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PROOF OF INSURANCE (2020 - 2021) CLOSED0 DATE (MMIDDIYYYY) ACC)(?r> CERTIFICATE OF LIABILITY INSURANCE THIS SCERTIFICATE 31612020RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT] UPON "I'HE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED EY 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 d9M,:s to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Risk Str g1Company NC144 .. RISK t rat egtle�.,Cot"np nY PH FAX ,20n0Main 5tret, Suite 450 WC, EA;): 949•242 J 4_(A)c, Irvine, CA 92614 E-MAIL gE �aDrrpR�s.$t .............. sYOaang@f'Iskrstrtege,.carri ... _ .... ......, „„ .. . Projects as on file Wilh the insured including but not lirrnited to Professional Services Agreement. City of El Se Undo, lits of'ficinls and employees are named as additional insureds and prirnary/non-contributory clause applies to the general Irabiiity policy °Neta attached endrirsernTe'nt Umbrella Uablldy follows form to the general, auto and employer's liability policies. CERTIFICATE (HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Charles Mallory ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street Sl Segundo CA. 90245-3813 AUTHORIZED REPRESENTATIVE d: Michael Christian ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2018/03) The ACORD name and logo are registered marks of ACORD 54494736 1 20-21 FL, 19-20 GL -AL -UL -WC I Sherry Young 1 3/6/2020 11:39:49 AM (BST) I Page 1 of 3 INSURER(S) AFFORDING COVERAGE ..,, NAIC N ., strategies.com CA DOI License No. OF06675 Casualty SURER A : Travelers, , y Cc of Annerica elnfi 25674 INNS RED rotal Bee INSURER e: Alllneloa Financial . t In$. Co 41840 . , P2S Inc. qtr? ns Hanover AITlerla." I Y.. 6064 INSURERc TheI Insurance Cornagn 30443 .2 Engineering, Inc. �,tine 5000 F arNn, t., 8th FI, nkp Casuals Co INSURER D Continental Y Long leach CA 90815 INSURER,E .._ INSURER F: COVERAGES CERTIFICATE CERTIFICATE NUMBER: 54494736 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, CONDITIONSI OTSUCH CIES. LIMITS SH HAVE E CLAIMS BEEN REDUCED .I '16808N700OLI MOLT EFF POLfCY EiP LIMITS I ��D INTEXCLUSIONSTYPE URYMUM EACIwOCCURRENCE $ 1, 0, GENERALL V COMMERCIALCLAIMS I CEAIxt .. ,004 T r;M LtiAMA65 T R E, 1" 00 s x ., GICC:'IJF. MADE � ' I IeAEMIS o q _.. ,fnr el �' - ..... � 5510,000 PERSONA.L�&ADV INJURY .. t,000,000 GEGREG, 'L LIMIT APPLIES PER: w TE $$2,000,000 AGGREGATE PRCI — POLICY ✓ LO(.' 1 _ r ROOU'G • COMP/OP AGG JEC,r —„$2,000.000 .. OTHER B AUTOMOBILE LIABILITY AW39122842 7/1 /2019 7/1/2020 COMBINED SINGLE L IMIT -_ -$, -- tODILYINJURY ----,,$1",000„,-0--0-- 0 i ANY AUTO .SCHEDULEDBODILYINJURY (Perperson) OWNED (Per accident) $ 1 AL11 C,ONLY IAUTOS HIRED NONOVIED , , PRUILRIDAk1O: $ ✓ Y0101VI.Y „AUTOS ONLY C�qiwJ� rIx1} $ B AB OCCUR 7 EACHOCCU'RRENCEA 00,0,,000 CLAIMS -MADE .........---$ _$4, AGREGAIE -s4000,000EXCE5SLAB... C .✓ ., ,.. I ✓ � ()ED R,"I'ENIICN$D C WORKERS COMPENSATION W239122627 PER Oltl"I 711./2019 7/1/2020 IEf S T,ur1T E AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE �NIA E EACH ACCIDENT $1 000,, 0 OFFICER/MEMBER EXCLUDED9 (Mandatory in NH) . tASE - EA EI�IPLw'�'Y E L DIS "- - - EE S$1u000y0, . p^'ril�etrrralriir x'Ior�'s balow DISEASE -r�'OU YLIM '5$1,00'0.0100 D Prof,Rltl:�ml” eSslraribal L'iabilit, Y AEH288'2833016 3/7/2020 3/7/2021 Per Claim: 55,000„000T I 1 Aggregate: $5,000,000 I II DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Projects as on file Wilh the insured including but not lirrnited to Professional Services Agreement. City of El Se Undo, lits of'ficinls and employees are named as additional insureds and prirnary/non-contributory clause applies to the general Irabiiity policy °Neta attached endrirsernTe'nt Umbrella Uablldy follows form to the general, auto and employer's liability policies. CERTIFICATE (HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Charles Mallory ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street Sl Segundo CA. 90245-3813 AUTHORIZED REPRESENTATIVE d: Michael Christian ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2018/03) The ACORD name and logo are registered marks of ACORD 54494736 1 20-21 FL, 19-20 GL -AL -UL -WC I Sherry Young 1 3/6/2020 11:39:49 AM (BST) I Page 1 of 3 Insured: 112S Inc 112S Engineermaa, Inc Policy No. :6808N700523 Effective Date :7/15/2019 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person or organization; or d. For "bodily injury", "property damage" or "personal injury" for which such person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Pnrt. f. This insurance does not apply to the rendering of or failure to render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III — Limits Of Insurance. h. This insurance does not apply to "bodily injury" or "property Gamagra" caused by "your work" and included in the 'products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured'. ur der this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81 08 15 Q 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission ,.z, 91ryr; I ca -:a vii, 11. zu (: i, kT. car. W: i ;Sri,.: :y Y0111113 I 1/b/ '020 11 19;1:a SAM Wr,T) I a,�Xe 2 0L J Page 1 of 2 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After you have signed that written contract; b. While that part of the written contract is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission 5,4494 7)C 1 20 21 PL, 19 20 GL AL-uf, WC.,' I vy,erry"k'ouny I l/i/1020 IL ;39:49 AN (PSIT) I NG+ye 'Y o4. 3 CG D3 81 09 15 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless otherwise stated. This endorsement effective on 7/1/2019 part of Policy No. WZ39122627 of the The Hanover American Insurance Company issued to: P2S Inc. P2S Engii eor1r,y MC; Premium (if any) $ at 12:01 am standard times forms a Authorized Representative 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) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.000% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION WITH WHOM YOU AGREE IN WRITING TO WAIVE YOUR RIGHT TO RECOVER AGAINST THEM. YOU MUST AGREE TO THiS WAIVER PRIOR TO THE DATE OF LOSS Job Description: Projects as on file with the insured WC 252 040 84 49453175 1 19-20 GL -AL -UL -WC -PL I She—Y Young 1 6/24/2019 7:12:06 AM 4POTi I Page 4 of 4