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ICRMA 2019 - State of California Caltrans, Div of Traffic Operations District 07 Independent Cities Risk Management Authority 18201 Von Karman Ave., Suite 200, Irvine, CA 92612 949.349.9882 Liability Certificate ofCoverage Additional Covered Party Certificate Number: 2018-0076 Certificate Holder: State of California/Caltrans; Division of Traffic Operations District 07 Attn: Michael Sarieh, P.E. 100 S. Main Street, MS 09 Los Angeles,CA,90012 Covered Party: City of El Segundo Description of Use of Caltrans facilities for El Segundo Fire Department's tiller truck driver training. The State of California/Caltrans Covered Activity: is an additional covered party with regard to any negligent acts or omissions of the City of El Segundo, its officers, officials, employees and volunteers. Memorandum of ICRMA GL 2018 Coverage Number: Effective Date: 7/1/18 Expiration Date: 7/1/19 Limits: $1,000,000 (per occurance) Self-Insured Retention: $ 750,000 The Following General and automobile liability asdefined in the memorandum of coverage on file with the covered party Coverage is in named above. Sexual misconduct not specifically excludedfor the city. effect: This is to certify that the coverage listed above has been issued to the Covered Party named above for the coverage 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 coverage afforded as described herein is subject to all the terms, exclusions, and conditions of the Liability Memorandum of Coverage of the ICRMA, which is available for your review upon request. Pursuant to the definition of Covered Party in the Liability Memorandum of Coverage, the certificate holder named above is an additional covered party for covered claims arising out of the covered activity stated above and is subject to the limits stated above. *Such limits are inclusive of the city’s SIR. Coverage is in effect from 12:01 a.m. Pacific Standard Time of effective date to12:01 a.m. Pacific Standard Time of expiration date as stated above and will not be canceled, limited, or allowed to expire except upon 30-day notice to the certificate holder. Date Issued: 7/4/2018 Renewal: Yes Authorized Representative Signature: