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PROOF OF INSURANCE (2021 - 2021) CLOSEDClient#: 394653 RPLAURAI ACORDTM CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDD/YYYY) 3/03/2020 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 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 i fcaAME1 .T Joyce Williams i USI Insurance Services LLC PHONE FM AMC,. �? .90':949 790-9290 � IQ, N,p), 484,652-5044 .. ... A MAIL joyce.williams@usi.com 7535 Irvine Center Dr. Suite 250 "p8''`' INSURER(S) AFFORDING COVERAGE NAIC # Irvine, CA 92618 INSURER A : thio Security Insurance Company 24082 ............... INSURED ................................................................. INSURER B Fire ., an FirPBY Casualty Company .......... L24066 R.P. Laurain $ Associates Inc. INSURER c Preferred to s Company 0.9 00 3353 Linden Avenue #200 .._____ _._._._._._ ._..--- INSURER D nlmarraa nam NmRe�nnr141840 Long Beach, CA 90807 INSURERE: �.............................................� INSURER F: 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. LTR' COMMERCIAL GENERAL LIABILITY IN:....'.'.0 . .. .. POLICY EFF POLICY EXP I. Udlk """ "' INSURANCE f(, ,(,____________........._ .................w.._.n._..... 2/11/2020 02/11/202111,EAC.H„OCCU,RRENCE........................�5 2 I TYPE OF INSU BZS56359287 $2 0,00 OOO POLICY NUMBER (MM/DD/YYYYI_IMM/DD/YYYYI A .. XII .......... �n. ...... ._...u..W......ISES,(Ea occurrence) ._......... .. ��............................ DAMAGE$300 00 TO RENTED 0 CLAIMS -MADE .00CUR PREM.....w............................................... -.... one ............................_. --. .PERSONALA& ADV INJURY .15 on) $,000 _2,000,000 ... GENERAL AGGREGATE ,$ 00,000 _GE�'LAGGRE'U'..................................... .. p . O..... JECOT LOC PRODUCTS :.. M...�O....,,A,, ... ......,r..__.... POLICY � C PAGG ,$4,000,000 OTHER: D AUTOMOBILE LIABILITY ..............................................................................................................................._..... AW3A89863204 02/11/2020 02/11/2021 COMBINED SINGLE �.IMaT REa a�CA:ddeinE) s1,000,000 X ANY AUTO BODILY INJURY (Per person) $ '�..'........'OWNED .'X'....SCHEDULED ONLYJURY(Per AUTOS -CINAUTOS accident) $ X HIRED NON -ODD .......................... PRA0�fFbAMAGE ........_........$AUTOS ONLY ONLY AUTOS er anil ..B _...X UMBRELLA LIAB X I OCCUR USA56359287....... ........................................XXX..O2/11/202O.u02/11/2021 EACH OCCURRENCE $5,000,000 EXCESS S LIAR CLAIMS-MAD,E AGGREGATE $5 OOO,OOO N $1 OOOO $ _. C ..... .H....X.. Y.........._......TIO .............__..._.�... WORKERS COMP ENSATIO WKN1653063 PER.. �..�........_..............................._a.... X...�._._ ...� .......-u ............... 02/11/2020 02/1112021 Y / N ....................� ............. ANDEMPL I ECUTIVE� E.L..EACH ACCIDENT $1,000,000 OFFICERIIMEMSER FXCLU LO7 N I A (mandatory in NH,) E.L DISEASE - EA EMPLOYEE' $1,000,000 If yes, describe under „D•ESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY,LIMIT $,1 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of EI Segundo, its officials, and employees are named as additional insureds as respects General Liability as per written contract. Primary and Non -Contributory Wording applies. ow CE'RTIFIC'ATE HOLDER CANCELLATION Cit of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Office of the City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Mona Shilling 350 Main Street AUTHORIZED REPRESENTATIVE EI Segundo, CA 90245 �� a lo(«�Cr-r, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S28122284/M27596029 JMWJB BUSINESSOWNERS BP 79 96 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SUBJECT PAGE AGGREGATE LIMITS OF INSURANCE 3 AMENDMENT OF INSURED CONTRACT DEFINITION 4 BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 2 BODILY INJURY 4 BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU 2 DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 4 INCIDENTAL MEDICAL MALPRACTICE 2 MOBILE EQUIPMENT 2 NEWLY FORMED OR ACQUIRED ORGANIZATIONS 3 PERSONAL AND ADVERTISING INJURY 4 SUPPLEMENTARY PAYMENTS 2 Bail Bonds Loss Of Earnings © 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 Section II - Liability is amended as follows: I. SUPPLEMENTARY PAYMENTS Paragraph f.(1)(b) of A Coverages is replaced by the following; (b) Up to $3000 for cost of bail bond required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to furnish the bonds. Paragraph 1.f.(1)(d) of A Coverages is replaced by the following; (d) All reasonable expenses incurred by the insured at our request to assist us in the Investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off r� from work. II. BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU With respect to the coverage provided under this endorsement, Section II - Liability is amended as follows: ..... 1. The final paragraph of B.1. Exclusions - Applicable To Business Liability Coverage is deleted and replaced by the following: With respect to the premises which are rented to you or temporarily occupied by you with the permis- sion of the owner, Exclusions c., d., e., g., h., k., I., m., n. and o. do not apply to "property damage". 2. Paragraph D.2. Liability And Medical Expenses Limits Of Insurance is deleted and replaced by the _ following: The most we will pay under this endorsement for the sum of all damages because of all "property damage" to premises while rented to you or temporarily occupied by you with the permission of the owner is the Limit of Insurance shown in the Declaration. 3. Paragraph D.3. Liability And Medical Expenses Limits Of Insurance is deleted. III. INCIDENTAL MEDICAL MALPRACTICE Exclusion 1.j.(4) does not apply to Incidental Medical Malpractice Injury coverage. N The following is added to F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS: 23. 'Incidental Medical Malpractice Injury" means bodily injury arising out of the rendering of or failure to render, during the policy period, the following services: a. medical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food or bev- erages in connection therewith; or b. the furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. This coverage does not apply to: 1. expenses incurred by the insured for first- aid to others at the time of an accident and the Duties in the Event of Occurrence, Claim or Suit Condition is amended accordingly; 2. any insured engaged in the business or occupation of providing any of the services described under a. and b. above; a 3. injury caused by any indemnitee if such indemnitee is engaged in the business or occupation of providing any of the services described under a. and b. above. IV. MOBILE EQUIPMENT 1. Section C. Who is An Insured is amended to include any person driving "mobile equipment' with your permission. V. BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 1. Section C. Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy under a written contract or written agreement. The written contract or agreement must be: a. currently in effect or becoming effective during the term of this policy; and b. executed prior to the "bodily injury", "property damage", "personal and advertising injury". © 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4 9 2. The insurance provided the additional insured is limited as follows: a. The person or organization is only an additional insured with respect to liability arising out of (1) Real property, as described in a written contract or written agreement, you own, rent, lease, maintain or occupy; (2) Caused in whole or in part by your ongoing operations performed for that insured. b. The limits of insurance applicable to the additional insured are those specified in the written contract or written agreement or the limits available under this policy, as stated in the Declara- tions, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. c. The insurance provided the additional insured does not apply to: (1) Liability arising out of the sole negligence of the additional insured; (2) "Bodily injury", "property damage", "personal and advertising injury"; or defense coverage under the Supplementary Payments section of the policy arising out of an architect's, en- gineer's or surveyor's rendering of or failure to render any professional services including: (a) The preparing, approving maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (3) Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Declarations; or (4) Structural alterations, new construction or demolition operations performed by or for the person or organization designated in the Declarations. 3. Any coverage provided hereunder shall be excess over any other valid and collectible insurance avail- able to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be primary or you request that it apply on a primary basis. VI. NEWLY FORMED OR ACQUIRED ORGANIZATIONS The following is added to C. Who Is An Insured: 3. Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States of America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no similar insurance available to that entity. However, a. Coverage under this provision is afforded only until the 180th day after the entity was acquired or incorporated or organized by you or the end of the policy period, whichever is earlier; b. Coverages A. Paragraph 1. Business Liability, does not apply to: (1) "Bodily injury" or "property damage" that occurred before the entity was acquired or incor- porated or organized by you; and (2) "Personal and advertising injury" arising out of an offense committed before the entity was acquired or incorporated or organized by you; and c. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. VII. AGGREGATE LIMITS The following is added to Aggregate Limits Paragraph 4. of D. Liability and Medical Expenses Limits of Insurance: The Aggregate Limits apply separately to each of "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. The Aggregate Limits also apply separately to each of your projects away from premises owned by or rented to you. For the purpose of this endorsement only, "location" means premises involving the same or connect- ing lots, or premises whose connection is interrupted only by a street, roadway, waterway or right- of-way of a railroad. m 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 3 of 4 VIII. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 1. The requirement in E. Liability And Medical Expenses General Conditions paragraph 2.a. that you must see to it that we are notified of an "occurrence" or offense which may result in a claim applies only when the "occurrence" is known to any insured listed in Paragraph CA. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. 2. The requirements in E. Liability And Medical Expenses General Conditions paragraph 2.b. that you must see to it that we receive notice of a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to any insured listed under Paragraph C.1. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. IX. BODILY INJURY Paragraph 3. of F. Liability And Medical Expenses Definitions is replaced by the following: 3. "Bodily Injury" means: a. Bodily injury, sickness, disease, or incidental medical malpractice injury sustained by a person, and includes mental anguish resulting from any of these; and including death resulting from any 81 of these at any time. X. AMENDMENT OF INSURED CONTRACT DEFINITION = Paragraph 9. of F. Liability And Medical Expenses Definitions is replaced by the following: 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract'; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition oper- ations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indem- nification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "property damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be considered an "insured contract" to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construc- tion or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: N (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. XI. PERSONAL AND ADVERTISING INJURY Paragraph 14. b. of F. Liability And Medical Expenses Definitions is replaced by the following: b. Malicious prosecution or abuse of process. m 2013 Liberty Mutual Insurance. All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4 CERTIFICATE OF INSURANCE Producer: Issue Date: 11/19/2020 Office of the City Clerk This Certificate is issued as a matter of information only and LTA ADMINISTRATORS & INSURANCE SERVICES confers no rights upon the Certificate Holder. This Certificate P.O. Box 1319 does not amend, extend or alter the coverage afforded by the Santa Barbara, CA 93102-1319 policy below. Insured: 103082 Cf')NIPANY AFI°"ORDJNG COVERAGE LAURAIN, R.P. & ASSOCIATES, INC. 3353 Linden Avenue Suite 200 Aspen American Insurance Company Long Beach, CA 90807 Fax Number: 562-988-2927 Authorized Representative This is to certify that the policy of insurance listed below has been issued to the Insured named above for the policy period indicated. Notwithstanding any recluirenient, teras ot, Condition of ony contract or other document with respect to which this Certificate may be issued or may pert4it the insurance A16rded by the policy described herein is subject to all the terms, exclusions and conditions a:i'.such policy, Limits shown niay have been reduced by paid claims, DISCLAIMER: This certificate of insurance does not affirmatively or negatively amend, extend, or alter the coverage afforded by the insurance policy. TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMITS Professional Liability AAI004109-06 12/07/2020 12/07/2021 Each Claim $ 1,000,000 General Aggregate $ 2,000,000 Description of Operations/Locations/Special Items: REAL ESTATE APPRAISERS PROFESSIONAL LIABILPI'Y INSURANCE Certificate Holder: Cancellation: City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Office of the City Clerk BE CANCELLED BEFORE THE EXPIRATION DATE Attn: Mona Shilling THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 LIA0001 (11/97) Certificate Holder Copy Workers Compensation and Employers Liability rreferred Ep Insurance Policy iµ..,N. S.,U MuR.,u.A..eN, C „E c;%'> M P A N Y Waiver of Our Right to Recover from Others Endorsement — California 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 determined by multiplying the California workers' compensation premium due on such remuneration by the factor 0.050. Schedule Person or Organization City of EI Segundo Office of the City Clerk 350 Main Street EI Segundo, CA 90245 !tt«77rT-TTMIMfM RE: contract requirement for appraisals at various sites This endorsement is subject to a minimum premium charge of $200 Nothing in this endorsement shall vary, alter, waive or extend any of the terms, conditions or limitations of this policy other than as stated above. Nothing elsewhere in this policy shall be held to vary, alter, waive or limit the terms, conditions, agreements or limitations of this endorsement. This Endorsement when attached to Policy Number: WKN 165306-3 issued to R P, LAURAIN & ASSOCIATES, INC shall be valid and shall form part of referenced policy, The effective date of this endorsement is 02/11/20 at 12:01 A M Endorsement No.: 36 Producer Number: 96020 Agency Name: USI INSURANCE SERVICES, LLC PE1104 05/01/98 Date Issued: 03/06/20 Refer To Signature Page Authorized Representative