PROOF OF INSURANCE (2020 - 2020) CLOSEDClient#: 1291580 04CORRACON
ACORD,. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY)
8/1312020
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(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).
PRODUGERt NA}NEAGT Angelique Lopez
McGriff Insurance Services ii PHONE 714 941-2829 FAX 877-297-9259
I (AIC, No. Ext): Mc.
of:
2400 E Katella Ave Suite 1100 a pass: angelique.lopez@mcgriffinsurance.com
Anaheim, 92806 ( INSURER(S) AFFORDING COVERAGE NAIL II
714 941-280000 I INSURER A: Colony Insurance Company 39993
INSURED
Corral Construction &Development Inc I INSURERS: State Compensation $anon Ins. Fund of CA 35076
5211 E. Washington Blvd. #2-122
INSURER C : Ohio Security Insurance Company 24082
{
Commerce, CA 90040 I INSURER 0: I
INSURER E: I
INSURER F: I
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR ADDL SUER POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMIDDIYYYY) tMM1DiNYYYYS LIMIT$
A X COMMERCIAL GENERAL LIABILITY 101 GL000316106 12/08/2019 12/0$/202 I EACH OCCURRENCE 62,000,000
CLAIMS -MADE II OCCUR I PREMISES tEa occur° noel $50,000
X BI/PD Ded:500 MED EXP (Any one person) x5,000
PERSONAL & ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $3,000,000
POLICY [ JEC7 LOC I PRODUCTS - OOMPtOP AGG $3,000,000
OTHER; S
AUTOMOBILE LIABILITYBAS57476683 12108/2019 12/08/202 co acBcaen SINGLE LIMIT(Ea $1,000,000
ANY AUTO BODILY INJURY (Per person) $
OWNED
ONLY SCHEDULED
AUTOSBODILY INJURY (Per accoent) $
xHIRED NON -OWNED
X X PROPERTY DAMAGE
AUTOS ONLY ( -- -- -
AUTOS ONLY Per acc'rdentt $
UMBRELLA LIAR OCCUR ( EACH OCCURRENCE I, $
EXCESS LIAR CLAIMS -MADE AGGREGATE I $
DED I I RETENTION$ I I6
B WORKERS COMPENSATION 903611819 12/01/2019 12/0112020 XPER I (OR
AND EMPLOYERS' LIABILITY
YIN 'U'E—
ANYPROPRIETORIPARTNERtEXECUTIVE E.L. EACH ACCIDENT $'1,000,000
OFFICER/MEMBER EXCLUDED? NIA
(Mandatory in NH) I E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E,L. DISEASE - POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1£11, Additional Remarks Schedule, may be attached it more space is required)
City of El Segundo, its officials, and employees are included as additional insured with respect to general
liability as required by written contract per form CG2010 0413 attached. Primary wording applies. Waiver of
Subrogation applies to General Liability per form U047-0310 attached and to Work Compensation per
endorsement ordered and to follow.
CERTIFICATE HOLDER
18111 11634111K.111101,2
City Of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS -
EI Segundo, CA 90245
AUTHORIZED REPRESENTATIVE
Signature not on file.
I
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S26329493/M24857320 TLAMS
101 GL 0003161-06
COMMERCIAL GENERAL LIABILITY
CG 2010 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) Location(s) Of Covered Operations
AS DESIGNATED IN WRITTEN CONTRACT WITH THE All Commercial and/or Residential-Remodel/Repair
NAMED INSURED work as required by written contract with the insured
I Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section I[ — 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.
C. With respect to the insurance afforded to these 2. Available under the applicable Limits of
CG 20 10 04 13 @ Insurance Services Office, Inc., 2012 Page 1 of 2
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
101 GL 0003161-06
Insurance shown in the Declarations;
whichever is less,
This endorsement
Applicable Limits of
Declarations.
shall not increase the
Insurance shown in The
Page 2 of 2 @ Insurance Services Office, Inc,, 2012 CG 20 10 04 13
101 GL 0003161-06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section
IV — Conditions:
We waive any rights of recovery we may have against any person or organization because of payments we
make for injury or damage resulting from your ongoing operations or "your work" done under a contract with
that person or organization and included in the "products -completed operations hazard" if:
a, you agreed to such waiver;
b. the waiver is included as part of a written contract or lease; and
c. such written contract or lease was executed prior to any loss to which this insurance applies.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
U047-0310 Includes copyrighted material of ISO Properties, Inc., Page I of 1
with its permission.
ENDORSEMENT AGREEMENT
WAIVER OF SUBROGATION
9036118-19
RENEWAL
SP
2-83-35-91
PAGE 1
ROME OFFICE
SAN FRANCISCO EFFECTIVE AUGUST 17, 2020 AT 12.01 A.M.
ALL EFFECTIVE DATES ARE AND EXPIRING DECEMBER 1, 2020 AT 12.01 A.M.
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
CORRAL CONSTRUCTION &
5211 E WASHINGTON BLVD STE 2
COMMERCE, CA 90040
ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING,
IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND
WAIVES ANY RIGHT OF SUBROGATION AGAINST,
THE CITY OF EL SEGUNDO
WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS
POLICY IN CONNECTION WITH WORK PERFORMED BY,
CORRAL CONSTRUCTION S
IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN
PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION
OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE
EMPLOYER.
IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH
EMPLOYEES SHALL BE INCREASED BY 03t.
NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND
ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY
OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS IN THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
AUTHQRIZED REPRESENT IVE
SCIF FORM 10217 iREV,4.2018I
AUGUST 24, 2020
PRESIDENT AND CEO
2570
OLD DP 217