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Insurance Certificates 2021/22 Creative Lighting & Electrical® CERTIFICATE OF LIABILITY INSURANCE ACCOR " DATE (MM/DD/ 12/14/2021YYYv) 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 CONTACT NAME: Cherri Walsh FAX A/C No Ext : 626-699-4600 AIC No 626-699-4601 Cherri J Walsh Insurance Services, Inc 302 N Citrus Ave A DRESS: Cherriwalsh@allstate.com Covina, Ca 91723 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Houston Specialty Ins Co - IX "A-" 12936 INSURED INSURERB: Allstate Insurance Company - XV "A+" 19232 INSURERC: National Union Fire Ins Co - XV "A" 19445 Creative Lighting & Electrical, Inc INSURERD: State Compensation Insurance Fund 35076 1654 Illinois Ave Suite 13 INSURER E : Perris, Ca 92571 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY TEN-27109 08/01/2021 08/01/2022 EACH OCCURRENCE $ 1 ,000,000 DAMAGE TO FEN TED PREMISES Ea occurrence $ 100,000 >< COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP (Any one person) $ 5,000 A PERSONAL & ADV INJURY $ 1 ,000,000 X Per Project Aggregate 5,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY 648823140 08/01/2021 08/01/2022 EOa accident) MIINED SINGLE LIMIT $ 1 ,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ B NON -OWNED HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EBU016828018 08/01/2021 08/01/2022 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE DED RETENTION $ ZERO $ WORKERS COMPENSATION 928104221 08/01/2021 08/01/2022 WC STATU- OTH- TORY LIMITS ER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 1 ,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE N / A E.L. DISEASE - EA EMPLOYEE $ 1 ,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of La Quinta, its officials, employees, and agents are named as additional insured per General Liablity Form GC 00 01 12 07. Primary and Non -Contributory and Waiver of Subrogation applies to General Liability when required by written contract. Waiver of Subrogation applies to Workers Compensation when required by written contract. Additional Insured and Waiver of Subrogation applies to Commercial Auto Liability Coverage when required by written contract. *30 Days notice of cancellation - 10 Days for non-payment of premium CERTIFICATE HOLDER CANCELLATION City of La Qunita 78495 Calle Tampico La Quinta, Ca 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME BROKER COPY REP 02 9282307-21 RENEWAL NA 5-03-27-53 EFFECTIVE AUGUST 1, 2021 AT 12.01 A.M. PAGE 1 OF 1 AND EXPIRING AUGUST 1, 2022 AT 12.01 A.M. ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS CREATIVE LIGHTING & ELECTRICAL, IN 1654 ILLINOIS AVE STE 13 PERRIS, CA 92571 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. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED INSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JULY 1, 2021 2572 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) 197RDISONWAVA POLICY NUMBER: TEN-27109 COMMERCIAL 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: Only such Person or Organization where required in a written contract with the Named Insured under this policy, entered into prior to the loss or "occurrence". 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 ❑ COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEN-27109 PRIMARY AND NON-CONTRIBUTING INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Notwithstanding the provisions of sub -paragraphs a, b, and c of this paragraph 4, with respect to the Third Party as defined below, it is understood and agreed that in the event of a claim or "suit" caused in whole or in part by the Named Insured's 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: Absence of a specifically named Third Party above means this endorsement applies only to those third parties required to be named as an Additional Insured as Primary and Non -Contributory coverage specified in a written contract with the Named Insured under this policy, entered into prior to the "loss" or "occurrence". All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. TEN-27109 Includes copyright material of Insurance Services Office, Inc. Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Organ izations : Locations Of Covered Operations Only those parties required to be named as an Addi- ALL tional Insured in a written contract with the Named Insured under this policy, entered into prior to loss or "occurrence". 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", "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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Only those parties required to be named as an ALL Additional Insured in a written contract with the Named Insured under this policy, entered into prior to loss or "occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEN-27109 DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT WITH CAP This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Designated Construction Projects ALL PROJECTS WHERE REQUIRED BY A WRITTEN CONTRACT EXECUTED PRIOR TO LOSS OR "OCCURRENCE". (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay damages caused by "occurrences" under COVERAGE A (SECTION 1), which can be attributed only to ongoing operations at a single designated construction project shown in the schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. However, the most we will pay under the Designated Construction Project General Aggregate Limit for all projects combined is $5,000,000 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A. except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazards", regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A for damage shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. TEN-23610 Page 1 of 2 COMMERCIAL AUTO AACW201011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ENHANCEMENT ENDORSEMENT Coverage provided under this policy is modified by the attachment of this endorsement. If there is any conflict in coverage provisions between this form and any state specific endorsement also attached to this policy, the provision(s) of the state specific form shall apply. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM In SECTION I - COVERED AUTOS, the following changes are made: The following is added: D. Physical Damage Coverage for Temporary Substitute and Leased Autos If Physical Damage Coverage is provided by this policy, the following kinds of "autos" are covered "autos" for the same coverages provided by the policy: 1. Any private passenger "auto", or other than private passenger vehicle with gross vehicle weight of 20,000 lbs. or less, you do not own while used with the permission of the owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction. 2. Private passenger "autos" and other than private passenger vehicles with gross vehicle weight of 10,000 lbs. or less, leased, hired, rented, or borrowed for a period of 30 days or less. This does not include any vehicle you lease, hire, rent, or borrow from any of your "employees" or partners or members of their households. d. Any organization, other than a partnership or joint venture, over which you maintain ownership or in which you hold a majority interest. This provision applies only if there is no similar insurance provided to that organization. e. Any organization you acquire or form after policy inception, other than a partnership or joint venture, over which you maintain ownership, or in which you hold a majority interest. Coverage under this provision does not apply; (1) If there is similar insurance provided to that organization; or (2) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. Any person or organization that you are required to name as an additional insured under the terms of a written job contract, or by written insurance requirements executed prior to any covered 'loss" or claim. This protection applies only if the person or organization is liable for the conduct of an "insured" and only to the extent of that liability. Under A. Coverage, Coverage Extensions, Supplementary Payments, subparagraphs (2) and (4) are replaced with the following: (2) Up to $5,000 for cost of bail bonds (including In SECTION II — LIABILITY COVERAGE, the bonds for related traffic law violations) required following changes are made: because of an "accident' we cover. We do not have to furnish these bonds. Under A. Coverage, Who Is An Insured, the following is added: Includes copyrighted material of Insurance Services Office, Inc., with its permission AACW201011 Allstate Insurance Company Insured Full Copy Page 1 of 3 (4) All reasonable expenses incurred by the "insured" at our request, including loss of earnings up to $500 a day because of time off from work. Under B. Exclusions, Fellow Employee, the following paragraph is added: But this exclusion does not apply to "bodily injury" to a fellow "employee" caused by any person whose position within the insured organization is at or above the level of manager or supervisor. Coverage afforded by this provision is excess over any other collectible insurance. In SECTION III - PHYSICAL DAMAGE COVERAGE, the following changes are made: Under A Coverage, Glass Breakage - Hitting A Bird Or Animal - Falling Objects Or Missiles, the following is added: If damage to glass is repaired in lieu of being replaced, no deductible will apply for repair only. Under A Coverage, Coverage Extensions, the following is added: c. Personal Effects Coverage In the event of a total theft of your covered "auto", for which you carry either Comprehensive or Specified Causes of Loss coverage, we will pay up to $500 for the personal effects which are: 1. owned by you; and 2. in your covered "auto" at the time of the total theft of such "auto". No deductible applies to Personal Effects Coverage Under A Coverage, the following is added: 5. Lease and Loan Gap Coverage In the event of a total "loss" to a covered "auto" shown in the Schedule or Declarations for which a specific premium charge indicates that physical damage coverage applies, we will pay any unpaid amount due on the lease or loan for a 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. Under D. Deductible, the following paragraph is added: When Collision Coverage is provided by this policy, the deductible amount will not be subtracted from the loss payment in collisions involving your covered "auto" and another auto covered by Allstate Insurance Company or any of it's affiliates. In SECTION IV - BUSINESS AUTO CONDITIONS, the following changes are made: Under A Loss Conditions, Duties In The Event Of Accident, Claim, Suit Or Loss Condition, the following is added under subpart a: Knowledge of an "accident" or "loss" by any of your agents, servants or "employees" shall not in itself constitute knowledge by you, unless you or one of your corporate officers or managers, or any assignee, shall have received such notice from the agent, servant or "employee". When you report an occurrence of any "accident" or "loss" to a Worker's Compensation carrier or self insured plan providing the named insured's Worker's Compensation insurance which later develops into a claim submitted under this policy, failure to report such "accident" or "loss" to us at the same time shall not be deemed a violation of this condition. After you become aware of such liability claim arising from the "accident" or "loss", you must give us prompt notice. Under A Loss Conditions, Transfer of Rights of Recovery Against Others To Us, the following is added: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of work you perform under a contract with such person or organization, in which you have agreed to waive your right of such recovery. Includes copyrighted material of Insurance Services Office, Inc., with its permission AACW201011 Allstate Insurance Company Insured Full Copy Page 2 of 3 Under B. General Conditions, Concealment, Misrepresentation Or Fraud, the following is added: This condition does not apply to any omission or failure to provide material facts if the omission or failure was unintentional. Includes copyrighted material of Insurance Services Office, Inc., with its permission AA CW 20 10 11 Allstate Insurance Company Page 3 of 3 Insured Full Copy