No preview available
PROOF OF INSURANCE (2023) CLOSEDACCORD® CERTIFICATE OF LIABILITY INSURANCE `....•�� DATE(MM/DD/YYYY) 6/15/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Risk Strategies Company CONTACT NAME: Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 PHONEExt: 949-242-9240 FAXNo E-MAIL ADDRESS: syoung@risk-strategies.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Travelers Indemnity Co of Connecticut 25682 www.risk-strategies.com CA DOI License No. OF06675 INSURED MINIS Engineers, Inc. 201 N. Calle Cesar Chavez, Suite 300 INSURER B: Travelers Property Casualty Co of America 25674 INSURERC: Travelers Casualty and Surety Co of America 31194 INSURERD: Santa Barbara CA 93103 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 68753702 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 ✓ 6802JO51458 6/14/2022 6/14/2023 EACH OCCURRENCE $$1,000,000 CLAIMS -MADE EVI OCCUR DA PREMSESOEaoccurrDence $$1,000,000 MED EXP (Any one person) $$10,000 PERSONAL & ADV INJURY $$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $$2,000,000 POLICY JE� LOC PRODUCTS - COMP/OPAGG $$2,000,000 $ OTHER: B AUTOMOBILE LIABILITY BA8R521641 6/14/2022 6/14/2023 C(EaOMBINEDSINGLELIMIT $$1,000,000 ✓ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY B �/ UMBRELLALIAB �/ OCCUR CUP8E545094 6/14/2022 6/14/2023 EACH OCCURRENCE $$10,000,000 AGGREGATE $$10,000,000 EXCESS LAB CLAIMS -MADE DED ✓ RETENTION $0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y❑ ✓ U1361<139301 6/14/2022 6/14/2023 �/ STATUTE OERH E.L. EACH ACCIDENT $$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 C Professional Liability 107272696 6/14/2022 6/14/2023 Per Claim: $5,000,000 Aggregate: $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Projects as on file with the insured. City of El Segundo, its officials and employees are named as additional insureds and primary/non-contributory clause applies to the general liability policy and a waiver of subrogation applies to the work comp policy -see attached endorsements. CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works ACCORDANCE WITH THE POLICY PROVISIONS. Attn: John Gilmour 350 Main St. El Segundo CA 90245 AUTHORIZED REPRESENTATIVE Ile RSC Insurance Brokerage ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 68753702 122-23 GL-AL-UL-WC-PL I Sherry Young 16/15/2022 10:13:15 AM (PDT) I Page 1 of 4 Insured: mwaEngineers, Inc. Policy No. :»x000 /znx Effective oate:m/4/zozz COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET �����U�UA���U U�������� ���o���� o ADDITIONAL no���o��� �������U������ ����U����� ���� ������A���� (ARCHITECTS, �~�� n�m �~n���nn��~�~n�p� »��n��� SURVEYORS) v�'n�m�' � x � This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION U —VVHO IS Any person or organization that you agree in n ~written contract requiring insurance" to include an on additional insured on this Coverage pnrt, 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, orinconnection with premises owned hyorrented to you. The person nrorganization does not qualify na an additional insured: c. With respect to the independent ncda or omissions nfsuch person nrorganization; nr d. For "bodily injury'. "property damage" or "personal injury" for which such person or organization has assumed liability in a contract nragreement. The insurance provided tosuch additional insured is limited as follows: e. This insurance does not apply onany basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. f. This insurance does not apply to the rendering of or toi|un* to render any "professional services". g. In the event that the Linlda of Insurance of the Coverage Part shown in the Oeohomginna exceed the limits of liability required by the "written nnntnont requiring inaurnnne", the insurance provided to the additional insured shall belimited tUthe limits nfliability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section ||| — Limits OfInsurance. h. This insurance does not apply to ~bodily injury" or"property damage" caused by "your vvnrK' and included in the "products - completed operations hazapd" unless the, "written contract requiring insomomcm� opeeNUea|ky requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only tnsuch "bodily injury" or "property damage" that occurs before the end of the period of time for which the `�mr@tem onntnoot requiring insurance" requires You to provide such coverage or the end of the, policy period, whichever ksearlier. 2. The following is added to Paragraph 4.a- of SECTION |V — 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 UM any other basis, that is available to the, additional insured for n |naa we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided tnthe additional insured under this Coverage Part must apply on a primary basis ore primary and non-contributory haoin' this insurance is primary to other insurance available to the additional insured which covers that person nrorganizations an 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 nfonoffense committed; after you have signed that "written contract requiring innurance"But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, exneaa, contingent or on any other basis, that is available to the additional insured when that person or organization is on additional insured under any other insurance. CG03 818915 Q 201nThe Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission 68753702 1 22'23 GL-AL-UL,C'`L I Sherry Young 1 6/15p022 m.o.z`em (PDT) I Page 2 of 4 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" "property damage" or "personal injury" arising out of "your work!' performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury' offense is committed. 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 ini effect; and c. Before the end of the policy period. Page 2 of 2 Q 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission 68753702 1 22-23 GL-AL-UL-WC-PL I Sherry Young 1 6/15/2022 10:13:15 AM (PDT) I Page 3 of 4 CG D3 81 09 15 WORKERS COMPENSATION AND EMPLOYERS LIABILITY ENDORSEMENT WC 99 03 76 (00) Insured: MNS Engineers, Inc. Policy No.: U136KI39301 Effective Date: 6/14/2022 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. 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 5.000% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION WITH WHOM YOU AGREE IN WRITING TO WAIVE YOUR RIGHT TO RECOVER AGAINST THEM. YOU MUST AGREE TO THIS WAIVER PRIOR TO THE DATE OF LOSS Job Description: Projects as on file with the insured. Authorized Representative 68753702 122-23 GL-AL-UL-WC-PL I Sherry Young 16/15/2022 10:13:15 AM (PDT) I Page 4 of 4