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Insurance Certificates 2023/24 Creative Lighting & ElectricalClient#: 2021261 CREATLIGI ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)8/01/2023 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services, LLC Lic # 0G11911 333 South Grand Avenue, Suite 1450 Los Angeles, CA 90071 ACT Chloe Domange PHONE 213 337-6400 FAX (A/C, No, Ext): (A/C, No): a usi.com ADDREE-MAIL SS: chloe.domange@usi.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : James River Insurance Company 12203 INSURED Creative Lightning & Electrical, Inc 1654 Illinois Ave Suite 13 Perris, CA 92571 INSURER B : State Compensation Insurance Fund of CA 35076 INSURER C: United Financial Casualty Company 11770 INSURER D : 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. LTRRPOLICY TYPE OF INSURANCE INSRW VD POLICY NUMBER EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X 001336621 08/01/2023 08/01/2024 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR PREMISES Ea RENTED $100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 X $2,500 Ded GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES JE 0 PER: LOC PRODUCTS - COMP/OP AGG $2,000,000 $ C AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY X X 008572720 08/01/2023 08/01/2024 (E° aocideD) INGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X 001464260 08/01/2023 08/01/2024 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N y N / A X 93435322023 08/01/2023 08/01/2024 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 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) Workers Compensation Policy: $1,000,000 for Employer's Liability Limit. The City of La Quinta, its officials, employees, and agents are included as additional insured as it relates to the General Liability and Auto as required by written contract in accordance with the terms and conditions of the policy. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of La Quinta 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 ACORD 25 (2016/03) 1 of 2 #S41034725/M41034396 • © 88-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CXDJA DESCRIPTIONS (Continued from Page 1 The insurance provided will be primary and any other insurance shall be excess and non-contributory per written contract in accordance with the terms and conditions of the policy. Waiver of subrogation applies to workers compensation and Auto Liability as required by written contract in accordance with the terms and conditions of the policy. 30 Days notice of cancellation - 10 Days for non-payment of premium as required by written contract in accordance with the terms and conditions of the policy. SAGITTA 25.3 (2016/03) 2 of 2 #S41034725/M41034396 POLICY NUMBER: 00133662-1 COMMERCIAL GENERAL LIABILITY CG20100704 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 Organization(s): Location(s) Of Covered Operations Where required by written contract or written agreement All operations of the Named Insureds 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 oth- er than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project. CG20100704 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: 00133662- 1 COMMERCIAL GENERAL LIABILITY CG20370704 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 Opera - tions Where required by written contract or written agreement All operations of the Named Insureds 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 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". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: 00133662- 1 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: Where required by written contract or written agreement 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 ❑ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Organization(s): If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4-10 Page 1 of 1 SCHEDULE A FORMS AND ENDORSEMENTS THAT APPLY TO THIS POLICY: POLICY NO. 00133662-0 FORM NUMBER ILP001-0104 AP0100US-0403 PN-03US-1219 MC0001 US-0416 AP0001 US-0403 CG0001-1207 BFR4001-0721 AP2103US-0607 AP2300US-1106 AP5012US-1203 MC2105US-1016 MC2126US-0913 CG2010-0704 CG2037-0704 CG2404-0509 AP5031 US-0410 AP1013US-1119 AP2033US-0320 AP2104US-1012 AP2107US-0403 AP5066US-0222 CG0068-0509 CG2107-0514 CG2136-0305 CG2147-1207 CG2167-1204 CG2186-1204 L0021-0908 AP1007US-0514 AP2029US-0222 AP2031 US-0411 AP2036US-1105 AP2102US-0403 AP2111US-1105 AP5039US-1209 AP5043US-0310 AP5056US-0413 GC2131 US-0403 MC2104US-0810 MC2143US-0918 DESCRIPTION US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders Privacy Policy California Surplus Lines Policyholder Notice Commercial General Liability Declarations Schedule A Commercial General Liability Coverage Form Cyber Coverage Insurance Minimum Policy Premium Composite Rate Endorsement Policy Limitation - Amended Aggregate Limits of Insurance per Project Deductible Endorsement - Damages and Expenses Premium Base Endorsement Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization Additional Insured - Owners, Lessees or Contractors - Completed Operations Waiver of Transfer of Rights of Recovery Against Others to Us Primary and Non Contributory Endorsement Premium Audit Conditions Amended Independent Contractors - Special Audit Provisions - Specified Limits Common Policy Conditions Binding Arbitration Anti -Stacking Endorsement Recording and Distribution of Material or Information in Violation of the Law Exclusion Exclusion - Access or Disclosure of Confidential or Personal Info and Data -Related Liability - Limited BI Exception Not Inc' Exclusion - New Entities Employment -Related Practices Exclusion Fungi or Bacteria Exclusion Exclusion - Exterior Insulation and Finish Systems Nuclear Energy Liability Exclusion Exclusion Operations Covered by a Consolidated Insurance Program (Wrap -Up, OCIP, CCIP) Combined Policy Exclusions Exclusion - Cross Suits Absolute Pollution and Pollution Related Liability - Exclusion Communicable Disease Exclusion Exclusion - Punitive Damages Tainted Drywall Material Exclusion Exclusion - Change in Use or Occupancy Exclusion - Work Performed In Designated States or Jurisdictions Fiduciary Exclusion Exclusion - Work on Behalf of Condominium Owners Association Exclusion - Newly Constructed Residential Housing AP0001 US O4-03 1 of 2 AP5027R-0115 CG2175-0115 AP5048US-0410 Rejection of Coverage for Certified Acts of Terrorism Coverage Exclusion of Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed Outside the United States California - Service of Suit AP0001 US O4-03 2 of 2