Loading...
PROOF OF INSURANCE (2023) CLOSEDClient#: 1266412 305FLEMIENV DATE(MM/DD/YYYY) ACORD,M CERTIFICATE OF LIABILITY INSURANCE 4/29/2022 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sonia Morris NAME: McGriff Insurance Services PHONE 714 941-2800 FAX 877 297 1101 (AIC Na,, �at_ ......m.-... - - - LA/q,. Na 130 Theory Ste 200 MAIL Sonia.Mo@McGrm iff co .........Irvine, CA 92617 ..... . INSURER(S) su _... ADDRESS;m s ING 714 941-2800 - Crum & Forster Ssecialtyol su.,....COVERAGE NAIC # ...............................................................�4 ra a Co �44520 INSURED Fleming Environmental Inc. PO Box 6130 Fullerton, CA 92834 INSURER A : P . �.m........'----_.....__.......... I..,_�..................................��.:................................._. NSURER B : Oak River Insurance Company 34630 Travelers Property Casual Co of Amer 256 INSURER C : P Y Casualty 74 INSURER D : National Specialty Insurance Company 22608 INSURER E : 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 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR �. TYPE OF INSURANCE,,,,,,, LTR ADDL" INSR SU .„R WVo � � POLICY NUMBER POLICY EFF POLICY EXP (MWODt YVY), (MM/PDIYYYY) LIMITS , .. .,,. ,,,,,,,, A X COMMERCIAL GENERAL LIABILITY ..... EPK139585 . - EACH OE 5/01/2022 05/01/2023� 000,00,,, CLAIMS -MADE X� OCCUR J RENTLU rg5 OOO -.o.. PRE � jE mµ a GdrGerore� 0, X Pollution Liab MED EXP tiAnyonr person) � $5000 X Professional Llab ' PERSONAL & ADV INJURY -. $1,000 OOO - GATE LIMIT APPLIES PER: cEN�L AGGREGATE . GENERAL AGGREGATE s I � 2,000,000 PRO { } POLICY � X JECT I V LOG PRODUCTS COMP/OPAGG $2 000 000 .. ...... 1 OTHER $ D AUTOMOBILE LIABILITY ..... GM1023901 U(7E4"rBNtiWFD,aINCiI E l„4MC6 5/01/202205/0 1/2023:.CF�a��y�?�ml� $1,000,000 X ANY AUTO .. BODILY INJURY (Per person) $ � OWNED j SCHEDULED W.. AUTOS ONLY AUTOS BODILY INJURY (Per accident) ....... HIRED NON -OWNED X �'ROPERTY DAMAGE $ AUTOS ONLY X.. AUTOS ONLY '.. I Per a! rOdent) A UMBRELLA LIAB — X OCCUR ' EFX120283 _ 5/01/2022 05/01/2023 EACH OCCURRENCE X EXCESS CLAIMS -MADE AGGREGATE 0 DED L........X,1 RETENTION $, S® ee,. ., WORKERS COMPENSATION B , FWC318624 L ,, , . , . .. PER 5/O1/2022 O5/01/2023 LIABILITYYIN .PR E( AN�DEMPLOYERRS'LI EXECUTIVE L EACH ACCIDENT 0 000 OMFFFECERIMln`pIUSERR EXCLUDED? N ny NIA Y E L D SEASEE- EA EMPLOYEE,~.... 000 000 If yes, describe under .. ._mc PO.OFOPERATIONS. beow.,,...... . .............. ......,... ........,. ........ DISEASE-POLIC,Y ,LIMIT ;,$1, 000,000 C Rented/Leased QT6603L337320TIL22 5/01/2022 05/01/2023 $160,000 Limit Equipment $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: The City of El Segundo, its officers, officials, employees, agents and volunteers are named as additional insured as respects general liability, this insurance is primary and noncontributory with any other insurance of the additional insured; and waiver of subrogation applies as respects workers compensation as required by written contract, per endorsements attached. Should any policy be cancelled before the expiration date, McGriff Insurance Services will mail 30 (thirty) days written (See Attached Descriptions) ERTIFICATE City f El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y og THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 150 Illinois Street El Segundo, CA 90245-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S29939176/M29938837 SOMOR DESCRIPTIONS (Continued from Page 1) notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non-payment of premium. SAGITTA 25.3 (2016/03) 2 of 2 #S29939176IM29938837 Fleming Environmental Inc. EPK139585 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONIAL INSURED: - OWNERS, • ""' CONTRACTORS This endorsement modifies insurance provided under the following:: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s) Where Required By Written Contract SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability caused, in whole or in part, by "your work" for that insured which is performed by you or by those acting on your behalf. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0111-0211 Page 1 of 1 Fleming Environmental Inc. EPK139585 Crum Forster part or the CMR1-,r�,ti group THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE _........ ........ ........ Name of Additional Person(s) or Location And Description Of Completed Organization.W-............m._...........................................__..._._.....Operations Where Required by Written Contract Where Required by Written Contract ................ -- Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section III — Who Is An Insured within the Common Provisions is amended to include as an 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". EN0320-0211 Page 1 of 1 Fleming Environmental Inc. EPK139585 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following:. COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s): Where Required By Written Contract SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by you, or by those acting on your behalf. This insurance shall be primary and non-contributory, but only in the event of a named insured's sole negligence. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED„ EN0119-0211 Page 1 of 1 Fleming Environmental Inc. FLWC318624 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations 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 Insured Fleming Environmental Inc. Insurance Company Oak River Insurance Company WC 99 04108 (Ed. 9-14) Policy No. FLWC318624 Countersigned by Endorsement No. Premium $