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PROOF OF INSURANCE (2021) CLOSEDM page 2 of 7 Client#: 1266412 305FLEMIENV ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MNVDDNYYV) 1 04/24/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY 08 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 -ADDITIONAL INSURED, the po I icy(I a a) must have ADDITIONAL INSURED provisions or be endorsed. -cer-ii-ticateh'D It 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 McGrIff Insurance Services 2400 E Katella Ave Suite 1100 Anaheim, CA 92806 714 941-2800 INSURED- - ---- -------- Fleming Environmental Inc. 1372 East Valencia Drive Fullerton, CA 92831 COVERAGES CERTIFICATE NUMBER: CONTACT NAME: Aille Mosier PHONE714 941-49,06- F . Ax r=_M I .ADDRESS: amosier@mcgriffinsurance.com INSURERS) AFFORDING COVERAGE I - , Ir - - 1 . - . . . INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF I NAIL - I York INSURER A: Homeland Insurance Company New 0 f BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS S14OWN MAY HAVE ............ msunEn B; Oak River Insurance Company34530 4NSA — --------- 'soav-, -- LTA TYPE OF INSURANCE POLICY NUMBER ---M" -------- ------ - -- P 0-- C ICY. -EF- F- - —1-P---O—L -�C Y- a X P fMM1BD1yXy INSURER c; Travelers Property Casualty Co of Amer A, X COMMERCIAL GENERAL, LIABILITY 7930050560004 ;25674 _S D , American Automobile InCo INSURE CLAIMS,K4ADE X OCCUR 1849 INSURER E INSURER F: 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 S14OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 4NSA — --------- 'soav-, -- LTA TYPE OF INSURANCE POLICY NUMBER ---M" -------- ------ - -- P 0-- C ICY. -EF- F- - —1-P---O—L -�C Y- a X P fMM1BD1yXy . ..... - --- ---- LIMITS A, X COMMERCIAL GENERAL, LIABILITY 7930050560004 05/01/2020 105/01120211 EACH OCCURRENCE S1,0M.000 CLAIMS,K4ADE X OCCUR DAMAGHOPENTED S300,000 X1 Pollution Liab ME EXP lAny one petz;om) S 10,000 Xi Professional Liab ... ........ PERSONAL a ADV INJURY }S1 000 G�N'L AGGREGATE UMIT APPLIES PEP: 9ENERI AGGREGATE s 2,000,000 PRO, I POLICY X! JECT -_iLOC 1'P132RYCTS-COMP/OPAGG s2,000,000 OTHER. D AUTOMOBILE LIABILITY SCV00M02001 0510112020;05101/2021 c0I INSING:EE Ul'Aff, S1,0M,000 X ANY AUTO BODILY INJURY (Per pvrSon) !S OW NED SCHEDULED AUTOS ONLY : SCHEDULED AUTS B INJURY (Peraccident): S H RED NON -OWNED X I iAUTOS ONLY :_X AUTOS ONLY L is A UMBRELLA LIAR :X C,UR i793OO5O57OOO4 05101/2020 05101/20211 EACH OCCU RRENCE i SS'00P'000 i X EXCESS LIAB CLAI&IS*AADE I AGGREGATE !DED i X: RETENTION$() WORKERS COMPENSATION B AND EMPLOYERS' LIABILITY FLWC1 14561 05/01 [PER i !OTH;' /2020 05/01/2021 X STATUTE.----- En 7N ANY PROPRIETORIPART NER/EXECUTWE !OORMEYCLUDED? WINIA� - 'E.L, EACH ACCIDENT (Mandatory in NH) It yes, oWacrbe under E.L. DISEASE - EA EM DESCRIPTION OF OPERATIONS below ....... ... .. .... .. DISEW,t - POLICY L-111AII $1,000,000 C Rented/Leased OT6603L337320TIL 06/0112020i'051011/2021i $160,000 Limit 'f Equipment $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS tVEHICLES (ACORD 10I.Additional Remarks Schedule, may boallachad 11mora space Is roclufrod) RE: Maintenance Agreement No. $331 The City of El Segundo, its officers, officials, employees, agents and volunteers are named as additional insured as respects general liability, this insurance is primary and noncontributory with any other insurance of the additional insured; and waiver of subrogation applies as respects workers compensation as required by written contract, per endorsements attached. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 150 Illinois Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (/201y6103/), 1 of 2 The ACORD name and logo are registered marks of ACORD #S951 119P9-x;r11 RIZIAS M DESCRIPTIONS (Continued from Page 1) ...... ..... .... ... .. Should any policy be cancelled before the expiration date, BB&T Insurance Services will mail 30 (thirty) days written notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non-payment of premium. SAGITTA 25.3 (tot 6103) 2 of 2 #S256183661M25618336 292 page 3 of 7 - N - Policy Number -.793-00-50-56-0004 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement only modifies coverage provided under the following-, COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person orr organiZation for which the lai .ied Tnsured has agreed to provide insurance oxior to loss as provided by this policy b,.it only to the scope or insurance igreed to by the Naned insured. page 4 of 7 Location And Description Of Completed Operations: Any location or coaipleted operation, b -at only tc., the scone oz j,nsurance agreed to by the Named Insjred. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION 11 — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the SCHEDULE above, but only with respect to liability for bodily injury, property damage or environmental damage caused, in whole or in part, by your work at the location designated and described in the SCHEDULE above performed for that additional insured and included in the products - completed operations hazard. All other terms and conditions remain the same. OBENV GE 304 (02 11) Includes copyrighted material of Insurance Services. Office, Inc. Copyright 2011, One6eacon Insurance Group LLC E -INSURED I of I page 5 of 7 Policy Number. -793-00-50-56-0004 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - FORM I This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the Named TnSured has agreed to provide insurance insurance pr -,or to loss as provided by tris po -cv but on -'y to the scope of .'nsurance agreed to by the Named Tnsured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION 11 — WHO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added. - 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (a) 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 site of the covered operations has been completed-, or (b) 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. All other terms and conditions remain the same, OBENV GE 301 (02 11) Includes copyrighted material of Insurance Services Office, Inc. 1 Of I Copyright 2011, OnoBeacon Insurance Group LLC E -INSURED 714 E page 6 of 7 Fleming Environmental Inc. Policy Number.793-00-50-56-0004 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IV - CONDITIONS, 8. Other Insurance, is amended by adding the following paragraph. - This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement, that this insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same. 0 BENV GE 319 (02 11) Includes copyrighteo material of Insurance Services Office, Inc, I of 1 Copyright, One5eacon Insurance Group, 2011 N 226 page 7 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04106 (Ed, 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA BLANKET BASIS 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.) 'The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver - Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description All CA Operations Waiver Premium This endorsement changes the poity to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 05/01/2020 Polleytoo_FLWC114561 Endorsement No. Insured Insurance Company Oak River Insurance Company WC 99 041013 (Ed. 9-14) Countersigned by Premium $