PROOF OF INSURANCE (2024 - 2024) CLOSEDN
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Client#: 1252713 305STRADYOC
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ACORD.CERTIFICATE LIABILITY I [!1;2312023 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 thecertlficat .... .. " .-_-__" -__ ..-.,...___ � _- -.--_ ___..._.- -v,.--,._-.-_ ... _ _----
e 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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER N,d 14WEAC
McGriff Insurance Services LLC aoa -- FAQ
A_C,R�g xl ....... . �)Ru V�o�-.-
130 Theory Ste 200 ED AIL ,, CertsCA@McGriff.com
Irvine, CA 92617
714 941-2800 INSURERIS) COVERAGE C NAIC k
INSURER B : Federal Insurance P y ..0397
_ INSURER A 9 Insurance Company 2
INSURED rance Company 20281
Stradling Yocca Carlson & Rauth APC _. ...-
660 Newport Center Drive, Suite #1600 INsuaER c
Newport Beach, CA 92660 INSURER D
INSURER E
_........... _ -- _ a __- __
INSURER F :.
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.
TR
TYPE OF INSURANCE
POLICY
�.�,..
YLIMITS
(5/01/2023
A
�(�C0MMERCIALGENERALLIABILITY
........,,,-
35327003
e
05 /01/2024 024r EACH OCCURRENCE $1 m000,000
CLAIMS -MADE Xm� OCCUR
PR t'IOB�E.NpE'1
J 10 a;NT�1 a000,000
MED EXP (Any one person} $1 Oa 000
..,, .....
PERSONAL&ADV INJURY $1,0001000
............................. .. .....,.,.......,
GENL AGGREGATE APPLIES PER:
GENERAL AGGREGATE $210%000
PLI MIT
(� V
X,
. m„ POLICY YJECT w „I LOD
PRODUCTS COMP/OP AGG $INCLUDED
OTHER;
B
.....-.-_.........
74988851 .- .......,.
000 0
5/01/2024 , OO
5/01/2023 0..,-al'SIE}},IIa6CIF.IM1T �. a
-ryAUTOMOBILELIABILITY
ANY Auro
..
BODILY INJURY (Per person ) 1 $1
OWNED SAUTCHEDULED
AUTOS ONLY OS
BODILY INJURY (Per accident) $
__..
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
,......... ,,,
RRr7W G'f411'YQAMF%r"'F
gPrr aar1ltlt nNk $ --_
B
TX
OCCU
X�
�79726620
EAH OCCURRENCE
5/Oi/2023 05/01/2024cF 000000
CLAIMS-MADE,..
EXCESS ABIAB
AGGREGATE $27.000.000
A AND EMPLOYERSEN i aE:cEcuTlvE� 71700994 1/03/2023 11/03/2024 XL IER
STATL �ORH 1
OFFANY PEFVMF. T ERdPA, a ..m �. ..
i"bF�'li"L'F�^Ct.EFMCiE6�&FM�i"2L!CgEf,7". N/A
(Mandasaaiy In NH) E L DISEASE EA EMPLOYEE 31
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L., DISEASE - POLICY LIMIT $1
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
RE: Contract Agreement. City of El Segundo its officials, and employees are included as Additional Insured
as respects General Liability as required by written Contract. General Liability is Primary and
Noncontributory as required by written contract. Waiver of Subrogation applies as respects Workers
Compensation as required by written contract. 60 Day Notice of Cancellation- Nonrenewal (20 Day In the event
of non-payment).
City of El Segundo
Attn: Administrative Technical Specialist
350 Main Street
El Segundo, CA 90245-0000
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
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
107 #S33113881/M33113623 SSTAN
M-
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IN
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Liability Insurance
Endorsement
Policy Period
05/01/2023 to 05/01/2024
Effective Date
05/01/2023
Policy Number
35327003
Insured Stradling Yocca Carlson & Rauth APC
This Endorsement applies to the following forms:
GENERAL LIABILrrY
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 organizatimis an insured only:
if and then only to the extent the person or organization is describedin the Schedule; J
status as an insured;
for activities that did not occur, in whole Or in F. before the execution of the contract o
agreement; and
w r damaves. loss. cost or exDens e for iniury or d4w.?ae to which this insurani,
4R
, Ar MION"i,
that is more specificaflyidentified under any other provision of the Who 1% An Insured
section (regardless of any limitation applicable thereto).
with respeetto any assumption of liability(of another person or organization)by them in a
cWtt'ViCt WTAM'e gi j jo J�e jjq'fJ16 for dam q_ �l 4StA)r
would have in the absence of such contract or agreement.
Liability Insurance Addidonal Insured - continued
Form 80-02-2367 (Rev 5-07) Endorsenwg Page I
a
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Liability Endorsement
(continued)
Conditions
Other Insurance - If you are obligated, pursuant to a contract or agreement, to provide the person or organization
PHmary, Noncontributory shown in the Schedule with primary insurance such as, is afforded by this policy, then in such case
Insurance - Scheduled this insuranceis primary and we will not seek contribution from. insurance availableto such person
Person Or Organization or organization.
Schedule
i urance ns as is afforded by this policy.
All other terms and conditions remain unchanged.
Authorized Representative
Liability Insuranoe Additionalinsured-Sch!d e�]LqLl%q lastpage
_jL i
Form (7,02-2367 (Rev. 5-07) Endorsement Page 2
0
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Stradling Yocca Carlson & Rauth APC
35327003
CHUBS®
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 'I I lie first named insured may cancel this policy or any of Us individuall coverages at any time by
sen(fing us a written request or by retuining die iliolicy and stall ag when thtreaft.er cancellation is to
uae effect.
We may cancel this policy or any ofits individual coverages at.. any Lirne by sending to the first
narnrd insured a notict 60 days (20 days, in the event of non-payment of'preniihim) in advance of
the cmicellation (late. Our notice of cmicellation will be mailed to the first nanied insured"s last
known address, and Yvill. indicate the date on which coverage is torminate(iff Notice of cancellahon
is mailed, proof of maifing will be sufficient proof af notice.
'I'lic earned. prer.n.hun will be computed. on a pro rata basis. Any uneamed prei.M.'um will lie returned
as soon is practicable.
O�anges 1,110s :xAicy Can only bo Changed by a vYnKen audorstflmiiii dhzit lxcowncs pait of Lhis policy, He
en6wsenr,in� ansil bc hy cine ofour auffioril"e'd lielnos0..lw0ve's
Cotnplianc,,e By himuoreds 96,, have iic� difly w provu]e coveiragic under 116s podcY, uriless you and miy MicK ifivLflved iiamared
have, hifly oi�nnpfied w�ffi 'afl of iho �CrT�ns ffild GOIR11611111S Of ffiC t)Ofi'Jy,
ColfrViiance �illfth This kwuiznce docs noL apIl!fly k) ffie cMent fl�M Lrade, cn cconom�c SancGonsoii OJI(3 LMNIS M
A�!�'lil�nf,'�),�,f��,11,�C�il,�io:�, � rogafladons pTohi1!!it us fimihmirarice
113anctions
Any wrens of thils irmurasice whichave irl conwet vvidil the q�)Pficabo Ma1u 6s of flic MaLe in whwh
ads lug ficy is kswxl are:;unundcd to coliffbnn faun Such stanacs,
Frst Named Insured The person or organization first namied in the, Decluations is.prifrizrily responsilAc fbr paynnent of
all prerniurns. The first narned insured will act on behalf Dui" ali other named insureds for the giving
and. receiving of'notice of cancellation or nonrenewal and the receiving of any return preaniums that.
Nxorne, payable under this policy.
Wemulv�
mac unspccukxis and ^anvcys w myOiinel',
give you rcp)ris on i1w, coiii(fl6ons we find; and
rMCM11111crid cltmges.
Common Policy Conditions
Form 80-02-9090 (Rev, 6-05) Contract
Page 1of2
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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.
�x
itles Of Paragraphs I'lie titles of the various ltaralp,raphs of this po Ucy and endorserneMs, U" any, attached to this policy
are inseii ted solely for convenience or reference and are not to be deemed in any way to lirn.h. or
affect the provisions to which they relate,
Fransfer Of Rights And Your irights and duties under this inskmaice may not the transferred without our written consent,
Duties Howeweir, if you die, then your rights and duties will be, transferred to your legal represrntative, but
only while acting within the scope of duties as your legal representative, or to anyoii.-ie hav[ng
b
temporary custody of your property until your legal representative has been appointed,
When We Do Not Pene w If we decide not to renew this policy, we will mail or deliver to the first, named insured's last known
address, written notice of the nonrenewal notless than 60 days before the expiration date. If notice
of nonrenewal is Irnailed, proof of mailing vrill be sufficient, proof of notice"
Common Policy Conditions
Form 80-02-9090 (Rev. 6-05) Contract Page 2 of
112
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C H U B B® Liability Insurance
Endorsement
Policy Period 05/01 /2023
Effective Date 05/01/2023
Policy Number 35327003
TO 05/01 /2024
Insured Stradling Yocca Carlson & Rauth APC
Name of Company FEDERAL INSURANCE COMPANY MAY 8, 2022
Date Issued
This Endorsement applies to the following forms:
GENERAL LIABILITY
Under Conditions, Transfer Or Waiver Of Rights Of Recovery Against Others, the following
provision is added;
Conditions
Transfer Or Waiver Of However, we waive any right of recovery we may have against the designated person or organization
Rights Of Recovery shown below because of payments we make for injury or damage arising out of your ongoing
Against Others operations or done under a contract with that person or organization and included in the
produck-completed operations hazard. This waiver applies to the designated person or
organization.
Designated Person Or Organization
PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT
TO A CONTRACT OR AGREEMENT, TO PROVIDE WPPH SUCH INSURANCE
AS IS AFFORDED BY THIS POLICY,
All other terms and conditions remain unchanged.
Authorized Representative Q-0-SAI-1 0a
Liabtiity Insurance Condition - waiver Of Transfer Of Rights Of Recovery
Form 80-022362 (Rev. 4-01) Endorserent
last page
Page 1
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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 natned in the Schedule, but this waiver applies only with respect to bodily injury
arising out of the operations desvri eti 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
Specific Waiver
Marne of person or organization
() Blanket Waiver
Any person or organization for whom the gamed Insured has agreed by written contract to furnish this waiver.
2. Operations:
3• PrerniUM,
The premium charge for this endorsement shall be _1% ,, percent of the California premium developed on payroll in
connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Minimum Premium:
._� this riz6d .Represe'tative
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 11/03/2023 Policy No. 71700994 Endorsement No.
Insured Stradling Yocca Carlson & Rauth APC Premium $ Incl.
Insurance Company Vigilant Insurance Company
Countersigned By
WC 30 03 75 (05/18)
I
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