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PROOF OF INSURANCE (2020) CLOSEDClient#: 25361 GEOSCONS YYYY) /2019 MIDDI ACORD,. CERTIFICATE OF LIABILITY INSURANCE 3/18DATE (MM/DD/ 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 end�w _............ orsed. 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 CONTACTAAECarly Underwood Greyling Ins. Brokerage/EPIC PHONE4225 552 770..IIPAX 866.550.4082 (APIC, No, Exl): a (A/C'. No): 3780 Mansell Road, Suite 370 E-MAIL @g y g Alpharetta, GA 30022 ADDRESS, carly.0„n„derwood gre lin .com....... ; INSURED Geosyntec Consultants, Inc. 900 Broken Sound Parkway NW, Suite 200 Boca Raton, FL 33487 V INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins. Co. 19445 INSURER B: New Hampshire Ins. Co. _._.__..__......._ 23841 INSURER C: Allianz Underwriters Insurance 36420 P INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 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 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. LN` TYPE OF INSURANCE Al ............................ POLICY NUMBER lPkOmFGICPYWFYF FOLIC YYYY......__-......................................LL.........., POLICY EXP, LIMITS ._...._.._ .-..._...._,._......._..................._.......H�� p_......,.,.,.,.,.,.,.,.,.,.,.,.,.,.,.,.,.......................................,.,.,.,.,.................._..�,...............,........._..L............_........_._.........,��_..�...�...m............_._.._..L.,.,.,.,.,.,.,.,.,.,.......,.,.,.,.,.,.,.,.,.,.,.,.,......_ COMMERCIAL GENERAL LIABILITY CH OCC ,0001000 A X 5268179 04/01 /2019 04/01 12020 w Va OCCURRENCE ,_ $ 7. 'Vol qq w�. ............ CLAIMS -MADE 17X OCCUR PREMISES a occurrence) $500 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY � JECT XX LOC OTHER: A AUTOMOBILE LIABILITY A X ANY AUTO OWNED - SCHEDULED AUTOS ONLY AUTOS X HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY UMBRELLA ............... .... LIAB OCCUR EXCESS LIAB CLAIMS -MADE .DED..„......„.,RETENTL.........._........._................._................_...... VVII VVII ON$ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? N N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below C Prof Liab (PL)/ Contr. Poll (CPL) MED EXP (Any one person) $25,000 [PERSONAL 8 ADV INJURY $1,_000,000 GENERALAGGREGATE s2,000,000 PRODUCTS -COMP/OP AGG $2,000,000 ................... COMBINED SINGLE LIMIT (AOS) 04/01/2019 04/01/2020 $1,000,000 4489674 (MA) 04/01/2019 04/01/2020 BODILY INJURY (Per person) $ . ....................-.......,.......,................ ,.........., BODILY INJURY (Per accident) $ .... r/aaBr�idr'rwi AhIA1G.w...................,.�$................................................... EACH OCCURRENCE $ AGGREGATE ......A.... $ 015893709 (AOS) 04/01/2019 04/01/202 X ,ER UTF I I°S” 015893710 (CA) 04101/2019 04/01/2020 E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 U51-00010219 04/01/2019 04/01/2020 Ea Incident $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: Municipal Stormwater Permit Assistance 2017-18. The City of EI Segundo, its officials, and employees are named as Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary & non contributory where required by written contract. Waiver of Subrogation is applicable where required by written contract & allowed by law. CERTIFICATE HOLDER CANCELLATION City of EI Segundo -Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1456986/M1456557 CU N D 1 POLICY NUMBER: 5268179 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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 o Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. 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) 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. B. 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 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 0 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 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 O Insurance Services Office, Inc., 2012 CO 20 10 04 13 0 POLICY NUMBER: 5268179 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 1-11, "' L SCHEDULE f Name Of Additional Insured Person(s) Location And Description Of Completed Operations V Or Organization(s) ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. PER THE CONTRACT OR AGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations- A. eclarations 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 agree- ment, the insurance afforded to such addi- tional 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 Insu- rance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations. CG 20 37 04 13 ® Insurance Services Office, Inc., 2012 Page 1 of 1 0 BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 4/1/2019 forms a part of Policy No. 15893710 Issued to GEOSYNTEC CONSULTANTS, INC. By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy. WC 04 03 61 Countersigned by _ _ _„ _ - - _ _ m _ _ _ _ _. _ _ _ ,_ (Ed. 11/90) Authorized Representative