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PROOF OF INSURANCE (2021) CLOSEDACoR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/1 /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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: HONE A/CC. Ext : (888) 780-5381 FAX No : (866) 828-2424 ADDRESS: Certificate@Hanover.com WILLIS TOWERS WATSON MIDWEST INC INSURER(S) AFFORDING COVERAGE NAIC# 233 S WACKER DR,SUITE 2000 INSURERA: Citizens Ins Cc of America 31534 CHICAGO IL 60606 INSURED INSURER B : Hanover Insurance Cc 22292 INSURERC: Hanover American Ins Cc 36064 INSURERD: BUCKNAM INFRASTRUCTURE GROUP INC INSURER E 3548 SEAGATE WAY STE 230 INSURER F : OCEANSIDE CA 92056 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 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 ✓ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE W] OCCUR DA PREM SESOEa occurrDence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 2,000,000 A Y Y OBC A399956 06 09/16/2020 09/16/2021 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY Z PRO- JECT ❑ LOC PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y N OBC A399956 06 09/16/2020 09/16/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ VHIRED V / NON -OWNED AUTOS ONLY V AUTOS ONLY ✓ UMBRELLALIAB ✓ OCCUR EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 A EXCESS LIAB CLAIMS -MADE Y Y OBC A399956 06 09/16/2020 09/16/2021 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICE R/MEMBER EXCLUDED? � (Mandatory in NH) N/A Y WZC A399946 06 09/16/2020 09/16/2021 / PER OTH- V STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Architects & Engineers Prof Liab N N LHC H023717 01 09/16/2020 09/16/2021 Claims -Made: $2M Ea Claim/$2M Agg DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of El Segundo, its officials and employees are Additional Insured on the General Liability pursuant to the terms and conditions by form 391-1586. Additional Insured is primary to the extent provided by form 391-1586. Waiver of Subrogation as provided by form 391-1003 (pg 80 of 81) and WC040306. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF EL SEGUNDO ATTENTION: STEPHANIE KATSOULEAS, P.E. AUTHORIZED REPRESENTATIVE 350 MAIN STREET EL SEGUNDO CA 90245 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: BUSINESSOWNERS COVERAGE FORM injury and advertising injury". A. Additional Insured by Contract, Agreement or Permit (2) To any person or organization included The following is added to SECTION II - as an insured by another endorsement issued by us and made part of this LIABILITY, C. Who Is An Insured: Coverage Part. Additional Insured by Contract, Agreement or (3) To any lessor of equipment: Permit a. Any person or organization with whom you (a) After the equipment lease expires; agreed in a written contract, written or agreement or permit that such person or (b) If the "bodily injury", "property organization to add as an additional insured damage", or "personal and on your policy is an additional insured only advertising injury" arises out of sole with respect to liability for "bodily injury", negligence of the lessor "property damage", or "personal and (4) To any: advertising injury" caused, in whole or in part, by your acts or omissions, or the acts (a) Owners or other interests from or omissions of those acting on your behalf, whom land has been leased if the "occurrence" but only with respect to: or offense takes place or the offense is committed after (1) "Your work" for the additional insured(s) the lease for the land expires; or designated in the contract, agreement "bodily (b) Managers or lessors of premises if: or permit including injury" or "property damage" included in the (i) The"occurrence" takes place or "products -completed operations hazard" the offense is committed after only if this Coverage Part provides such you cease to be a tenant in that coverage. premises; or (2) Premises you own, rent, lease or occupy; (ii) The "bodily injury", "property or damage", "personal injury" or (3) Your maintenance, operation or use of advertising injury arises out of structural alterations, new equipment leased to you. construction or demolition b. The insurance afforded to such additional operations performed by or on insured described above: behalf of the manager or lessor. (1) Only applies to the extent permitted by (5) To "bodily injury", "property damage" or law; and "personaland advertising injury"arising (2) Will not be broader than the insurance out of the rendering of or the failure to which you are required by thecontract, render any professional services. agreement or permit toprovidefor such This exclusion applies even if the claims additional insured. against any insured allege negligence (3) Applies on a primary basis if that is or other wrongdoing in the supervision, required bythe written contract, written hiring, employment, training or agreement or permit. monitoring of others by that insured, if the "occurrence" which caused the 4 Will not be broader than coverage () 9 "bodily injury" or "property damage" or provided to any other insured. the offense which caused the "personal (5) Does not apply if the "bodily injury", and advertising injury" involved the "property damage" or "personal and rendering of or failure to render any advertising injury" is otherwise professional services by or for you. excluded from coverage under this d. With respect to the insurance afforded to Coverage Part, including any these additional insureds, the following is endorsements thereto. added to SECTION II - LIABILITY, D. Liability c. This provision does not apply: and Medical Expense Limits of Insurance: (1) Unless the written contract or written The most we will pay on behalf of the agreement was executed or permit was additional insured for a covered claim is the issued prior to the "bodily injury", lesser of the amount of insurance: "property damage", or "personal 391-1586 0816 Includes copyrighted material of Insurance Services Offices, Inc., with its permission. Page 1 of 2 1. Required by the contract, agreement or permit described in Paragraph a.; or 2. Available under the applicable Limits of Insurance shown in the Declarations. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations B. Aggregate Limits of Insurance per Project or per Location The following changes are made to SECTION II - LIABILITY: 1. The following is added to SECTION II - LIABILITY, D. Liability and Medical Expenses Limits of Insurance, paragraph 4: The Aggregate Limits of Insurance apply separately to each of "your projects" or each "location" listed in the Declarations. 2. For the purpose of coverage provided by this endorsement only, the following is Hanover Insurance Group- OBCA399956 1309570 added to SECTION I I -LIABILITY, F. Liability And Medical Expenses Definitions: 1. "Your project' means: a. Any premises, site or "location" at, on, or in which "your work" is not yet completed; and b. Does not include any "location" listed in the Declarations. 2. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 391-1586 0816 Includes copyrighted material of Insurance Services Offices, Inc., with its permission. Page 2 of 2 insured's rights against all those other insurers. c. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self -insured amounts under all that other insurance. d. We will share the remaining loss, if any, with any other insurance that is not described in this provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations for this Coverage. e. Method of Sharing 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. f. When this insurance is excess, we will have no duty under Business Liability Coverage to defend any claim or "suit" that any other insurer has a duty to defend. If no other insurer defends, we will undertake to do so; but we will be entitled to the insured's rights against all those other insurers. Premiums 1. The first Named Insured shown in the Declarations: a. Is responsible for the payment of all premiums; and b. Will be the payee for any return premiums we pay. 2. The premium shown in the Declarations was computed based on rates in effect at the time the policy was issued. On each renewal, continuation or anniversary of the effective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. 3. With our consent, you may continue this policy in force by paying a continuation premium for each successive one-year period. The premium must be: a. Paid to us prior to the anniversary date; and b. Determined in accordance with paragraph 2. above. Our forms then in effect will apply. If you do not pay the continuation premium, this policy will expire on the first anniversary date that we have not received the premium. 4. Undeclared exposures or change in your business operation, acquisition or use of locations may occur during the policy period that is not shown in the Declarations. If so, we may require an additional premium. That premium will be determined in accordance with our rates and rules then in effect. J. Premium Audit 1. This policy is subject to audit if a premium designated as an advance premium is shown in the Declarations. We will compute the final premium due when we determine your actual exposures. 2. Premium shown in this policy 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 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. 3. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. K. Transfer of Rights of Recovery Against Others to Us 1. Applicable to SECTION I - PROPERTY Coverage: If any person or organization to or for whom we make payment under this policy has rights to recover damages from another, those rights are transferred to us to the extent of our payment. That person or organization must do everything necessary to secure our rights and must do nothing after loss to impair them. But you may waive your rights against another party in writing: 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 80 of 81 a. Prior to a loss to your Covered Property. b. After a loss to your Covered Property only if, at time of loss, that party is one of the following: (1) Someone insured by this insurance; (2) A business firm: (a) Owned or controlled by you; or (b) That owns or controls you; or (3) Your tenant. You may also accept the usual bills of lading or shipping receipts limiting the liability of carriers. This will not restrict your insurance. 2. Applicable to SECTION II - LIABILITY Coverage: 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 such rights. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce them. Hanover Insurance Group- OBCA399956 1309570 We waive any right of recovery we may have against any person or organization with whom you have a written contract, permit or agreement to waive any rights of recovery against such person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This condition does not apply to Medical Expenses Coverage. L. Transfer of Your Rights and Duties Under This Policy Your rights 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 that legal representative is acting within the scope of their duties as your legal representative. Until your legal representative is appointed, anyone with proper temporary custody of your property will have your rights and duties but only with respect to that property. 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 81 of 81 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 2 % % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Schedule Job Description BLANKET AS REQUIRED BY 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 Policy No. W Z C -A3 9 9 9 4 6- 0 6 Endorsement No. Insured Insurance Company THE HANOVER AMERICAN INSURANCE COMPANY Countersigned By WC 04 03 06 (Ed 04-84)