PROOF OF INSURANCE (2024 - 2024) CLOSEDA R CERTIFICATE OF LIABILITY INSURANCE FIDATE (MMDDZ"
01/22J2024 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 INSUli AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTAWt If the certificateholderis an AODMONAL INSURED, the policy(ies) must have ADMTiONALINSURED provisions or be endorsed,
If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
i this certificate does not confer rights to the certificate holder in lieu of such ondomemont(s).
PRODUCER Cz_N1A(_.TDsa Anderson
NA,ME�
Shaw Moses Mendenhall & Associates Iris. Agency PHORE (626) 799-7813 1,PV)rAC No _(626) 799- 784
License #0094511 !HA lisa@—smmainsurance-ccm Nol:
ADDRESS:
........... ....
625 Fair Oaks, Suite 158 p INSURER($) AFFORDING COVERAGE !AIC 0
South Pasadena CA 91030 tUSURERA: Travelers Gas and Surety
.. . . . ...... ....
INSURED Tomovich &Associates INS.UREA R: Stale Compensalian ins Fund
INSURER C: Evanston Insurance Company
9611 Beverly Road INSURER D
_INSURER E
Pica Rivera CA 90660 INSURERF.
COVERAGES CERTIFICATE NUMBER: 2!023-2024 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 MAYBE 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,
L GUEM . . .... FULP ...... . . . . . . poucy P
TYPE OF INSURANCE LIMITS
LTR TYPE OF 11 MsD WVD POLICY NUMBER MWOON"yyys
... . . ......
iYYYys ffq I
X COMMERCIAL G9;9iZuXBILrTY EACH OICURREprE 3 1,000,000
CLAW[SWADE OCCUR S 50,000
,E11FI�lSESlFa-_r or.,�A Ag_ _L_
MED EXP on) $ 5,000
'. ...... .
A 4TC07T94858ATCT23 09/1512023 0911512024 PER SONAL&ADVINJURY is 1,000.000
GZWLAGGREGATE LIMITAPPLIES PER ±MRALAq0AEGATE 5 2.000.000
_<L�POLI'C'Y L_ J IPRC"i LOC _Lq0ouCTS . co�r��m GG s 2.000.000
1E
0 'T
THER-
AUTOMOBILE LIABILITY U:a ac�dW.000
X ANYAUTO BODILY INJURY (Per person) S
A OWNED F--] SCHEDULE® 8107T95400223 0911512023 0911512024 BODILY INJURY (per S
OS AURTONLY -_ — _M_ - ................ HIED NON-TEP F5ROO TYDAMA06
AUTOS ONLY AUTOS NL, [Nr.acCdfnfi
H I Medical payments S 5,000
. . . ..........
...........
>< I. UMBREI OCCUR S 1,000,000
A CUP7T95470823 09/1512023 09115/2024 1,000,000
I AGGREGAI E
LIAB
__L
i_1'Z'1-'C1F.7 T-R;Tim . . ....
AND EMPLOYERTUABILITIONY YINFLR rR
ANY PROPR�ETOPZIPARTNuR,rr'K,-�,C�fTOi'E My s 1.000,000
B N/A 916926622 11101/2023 11,101/2024
0rrA,',C-RN5,&1aER 1,000,000
IMandatary In NHJ
11 9es, daSrritm under
1,000,000
c Pollution Liability CPLMOL119313 0911512023 09/15f2024 Aggregate Limit $2,000,000
...... .... .....
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddItional Remarks Schedule, may he aKach@d if more space Is requilred)
The City of El Segundo, its officials and employees and volunteers are added as Additional Insured. Coverage is primary and non-contributory. Waiver of
subrogation provided
'30 day notice of cancellation except 10 days for non-payment
CERTIFICATE HOLDER CANCELLATION
kW#1
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ElSegundo CA 90245
0"FClI'v
1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD
INSURANCE REQUIREMENTS
[MUST BE SUBMITTED WITH PROJECT PROPOSAL]
Company Name: Tomovich & Associates
To be awarded this contract, the successful bidder must procure and maintain the following types of
insurance with coverage limits complying, at a minimum, with the limits set forth below:
Tvne of Insurance Limits
Commercial general liability: $2,000,000
Business automobile liability: $1,000,000
Workers compensation: Statutory requirement
Commercial general liability insurance must meet or exceed the requirements of ISO-CGL Form No. CG
00 01 11 85 or 88. The amount of insurance set forth above must be a combined single limit per
occurrence for bodily injury, personal injury, and property damage for the policy coverage. Liability
policies must be endorsed to name the City, its officials, and employees as "additional insureds" under said
insurance coverage and to state that such insurance will be deemed "primary" such that any other
insurance that may be carried by the City will be excess thereto. Such endorsement must be reflected on
ISO Form No. CG 20 10 11 85 or 88, or equivalent. Such insurance must be on an "occurrence," not a
"claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior
written notice to the City.
The insurer will agree in writing to waive all rights of subrogation against the City, its officers, officials,
employees and volunteers for losses arising from work performed by the Contractor for the City.
Automobile coverage must be written on ISO Business Auto Coverage Form CA 00 01 06 92 or CA 00 0I
01 87, including symbol 1 (Any Auto).
The Consultant must furnish to the City duly authenticated Certificates of Insurance evidencing
maintenance of the insurance required under this Agreement, endorsements as required herein, and such
other evidence of insurance or copies of policies as may be reasonably required by the City from time to
time. Insurance must be placed with admitted insurers with a current A.M. Best Company Rating
equivalent to at least a Rating of "A:VII." Certificate(s) must reflect that the insurer will provide thirty
(30) day notice of any cancellation of coverage. The Consultant will require its insurer to modify such
certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of
cancellation imposes no obligation, and to delete the word "endeavor" with regard to any notice
provisions.
By signing this form, the bidder certifies that it has read, understands, and will comply with these
insurance requirements if it is selected as the City's consultant. Failure to provide this insurance will
render the bidder's proposal "nonresponsive."
1 /2 <--/z `I
Date
I-C-15
7-2.4
7-3
RECORD Of 'WA(al S IA1D: l'SPI C7"ION
Every Contractor and subcontractor will keep an accurate certified payroll records showing the
name, occupation, and the actual per diem wages paid to each worker employed in connection
with the Work. The record will be kept open at all reasonable hours to the inspection of the body
awarding the contract and to the Division of Labor Law Enforcement. If requested by the City, the
Contractor will provide copies of the records at its cost,
LIABIL1DNSIC HA ICE,
Subsection 7-3, Liability Insurance, of the SSPWC is deleted in its entirety and replaced by the
following subsections.
7-3.1 GENERAL
Contractor will procure and maintain for the duration of the contract the following insurance
coverages and limits against claims for injuries to persons or damage to property which may arise
from or in connection with the performance of the work covered by this agreement by the
Contractor, its agents, representatives, employees or subcontractors:
COVERAGE PER OCCURRENCE
Comprehensive General Liability
Business Auto
Workers' Compensation
ISO FORM COMBINED
SINGLE
LIMIT
CG 20 10 11 85 or 88 $2,000,000
CA 00 01 01 87 $1,000,000
Statutory
Contractor will provide endorsements or other proof of coverage for contractual liability,
Combined single limit per occurrence will include coverage for bodily injury, personal injury, and
property damage for each accident.
If Commercial General Liability Insurance or other form with a general aggregate limit is used, the
policy will be endorsed such that the general aggregate limit will apply separately to this contract
and a copy of the endorsement provided to the City.
Liability policies will contain, or be endorsed to contain the following provisions:
GENERAL LIABILITY AND AUTOMOBILE LIABILITY:
The City, its officers, officials, employees, agents, and volunteers will be covered as insureds as
respects: liability arising out of activities performed by or on behalf of the Contractor; products
and completed operations of the Contractor; premises owned, occupied or used by the Contractor;
or automobiles owned, leased, hired or borrowed by the Contractor. The coverage will contain no
special limitations on the scope or protection afforded to the City, its officers, officials, employees,
agents, or volunteers.
The Contractor's insurance coverage will be primary insurance as respects the City, its officers,
officials, employees, agents, and volunteers. Any insurance or self-insurance maintained by the
City, its officers, officials, employees, agents, and volunteers will be excess of the Contractor's
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insurance and will not contribute with it.
The insurer will agree in writing to waive all rights of subrogation against the City, its officers,
officials, employees and volunteers for losses arising from work performed by the Contractor for
the City.
Any failure to comply with reporting provisions of the policies will not affect coverage provided
to the City, its officers, officials, employees, agents and volunteers.
The Contractor's insurance will apply separately to each insured against whom claim is made or
suit is brought, except with respect to the limits of the insurer's liability.
WORKERS' COMPENSATION:
The insurer will agree to waive all rights of subrogation against the City, its officers, officials,
employees and volunteers for losses arising from work performed by the Contractor for the City.
ALL COVERAGES:
Each insurance policy required by this subsection will be endorsed to state that coverage will not
be suspended, voided, cancelled by either party, reduced in coverage or in limits except after thirty
(30) days written notice by certified mail, return receipt requested, has been given to:
CITY CLERK
City of El Segundo
350 Main Street
El Segundo, CA 90245
Notwithstanding the foregoing, the endorsement may state that insurance may be cancelled upon
ten (10 day notification for non-payment of premium. The Contractor will provide the City with
updated proof of insurance should the Contract Time extend beyond the policy expiration date.
All liability insurance will be on an occurrence basis. Insurance on a claims made basis will be
rejected. Any deductibles or self -insured retentions will be declared to and approved by City. The
insurer will provide an endorsement to City eliminating such deductibles or self -insured retentions
as respects the City, its officials, employees, agents, and volunteers.
Except for Workers Compensation Insurance, Contractor will furnish to City certificates of
insurance and endorsements on forms acceptable to the City's City Attorney, duly authenticated,
giving evidence of the insurance coverages required in this contract and other evidence of coverage
or copies of policies as may be reasonably required by City from time to time.
Certificate/endorsement for Workers Compensation Insurance will be furnished on State Comp
Fund or other industry standard form. Except for worker's compensation insurance, all insurance
required herein will be placed with insurers with a Best's Rating of not less than A:VII. Worker's
compensation insurance policies will meet the requirements of California law.
All subcontractors employed on the work referred to in this contract will meet the insurance
requirements set forth for Contractor. Contractor will furnish certificates of insurance and
endorsements for each subcontractor at least five days before the subcontractor entering the job
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site, or Contractor will furnish City an endorsement including all subcontractors as insureds under
its policies.
Except as provided in Subsection 6-10, the Contractor will save, keep and hold harmless the City,
its officers, officials, employees, agents and volunteers from all damages, costs or expenses in law
or equity that may at any time arise or be claimed because of damages to property, or personal
injury received by reason of or in the course of performing work, which may be caused by any
willful or negligent act or omission by the Contractor or any of the Contractor's employees, or any
subcontractor. The City will not be liable for any accident, loss or damage to the work before its
completion and acceptance, except as provided in Subsection 6-10.
The cost of such insurance will be included in the various items of work in the Contractor's bid and
no additional compensation for purchasing insurance or additional coverages needed to meet these
requirements will be allowed.
In the event that any required insurance is reduced in coverage, cancelled for any reason, voided or
suspended, Contractor agrees that City may arrange for insurance coverage as specified, and
Contractor further agrees that administrative and premium costs may be deducted from payments
due to the Contractor. Contractor will not be allowed to work until alternate coverage is arranged.
7-3.2 II.ESP(N>1:I31I.11 1 ] C1 1iMtaE
In addition to the provisions of Subsection 7-3 of the SSPWC as between the City and Contractor,
Contractor will take and assume all responsibility for the work as stated herein or shown on the
plans.
The Contractor will bear all losses and damages directly or indirectly resulting to it, to the City, its
officers, employees, and agents, or to others on account of the performance or character of the
work, unforeseen difficulties, accidents, traffic control, job site maintenance, or any other causes
whatsoever.
The Contractor will assume the defense of and indemnify and save harmless the City of El
Segundo, its officers, employees, and agents, from and against any and all claims, losses, damage,
expenses and liability of every kind, nature, and description, directly or indirectly arising from the
performance of the contract or work, regardless of responsibility for negligence, and fi-om any and
all claims, losses, damage, expenses, and liability, howsoever the same may be caused, resulting
directly, or indirectly from the nature of the work covered by the contract, regardless of
responsibility for negligence, to the fullest extent permitted by law. In accordance with Civil Code
§ 2792, nothing in this Subsection 7-3.2 or in Subsection. 7-3 of the Standard Specifications will
require defense or indemnification for death, bodily injury, injury to property, or any other loss,
damage or expense arising from the sole negligence or willful misconduct of the City, or its
agents, servants or independent contractors who are directly responsible to the City, or for defects
in design furnished by such persons. Moreover, nothing in this Subsection 7-3.2 or in Subsection
7-3 will apply to impose on the Contractor, or to relieve the City from, liability for active
negligence of the City.
The City does not, and will not, waive any rights against the Contractor which it may have by
reason of the aforesaid hold harmless agreements because of the acceptance by the City, or deposit
with City by Contractor, of any insurance policies described in Subsection 7-3 of the Standard
Specifications. This hold harmless agreement by the Contractor will apply to all damages and
II-B-23