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PROOF OF INSURANCE (2022 - 2022) CLOSEDACCORD® CERTIFICATE OF LIABILITY INSURANCE �....•�� DATE(MM/DD/YYYY) 3/18/2021 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER GMGS Risk Management & Insurance Services 6201 Oak Canyon, Suite 100 Irvine, CA 92618 CONT NAMEACT Charise Ferguson a°NNo, Ext : 949 559-3367 A/C No): 949 559-6703 E-MAIL ADDRESS: charisef@gmgs.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Travelers Indemnity Company of Connecticut 25682 www.gmgs.com OB84519 INSURED Alcorn Fence Company (Riverside Office) Alcorn Fence Company dba: Atlas Fence Company 9901 Glenoaks Boulevard INSURER B : Travelers Property Casualty Co of America 25674 INSURERC: INSURERD: Sun Valley CA 91352 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 60707891 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A �/ COMMERCIAL GENERAL LIABILITY DT22-CO-2394A522-TCT-21 2/28/2021 2/28/2022 EACH OCCURRENCE $2,000,000 CLAIMS -MADE 11/1 OCCUR DA PREM SESOEa occurrDence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $4,000,000 POLICY ❑PRO JECT ❑ LOC PRODUCTS - COMP/OPAGG $4,000,000 $ OTHER: A AUTOMOBILE LIABILITY 810-908OX583-21-26-G 2/28/2021 2/28/2022 Ee aBINEDtSINGLE LIMIT $ 1 000 000 ✓ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ PR E Peorr acdenDAMAGE $ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY Comp Ded $1,000 $ Coll Ded $1,000 UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE UB-3K109874-20-26-G UB-31<109874-21-26-G 4/1/2020 4/1/2021 4/1/2021 4/1/2022 �/ SPER TATUTE OERH E.L. EACH ACCIDENT $ 1 ,000,000 OFFICE R/M EMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1 000 000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: AFC# L3944; Stevenson Field Fence Repairs Project; Holly Ave. & Eucalyptus Dr., El Segundo, CA 90245 This certificate may be relied upon only if the certificate addendum referred to herein is attached hereto. CERTIFICATE HOLDER CANCELLATION AFC# L3944 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo CA 90245 AUTHORIZED REPRESENTATIVE �. ✓✓�� �L Steve Mosier ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 60707891 121-22 A-PD/G/W/1J35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 1 of 8 AGENCY CUSTOMER ID: LOC #: ACCOR 0 ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED GMGS Risk Management &Insurance Services Alcorn Fence Company (Riverside Office) Alcorn Fence Company dba: Atlas Fence Company POLICY NUMBER 9901 Glenoaks Boulevard Sun Valley CA 91352 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of El Segundo ADDRESS: 350 Main Street El Segundo CA 90245 RE: AFC# L3944; Stevenson Field Fence Repairs Project; Holly Ave. & Eucalyptus Dr., El Segundo, CA 90245 As respects General Liability coverage, The City, its officers, officials, employees, agents, and volunteers are added as Additional Insured per CGD2460419 attached, and this insurance is primary per CGT1000219 attached. As respects General Liability coverage, a $5,000 Property Damage Deductible applies Per Occurrence. As respects Automobile Liability coverage, The City, its officers, officials, employees, agents, and volunteers are added as Additional Insured per CAT3530215, and this insurance is primary, per CAT4990216 attached. As respects Automobile Liability coverage, a $1,000 Property Damage Deductible applies Per Accident. As respects Workers' Compensation coverage, a Waiver of Subrogation is hereby included, per WC990376 (A)-001 attached. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 60707891 121-22 A-PD/G/W/U35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 2 of 8 Alcorn Fence Company (Riverside Office) Alcorn Fence Company dba: Atlas Fence Company DT22-CO-2394A522-TCT-21 COMMERCIAL GENERAL LIABILITY BLANKETADDITIONAL •d ucts-Com pletedOperations If Required By C This endorsement modifies insurance provided underthe following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury' or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such 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 or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury' arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 0419 0 201 B The Travelers Indemnity Company. All rights reserved. Page 1 of 2 60707891 121-22 A-PD/G/W/U35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 3 of 8 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 ® 2018 The Travelers Indemnity company. All rights reserved. CG D2 46 0419 60707891 121-22 A-PD/G/W/U35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 4 of 8 Alcorn Fence Company (Riverside Office) Alcorn Fence Company c1ba: Atlas Fence Company DT22-CO-2394A522-TCT-21 If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Non -Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an 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 that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury' or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury' for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Cowrage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. a. The statements In the Declarations arIII, accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The u-ii-tte-stional a-vor 1111W.1111MAININ =11F i inIPM WM171111(4. MIGIFF—TiFiRLHIF pWFQMisiQn does not affect our right to collect additional MMLZM,EJMLeA Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce them. If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1 . "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, ands us copies at such times means of communication; and as we may request, b. Regarding websites, only that part of a website 6® Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 O 2017 The Travelers Indemnity Company. All rights reserved, CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 60707891 1 21-22 A-PD/G/W/U35/Eq-RL I Charise Ferguson 1 3/18/2021 7:47:30 AM (PDT) I Page 5 of 8 Alcorn Fence Company (Riverside Office) 810-9080X583-21-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION 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. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COW ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.7., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 150th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — 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 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS 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 II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COW ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 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 CA T3 53 02 15 ® 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 60707891 121-22 A-PD/G/W/1J35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 6 of 8 COMMERCIAL AUTO Alcorn Fence Company (Riverside Office) Alcorn Fence Company dba: Atlas Fence Company 810-9080X583-21-26-G ki • • " o] • - . This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II -- COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". The following is added to Paragraph B.5., Other Insurance of SECTION CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5.Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 to 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 60707891 121-22 A-PD/G/W/U35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 7 of 8 - ^ WORKERS COMPENSATION JI AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: 1_113-31<109874-20-26-G UB-3K109874-21-26-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. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 4/1/2020 Policy No. 1_113-31<109874-20-26-G Endorsement No. Insured Alcorn Fence Company (Riverside Office) Premium Alcorn Fence Company dba: Atlas Fence Company Insurance Company Countersigned by, DATE OF ISSUE: 03-14-19 ST ASSIGN: 60707891 121-22 A-PD/G/W/1J35/Eq-RL I Charise Ferguson 13/18/2021 7:47:30 AM (PDT) I Page 8 of 8 Page 1 of 1