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PROOF OF INSURANCE (2023) CLOSEDC CERTIFICATE OF LIABILITY INSURANCE DATE`MM,DD,YYrY) 11/9/2023 8/15/2023 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. 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 Lockton Insurance Brokers,LLC NAME.: CA License #01715767 PHONE � FAX 777 S. Figueroa Street, 52nd fl. a N.g Eats m. .... Los Angeles CA 90017 ADDRESS` 213-689-0065 _ INSURER(S) AFFORDING COVERAGE . NAIC # INSURER A: Travelers Property Casualty Comeany of America 25674 .................. .............................. .�e............�... INSURED Willdan Engineering INSURER B : Allied World 1506306 2401 East Katella Avenue, Suite 300 INSURER C : Anaheim, CA 92806 INSURER D INSURER E : Lines Insurance rr1VFRAr:FS WIT TT)fll rFRTIFIrATF NIIMRFR^ 10Rt lnIO REVISION NUMBER' "k"'Y 1(`YYYY 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. 1"N5ft TYPE OF INSURANCE.... SUBRi ................POLICY NUMBER.. -- .,�.... POLICY F POLICY EXP' ..,..`... ........ ..--. ..-.•.,...._........_ LTR E MMIDDAR'YYY MM1DO YY LIMITS A ^(' COMMERCIAL GENERAL LIABILITY Y i N I P-630-7TO16289-TIL-22 11/1/2022 11/9/2023 EACH OCCURRENCE x CLAIMS -MADE CCeUR PREM4SEa..,,&aoco�pawr Q000 ., _Epp. Benefits ts Llab..Oe MED EXP (Any one wwwwp.$1A a 5,OQ Contr. Liab. Incl._.._ URY NAL &ADV INJ PERSO......................_,._.....,,..._.a $ 1 Q00 �00 _.n. 1 GEN'LAGGREGATE LIMIT APPLIES PER: AGGREGATE $ 2 000,000 POLICY JEC LOC µ,GENERAL PRODUCTS -COMP/OP AGG ,. $ 2 000 000 J OTHER, $ A AUTOMOBILE LIABILITY y N 810-7TO1965A-22-43-G 11/9/2022 I1/9/2023 COMBINED SINGLE: L,G M;I'T L c ,das R $ 1,000000 ANY AUTO BODILY INJURY (Per person) ------------ ........................_ $ .xxxxxxx —. -.._..a ....w.�. OWNED SCHEDULED BODPEYRITJYUDRY(PGeacadenl) $ xxXx AUTOS ONLY AUTOS HIRED NON -OWNED L ...... - $ XX Xxxxx AUTOS ONLY AUTOS ONLY '... R?rrrwocad�ppcRl $xxxxxxx UMBRELLA LIAB OCCUR '... '... NOT APPLICABLE EACH OCCURRENCE U $ xxxxxxx ..._...w EXCESS LIAB CLAIMS -MADE! ''... ''.... .. ..... AGGREGATE $ XxxXXXX - _-..m-._.- _..,�„�,.. ' D, RETENTION $ $- xxxxxxx A WORKERS COMPENSATION Y AND EMPLOYERS' LIABILITY UB-7T02108A-22-43-G 11/9/2022 11/9/2023 XIPT m OTH- - J s ATUTE E_R.... YIN ECUTIVE """ E L EACH ACCIDENT $ ] OOO�OQO OANY FFICERIMEMBER EXCLUDED? N / A i (Mandatory in NH) i E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under.._ DESCRIPTION OF OPERATIONS below ................ E.L. DISEASE - POLICY LIMIT $ 1. 000 000 B Arch&Eng Prof N Y 0313-5950 11/9/2022 11/9/2023 Per Claim:$1,000,000 Aggregate: $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. RE: Fire plan review services. City of El Segundo is included as Additional Insured(s) in accordance with the provisions of the General Liability and Automobile Liability policies. A Waiver of Subrogation is granted in favor of City of El Segundo in accordance with the policy provisions of the Professional Liability and Workers' Compensation policies. CERTI 19811079 City of El Segundo Attention: Nicole Pesqueira 350 Main Street El Segundo, CA 90245 ACORD 25 (2016/03) 4WAIIIIIINI 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 ©1688-201!rACMD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Attachment Code: D604000 Certificate ID: 19811079 T VE LERS ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 (A) - 007 POLICY NUMBER: UB-7T02108A-22-43-G 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 UB-7T02108A-22-43-G Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 11-21-22 ST ASSIGN: Page I of i