F ttettefornia Barricade Rentals, Inc. ntion: David F. Tangitau 1550 E. Saint Gertrude Place Santa Ana, CA 92705 CITY MANAGER Alvaro Nuflez CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Re: Extension of Agreement (N-2022-013-02) to Provide On -Call Traffic Control Services Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by California Barricade Rentals, Inc. DBA California Barricade ("Consultant"), and the City of Santa Ana, dated February 1, 2022, the time period of the Agreement is hereby extended for an additional two-year period through January 31, 2027. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement, as amended, remain unchanged and in full force and effect. Sincerely, Nabil Saba, PE Executive Director, Public Works Agency CITY LOSANTA AN 11 Alvaro Nunez City Manager APPROVED AS TO FORM LL Al Ky,rL�`Nellesen Assistant City Attorney ATTEST CALIFORNIA BARRICADE RENTALS By: David F. Tangitau Title: President SANTA ANA CITY COUNCIL Valerie Am... Thai Viet Phan Benjamin Vazquez Jessie Lopez Phil Bacena Johnathan Ryan Hemantlez Davltl Penaloze Mayor Mayor Pro Tam. Wool 1 Wood Wanda Wald Wartl5 wmol6 vamezcuafasan tohanesante-anaom bvazauezasanta-ani om jessislooeziRsanta-aim om obacemishsmiteami om BomhemantlezOsa to tloenalozar�santa-ana oro ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE (MMme"YYY) 06/25/2024 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 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 endorsementlsl. ELMCO INSURANCE,I 636 E N AV n ORANGEGE CA CA 92866 CALIFORNIA BARRICADE RENTALS 1550 E. SAINT GERTRUDE PLACE SANTA ANA CA 92705a., CONTA' • NAM ' _ PHONE NC Na a- iecyE-MAIL AOOR Li ce: 0509747 INSURE! INSUR' . B It JRERM COMPANY aw7�A THIS IS TO CERTIF THAT E P IES NSU CE L'IM BE' . VE MTN ISSUIJVj I :TA ED BO HE FJUERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CC dDIT JN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE :.,FORDED 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 yyl TYPE OFINSURANCE AODL BUBR POLICY NUMBER POLICYEFF DD POLICYEXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rX]OCCUR X X BCS2001609 07/01/24 07/01/25 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES(E. oa,venw) Is 100,000 MED. EXP (Any one Person) S EXCLUDED PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMRAPPLIES PER: X POLICY❑JECTPRO- LOG GENERAL AGGREGATE $ 2,600,000 PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: EMPLOYEE BENEFITS S 1,000,000 B AUTOMOBILE WRILITY X X 50011184701 07101124 07/01125 COMBINED SINGLE LIMIT (Ea aceNder) $ 1,000,000 X X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Par papersdn) $ BODILY INJURY (Per accident) $ PROPERTYDAWGE (paraccuenq $ $ C UMBRELLA UAB X OCCUR TXS000255500 07101/24 07101125 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 6,000,000 X EXCESS LIAR CLAIMS -MADE OEO J RETENTION$ $ D AND WORXEMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTWE YIN OFFICEFUME NHI oanda'-w In NioR EXCLUDED? ayes,d"eVW under DESCRIPTION OF OPERATCNS below NIA X 931316424 07101124 07I01125 X srArlRE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 E POLLUTION LIABILITY G73540124004 07/01/24 07101125 Each Pollution Condition $1,000,000 F PROFESSIONAL LIABILITY 010HO66384624 07/01/24 07/01/25 Aggregate Limit $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) SEE SUPPLEMENTAL CERTIFICATE INFORMATION vuvu,ve,,,.. uvwu� MAR LrCLL. IIVN City of Santa Ana SHOULD ANY OF THE ABOVE DESCRI Risk Management Division THE EXPIRATION DATE THEREOF, 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PR( 4th Floor AUTHORRED REPRESENTATIVE Santa Ana, CA 92702 Attention: o IEwE:) APPRc EG 8r SEVIEWED S APPROV®BY: A !u "44 ® Risk Management Specialist The ACORD name and logo are registered marks of ACORD SUPPLEMENT TO CERTIFICATE OF LIABILITY INS # 76907 JUN25E2024 DESCRIPTION OF OPERATIONS, LOCATIONS, VEHICLES The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are named as additional insured per form CG 20 38 12 19, CG 20 3712-19, & CG 20 1212-19 on the GL policy. Primary and Non -Contributory wording applies per form CG 20 01 12 19. Waiver of Subrogation in Favor of The City of Santa Ana per form CG 24 04 12-19. Additional Insured, Primary & Non -Contributory Wording, and Waiver of Subrogation applies per forms (50461AIS01, 500PNCV01, 50461SWF01) on the Auto policy. Waiver of Subrogation on the WC Policy per form #10217 Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per attached form UTS-410g (2.11). Professional Liability - $2,000,000 per occurrence and $2,000,000 aggregate $5,000,000 Excess to follow the GL, AUTO, WC per the attahced Dec Pages. Those usual to the insured's operations. RiefeMnugemmtDtvleian REVI D&APPROVmBr. Risk Management Specialist COMMERCIAL GENERAL LIABILITY CG 20 38 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) 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: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured described in Paragraph 1. or 2. above. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 2. "Bodily injury" or "property damage" occurring after: a. 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 CG 20 38 12 19 0 Insurance Services Office, Inc., 2018 Rick himgemmtDivielon REVIEWED & APPROVED BY: ® RKk Management SpeaNri b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 Risk MncgemadDlwion REVIEWED&ApP mBy: ' Ap "4ta ®' Risk Management Spedaiist POLICY NUMBER: BCS2001609 COMMERCIAL GENERAL LIABILITY CG 20 3712 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSCN OR CRGANI ZATI CN VVEN ALL LOCATIONS REWIRED BY NPtI TTEN CCNTRACf OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO VIHI CH TH S I NSURNgCE APPLIES, THAT SUCH PERSON CR ORGAN ZATI ON BE ADDED AS AN ADDI TI CNAL I NSURED CN YOUR PCLI CY. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. fiAeM�agemoilDiuisian IXf�viemeo&APPRWD7Bv: A+�p AIW44 ` Risk Management Specialist CG 20 37 12 19 © Insurance Services Office, Inc., 2018 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 a�/i g�k Risk MnueemetDlvielan REIAE ED&APPROv®ar. A+� Acuwte Of Risk Management Specialist POLICY NUMBER: BCS2001609 COMMERCIAL GENERAL LIABILITY CG 24 0412 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE ame Of Person(s) Or Organization(s): PERSON OR CRGANI ZATI CN FOR VVCM THE I NSURED HAS AGREED TO VAI VE RI G TS CF CCNERY, PROM DIED SUCH AGZEENENT I S MV E I N VRI Ti NG AND PRI OR TO THE LOSS Information re wired 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 0412 19 0 Insurance Services Office, Inc., 2018 Riek ManagementDiwian riEVIE &APPRMS36Y: ® Risk Management SpeaAist COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. 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 CG 20 01 12 19 ©Insurance Services Office, Inc., 2018 �. Risk MnngemadDMs1un e r?vie 6APPRovm Sr 00, Risk Management Specialist ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS Page HOME OFFICE SAN FRANCISCO 9313164-24 ALL EFFECTIVE DATES FW94EWA_1 AT 12:01 AM PACIFIC STANDARD TIME OR THE EFFECTIVE J711 TIME INDICATED AT y 1, 2024 AT 12:01 AN. SDWhern PACIFIC STANDARD TIME AND EXPIRING July 1, 2025 AT 12:01 AM 3671777 CAUFOMIA BARRICADE FENTALSINC 1550 ESNNTGBZI DERt SANTAANA, M927O5 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WEWILLNOT 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER SCHEDULE JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT AND ISSUED AT SAN FRANCISCO: June 24, 2024 7 Ail AUTHORIZED REPRESENTATIVE 2572 SCIF FORM 10217 (REV. 4 -MIS) r ,- PRESIDENT AND CEO R®kMnlcgo etDiwiml e; REVIEWED&APPRovm BY: ®'. 4p A Risk Management specialist KEMP+ER Auto COMMERCIAL Customer Service: (800) 722-3391 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company WAIVER OF SUBROGATION Claims Service: (800) 334-1661 ICopyTo I Policy ID Number I Expiration Date CITY OF SANTA ANA 20 Civic Center Piz, FI 4 Santa Ana, CA 92701 50011184701 I 07/01/2025 1201 a.m. Named Insured CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. In return for your premium payment shown below, we agree that our rights of subrogation or rights of recovery under the policy will not apply against the following person or organization: CITY OF SANTA ANA (name of person or organization) Additional premium in the amount of $250.00 will be retained by us regardless of any early termination of this endorsement or the policy. All other policy provisions remain unchanged. ADDL INSURED COPY 50461SWF01 AME RAMmagtmi dDMdmt Y R�EWEo & ARPRovaJ!S r: o,Y�1lii�ce7 A+juA�ad- Risk Management Spedalut ENDORSEMENT:3-1 iCEMPER Auto COMMERCIAL aulwce: told) Izz-'muI Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance ComDanv Claims Service: (800) 334-1661 PRIMARY AND NONCONTRIBUTORY ENDORSEMENT TO CITY OF SANTA ANA 20 CIVIC CENTER PLAZA 4TH FLOG SANTA ANA, CA 92702 Policy ID Number I Expiration Date 50011184701 07/01/2025 12:01 a.m. CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only if Form Number 500PNCV01 appears on your Declarations Page. This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A— LIABILITY COVERAGE OTHER INSURANCE — PART A ONLY The following is added to this section - The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. You have agreed in writing in a contractor agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b. Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. A- ju "44 Rek Management SpeaAist ADDL INSURED COPY AME,n-e, 500PNCV01 ENDORSEMENT : 3-1 KE PE Auto COMMERCIAL Customer Service: (800) 722-3391 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 334-1661 ADDITIONAL NAMED INSURED ENDORSEMENT Copy To Policy ID Number Expiration Date 50011184701 07/01/2025 12:01 a.m. CITY OF SANTA ANA Named Insured 20 CIVIC CENTER PLAZA 4TH FLOO SANTA ANA, CA 92702 1 CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. Additional Insured CITY OF SANTA ANA Part A - Liability Coverage, is changed as follows: The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability. The insurance provided by this endorsement will be excess over any other valid and collectible insurance. All other parts of this Policy remain unchanged. ADDL INSURED COPY 4 d RWtMntrgm,a�'.DiWsian REVIEWmI'e APPRW y: g 9�'f A+.0 "44 Ruk Management Spedarirt 50461AIS01 ENDORSEMENT: 3-1 ,a►co OR CERTIFICATE OF LIABILITY INSURANCE DATE (M/202YYY) 06/242025 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 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 Phone: (714) 973-1436 Fax: (714) 973-0011 CONTACT ELMCO INSURANCE, INC. NAME: ELMCO INSURANCE, INC. PHONE (714) 973-1436 FAX No: (714) 973-0811 636 E CHAPMAN AVENUE we No Ex E-MAIL contact@Elmcoinsurance.com ORANGE CA 92866 ADDRESS: FFORDING COVERAGE NAIC # INSURERS) A Agency Lic#: 0509747 INSURER AIX Specialty Insurance Company 12833 INSURED INSURERS INFINITY SELECT INSURANCE COMPANY 20260 CALIFORNIA BARRICADE RENTALS INC. INSURERC TRISURA SPECIALTY INSURANCE COMPANY 16188 1550 E. SAINT GERTRUDE PLACE INSURERD: STATE COMPENSATION INSURANCE FUND 35076 SANTA ANA CA 92705 SURPLUS LINES INSURANCE CC, 10172 INSURER WESTCHESTER INSURER PACIFIC INSURANCE COMPANY 10046 COVERAGES CERTIFICATE NUMBER: 79915 REVISION NUMBER:1 SUPERCEDES PREVIOUS REVISIONS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING 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 EFF POLICY EXP LIMITS INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LTR A X COMMERCIAL GENERAL LIABILITY X X L13MO7430800 07/01/25 07/01/26 EACH OCCURRENCE $ 1,000,000 DAMAGE TRENTE $ 100,000 CLAIMS -MADE I� OCCUR PREM SESO(Ea occurence) MED. EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X PRO ❑ LOC POLICY ❑ JECT PRODUCTS - COMP/OP AGG $ 2,000,000 EMPLOYEE BENEFITS $ 1,000,000 OTHER: B AUTOMOBILE LIABILITY X X 50011184701 07/01/25 07/01/26 COMBIidurt)NED SINGLE LIMIT $ (Ea accident) 1000000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS X AUTOS (per accident) X OCCUR TXS000255501 07/01/25 07/01/26 EACH OCCURRENCE $ 5,000,000 C UMBRELLA LIAB X CLAIMS -MADE AGGREGATE $ 5,000,000 EXCESS LAB DED I RETENTION $ $ WORKERS COMPENSATION D X 931316425 07/01/25 07/01/26 X STATUTE ERH AND EMPLOYERS' LIABILITY Y/ N E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, descdbe under E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below E POLLUTION LIABILITY G73540124005 07/01/25 07/01/26 Each Pollution Condition $1,000,000 F PROFESSIONAL LIABILITY 010H077065425 07/01/25 07/01/26 Aggregate Limit $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE SUPPLEMENTAL CERTIFICATE INFORMATION Tu Tran Tu Tmn Nguyen, 1:`555°z0°a°Z Nguyen APPROVED By Tu Tran Nguyen at 12:55 pm, Jul 02, 2025 CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. 4th Floor AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 Attention: -,ORD 25 (2014/01) Certificate # 79915 Revision # 1 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE SUPPLEMENT TO CERTIFICATE OF LIABILITY INS # 79915 JUN242025 DESCRIPTION OF OPERATIONS, LOCATIONS, VEHICLES City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Permittee including materials, parts, equipment, and personnel furnished in connection with such work or operations per form CG 20 38 12 19, CG 20 37 12-19, & CG 20 12 12-19 on the GL policy. Primary and Non -Contributory wording applies per form CG 20 01 12 19. Waiver of Subrogation in Favor of The City of Santa Ana per form CG 24 04 12-19. Additional Insured, Primary & Non -Contributory Wording, and Waiver of Subrogation applies per forms (50461AIS01, 500PNCV01, 50461SWF01) on the Auto policy. Waiver of Subrogation on the WC Policy perform #10217 Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per attached form UTS-410g (2-11). Professional Liability - $2,000,000 per occurrence and $2,000,000 aggregate $5,000,000 Excess to follow the GL, AUTO, WC per the attahced Dec Pages. Those usual to the insured's operations. uertmcate ;F 0 POLICY NUMBER: L13 M074308 00 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oraanization(s) Any person or organization for whom you are performin operations, when you and such person or organization have agreed in writing in a contract or agreement that such person or organization shall be added as an additional insured on your policy, provided the written contract or agreement is executed prior to the occurrence of any loss. Location(s) Of Covered Operations Various locations per written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 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 other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to required by a contract or will pay on behalf of the amount of insurance: :he additional insured is agreement, the most we additional insured is the 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER: L13 M074308 00 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETE® OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you have Various per written contract. performed work, when you and such person or Traffic control operations performed by the named organization have agreed in writing in a contract or insured. agreement that such person or organization shall be added as an additional insured on your policy, provided the written contract or agreement is executed prior to the occurrence�ofany loss.Information re uired to cothis Schedule if not shown above will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: L13 M074308 00 COMMERCIAL GENERAL LIABILITY CG24041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): 1. Any person or organization for whom you are performing operations or for whom you have performed work, when you and such person or organization have agreed in writing in a contract or agreement that you will waive any right of recovery against such person or organization, provided such written contract or agreement has been executed prior to the occurrence of any 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG2001 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. 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 CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Auto Kemper Commercial KEMPE P-1.11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 353-6737 BLANKET WAIVER OF SUBROGATION ENDORSEMENT Copy To ( Policy ID Number I Expiration Date 50011184701 07/01/2026 12:01 a.m. CALIFORNIA BARRICADE RENTALS, INC. 1550 E SAINT GERTRUDE PL SANTA ANA, CA 92705 Named Insured CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. 1. In return for your additional fee shown below, we agree that our rights of subrogation or rights of recovery under your policy will not apply against any person(s) or organization(s): a. For whom you are performing operations; and b. For whom you are obligated by virtue of a written contract or agreement to waive subrogation on your policy. 2. A person's or organization's waiver of subrogation status under this endorsement ends when your operations for that person(s) or organization(s) are completed. Additional fee in the amount of $160.00 will be retained by us regardless of any early termination of this endorsement or the policy. All other terms, and conditions of this policy remain unchanged. 50OBWS01 AMEND DATE: 07/01/2025 ENDORSEMENT: 4-4 COMMERCIAL Customer Service: (800) 722-3391 Copy To Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 BLANKET ADDITIONAL INSURED ENDORSEMENT CALIFORNIA BARRICADE RENTALS, INC. 1550 E SAINT GERTRUDE PL SANTA ANA, CA 92705 Policy ID Number Expiration Date 50011184701 07/01/2026 12:01 a.m. Named Insured CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the policy. No changes will be effective prior to the time changes are requested. This endorsement amends the policy as follows. Please read it carefully. The definition of "Insured" is amended to include as an insured any person or organization which you are obligated by virtue of a written contract or agreement to add as an additional insured. Such person or organization is an additional insured only with respect to liability arising out of your ongoing operations performed for the additional insured. There is no coverage for acts or omissions of any additional insured, their agent(s), or their employee(s). A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. 2. The additional insured(s) shall not increase our limits of liability. 3. We will pay damages only if such damages arise out of acts of omission of: a. You; or b. Any other insured except an additional insured added under the terms of this endorsement. We will not pay damages when the damages are caused solely by a person or organization added as an additional insured under the terms of this endorsement, their agent(s), or their employee(s). All other terms, limits, conditions and provisions of the policy remain unchanged. 500BAE01 AMEND DATE: 07/01/2025 ENDORSEMENT: 4-4 KEMPER Auto COMMERCIAL Customer Service: (800) 722-3391 Copy To Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 PRIMARY AND NONCONTRIBUTORY ENDORSEMENT CITY OF SANTA ANA 20 CIVIC CENTER PLAZA 4TH FLOO SANTA ANA, CA 92702 Policy ID Number Expiration Date 50011184701 07/01 /2026 12:01 a.m. Named Insured CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only if Form Number 500PNCV01 appears on your Declarations Page. This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A — LIABILITY COVERAGE OTHER INSURANCE — PART A ONLY The following is added to this section: The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. You have agreed in writing in a contractor agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b. Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. ADDL INSURED COPY AMEND DATE: 07/01/2025 500PNCV01 ENDORSEMENT: 4-1 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS Page 1 HOME OFFICE SAN FRANCISCO 9313164-25 ALL EFFECTIVE DATES RENEWAL AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT EFFECTIVE July 1, 2025 AT 12:01 AM. Southern PACIFIC STANDARD TIME AND EXPIRING July 1, 2026 AT 12:01 AM 3671777 CALIFORNIA BARRICADE RENTALS INC 1550 E SAINT GERTRUDE PL SANTA ANA, CA 92705-5310 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER SCHEDULE JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: June 24, 2025 AUTHORIZED REPRESENTATIVE 2572 SCIF FORM 10217 (REV. 4 - 2018) PRESIDENT AND CEO OLD DP 217 POLICY NUMBER: L13 M074308 00 COMMERCIAL GENERAL LIABILITY CG 20 12 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: 1. City Of Downey And Their Agents, Officers And Employees, Attn: Engineering Division, Po Box 7016 Downey, CA 90241-7016 2. The City Of Huntington Beach, Its Officers, Elected Or Appointed Officials, Employees, Agents And Volunteers 2000 Main Place, Hunti Beach. CA 92648 3. City Of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor, Santa Ana, CA 92702, City Of Santa Ana, Risk Management, It's Officers, Employees, Agents, Representatives, And Volunteers 4. The County Of Los Angeles And Public Entity Or Special District For Which The Los Angeles County Board Of Supervisors Is The Governing Body, And Their Agents Officers And Employees 5. County Of Orange Row Permits, P.O. Box 4048, Santa Ana, CA 92702-4048 6. The City Of Long Beach, It's Boards And Commissions, And Their Officials, Employees, And Agents City Of Long Beach Department Of Public Works, Project Management Division, 411 W. Ocean Blvd, 5th Floor, City Hall, Long Beach, CA 90802 7. The County Of Los Angeles And Public Entity Or Special District For Which The Los Angeles County Board Of Supervisors Is The Governing Body, And Their Agents,Officers And Employees, Shall Be Additional Insured(s) While Acting Within The Scope Of Their Duties Against All Claims Arising Out Of Or In Connection With The Work To Be Performed Department Of Public Works / Land Development Division, Po Box 1460, Alhambra, CA 91802-1460 8. The City Of El Cajon (And/Or The Successor Agency To The El Cajon Redevelopment Agency), And Its (Their) Elected And Appointed Officials, Officers, Employees And Volunteers (For Purposes Of This Policy, Individually And Collectively, The ("City Insured") As Additional Insureds. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO DESIGNATED ENTITY(S) This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Designated Entity Mailing Address or Email Address Number Days Notice City Of Santa Ana Risk Management 20 Civic Center Plaza, 4th Floor 30 Division Santa Ana, CA 92702 City Of El Cajon 200 Civic Center Way 30 El Cajon, CA 92020 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) If we cancel this policy for any reason other than nonpayment of premium, we will give written notice of such cancellation to the Designated Entity(s) shown in the SCHEDULE. Such notice may be delivered or sent by any means of our choosing. The notice to the Designated Entity(s) will state the effective date of cancellation. Unless otherwise noted in the SCHEDULE above, such notice will be provided to the Designated Entity(s) no more than the number of days in advance of the effective date of cancellation that we are required to provide to the Named Insured for such cancellation. Such notice of cancellation is solely for the purpose of informing the Designated Entity(s) of the effective date of cancellation and does not grant, alter, or extend any rights or obligations under this policy. ALL OTHER POLICY TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 801-0332 01 24 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1 Copyright 2024 The Hanover Atlantic Insurance Company, Ltd. All Rights Reserved. Copyright 2024 AIX Specialty Insurance Company. All Rights Reserved. KEMPERAuto COMMERCIAL Customer Service: (800) 722-3391 Copy To The City of Santa Ana 20 Civic Center Plz, FI 4 Santa Ana, CA 92701 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 WAIVER OF SUBROGATION Policy ID Number Expiration Date 50011184701 07/01/2026 12:01 a.m. Named Insured CALIFORNIA BARRICADE RENTALS, INC. This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. In return for your premium payment shown below, we agree that our rights of subrogation or rights of recovery under the policy will not apply against the following person or organization: The City of Santa Ana (name of person or organization) Additional premium in the amount of $250.00 will be retained by us regardless of any early termination of this endorsement or the policy. All other policy provisions remain unchanged. ADDL INSURED COPY AMEND DATE: 07/01/2025 50461SWF01 ENDORSEMENT: 4-6