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PROOF OF INSURANCE (2021 - 2021) CLOSEDDATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/30/2020 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(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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT GMOS Risk' Management & Insurance Services Jennifer Barton........................... ........................_..................._ .Art �N�dl: 9�...................... g NAME; Jennifer Barto 8201 Oak Canyon, Suite 100 PHONE FAX 949-559-6703 Irvine, CA 92818 M�f� ala= ienmferbCoNmos,cDm INSURER(S AFFORDING COVERAGE NAIC# www.gmgs.com OB84519 INSURED EEC Environmental d5a Enviromental Engineering Contracting Inc., One City Boulevard West, Suite 1800 Orange CA 92888 ur INSURERA: Great Divide Insurance ,.m aCompany INSURER B: American Fire and Casualtv Company INSURERC: Nautilus Insurance Companv INSURER D: INSURER E : INSURER F: 25224 24066 17370 COVERAGES CERTIFICATE NUMBER: 58383149 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRNSR .............. ADDL�SUBR ....... _._..POLIC EFF POLICY EXP _._._ TYPE OF INSURANCE POLICY NUMBER IMM lD LIMITS P rYYYYI_IMMFDDiYYYY) A ,V COMMERCIAL GENERAL LIABILITY iGLP2006942-18 10/31/2020 10/31/2021 EACHOCCURRENCE $5,000,000 CLAIMS -MADE I '� N OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRG $ 300.000 MED E . POLICY JECT LOC $ 5.000,000 OTHER, $5,000,000 AUTOMOBILE LIABILITY $ 5,000,000 ANY AUTO OWNED SCHEDULED AUTOS ONLY ., AUTOS HIRED NON -OWNED AUTOS ONLY 1__L AUHTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPR IETOR/PARTN ER/EXECUTI VE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below C Pollution Liability Professional Liability BAA(21)58333458 WCA200881517 YIN FNIA CCP2006941-18 "'6AlGftiGl='irk' E N"t E PRE mMISES-("Ea occurrence) $ 300.000 MED E . PERSONAL 8 ADV INJURY $ 5.000,000 GENERALAGGREG_ATE- $5,000,000 PRODUCTS - COMP/OP AGG $ 5,000,000 10/31/2020 10/31/2021CO uBBINEiD SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ �PROPERT'YDAMAGE $ dPat acodenli EACH OCCURRENCE $ AGGREGATE $_ - 5/24/2020 5/24/2021 (STATUTE d IOERH .,, _�.,.._.a_..,_... E,L EACH ACC.....IDENT $1,000,000 II E L DISEASE - EA EMPLOYEE( $ 1.000,000 E.L. DISEASE - POLICY LIMIT $1 „000,000 10/31/2020 10/31/2021 Each Poll Occurrence $5,000,000 Each Prof Liab Claim $5,000,000 General Aggregate: $10,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) RE: Sewer System Management Plan As resppects General Liability coverage, City of EI Segundo, its officials and employees are added as Additional Insureds per CG20100413 and CG20, 01219 and CG20371219 attached, and this insurance is primary per CG20011219 attached. As respects Automobile Coverage, Business Auto Coverage Form CA00011001 applies. As respects Workers" Compensation coverage„ a Waiver of Subrogation is hereby included pper WC040'306 attached. As respects General Liability coverage, 30 -day written notice of cancellation (10 days for non-payment of premium) applies per IL001711'98 attached, CERTIFICATE HOLDER CANCELLATION Sewer System Management Plan SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityy of EI Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street EI Segundo CA 90245 AUTHORIZED REPRESENTATIVE I Griff Griffith ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 58383149 120-21 G/A/UMB/POLL/E&O/WC I Jennifer Barton 110/30/2020 1:48:06 PM (PDT) I Page 1 of 7 EEC Environmental POLICY NUMBER: GLP2006942-18 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURE - 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, organization, or project with whom the named insured executes a written contract prior to the start of the project and is shown on a certificate of insurance issued by our authorized representative prior to the start date of the project Location(s) Of Covered Operations 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", "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. CG 20 10 12 19 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 Insurance Services Office, Inc., 2018 58383149 1 20-21 G/A/UMB/POLL/E&O/WC I Jennifer Barton 1 10/30/2020 1:48:06 PM (PDT) I Page 2 of 7 Page 1 of 2 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; whichever is less. This endorsement shall applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 56383149 1 20-21 G/A/UMB/POLL/E&O/WC I Jennifer Barton 110/30/2020 1:46:06 PM (PDT) I Page 3 of 7 not increase the CG 20 10 1219 EEC Environmental POLICY NUMBER: GLP2006942-18 COMMERCIAL GENERAL LIABILITY CG 20 37 1219 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(s) Or Orgianization(s) Any person, organization, or project with whom the named insured executes a written contract prior to the start of the project and is shown on a certificate of insurance issued by our authorized representative prior to the start date of the project Location And Description Of Completed Operations 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 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. CG 20 37 12 19 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 insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. © Insurance Services Office, Inc., 2018 58383149 1 20-21 G/A/UMB/POLL/E&O/WC I Jennifer Barton 1 10/30/2020 1:48:06 PM (PDT) I Page 4 of 7 Page 1 of 1 EEC Environmental dba Enviromental Engineering Contracting Inc., GLP2006942-18 COMMERCIAL GENERAL LIABILITY CG 20 01 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 58383149 1 20-21 G/A/UMB/POLL/E&O/WC I Jennifer Barton 110/30/2020 1:48:06 PM (PDT) I Page 5 of 7 EEC Environmental dba Enviromental Engineering Contracting Inc., COMMON 'POLICY CONDITIONS All Coverage Parts Included in this policy are subject to the following conditions. A- Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliver- ing to the first Named Insured wrrdeni notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation_ The policy period will end on that date. S. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than ,pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concming the insurance afforded. The first Named Insured shown In the Declarations Is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement Issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and re- cords as they relate to this policy at any time dur- Ing the policy period and up to three years after- ward - D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 00 17 11 98 IL 00 17 11 98 It. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2, of this condition apply not only to us, bort also to any rating, advisory, rate service or similar organization which makes In- surance Inspections, surveys, reports or rec- ommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reportsor recom- mandations we may make relative to cerlifica- tion, under state or municipal statutes, ordf nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your nights and duties under this policy may not be transferred without our written consent except In the case of death of an individual named insured. If you die., your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive, Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright, insurance Services Office, Inc., 1998 58383149 120-21 c/x/UMB/P01,1,/Ek0/wc I Jennifer Barton 110/30/2020 1:48:06 PM (PDT) I Paye 6 of 7 Page 1 of 1 D WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 04 84 NT1.11 NA ZVOI&O111 Okla N [cl: I S Kom N mm i 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 0.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization As required by written contract This endorsement changes the policy 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 5/24/2020 Insured EEC Environmental Insurance Company: Great Divide Insurance Company Policy No. WCA200881517 Countersigned by Endorsement No. WC 04 03 06 04 84 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual 2001. 50383149 1 20-21 G/A/UMB/POLL/E&O/WC I Jennifer Barton 1 10/30/2020 1:40:06 PM (PDT) I Page 7 of 7 Premium Page 1 of 1