PROOF OF INSURANCE (2021 - 2022) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE(MM,DDNYYY)
9/2/2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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.
IMPORTANM If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must 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 Ken Noden, CPCU
-MME
Wigmore Insurance Agency Inc. PHONE (714) 979-6543 FAX Ntl r (71aI54s-z9a3
EMAIL .�........,�...
880 W. 19th St. ADDRESSacommercial@wigmoreins.com
License #0811959 INSURERS„ p_AFFFORDING COVERAGENAIC
Costa Mesa CA 92627 INSURERA Travelers Pro er Cas. Cc of America 25674
INSURED INSURERS:. Houston Casualt Company 42374
RTI Consulting, Inc. INSURERC;
8325 McConnell Ave.
Los Anaaeles CA 90045
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOT\MTHSTANDING 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 LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Awwo
INSR ...M, - u~I POLICY OFF P EXP
T TYPE OF INSURANCE POUCYNUMBER MMIDO MM DI Y'
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE S
2,000,000
A CLAIMS -MADE Ez OCCUR
PRE RSESOEa" I xran sI 5 _ .
1,000, 000
X ''. Y 680-9H276593-21-47 3/30/2021 3/30/2022
MED EXP LAny tidna pa1'S47n $
5,000
PERSONAL S AOV INJURY S
2,000,000
GEN'LAGGREGATE LIMIT APPLIES PER
GENERAL.AGGREGATE S
4,000,000
X POLICY JET E. LOC
w
PRODUCTS_COMNOPAGG $
.._
4,000,000
OTHER:
S
AUTOMOBILE
LIABILITY
Ea SINEnl.,. 'LAIT
$
1,000,000
X
ANYAUTO
BODILY INJURY (Per person)
S
A',
ALL OWNED " SCHEDULED
AUTOS AUTOS
X
Y
BA-9N878B45-20-GRF
9/12/2020
9l12/2021
BODILY INJURY (Per accident I
$
PROPERTY DAMAGE.
P,z asock anKj
$
NON -OWNED
HIREDAUTOS AUTOS
$
UMBRELLAUAB
HCLMM&MADE
OCCUR
EACH OCCURRENCE
S
EXCESS LAS
AGGREGATE
'....$..
DE'D I I RETECaTION S
S
'WOPXERS COMPENSATION
�...
X 'TA1r
AND EMPLOYERS LIABILITY YIN
E.L. EACH�AC'CIDENT
$
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ANY PROPRIETORPPARTNEWEXECUTNE ��^y—�p�
OFFICERIMEMSER, EXCLUDED?
NIA
E.L. DISEASE - EA. EMPLOYEE
$
1,000,4d0
A
(Mandatory in NH) L.T�t...
y
U85K37391A-20-47-G
6/1/202tl
6/1/2021
11ges desuibe under
..."""._
DSCRIPTIONOFOPERATIONS balm
EA.,DISEASE "POLICY LIMIT
S
2,000,000
B
Professional Liability
MCC2023962
6/25/2020
6/25/2021
Each Claim
$1 , 000, 000
Aggregate
$2 , 000 , 000
DESCRIPTION OF OPERATIONS r LOCATIONS P VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER SCHEDULED ADDITIONAL INSURED (ARCHITECTS, ENGINEERS
AND SURVEYORS) FORM CG D3 82 09 15, THIS ENDORSEMENT INCUDES WAIVER OF RIGHTS OF RECOVERY LANGUAGE WHEN
MUIRED BY CONTRACT OR AGREEMENT, CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED (AUTO
LIABILIY) PER AUTO COVERAGE PLUS ENDORSEMENT CA T4 20 02 1S, WORKERS COMPENSATION
POLICY INCLUDES BLANKET
WAIVER OF OUR RIGHTS TO RECOVER FROM OTHERS ENDORSEMENT WC 99 03 76,
THE CITY OF EL SEGUNDO
35O MAIN STREET
EL SEGUNDO, CA 90245
t.r�n�.eL�L.r31 tvn
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 RrPRESENTAn VE
moL.hy W-gmore/K140
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)
COMMERCIAL GENERAL LIABILITY
POLICY NUMBER: 680-9H276593-21-47 ISSUE DATE: 02/12/2021
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SCHEDULED ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSONS OR ORGANIZATIONS:
THE CITY OF EL SEGUNDO
350 MAIN STREET
EL SEGUNDO CA 90245
PROJECT/LOCATION OF COVERED OPERATIONS:
OPERATIONS OF NAMED INSURED
PROVISIONS
1. The following is added to SECTION 11 — WHO IS
AN INSURED:
The person or organization shown in the
Schedule above is an additional insured on this
Coverage Part, but:
a. Only with respect to liability for "bodily injury",
"Property damage" or "personal injury": and
b. If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the "written contract
requiring insurance" applies, or in connection
with premises owned by or rented to you.
The person or organization does not qualify as an
additional insured:
c. With respect to the independent acts or
omissions of such person or organization: or
d. For "bodily injury", "property damage" or
'"personal injury" for which such person or
organization has assumed liability in a
contract or agreement.
The insurance provided to such additional insured
is limited as follows:
e. This insurance does not apply to the
rendering of or failure to render any
"professional services".
f. In the event that the Limits of Insurance of the
Coverage Part shown in the Declarations
exceed the limits of liability required by the
"written contract requiring insurance", the
insurance provided to the additional insured
shall be limited to the limits of liability required
by that "written contract requiring insurance".
This endorsement does not increase the
limits of insurance described in Section III —
Limits Of Insurance.
g. This, insurance does not apply to "bodily
injury" or "property damage"" caused by "your
work" and included in the "products -
completed operations hazard" unless the
"written contract requiring insurance"
specifically requires you to provide such
coverage for that additional insured, and then
the insurance provided to that additional
insured applies only to such "bodily injury" or
"property damage" that occurs before the end
of the period of time for which the "written
contract requiring insurance" requires you to
provide such coverage or the end of the
policy period, whichever is earlier.
CG D3 82 09 13 Q 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 2
Includes the copyrighted material of Insurance Services Office, Inc., with its permission
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COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. The following is added to SECTION 11 — WHO IS
AN INSURED:
Any person or organization that you agree in a
"written contract requiring insurance" to include as
an additional insured on this Coverage Part, but:
a. Only with respect to liability for "bodily injury",
"property damage" or "personal injury"; and
b. If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the "written contract
requiring insurance" applies, or in connection
with premises owned by or rented to you.
The person or organization does not qualify as an
additional insured:
c. With respect to the independent acts or
omissions of such person or organization; or
d. For "bodily injury", "property damage" or
..personal injury" for which such person or
organization has assumed liability in a
contract or agreement.
The insurance provided to such additional insured
is limited as follows:
e. This insurance does not apply an any basis to
any person or organization for which
coverage as an additional insured specifically
is added by another endorsement to this
Coverage Part.
This insurance does not apply to the
rendering of or failure to render any
"professional services".
g. In the event that the Limits of Insurance of the
Coverage Pan shown in the Declarations
exceed the limits of liability required by the
..written contract requiring insurance", the
insurance provided to the additional insured
shall be limited to the limits of liability required
by that "written contract requiring insurance".
This endorsement does not increase the
limits of insurance described in Section III —
Limits Of Insurance.
h. This insurance does not apply to "bodily
injury" or "property damage" caused by "your
work" and included in the "products -
completed operations hazard" unless the
"written contract requiring insurance"
specifically requires you to provide such
coverage for that additional insured, and then
the insurance provided to the additional
insured applies only to such "bodily injury" or
..property damage" that occurs before the end
of the period of time for which the "written
contract requiring insurance" requires you to
provide such coverage or the end of the
policy period, whichever is earlier.
2. The following is added to Paragraph 4-a. of
SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
The insurance provided to the additional insured
is excess over any valid and collectible other
insurance, whether primary, excess, contingent or
on any other basis, that is available to the
additional insured for a loss we cover. However, if
you specifically agree in the "written contract
requiring insurance" that this insurance provided
to the additional insured under this Coverage Part
must apply on a primary basis or a primary and
non-contributory basis, this insurance is primary
to other insurance available to the additional
insured which covers that person or organizations
as a named insured for such loss, and we will not
share with the other insurance, provided that:
(1) The "bodily injury" or "property damage' for
which coverage is sought occurs; and
(2) The "personal injury" for which coverage is
sought arises out of an offense committed-,
after you have signed that "written contract
requiring insurance". But this insurance provided
to the additional insured still is excess over valid
and collectible other insurance, whether primary,
excess, contingent or on any other basis, that is
available to the additional insured when that
person or organization is an additional insured
under any other insurance.
CG D3 8109 15 C 2015 The Travelers Indemnity Company. All rights reserved, Page I of 2
Includes the copyrighted material of Insurance Services Office, Inc., with its permission
COMMERCIAL GENERAL LIABILITY
MilliNno
o ense is commi(,ed,,,,,,,,
4. The following definition is added to the
DEFINITIONS Section:
"Written contract requiring insurance" means that
part of any written contract under which you are
required to include a person or organization as an
additional insured on this Coverage Part,
provided that the "bodily injury" and "property
damage" occurs and the "personal injury" is
caused by an offense committed:
a. After you have signed that written contract,,
b. While that part of the written contract is in
effect; and
c. Before the end of the policy period.
Page 2 of 2 0 2D1 5 The Travelers Indemnity Company. All rights reserved, CG D3 8109 15
Includes the copyrighted material of Insurance Services Office, Inc.. with its permission
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO COVERAGE PLUS ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only, Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BLANKET ADDITIONAL INSURED
B. EMPLOYEE HIRED AUTO
C. EMPLOYEES AS INSURED
D. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
E. TRAILERS —INCREASED LOAD CAPACITY
F. HIRED AUTO PHYSICAL DAMAGE
G. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES —INCREASED LIMIT
A. BLANKET ADDITIONAL INSURED
The following is added to Paragraph A.I., Who Is
An Insured, of SECTION 11—COVERED AUTOS
LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "Insured" for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section 11.
B. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.I.,
Who Is An Insured, of SECTION 11 — COV-
ERED AUTOS LIABILITY COVERAGE:
H. AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT —INCREASED LIMIT
1. WAIVER OF DEDUCTIBLE — GLASS
J. PERSONAL PROPERTY
K. AIRBAGS
L. AUTO LOAN LEASE GAP
M. BLANKET WAIVER OF SUBROGATION
performing duties related to the conduct of
your business,
2. The following replaces Paragraph b. in B,5.,
Other Insurance, of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
permission, while performing duties
related to the conduct of your busi-
ness.
However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".
An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED
operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is
under a contract or agreement in an "em- An Insured, of SECTION 11 — COVERED AUTOS
ployee's" name, with your permission, while LIABILITY COVERAGE:
CA T4 20 02 15 0 2015 The Travelers Indemnity Company, All rights reserved. Page 1 of 3
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COMMERCIAL AUTO
Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.
D. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2) of
SECTION III — COVERED AUTOS LIABILITY
COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.
2. The following replaces Paragraph A.2.a.(4) of
SECTION 11 — COVERED AUTOS LIABILITY
COVERAGE:
(4) All reasonable expenses incurred by the
"Insured" at our request, including actual
loss of earnings up to $500 a day be-
cause of time off from work,
E. TRAILERS —INCREASED LOAD CAPACITY
The following replaces Paragraph C.1. of SEC-
TION I — COVERED AUTOS:
"Trailers" with a load capacity of 3,000
pounds or less designed primarily for travel
on public roads.
F. HIRED AUTO PHYSICAL DAMAGE
The following is added to Paragraph AA., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Hired Auto Physical Damage Coverage
If hired "autos" are covered "autos" for Covered
Autos Liability Coverage but not covered "autos"
for Physical Damage Coverage, and this policy
also provides Physical Damage Coverage for an
owned "auto", then the Physical Damage Cover-
age is extended to "autos" that you hire, rent or
borrow subject to the following:
(1) The most we will pay for "loss" to any one
"auto" that you hire, rent or borrow is the
lesser of:
(a) $50,000;
(2) An adjustment for depreciation and physical
condition will be made in determining actual
cash value in the event of a total "loss".
(3) If a repair or replacement results in better
than like kind or quality, we will not pay for the
amount of betterment,
(4) A deductible equal to the highest Physical
Damage deductible applicable to any owned
covered "auto",
(5) This Coverage Extension does not apply to:
(a) Any "auto" that is hired, rented or bor-
rowed with a driver; or
(b) Any "auto" that is hired, rented or bor-
rowed from your "employee".
G. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense In-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
H. AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT —INCREASED LIMIT
Paragraph CA.b. of SECTION III — PHYSICAL
DAMAGE COVERAGE is deleted.
1. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
J. PERSONAL PROPERTY
The following is added to Paragraph A.4., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Personal Property Coverage
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which is:
(b) The actual cash value of the damaged or (1) Owned by an "insured"; and
stolen property as of the time of the (2) In or on your covered "auto".
"loss"; or This coverage only applies in the event of a total
(c) The cost of repairing or replacing the theft of your covered "auto".
damaged or stolen property with other No deductibles apply to Personal Property cover -
property of like kind and quality. age.
Page 2 of 3 @ 2015 The Travelers Indemnity Company. All rights reserved. CA T4 20 02 15
Includes copyrighted material of Insurance Services Office, Inc. with its permission
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K. AIRBAGS
The following is added to Paragraph 8.3., Exclu-
sions, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.I.b. and A.I.c., but
only:
a. if that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "loss".
L. AUTO LOAN LEASE GAP
The following is added to Paragraph AA., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Auto Loan Lease Gap Coverage for Private
Passenger Type Vehicles
In the event of a total "loss" to a covered "auto" of
the private passenger type shown in the Schedule
or Declarations for which Physical Damage Cov-
erage is provided, we will pay any unpaid amount
due on the lease or loan for such covered "auto"
less the following:
(1) The amount paid under the Physical Damage
Coverage Section of the policy for that "auto";
and
CA T4 20 02 15
COMMERCIAL AUTO
(2) Any:
(a) Overdue lease or loan payments at the
time of the"loss";
(b) Financial penalties imposed under a
lease for excessive use, abnormal wear
and tear or high mileage;
(c) Security deposits not returned by the les-
sor;
(d) Costs for extended warranties, Credit Life
Insurance, Health, Accident or Disability
Insurance purchased with the loan or
lease; and
(e) Carry-over balances from previous loans
or leases.
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the ex-
tent required of you by a written contract exe-
cuted prior to any "accident" or "loss", pro-
vided that the "accident" or "loss" arises out of
the operations contemplated by such con-
tract. The waiver applies only to the person or
organization designated in such contract,
0 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 3
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WORKERS COMPENSATION
TRAVELERSI' AND
ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183
ENDORSEMENT WC 99 03 76 ( A) - 001
POLICY NUMBER: UB-5K37391A-20-47-G
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
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.
The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre-
mium.
Person or Organization
ANY PERSON OR ORGANIZATION FOR
WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED
PRIOR TO LOSS TO FURNISH THIS
WAIVER.
Schedule
ENGINEERS
Job Description
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 Policy No. Endorsement No.
Insured Premium
Insurance Company
DATE OFISSUE: 04-17-20 ST ASSIGN:
Countersigned by
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