PROOF OF INSURANCE (2024) CLOSEDTRAUB-2 OP ID:
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 04/18/2023
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.
WSUBROGATION 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 endorsements .
PRODUCER
Alliance Mgt. & Insurance Sery
355 Via Vera Cruz #7
CA Agent/Broker LJc# 0737966
San Marcos, CA 92078
Michelle A. Nowell
INSURED
Norman A Traub &
Associates LLC
Towns ate Rd #330
lake'Viilage, CA 91361
-7116
760-471-7116
mnowennamis
C:.
r+r^rxrcaaxr t1=0 rIf:I1"A'T Ilwi'191W PP92• RFVIi;Il7N NIIIMRFI
760-471-9378
34118
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCELISTED 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.
_r--,..... ....
w�.... .........._....... LTR TYPE OF INSURANCE .....,........... --- ....,ne POLICY NUMBER .w„�,..,..__—
LIML..,,,...,.__
INSR ADDL SUB POLICY EFF POLICY E1dP LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
E gt OCCURRENCE
11000,000
� �
CLAIMS -MADE
-MADE X � OCCUR
X
PKV0000417
04/07/2023
; 04/07/2024
DAMAGE' TO RENTED
� IB �� 1
100,000
Errors & on
MED EMmP Aoy one persons.,
$ .,..... 5,000
X
__.
_—
1,000,000
PERSONAL&&Py NJURY
,, .. .P , .�..�.�
_.--......
u.
4,000,00
GEN'
t. AGGT�E GATE LIMIT APPLIES PER:
GATE,,, ___
GENERAL AGGRE,,,,,,,,
$ �...-.. -,
-Xm
POLICY �_ � jL LOC
PRODUCTS GOM,P/OP AGG.,
$. 1 OOO.00O
OTHER:
A
OOMRtlNEO SINGLE' LIMIT
COMBINED
1,000,00 0
AUTOMOBILE LIABILITY
.L,wk„elj
ANY AUTO
PKV0000417
04/07/2023
04/07/2024
BODILY INJURY (Per person
,,_ .................
......,.,
OWNED SCHEDULED
AUUTOS ONLY AUTO{S�W
_.�OD�,IL (INJNJRY Per ardent)...
5... ..... ....m,,,...
X A4N ONLY X_ AUOS OYNe�O�CE�Rcd�
DAMAGE
� ........ .. ....m
A
UMBRELLA LIAB X OCCUR
FACHIaCCURRENCE
$ 1,000,000
X
EXCESS LIAB CLAIMS -MADE
-DED
UMV0000558
04/0712023
04/07/2024
.nmm.
AGGREGATE
1.000,000^
5......................................
RETENTION $
WORKERS COMPENSATION
PER OTH-
I1..TUTE"'E'R
AND EMPLOYERS' LIABILITY
Y�1J'd
"""
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N / A
E L EAN 1-N ACCIDENT
S
(Mandatory in NH) I�
E L;,DISEASE - EA EMPLOYEE-
F
If yes, describe under
RI.. TI F OPFRATIQN§ below
FL. DISEASE - POLICY LIMIT
A
Professional Liab
PKV0000417
04/07/2023
0410712024
Prof Liab
1,000,000
A
Cyber
PKV0000417
04/07/2023
04/07/2024
Cyber
300,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
City of El Segundo is named as an additional insured with respect to the
work performed by the named insured.
Investigation, CA --
City of El Segundo
Human Resources
Rebecca Redyk
350 S Main Street
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
a
ACORD 25 (2016/03) C 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: PKV0000417
COMMERCIAL GENERAL LIABILITY
CIGL 79 03 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEE'S OR
CONTRACTORS - SCHEDULED PERSON O
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s)
Location(s) Of Covered Operations
Blanket as required by valid written contract.
Blanket as required by valid written contract.
Additional Information:
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to include as an additional insured the person or organization
shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and
advertising injury" arising out of:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your operations for the additional insured at the location shown in the Schedule.
However:
a. The insurance afforded to such additional insured only applies to the extent permitted by law;
b. If coverage provided to the additional insured is required by a contract or agreement, the insurance
CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2
afforded to such additional insured will not be broader than that which you are required by the contract or
agreement to provide for such additional insured; and
c. Regardless of the date of occurrence or when the injury or damage first occurs or is first discovered, a
person's or organization's status as an additional insured under this endorsement ends upon the earliest
of:
(1) The completion or termination of the contract or agreement between you and the additional insured
for the location shown in the Schedule;
(2) The date you cease actively performing operations for the additional insured at the location shown in
the Schedule; or
(3) The expiration or termination date of the policy or this endorsement.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to liability or damages for "bodily injury", "property damage", or "personal and
advertising injury":
1. Caused by, arising from, or included in the "products -completed operations hazard";
2. Arising out of the additional insured's sole negligence;
3. Arising out of work or operations performed by you that were completed prior to the effective date of this
endorsement; or
4. Which continues or progressively deteriorates after you cease actively performing operations for the
additional insured at the location shown in the Schedule, even if the injury or damage first occurred, or is
alleged to have first occurred, during the course of your operations for the additional injured.
C. Solely for purposes of this endorsement, the following definition is deleted in its entirety and replaced by the
following:
1. ""Products -completed operations hazard":
a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and
arising out of "your product" or "your work" except:
(1) Products that are still in your physical possession; or
(2) Work that has not yet been completed or abandoned. However, "your work" will be deemed
completed at the earliest of the following times:
(a) When all of the work called for in your contract has been completed;
(b) When all of the work to be done at the location shown in the Schedule has been completed if
your contract calls for work at more than one location; or
(c) When that part of the work done at the location shown in the Schedule has been put to its
intended use by any person or organization other than another contractor or subcontractor
working on the same project.
Work that may need service, maintenance, correction, repair or replacement, but which is otherwise
complete, will be treated as completed.
D. With respect to the insurance afforded to these additional insureds, the following is added to Section III —
Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on
behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2
Workplace Investigation Specialists License PI 188615
2625 Townsgate Road Suite 330, Westlake Village, CA. 91361
714-693-3428
Email: ba.normtraub@gniaii.com
EXEMPTION FROM AUTOMOBILE LIBILITY INSURANCE
Norman A. Traub & Associates does not own vehicles. Accordingly, I certify that Norman A.
Traub & Associates shall not utilize company -owned vehicles in the performance of the work
under this agreement.
All independent contractor investigators that provide investigation services use their vehicles.
Investigators can provide a city representative proof of automobile insurance.
T. Brock Avery
General Manager
Norman A. Traub & Associates LLC
SignatureDATE: 6-17-21
:
Workplace Investigation Specialists License PI 188615
2625 Townsgate Road Suite 330, Westlake village, CA 91361
714-69.3-3428 805-207-9216 www,norxmtraubassociates.com
F.rnail: ba,normtraub@gmail.com
July 8, 2021
Ms. Rebecca Redykl
Human Resources Director
City of El Segundo
I am aware of the provisions of Section 3700 of the Labor Code, which requires every
employer to be insured against liability for workers' compensation or to undertake self-
insurance in accordance with the provision of that Code, and I will comply with such
provision before commencing the performance of the work of his agreement.
I certify that in the performance of the work under the permit, license agreement,
purchase order, or contract with the City of El Segundo, which is the subject matter of this
certification, I shall not, in any manner, employ any person or contract with any person so
that any worker on said work would become subject to the workers' compensation laws of
the State of California.
By my signature below, I affirm under penalty of perjury, I am authorized to bind my
company, agency/agents, partnership and I am not required to comply with Section 3700
of the Labor Code, or any workers' compensation laws of the State of California, and
further, I agree to hold harmless, indemnify, and defend the City against any claim or
damage included by not limited to any subrogation demand arising from performance
under my contract with the City. I waive any right of subrogation against the City.
Norman A. Traub Associates does not have employees. All Associates are independent
contractors.
July 8, 2021
Authorized signature / Date
T. Brock Avery
General Manager/Principal
Norman A. Traub Associates
(714) 693-3428