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Insurance Certificates 2023/24 St. Nick's Christmas Lighting & Decor/ ACCOR " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/18/2023 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 Gina Villacis NAME: Kelly Williams Insurance Agency, Inc. aCNNo Ext : (562) 498-8661 (A/C No): (562) 985-0429 4400 E. Pacific Coast Hwy. E-MAIL gina@kellywilliamsins.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Mesa Underwriters Specialty 36838 Long Beach CA 90804 INSURED INSURER B : United Financial Casualty Company 11770 T&G Global, LLC, DBA: St. Nick's Christmas Lighting and Decor INSURER C : Scottsdale Insurance Company 41297 6861 Walker St INSURER D : Insurance Company of the West 27847 INSURER E : La Palma CA 90623 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2391804393 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 MAYBE 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE F OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (AnV one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 A Y MP0082001006709 09/07/2023 09/07/2024 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS Y 00885549 09/07/2023 03/07/2024 BODILYINJURY(Peraccident) $ PROPERTY DAMAGE (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 C EXCESS LIAB CLAIMS -MADE XLS1225999 09/07/2023 09/07/2024 DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N /A Y WSA 5073087 00 09/29/2023 09/29/2024 SPER TATUTE EORH X1 E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Subject to all policy terms, endorsements, and exclusions. Forms included CG 2010 1185, CIS 2404 1093, WC waiver of subrogation. Auto endorsement to follow. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of La Quinta ACCORDANCE WITH THE POLICY PROVISIONS. 78-495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta CA 92253 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD T&G GLOBAL, LLC POLICY NUMBER: MP0082001006709 EFFECTIVE 9/7/2023 - 9/7/2024 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization; Any person or organization to which you are obligated by virtue of a written contract to provide insurance such as is afforded by this policy, but only with respect to (1) occurrences taking place after such written contract has been executed and (2) occurrences resulting from work performed by you during the policy period, or occurrences resulting from the conduct of your business during the policy period. A person or organization that qualifies as an "insured" under the above paragraph of this Endorsement shall be an additional insured solely with respect to such additional insured's liability for "bodily injury," property damage" or "personal and advertising injury" caused in whole or in part by your acts or omissions in the performance of "your work" for the additional insured on or at "commercial construction projects." For the purposes of this Endorsement, "commercial construction projects" are defined as buildings or structures constructed for commercial use and also includes apartments, hotels, homes for the aged, dormitories or barracks. However, "commercial construction projects" shall not include any building or structure which contains individual owner occupied units or dwellings. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 0 T&G GLOBAL, LLC POLICY NUMBER: MP0082001006709 EFFECTIVE 9/7/2023 - 9/7/2024 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance 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. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 KELLY WILLIAMS INS 4400 E PACIFIC COAST LONG BEACH, CA 90804 Named insured T&G GLOBAL, LLC ST. NICK'S CHRISTMAS LIGHTING SERVICES 6861 WALKER ST LA PALMA, CA 90623 Commercial Auto Insurance Coverage Summary This is your revised Renewal Declarations Page Your policy information has changed PR99REJ31ME" COMMERC/AL Policy number: 00885549 Underwritten by: United Financial Cas Co August 16, 2023 Policy Period: Sep 7, 2023 - Mar 7, 2024 Page 1 of 5 agent.progressive.com Online Service Make payments, check billing activity, print policy documents, update your policy or check the status of a claim. 1-562-498-8661 KELLY WILLIAMS INS Contact your agent for personalized service. 1-800-444-4487 For customer service if your agent is unavailable or to report a claim. This Renewal Declarations Page is effective only if the minimum amount due to renew your policy is received or postmarked by September 7, 2023. Your coverage begins on September 7, 2023 at 12:01 a.m. This policy expires on March 7, 2024 at 12:01 a.m. This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto, unless the policy contract allows the stacking of limits. The policy contract is form 6912 (02119). The contract is modified by forms 2852CA (02/19), 4757 (02/19), Z442 (02/19), 1198 (07/16), 8610 (02/19), 4852CA (02/19), 4881CA (02/19) and Z228 (01/11). The named insured organization type is a corporation. Policy changes effective September 7, 2023 ............................................................ Premium change: ............................................................ Changes: $0.00 ...................................................................................................... City Of La Quinta has been added as an additional insured. Form 6489 CA (05/21) Continued Policy number: 00885549 T&G GLOBAL, LLC Paget of 5 Outline of coverage Description Limits Deductible Premium ............................................................................................................................................................................. Liability To Others $5,712 Bodily Injury and Property Damage Liability ............................................................................................................................................................................. $1,000,000 combined single limit Any Auto Legal Liability To Others 113 Bodily Injury and Property Damage Liability ............................................................................................................................................................................. $1,000,000 combined single limit Uninsured/Underinsured Motorist $500,000 combined single limit 544 ............................................................................................................................................................................. Uninsured Motorist Property Damage ............................................................................................................................................................................. Rejected Medical Payments $5,000 each person 107 ............................................................................................................................................................................. Comprehensive 194 See Auto Coverage Schedule ............................................................................................................................................................................. Limit of liability less deductible Collision 1,025 See Auto Coverage Schedule Limit of liability less deductible ............................................................................................................................................................................. Subtotal policy premium $7,695.00 ............................................................................................................................................................................. Waiver of Subrogation Fee 25.00 ............................................................................................................................................................................. Additional Insured Fee 75.00 ............................................................................................................................................................................. California Vehicle Assessment Fee 3.52 ............................................................................................................................................................................. Total 6 month policy premium and fees $7,798.52 Number of Employees: (0-10) Important information about fees The following additional fees may apply: Late payment fee $10.00 Fee for returned checks or refused payments $20.00 Rated drivers Auto coverage schedule 1. 2007 FORD ECONO/CLUB WGN Actual Cash Value (plus $2,000.00 Permanently Attached Equip) VIN: 1 FTNE14W57DB14977 Garaging Zip Code: 90623 Radius: 300 miles Personal use: N Body type: Cargo Van Liability WNW Med Pay Liability Premium Premium Premium .................................................................................................................................................................. Premium $1241 $166 $32 Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total .................................................................................................................................................................. Premium $1,000 $18 $1,000 $53 $1,510 ContiIs nued Form 6489 CA (05/21) Policy number: 00885549 T&G GLOBAL, LLC Page3 of 5 2. 2004 FORD ECONO/CLUB WGN Actual Cash Value (plus $2,000.00 Permanently Attached Equip) VIN: 1 FTNE24L54HA87358 Garaging Zip Code: 90623 Radius: 300 miles Personal use: N Body type: Cargo Van Liability Liability Premium UM/UIM Med Pay Premium Premium Premium ......................................................................................................................... $1161 $166 $30 Comp Physical Damage Deductible Comp Collision Collision Premium Deductible Premium Premium ......................................................................................................................... $1,000 $20 $1,000 $45 3. 2016 RAM RAM CHASSIS 550 Stated Amount: * $82,000 (including Permanently Attached Equip) VIN: 3C7WRMDL1GG148551 Garaging Zip Code: 90623 Radius: 300 miles Personal use: N Body type: Bucket Truck Liability Liability Premium UM/UIM Med Pay Premium Premium Premium ......................................................................................................................... $1064 $106 $20 Comp Physical Damage Deductible Comp Collision Collision Premium Deductible Premium Premium ......................................................................................................................... $1,000 $58 $1,000 $347 4. 2021 Ford F650 SUPER DUTY Stated Amount: * $84,000 (including Permanently Attached Equip) VIN: 1 FDNF6AN8MDF06042 Garaging Zip Code: 90623 Radius: 300 miles Personal use: N Body type: Box Truck Liability Liability Premium UM/UIM Med Pay Premium Premium Premium ......... $2246 .......................................................................... $106 $25 Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium ......................................................................................................................................... Premium $1,000 $98 $1,000 $580 *A vehicle's stated amount should indicate its current retail value, including any special or permanently attached equipment. In the event of a total loss, the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value, less deductible. Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. Premium discount Policy .............. 00885549 Loss Payee information .............. 1. Loss Payee Multi -Product Auto 3 ALTEC CAPITAL SERVIC 33 INVERNESS CTR PKW BIRMINGHAM, AL 35242 2016 RAM RAM CHASSIS 550 (3C7WRMDL1 GG148551) Auto Total $1,422 Auto Total $1,595 Auto Total $3,055 Form 6489 CA (05/21) ContiIs nued Additional Insured information .......................... 1. Additionallnsured 2. Additional Insured 3. Additional Insured 4. Additional Insured 5. Additional Insured 6. Additional Insured 7. Additional Insured 8. Additional Insured 9. Additional Insured 10. Additional Insured 11. Additional Insured 12. Additional Insured 13. Additional Insured Waiver of Subrogation information .................................. 1. Waiver of Subrogation ALTEC CAPITAL SERV 33 INVERNESS CT BIRMINGHAM, AL 35242 .................................................................... CITY OF CARSON 701 E CARSON ST CARSON, CA 90745 .................................................................... FS CREIT 555 AVIATI 555 S AVIATION ELSE GUNDO, CA 90245 .................................................................... CITY OF LOS ANGELES 200 N MAIN ST LOS ANGELES, CA 90012 .................................................................... CUSTOM TRUCK ONE SO 14670 RANDALL A FONTANA, CA 92335 .................................................................... CITY OF LONG BEACH P.O. BOX 570 LONG BEACH, CA 90801 .................................................................... ONTARIO INTERNATION 1923 E AVION ST ONTARIO, CA 91764 .................................................................... CITY OF BUENA PARK 6650 BEACH BLVD BUENA PARK, CA 90621 .................................................................... BUREAU OF STREET LI 1149 S BROADWAY LOS ANGELES, CA 90015 .................................................................... CITY OF WEST HOLLYWOOD PO BOX 947 MURRIETA, CA 92564 .................................................................... CITY OF BUENA PARK 6650 BEACH BLVED BUENA PARK, CA 90621 .................................................................... Glendale I Mall Assoc LP; Glendale II Mall Assoc LLC RE Mall Management Office 100 W Broadway, Ste 100 Glendale, CA 91210 .................................................................... City Of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 ONTARIO I N ERNATI ONAL AIRPORT AUTHORITY 1923 E AVION ST ONTARIO, CA 91764 Policy number: 00885549 T&G GLOBAL, LLC Page4 of 5 Form 6489 CA (05/21) ContiIs nued Policy number: 00885549 T&G GLOBAL, LLC Page 5 of 5 Important coverage notice Please inform us if your business owns any vehicles that are not currently described on the Declarations Page. Remember that all vehicles owned by your business must be specifically described on the Declarations Page at the beginning of each policy term for Any Auto Liability coverage to apply to an owned, unlisted vehicle during the term. Important Notice For your protection California law requires the following to appear on this form. Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. Company officers f President Secretary Form 6489 CA (05/21) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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 otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER 2 % of the total California Workers' Compensation premium Schedule Job Description CALIFORNIA OPERATIONS ONLY This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 09/29/2023 Policy No. WSA 5073087 00 Endorsement No. Insured T & G GLOBAL, LLC Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSURED