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PROOF OF INSURANCE (2014) CLOSED300694 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/23/2013 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 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 enldor'sement(s). PRODUCER CoNTACT Debbie Wheeler Ae: - _. _ ... . Commercial Lines - 800-868-8834 PHONE FAX 704 556-2766 {AdC Nod: 966 332-3051 DEB Wells Fargo Insurance Services USA, Inc. ADDRESS:" 6100 Fairview Road - INSURE _V " IC �s�AFFORDING COVERAGE NAIC # � - Charlotte, INC 28210 INSURER ; Valley Forge Insurance Company 20508 - . ... ....... INSURED INSURER B , Continental Casualty Company 20443 Digital Health Department, Inc INSURER Continental Insurance Company _..... 35289 7506 E. Independence Blvd #105 _.... ......._..... ..M...� ._....�__...— .. INSURER D INSURER E: Charlotte NC 28227 I"5URERF; COVERAGES CERTIFICATE NUMBER: 6606975 REVISION NUMBER: See below 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 .....�._ .... �..... AS aL _r.. 'PtYLBC'"r E.'FF b'O1�ICM BXP .- LT'R TYPE OF INSURANCE �oLgc�r'— NUMBER M $ODrVYYY WDDMYY LIMITS A GENERAL LIABILITY B5086068937 3/22/2013 oll $(22/2014 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY II?REewIISEFa ocu r«ncey $ 300,000 CLAIMS -MADE [K OCCUR MED tXfQ n one (e oru $ 10,000 X E&O Rel oR!!Ie 3122/13 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4000,000 ,.. .. .. GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ PRO, POLICY LOC E&O $ 1,000.000 AUTOMOBILE LIABILITY COMBINED SWGLE LIMIT Fu ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS BODILY INJURYPer accident) $AUTOS -- NON -OWNED PROPERT $ Y OARW4IA, HIRED AUTOS AUTOS f" rPEk B x UMBRELLA LI x OCCUR B5086069747 3/22/2013 V22f2014 EACH CSGA1RREfi&G 2,000,000 ..._.. _ ....... _.... EXCESS LIAR CLAIMS -MADE AGGREGATE ..., -_ .... $ 2.000,000 DED X RETENT'ION $ 10,000 $ WORKERS COMPENSATION X WC STAAU. oTH- C AND EMPLOYERS' LIABILITY YIN N WC586068971 3/22/2013 3/22/2014 TS l3Y GJIw41J. ANY PROPRMTOR/'F ARTNE'RIEXEC'U'T1VE EL EACHACCIDENT $ 500000 OFFICERfMEMOE,� EXCLUDED? (Mandatory In NH N/A ...... E.L. DISEASSE, - EA EMPLOYEE $ 500,000 Uos. describe udder SCRIPTION OF OPERATONS balgwar _.._ _ ..... - — E,1L DISEASE POLICY LIMIT $ 500,000 A E&O 135086068937 3122i13 3/22/14 $1,000,000 Limit DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (Attach ACORD 101„Additional Remarks Schedule, if more space is required) SB-300106-A 03/06 City of El Segundo, its employees, agents and volunteers are named as additional insured with respects to general liability. Waiver of subrogation applies in favor of additional insured with respects to general liability. CERTIFICATE HOLDER CANCELLATION City of El Segundo 314 Main St El Segundo, CA 90245 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 9m Mgzamrfl= The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. rfh! ca Nfi.fl. mnlams.10-1.AAAORA1 icsnxd on gl>30011) SB-300106-A (Ed. 03106) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TECHNOLOGY LIABILITY EXTENSION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part. A. ADDITIONAL INSURED — BLANKET VENDORS any other thing or substance by or for the vendor: or WHO IS AN INSURED is amended to Include as an additional insured any person or organization (referred to below as vendor) with whom you agreed, because of a written contract or agreement to provide insurance, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e: Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omission or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from which you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 3. This provision A. does not apply to any vendor Included as an insured by an endorsement issued by us and made a part of this Coverage Part. 4. This provision A. does not apply if "bodily injury" or "property damage" included within the "products -completed operations hazard" is excluded either by the provisions of the Coverage Part or by endorsement. B. MISCELLANEOUS ADDITIONAL INSUREDS WHO IS AN INSURED is amended to include as an insured any person or organization (called additional insured) described In paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or agreement but the written contract or agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and SB-300106-A Page 1 of 6 (Ed. 03106) (Version 1.0) SB-300106-A (Ed. 03/06) 2. Executed prior to the "bodily injury," "property rent, or control and to which this damage" or "personal and advertising injury," insurance applies: but (a) The existence, maintenance, Only the following persons or organizations are repair, construction, erection, or additional insureds under this endorsement and removal of advertising signs, coverage provided to such additional Insureds is awnings, canopies, cellar limited as provided herein: entrances, coal holes, driveways, a. Additional Insured — "Your Work" manholes, marquees, hoistaway openings, sidewalk vaults, street That person or organization for which you banners, or decorations and do work is an additional insured solely for similar exposures; or liability due to your negligence specifically (b) The construction, erection, or resulting from your work for the additional removal of elevators; or insured which is the subject of the written contract or written agreement. No (2) This insurance applies only with coverage applies to liability resulting from respect to operations performed by the sole negligence of the additional you or on your behalf for which the Insured. state or political subdivision has The insurance provided to the additional issued a permit. insured is limited as follows: This insurance does not apply to "bodily (1) The Limits of Insurance applicable to injury," "property damage" or "personal and advertising injuryarising out of the additional insured are those operations performed for the state or specified In the written contract or municipality. written agreement or in the Declarations of this policy, whichever c. Controlling Interest Is less. These Limits of Insurance are inclusive of, and not in addition to, Any persons or organizations with a the Limits of Insurance shown in the controlling interest in you but only with Declarations. respect to their liability arising out of: (2) The coverage provided to the (1) Their financial control of you; or additional insured by this (2) Premises they own, maintain or endorsement and paragraph F.9. of control while you lease or occupy the definition of "insured contract" these premises. under Liability and Medical Expenses Definitions do not apply This insurance does not apply to ppY "bodily injury" "property structural alterations, new construction d damage arising out of the he "products- and demolition operations performed by completed operations hazard unless or for such additional insured. required by the written contract or d. Managers or Lessors of Premises written agreement. A manager or lessor of premises but only (3) The insurance provided to the with respect to liability arising out of the additional insured does not apply to ownership, maintenance or use of that "bodily injury," "property damage," or specific part of the premises leased to "personal and advertising injury" you and subject to the following additional arising out of the rendering or failure exclusions: to render any professional services. This insurance does not apply to: b. State or Political Subdivisions (1) Any "occurrence" which takes place A state or political subdivision subject to P 1 after you cease to be a tenant in that the following provisions: premises; or (1) This insurance applies only with (2) Structural alterations, new respect to the following hazards for construction or demolition operations which the state or political performed by or on behalf of such subdivision has issued a permit in additional insured. connection with premises you own, SB-300106-A Page 2 of 6 (Ed. 03/06) (Version 1.0) SB-300106-A (Ed. 03/06) e. Mortgagee, Assignee or Receiver A mortgagee, assignee or receiver but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of a premises by you. This insurance does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. f. Owners/Other Interests — Land is Leased An owner or other interest from who land has been leased by you but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the land leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to lease that land; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. g. Co-owner of Insured Premises A co-owner of a premise co -owned by you and covered under this insurance but only with respect to the co -owners liability C- as co-owner of such premises. h. Lessor of Equipment Any person or organization from which you lease equipment. Such person or organization are Insureds only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their written contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: (1) To any "occurrence" which takes place after the equipment lease expires; or SB-300106-A (Ed. 03/06) (2) To "bodily injury," "property damage" or personal and advertising injury" arising out of the sole negligence of such additional insured. i. Managers or Lessors of. Trade Shows or Convention Centers Any person or organization from which you lease space at a premises for a trade show or convention, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf pertaining to the specific part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to lease space at that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. Any Insurance provided to an additional insured designated under paragraphs b. through i. above does not apply to "bodily injury' or "property damage" included within the "products -completed operations hazard." The following is added to Paragraph H. of the BUSINESSOWNERS COMMON POLICY CONDITIONS: H. Other Insurance 4. This insurance is excess over any other insurance naming the addltlonal insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this Insurance be either primary or primary and noncontributory. D. PROPERTY DAMAGE — PATTERNS, MOLDS AND DIES Paragraphs (3) and (4) of Exclusion k. Damage to Property of Section B. Exclusions Applicable to Businessowners Liability Coverage do not apply to patterns, molds, or dies in the care, custody, or control of the insured if the patterns, molds or dies are not being used to perform operations at the time of the loss. A limit of $25,000 per policy periodapplies to Property Damage — Patterns, Molds and Dies and is included within the General Aggregate Limit as Page 3 of 6 (Version 1.0) SB-300106-A (Ed. 03/06) described in Section D. Liability And Medical Expenses Limit of Insurance. The insurance afforded by this provision D. is excess over any valid and collectible property insurance (including any deductible) available to the insured, and the Other Insurance Condition is changed accordingly. E. BODILY INJURY Section F. Liability and Medical Expense Definitions Applicable to Businessowners Liability Coverage Form subparagraph 3. the definition of "Bodily Injury" is deleted and replaced by: "Bodily Injury" means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. F. EXPANDED PERSONAL AND ADVERTISING INJURY 1. The following is added to Businessowners General Liability Conditions, F. Liability and Medical Expense Definitions, 14. the definition of "personal and advertising injury": h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only If such discrimination or humiliation is: (1) Not done intentionally by or at the direction of: (a) The insured; or (b) Any "executive officer," director, stockholder, partner, member or manager (if you are a limited liability company) of the insured; and (2) Not directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person or persons by any insured. 2. Exclusions of Section B 1. Applicable to Business Liability Coverage, p. Personal and Advertising Injury is amended to include the following: (15) Discriminatlon Relating To Room, Dwelling or Premises Caused by discrimination directly or indirectly related to the sale, rental, lease or sub -lease or prospective sale, rental, Sam lease or sub -lease of any room, dwelling or premises by or at the direction of any insured. SB-300106-A (Ed. 03/06) (16) Fines Or Penalties Fines or penalties levied or imposed by a governmental entity because of discrimination. 3. This provision F. (EXPANDED PERSONAL AND ADVERTISING INJURY) does not apply to discrimination or humiliation committed in the states of New York or Ohio. Also, EXPANDED PERSONAL AND ADVERTISING INJURY does not apply to policies issued in the states of New York or Ohio. 4. This provision F. (EXPANDED PERSONAL AND ADVERTISING INJURY) does not apply if Section I — Coverage B — Personal And Advertising Injury Liability is excluded either by the provisions of the Coverage Dart or by endorsement. G. MEDICAL EXPENSE LIMIT I. Paragraph 3. of D. Liability And Medical Expenses Limits of Insurance Applicable to Businessowners Liability Coverage Form is deleted and replaced by the following: 3. Subject to item 2. above, the most we will pay for the sum of all damages because of all "bodily injury" and "property damage" and "medical expenses" arising out of any one "occurrence" Is the Llablilty and Medical Expense Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the greater of: (1) $15,000; or (2) The Medical Expense Limit shown in the declarations. 2. This provision G. (Medical Expense Limit) does not apply if Medical Expense is excluded either by the provisions of the Coverage Part or by endorsement. H. SUPPLEMENTARY PAYMENTS Under A Coverages 1, Business Liability (Bodily Injury, Property Damage, Personal and Advertising Injury Coverage Extension — Supplementary Payments, Paragraph (1) (b), 1. Under Section I — Supplementary Payments — Coverag+es A and B, Paragraph 1.b., the limit of $1,000 shown for the cast of ball bonds is replaced by $2,500: 2. In Paragraph 1 A., the limit of $250 shown for daily loss of earnings is replaced by $1,000. Page 4 of 6 (Version 1.0) SB-300106-A (Ed. 03/06) I. PROPERTY DAMAGE — ELEVATORS Section B Exclusions Applicable to Businessowners Liability Coverage Form paragraphs (3), (4) and (6) of Exclusion k. and Exclusion I. do not apply to the use of elevators. The insurance afforded by this provision I. is excess over any valid and collectible property Insurance (including any deductible) available to the insured, and the Other Insurance Condition is changed accordingly. J. LEGAL LIABILITY— DAMAGE TO PREMISES 1. Under Section B — Exclusions Applicable to Businessowners Liability Coverage Form Exclusion k. is replaced by the following. "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems) to premises including the contents of such SB-300106-A (Ed. 03106) premises, rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section D. Liability and Medical Expense Limits of Insurance. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard." 2. Under Section B. Exclusions 1. Applicable to Business Liability Coverage the last paragraph is deleted and replaced by the following. Exclusions c. through n. do not apply to damage by tire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Damage to Premises Rented to You Limit of Insurance applies to this coverage as described in Paragraph D. Liability And Medical Expenses Limits of Insurance. 3. Paragraph 5. of D. Liability and Medical Expenses Limits of Insurance Applicable to Businessowners Liability Coverage Form is replaced by the following: 5. The most we will pay under Business Liability Coverage for damages because of "property damage" to premises rented to you, or In the case of fire, lightning, explosion, smoke, or leakage from automatic fire protective systems, while rented to you or temporarily occupied by you with the permission of the owner, is the Damage To Premises Rented To You Limit is the greater of: a. $500,000; or b. The Damage To Premises Rented To You Limit shown in the Declarations. The Damage to Premises Rented to You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leakage from automatic fire protection systems, or any combination of the five. If more than one limit of insurance under this policy and any endorsements attached thereto apply to any claim or "suit," the most we will pay under this policy and the endorsements is the single highest limit of liability of all coverages applicable to such Page 5 of 6 (Version 1.0) SB-300106-A (Ed. 03/06) claim or "suit." However, this paragraph does not apply to the Medical Expenses limit set forth in paragraph G. Medical Expense Limit, above. The Limits of this policy apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting at the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. 4. This provision J. LEGAL LIABILITY — DAMAGE TO PREMISES does not apply if Damage To Premises Rented To You Liability under A. Coverages 1. Business Liability is excluded either by the provislons of the Coverage Part or by endorsement. K. BROAD KNOWLEDGE OF OCCURRENCE The following is added to E. Businessowners General Liability Conditions Applicable to Businessowners Liability Coverage Form. 7. Broad Knowledge of Occurrence You must give us or our authorized representative notice of an "occurrence," offense, claim, or "suit" SB-300106-A (Ed. 03106) only when the "occurrence," offense, claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) An executive officer or the employee designated by you to give such notice, if you are a corporation; or (4) A manager, if you are a limited liability company. L. NOTICE OF OCCURRENCE The following is added to paragraph 2. of E. Businessowners General Liability Conditions Applicable to Businessowners Liability Coverage Form — Duties in The Event of Occurrence, Offense Claim or Suit: Your rights under this Coverage Part will not be prejudiced if you fail to give us notice of an "occurrence," offense, claim or "suit" and that failure is solely due to your reasonable belief that the "bodily injury" or "property damage" is not covered under this Coverage Part. However, you shall give written notice of this "occurrence," offense, claim or "suit" to us as soon as you are aware that this insurance may apply to such "occurrence," offense claim or "suit." Page 6 of 6 (Version 1.0) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY we 00 0313 (Ed. 4-84) WAIVER OF OUR RIG14T TO RECOVER FROM OTHERS ENDORSEMENT "4"V"e have the right to recover out payments from anyons liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. ('his agreement applies only to the extent that you perform worn under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule, Schedule Hlanket City of El Segundo 314 Main St El Segundo; CA 90241V I--," This endorsement changes the policy to which" is aaached and is effective on the date Issued unless otherwise stated. (fie Information below is required only when this endorsement Is Issued subsequent to Preparation of the pollcy? . Endorsement Efteotivs 3/ 2 2/ 13 Policy No. W C 5 8 6 0 6 8 9 71 ofmn1 Insured Digital Health Department Inc j countersigned by Insuranoe Company TM Continental Insurance_ Company We 00 0313 (Ed.4- 4) copyright i 983 National !round! on CorrlpensaUan Insurance.