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PROOF OF INSURANCE (2021) CLOSEDClient#: 25361 GEOSCONS II TE (MM ACORDTM CERTIFICATE OF LIiABILIW INSURANCE IDD/YYYY) a DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THI S 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(les) 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 ceiACr Carly Underwood Gre lin Ins. Brokerage/EPIC {n"Ic°NxFAX 770 — . .. l866.550 40„8 INC, No 2Eau: 3780 Mansell Road, Suite 370dILcary.underwood 1.re_lln i.Com Alpharetta, GA 30022 INSURER(S)AFFORDING COVERAGE NAIC ,#.. INSURER A National Union Fire Ins. Co. 19445 INSURED .- -- New..Hamp Geos ntec Consultants, In. INSURER D d W shire Ins. ce p u23841 INSURE IesuRER C old Assurance Company (U.S.) J 19489 900 Broken Sound ParkwayNW, Suite 200 Aloe Boca Raton, FL 33487 INSURER E: I�III INSURER F; X COVERAGES CERTIFICATE NUMBER: 20.21 REVISION N 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. LSR .., CE.R, .. .... ....,POLICY NUMBER (MW(M Y Y) (MM,fDDfmY) IT : .. R TYPE OF INSURANCE I BPoLITY IADOL SUBR POLIO E F POLICY EXP EACH OCCURRENCE LIMIT L RRENCE $1,000,000 CLAIMS -MADE X 5268179 O4I01/2020 0410112021 ' R........,IS„EsERa„o,N�,.uTurDnc(a),,, $5008000 COMMERCIAL GENERAL... OCCUR „,,..... A _ ny one person) $25,000 EEM XP (A........ PERSONAL & ADV INJURY $1,000,000_ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 ^ ......... .. ................2,000,000 XI JECT X LOC PRODUCTS - COMPIOPAGG $ PRO - POLICY II A AUTOMOBILE LIABILITY(AOS) COMBINED OTHER: 4489673 AOS 04101/20 ). 20 04101/20211 s"'"SLE LIMIT 2,000,000 ., JURY( (Per person) $ __ -- A _ A ANY AUTO 4489674 (MA) 04101/2020 04/0112021 BODILY IN P �° OWNED _,SCHEDULED BO N( accident) $ AUTOS ONLY AUTOS X HIRED XO-O $ 0ONLY ,AUTOSONLY fer occd , UMBRELLA LUIB OCCUR EACH OCCURRENCE $ EXCESS LIARCLAIMS-MADE AGGREGATE $ PgD B WN� NERRS COMPENSATION $ r I N 015893709 (AOS) 04/01/2020 04 . / ( I /01/2021 XlPTATI? l �. RPERH A ANY OFFIf iMandFOWREP�,"iSOHRPEXXC'LUEDEEYDE?ECUTIVE NIA 015893710 CA 04101/2020 04/01/2021 E.L.DSEASECH CIDENTEAEMPLOYEE $1a000p000,,,,,, If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $1,000,000 C .. Prof Liab (PL)I 03122723 04/01/2020 04/01/2021 Each Act $2,000,000 Contr. Poll (CPL) Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 City of EI Segundo -Public Works 350 Main Street EI Segundo, CA 90245-0000 CANCELLATION 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 ,41v- ©1988-2015 ACORD CORPORATION. All rights reserved. This page has been left blank intentionally. 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 Name Of Additional Insured Person(s) 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. Location(s) Of Covered Operations PER THE CONTRACT OR AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section If - Who Is An Insured is amended to include as an additional insured the person(s) or orgenization(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 lother 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 13 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 0 Insurance Services Office, Inc., 2012 CG 20 10 04 13 O POLICY NUMBER; 5269179 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 SCHEDULE Name Of Additional Insured Person(sl Location And Description Of Completed Operations Or Organizationls) ANY PERSON OR ORGANIZATION WHOM PER THE CONTRACT OR AGREEMENT 0 YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTEREDINTO. 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" 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 This page has been left blank intentionally. 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 04/01/2020 Issued to GEOSYNTEC CONSULTANTS, INC. forms a part of Policy No. WC 015893710 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 _ _ _ _ _ _ _ _ _ _ - _ _. _ _ _ - _ _ (Ed. 11190) Authorized Representative This page has been left blank intentionally.