SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
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. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
4/24/2026
IOA Insurance Services
611 North Brand Boulevard, Suite 1300
Glendale CA 91203
323-951-4200 323-951-4260 License#: 0E67768 California Automobile Insurance Company 38342 EPAXSYS-01 Great American E & S Insurance Company 37532 Epax Systems Inc.
14641 Arminta Street
Panorama City CA 91402
121294683
B X 1,000,000 X 500,000 20,000 1,000,000 2,000,000 X
Y Y PLF501736 4/8/2026 4/8/2027
2,000,000
A 1,000,000 X
X X
Y Y BA040000020012 1/11/2026 1/11/2027
B X 2,000,000 X
XSF501737 4/8/2026 4/8/2027
2,000,000 X
0 Certificate Holder is included as Additional Insured with respect to General Liability (per form to follow from carrier) & Auto Liability when required by written contract. General Liability (per form to follow from carrier) and Auto Liability is Primary and Non-Contributory when required by written contract. Waiver of Subrogation applies to General Liability (per form to follow from carrier) and Auto Liability when required by written contract and to the extent permitted by law.
Umbrella Liability Follows Form.
The City its Officers, Elected & Appointed Officials, Emloyees & Volunteers are Certificate Holders and Additional Insureds with respects to the General Liability when required by written contract per form #ESG3206 01/16 attached
City of Redondo Beach
Public Works Department
531 N Gertruda Ave.
Redondo Beach CA 90277
USA
MCA20480711
BABAI01#Insured#George Lee George Lee George Lee George Lee George Lee George Lee George Lee George Lee THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
The following is added to the Section II - Liability Coverage, Paragraph A.1. Who Is An Insured Provision:
Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period is an "insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II.
Copyright 2023 Mercury Insurance Services, LLC. All rights reserved.
MCA CABE 08 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Mercury Business Auto Broadening Endorsement
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS
III. SUPPLEMENTARY PAYMENTS
IV. ADDITIONAL TRANSPORTATION EXPENSE
V. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE
VI. GLASS REPAIR – DEDUCTIBLE WAIVER
VII. TWO OR MORE DEDUCTIBLES
VIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS IX. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS X. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT
XI. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH XII. PERSONAL EFFECTS COVERAGE
XIII. LOSS OF USE EXPENSES
XIV. DEVICES DESIGNED FOR USE WITH AUDIO, VISUAL OR DATA ELECTRONIC EQUIPMENT XV. PHYSICAL DAMAGE DEDUCTIBLE – VEHICLE TRACKING SYSTEM XVI. CHAINS, TARPS, AND BINDERS COVERAGE
Copyright 2023 Mercury Insurance Services, LLC. All rights reserved.
MCA CABE 08 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 2 of 4
BUSINESS AUTO COVERAGE FORM
I. NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named Insured) SECTION II – COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added:
Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity.
Coverage under this provision is afforded only until the end of the policy period.
Coverage does not apply to an “accident” which occurred before you acquired or formed the organization.
II. EMPLOYEES AS INSUREDS
SECTION II – COVERED AUTOS LIABILITY COVERAGE, A. COVERAGE, 1. Who Is An Insured, the following is added:
Any “employee” of yours is an “insured” while using a “covered auto” you do not “own”, lease, hire, rent, or borrow, which is used in connection with your business.
III. SUPPLEMENTARY PAYMENTS
SECTION II – COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 3. Coverage Extensions, a.
Supplementary Payments, Subparagraphs (2) and (4) are replaced by the following:
(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We are not obligated to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work.
IV. ADDITIONAL TRANSPORTATION EXPENSE
SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Coverage Extensions, a.
Transportation Expenses, is amended by:
Replacing $20 per day with $50 per day, and the $600 maximum with $1,000 maximum.
If your business shown in the “Declarations” is other than an auto dealership, we will also pay up to $1,000 for reasonable and necessary costs incurred by you to return a stolen “covered auto” from the place where it is recovered to its usual garaging location.
V. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3.a., is amended to add the following:
This exclusion does not apply to the accidental discharge of an airbag.
VI. GLASS REPAIR – DEDUCTIBLE WAIVER
SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added:
No deductible applies to glass damage if the glass is repaired rather than replaced.
Copyright 2023 Mercury Insurance Services, LLC. All rights reserved.
MCA CABE 08 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 3 of 4 VII. TWO OR MORE DEDUCTIBLES
SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added:
If two or more "company" policies or coverage forms apply to the same accident:
1. If the applicable Business Auto deductible is the smallest, it will be waived; or
2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible; or
3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived.
For the purpose of this endorsement "company” means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies.
VIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit, Or Loss, a., In the event of "accident", you must notify us of an "accident" applies only when the "accident" is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation.
IX. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, or Fraud, the following is added:
Any unintentional omission of or error in information given by you, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery.
This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.
X. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT
SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, the following is added and supersedes any provision to the contrary:
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.
XI. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V – DEFINITIONS, D. "Bodily Injury” is amended by adding the following:
"Bodily injury" also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease.
Copyright 2023 Mercury Insurance Services, LLC. All rights reserved.
MCA CABE 08 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 4 of 4 XII. PERSONAL EFFECTS COVERAGE
SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Coverage Extensions, the following is added:
Personal Effects
We will pay up to $500 for “loss” to personal effects which:
(1) Are owned by you or a driver listed in the “Declarations”; and (2) Are in or on a “covered auto” at the time of “loss”.
This coverage applies only in the event of a total theft of a “covered auto”. No additional deductible applies to the coverage. Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment are not considered personal effects.
XIII. LOSS OF USE EXPENSES
If you pay the premium for Hired Auto Physical Damage, we will pay expenses for which you become legally responsible to pay for loss of use of an “auto” due to “loss” or “accident” covered by Hired Auto Physical Damage. However, the most we will pay for any expenses for loss of use is $20 per day, to a maximum of $600. The insurance provided by this provision is excess over any other collectible insurance.
XIV. DEVICES DESIGNED FOR USE WITH AUDIO, VISUAL OR DATA ELECTRONIC EQUIPMENT SECTION III – PHYSICAL DAMAGE COVERAGE, B. Exclusions, 4.a., is replaced by the following:
a. Under Comprehensive Coverage we will pay up to $200 for “loss” to tapes, records, discs or other similar audio, visual, data electronic devices designed for use with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment:
(1) Are your property or that of a driver listed in the “Declarations”; and (2) Are in a “covererd auto” at the time of “loss”.
This coverage applies only in the event of a total theft of a “covered auto”. No additional deductible applies to this coverage.
XV. PHYSICAL DAMAGE DEDUCTIBLE – VEHICLE TRACKING SYSTEM SECTION III – PHYSICAL DAMAGE COVERAGE, D. Deductible, is amended by adding the following:
Any Comprehensive Deductible shown in the “Declarations” will be reduced by 50% for any "loss" caused by theft if the “covered auto” is equipped with a vehicle tracking device such as a radio tracking device or a global position device and that device was the method of recovery of that “covered auto” by the “insured” or law enforcement.
XVI. CHAINS, TARPS, AND BINDERS COVERAGE
SECTION III – PHYSICAL DAMAGE COVERAGE, C. Limits Of Insurance, the following is added:
The most we will pay for the "loss" to chains, tarpaulins, binders, and cargo securing devices will be $500.
The chains, tarpaulins, binders, or cargo securing devices must be in or on the "covered auto" at the time of "loss".
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
SECTION IV – BUSINESSS AUTO CONDITIONS, A. Loss Conditions, 5. 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 to the extent required of you by a written contract executed prior to any “accident” or “loss”, provided that the “accident” or “loss” arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract.
MCA04440913