PROOF OF INSURANCE (2023 - 2023) CLOSED01c
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Client#: 1252713 305STRADYOC
DATE (MM/DDNYYY)
ACORD. CERTIFICATE OF LIABILITY INSURANCE 11/01/2022
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.
orsed.
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
NAMr=.
McGriff Insurance Services PHONE FAX
130 Theory Ste 200 E AILS CertSCA
.. A1C No Ext
N.cGriff.com
Irvine, CA 92617 _ ,".�.. A��.... .......... � ._._ _.._ .....
INSURER(S) AFFORDING COVERAGE NAIC #
714 941-2800 INSURERA _ . _ Vigilant IIns 11 n urace Compan 7
y 2039
INSURED ruerFederal Insurance Companv 20281
Stradling Yocca Carlson & Rauth APC
INSURER C ;
660 Newport Center Drive, Suite #1600 _
IN D
Newport Beach, CA 92660 NSUR R E I 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..
NNSR POLICY EFF � PIWD EXp.,
AODL(D CYNUMB ER (MM/D7/YYYY) �MM/DD/YYYY)• LIMITS
TYPE OF INSURANCE POLICY
LTn. INSR VIVO
GENERALLIABILITY
A COMMERCIAL" 35327003 5/01/2022 05/01/2023 EACH _
OCCURRENCE
®�
�$1,000,000
Ap�Ac , O Rrr*NTa •.D
CLAIMS -MADE � XI OCCUR � RErhaklS�(La+�c�erwarr�nce1
s 1 OOO OOO
a ,•
MED EXP (Any one person)
$ 10,000 ._ ,,,....w
_....
PERSONAL & ADV INJURY
............... ..... ........... _ ,
......
$1 000 000 ... ...
GEN L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE
$ 2,000,000
PRO—
PRO LOC UCTS COMP/OP AGG
JECT r PROD
S INCLUDED
a OTHER .............. .- .. _...._ .....---._...._. ......I
m ,...,.. __,_m .... ,m....
B AUTOMOBILE LIABILITY .__. 74988851 5/01/2022 05/01/2023 COMBINED SING EUMFf
'Ira aCvrIV ti .. .... .........
S
.,,..,,,,
1 000 000
..?..... ?
ANY AUTO BODILY INJURY (Per person)
$
.,. „�.
—_
OWNED SC ED LED BODILY .R e
AUTOS ONLY AUTOS INJURY Per accident)
$
HIRED 'NON -OWNED PROPERTY DAMAGE
X Per co
AUTOS ONLY �, AUTOS ONLY ( ,_-";tlmlj ..____ .._
$
..... .........,w,..
..B UMBRELLA LIA,. .......... . ...... ,,.,, -----._.._.__ ,..., ... ,,,
..
Bi X ,.00CUR........,,.. 7� 2 .. "_..... ... EACH O,. � �
ccuRRenlc
9726620 5/01/2022 05/01/202 E
...�. �,.,
s27,000
EXCESS LIA.B AGGRE.
.. _ GATE
s27 OOOt000
,000 ..., .._..
RE TENTION $
$
......mADE
_- DEG... ...rt .,CL...... .. ..,
A WORKERS COMPENSATION 71700994 1110312022 11/03/2023 X PER �OTH
STATE SE° ER
AND EMPLOYERS' LIABILITY
ANY PROP RIETORIPARTNER/EXECUTIVE yJ N E L EACH ACCIDENT
0,000,000
OFFICER/MEMBER EXCLUDED? 'N/A ^^ -----------
(Mandatory EA EMPLOYEE $1 O00 0O0
(Mandato In NH) E L DISEASE .......,.,.. "..... " ..,.,. ._a ,,,.,..
If yyes, describe under
yDESCRIPTIONOFOPERATION.S..below_.......... .`............- _ ......._..........�.......�,",,.............. ...... ........."...... .._....... ELDISEASE- POLICY LIMIT
51,000,000
DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required)
Certificate is subject to policy limits, conditions and exclusions.
RE: Contract Agreement. City of El Segundo its officials, and employees are included as additional insured
as respects to General Liability coverages as required by written Contract. General Liability coverage is
primary and noncontributory as required by written contract. Waiver of Subrogation is included with respect
to Workers Compensation as required by written contract. 60 Day Notice of Cancellation- Nonrenewal (20 Day
in the event of non-payment).
CI of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Administrative Technical Specialist ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
El Segundo, CA 90245-0000 AUTHORRED REPRESENTATIVE
m 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
757 #S30998146/M30983859 SSTAN
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Liability Insurance
Endorsement
Policy Period 05/01/2022 05/01/2023
Effective Date
Policy Number 35327003
Insured Stradling Yocca Carlson & Rauth APC
Name of Company VIGILANT INSURANCE COMPANY
Date Issued
This Endorsement applies to the following forms:
GENERAL LIABILITY
Under Who Is An Insured, the following provision is added.
Who Is An Insured
Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are
Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by
Or Organization this policy.
However, the person or organization is an insured only:
• if and then only to the extent the person or organization is described in the Schedule-,
to the extent such contract or agreement requires the person or organization to be afforded
status as an insured;
• for activities that rid not occur, in whole or in part, before the execution of the contract or
agreement; and
• with respect to damages, loss, cost or expense for injury or damage to which this insurance
applies.
No person or organization is an Insured under this provision:
• that is more specifically identified under any other provision of the Who Is An Insured
section (regardless of any limitation applicable thereto).
Llablilty Insurance Additional Insured - Scheduled Person Or Organization
Form 80-02-2367 (Rev. 5-07) Endorsement
go=
a
Mi
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Who Is An Insured
Additional Insured - with respect to any assumption of liability (of another person or organization) by them in a
Scheduled Person contract or agreement. This limitation does not apply to the liability for damages, loss, cost nr
Or Organization expense for injury or damage, to which this insurance applies, that the person or organization
(continued) would have in the absence of such contract or agreement.
Under Conditions, the following provision is added to the condition titled Other Insurance.
Conditions
Other insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization
Primary, Noncontributory shown in the Scherinle with primary insurance such as is afforded by this policy, then in such case
Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance availableto such person
Person Or Organization or organization.
Schedule
Persons or organizations that you are obligated, pursuant to a contract or agreement,
to provide with such insurance as is afforded by this policy.
All other terms and conditions remain mchanged.
Authorized Representative
L./ability Insurance Additional Insured- Scheduled Person Or Organization
Form 80-02-2367 (Rev. 5-07) Endorsement
6
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Stradiing Yocca Carlson & Rauth APC
35327003
E H U B B®
Conditions
Audit Of Books And
Records
Common Policy Conditions
Contract
The following Conditions are included under each part of the policy, unless stated otherwise.
We may audit your books and records as they relate to this insurance at any time during the term of
this policy and up to three years afterwards.
Cancellation the first named insured may cajiceH. this policy or tunny of its hidividual coverages at any firne Iby
sendhig us a written request or by n,*jrning the P olicy mid statinp whun thereafter cancellation is to
,
take effccL
We arty cancel this policy or any of its individual coverages at. any Lirno by sending to the first
narned insured a notice 60 days (20 days in the event of non-payrnent of preiWum) in advanct, of
die cancellation date, Our notice of cancellation will The mailed to the RrM named insured's last
known address, mid Will indicate the ' date on which coveirage is tenna irrC(J,L if notice of can nctfflado
is rnailed, proof of mailing will besuffident proof of notice.
The earned premium will be corriputed on a pro rata. basis. Any unearned prernium will. be returnLed
as soon as, prachicable.
Changes Thn policy cin ony be changed btu a written cudcmsem�mt aiatbox=s mart of ffiis poUcy. The
endoisament mnst be snjx,ncd Lsy one of our auffiorited ii epresonm0ws
Comj�)Iiance By h7surods We have no duty to pravnde oovctaj�' e undeir the s pohey unless you and:any officr �nvolvcd �nqurcd
hxve flAfly cumphcd with an of die, t<!mns aud condlhons ofWe pohcy
Gallop I Mld'INrTh�s Nf&surS rohdolotpi prytdhe �og xitnesnut rOnacterjdeoi econornic sanctio'as aaiHither hams or
a,mlaplwi
PPfl.)it us Frm
Sanctions
Conformance /%ny kxms oIF Mis nnsukaucc whicb are iiconflict wiLh ffic ernpplicabbl AahAes of theStaLL, u1i which
dii!s policy is ismxd are wrbinidod b cm&brM K, such ARLI'Mcs,
First Narned Insured The person or organization first nw.n.ed in the Declarations is 1primarilly responsible for paynacrit of
all prenilums. The first manned insumxl will as;t c)n behalf' of all other narned insuzedsfoy. the giving
and receiving of notice of cancellation or nonrenewal and the ieceiving of nanny return premiums that
becorne. payable under Us policy
jns;7,ections And Surveys A`cimkv�
nvake hispccAoiis and siurvuys w any daiel!�
g�ive you ropoits on the coniffifions Nit flnd� and
recoMMUNI changes,
Common Policy Conditions
Form 60-02-9090 (Rev. 6- Contract Page 1of2
page 7 of 11
-Com-dffians
Inspections And SurVeys Any inspections, surveys, reports or recommendations relate only to insurability and the premiums
(continued) to be charged. We do not make safety inspections. We do not undertake to perform the duty of any
person or organization to provide for the health or safety of workers or the public. And we do not
warrant that conditions:
are safe or healthful; or
comply with laws, regulations, codes or standards.
This condition applies not only to us, but also to any rating, advisory, rate service or similar
organization which makes insurance inspections, surveys, reports or recommendations for us,
Titles Of Paragraphs The titles of the various paragraphs ofthis policy and ondorsernents, if any, attached. to this policy
are lnsei ted solely for convenience or refkrence and are not to be dectned in any way to limit or
affect the provisions to which they relate.
Transfer Of Rights And Your rights and duties under this insurance, may not be transferred without our written consent.
Duties However, if you die., then your rights and duties will be transferred to your legal representative, but
only while acting within the scope of duties as your legal representative, or to anyone having
temporary custody of your property until your legal representative has been appointed.
When We Do Not Renew If we decide. not to renew this policy,, we will mail or deliver to the first namexi insured's last.10own
address, written notice of the nonrenewal not less tbari 60 days before the expiration date,. If notice
of nonrenewa.] is mailed, proof of." inaffing will be saffirient proof of notice.
Common Policy Conditions
Form 80-02-9090 (Rev. 6-05) Contract Page 2 of 2
762
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Stradling Yocca. Carlson & Rauth APC
35327003
Candftns
Duties In The Event Of F. Knowledge of an occurrence or offense by an agent or employee of the insured will not
Occurrence Offense, constitute knowledge by the insured, unless anofficer (whether or not an employee) of any
Claim Or Suit insured or an offlcer§ designee knows about such occurrence or offense.
(continued)
G, Failure of an agent or employee of the insured, other than an officer (whether or not an
employee) of any insured or an officer§ designee, to notify us of an occurrence or offense
that such person knows about will not affect the insurance afforded to you.
H. If a claim or loss does not reasonably appear to involve this insurance, but it later develops
into a claim or loss to which this insurance applies, the failure to report it to Us will not
violate this condition, provided the insured gives us immediate notice as soon as the insured
is aware that this insurance may apply to such claim or loss.
Legal Action Against Us No person or organization has a right under this insurance to:
• j oin its as a party or otherwise bring us into a snit seeking damages fi-om an insured; or
• sue us on this insurance unless all of the terms and conditions of this insin-ance have been
fully complied with.
A person or organization may sue us to recover on an agreed settlement or on a final judgment
against an insured obtained after ail actual:
• trial in a civil proceeding; or
• arbitration or other alternative dispute resolution proceeding;
but we will not be liable for damages that are not payable under the terms and conditions of this
insurance or that are in excess of the applicable Limits Of Insurance.
Other Insurance If other valid and collectible insurance is available to the insured for loss we would otherwise
cover wider this insurance, our obligations are limited as follows.
Primary Insurance
This insurance is primary except when the Excess Insurance provision described below applies.
If this insurance is primary, our• obligation-, are not affected unless any of the other insurance is also
primary. Then, we will share with all that other insm-ance by the method described in the Method of
Sharing provision described below.
Excess Insurance
This insurance is excess over any other insurance, whether primary, excess, contingent or on any
other basis:
A. that is Fire, Extended Coverage, Builders Risk, Installation Risk or similar insurance for
your work;
B. that is insurance that applies to property damage to premises rented to you or temporarily
occupied by you with permission of the owner
C. if the loss arises our of aircraft, autos or watercraft (to the extent not subject to the Aircraft,
Autos Or Watercraft exclusion);
Liability Insurance
Form 80-02-2000 (Rev. 4-01) Contract Page 22 ot32
765
M
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General Liability
Conditions
Other Insurance D. that is insurance:
(continued) 1 provided to you by any person or organization working under contract or agreement
for you; or
2. under which you are included as an insured, or
E. that is insurance under any Property section of this policy.
When this insurance is excess, we will have no duty to defend the insured against any suit if any
other insurer hag a duty to defend such insured against such suit. If no other insurer defends, we
will undertake to do so, but we will be entitled to the insured§ lights against all those other
insurers.
When this insurance is excess over other insurance, we will pay only our share of the amount of
loss, if any, that exceed,; the sum of the total:
amount that all other insurance would pay for loss in the absence of this insurance; and
of all deductible and self -insured amounts under all other insilrance.
We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not negotiated specifically to apply in excess of the Limits Of
Insurance shown in the Declarations of this insurance.
If all of the other insurance pen -nits contribution by equal shares, we will follow this method also.
Under this method each insurer contributes equal amounts until it has paid its applicable limits 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 conni b Lite by
limits. Under this method, each insureA -hare is based on the ratio of its applicable limit,,; of
insurance to the total applicable limits of insurance of all insurers.
Premium Audit We will compute all premium for this insurance in accordance with our rules and rates.
In accordance with the Estimated Premiums section of the Premium Summary, premiums shown
with all asterisk (*) are estimated premiums and are subj ect to audit.
In addition to or in Bell of such designation in the Premium Summary, premiums may be designated
as estimated pretnil-uns elsewhere in this policy. In that case, these premiums will also be sub' .) ect to
audit, and the second paragraph of the Estimated Premium,; section of the Premium Summary will
apply.
Separation Of Insureds Except with respect to the Limits Of Insurance, and any lights or duties specifically assigned in this
insurance to the first named insured, this insurance applies:
• as if each named insured were the only named insured; and
• separately to each insured against whom claim is made or suit is brought.
Liability Insurance
Form 80-02-2000 (Rev. 4-01) Contract Page 23 of 32
766
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Workers' Compensation and Employers' Liability Policy
Named Insure._._.,...—. . - - � .�.. ......._..__._...� .....__ ....._..
d Endorsement Number
Stradling Yocca Carlson & Rauth APC
Policy Number
mboL _ Number: 71700994
Policy Period Effective Date of Endorsement
11/03/2022 TO 11/03/2023
Issued By (Name of Insurance Company)
Vigilant Insurance Com an
-.-Insert, the policy, number, The rernNn�,e-• of the information is to be scam la��ed �anl when this ��adtarserr er fl; is iss�rasd wul�s� ia�rtSw tea Nk�e a e�fsscw�4�ar1 p� 16��a IATT�Py',
CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the
Information Page.
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, but this waiver applies only with respect to bodily injury
arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver
from us.
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work
described in the Schedule.
Schedule
1. (❑) Specific Waiver
Name of person or organization
Any person or organization where you are required pursuant
to a written contract or agreement to waive rights of
subrogation against such person or organization.
(N) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver,
2. Operations:
3. Premium:
The premium charge for this endorsement shall be 1% percent of the premium developed on payroll in
connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium,
WC 90 03 75 (05/18)
Authorized I epresentafive
763
N
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