Loading...
PROOF OF INSURANCE (2025)d DATE (MMIDD/YYYY) C40RL> CERTIFICATE OF LIABILITY INSURANCE 3/18/2024 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 CONrACT Edgewood Partners Ins. Center/Greyling PHONE 1Pr�y hloyola FAx" 3780 Mansell Rd. Suite 370 E-MAIL E MAIL re lln carts re lln om Alpharetta GA 30022 _AlafzREs 9_..Y,,..g , � "� 9 _�m..... ...... _ ..... -- INSURER S) AFFORDING COVERAGE NAIC # INSURERA National Union Fire Ins Co of Pittsbu 19445 --- .....,..�KIMLASS ~INSURERC New H ce Com Inc �, 19489 421 KirriIFa ettev fie SAtreetCSu to 600 amd sh re Insuren� _ INSURED INSURERS Allred CO (U S ) INSURER D LIO d 5841 y P. Pant 23 Raleigh, NC 27601 �_----_ y s of London m _ _y 8 202 9 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1977475902 KCVI,IUN NUMtStK: 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. ..... ..� ......., ....----_AWL AA���I__, ------ T ---...... ..... .����...MMIPQ/YYYY CY EXP LIMITS . .... ........_ ...TYPE INSR OF INSURANCE POLICY NUMBER iAM/D....... LTR DPYYYY.. ( MMERCIALGENERALUABILITY GL5268169 4I1I2024 4l1/2025 EACH OCCURRENCE s2,000,000 � �� PREMISESlEs ogaurrenceJ $1,000,000 _ CLAIMS -MADE OCCUR ggM fbR N;y! . _...... $ 25,000 X MED EXP (And one Person)..,„..--. — .. .......... Contractual Liab ......... PERSONAL 8 ADV INJURY $ 2,000,000 _ � A GEN L AGGREGATE LIMIT APPLIES PER. GREGATE $ 4.0 00 000 ....l C ..... �...- .-- ............ - POLICY X P'O X LOC PRODUCTS COMP/OP AGG $ 4,000 000 OTHER • AU 7 MOBILE LIABILITY 4489663 () 4/1/2024 4/1/2025 rddm COMBDINGLk LIMIT $ 2,000 OOOWm ...... A.- '... X ANY AUTO CA (MA) 4/1/2024 4/1/2025 �,_BODILY INJURY (Per person) $ - OWNED SCHEDULED BODILY Peraca dent) $ AUTOS ONLY X AUTOS HIRED NON -OWNED fl ROPEfrTYDAMAGE $ AUTOS ONLY AUTOS ONLY Grcartlen —.) B X UMBRELLALIAB X OCCUR 03127930 4/1/2024 4/1/2025 EACH OCCURRENCE $5000 000 _ X EXCESS LIAR CLAIMS -MADE AGGREGATE... _ �. $ 5 000 000 ,...... .—_..- . .�...... .. DED X RETENTION $ $ C WORKERSCOMPENSATION WC015893685 AOS ( ) 4l1/2024 4/1/2025 PER X ER STATUT O F C AN.. D EMPLOYERS' LIABILITY Y / N WC015893686 (CA) 4/1/2024 4I1I2025 E1 EACH ACCIDENT $ 2 ANYPROPRIETOR/PARTNERIEXECUTIVE N 'OFFICER/MEMBER EXCLUDED? N/AI -- ,000000 . _ (Mandatory in NH) E,L DISEASEµ EA EMPLOYEE $ 2.000 000_ If yes, describe under ��� �� �� � m..-� ---{ EL DISEASE LIMIT � ----- 9 $ 2,000,000 DESCRIPTION OF OPERATIONS below -POLICY D Professional Liability B0146LDUSA2404949 4/1/2024 4/1/2025 Per Claim Aggregate $2,000.000 $2,000.000 DESCRIPTION Of OPERATION'S F LOCATIONS I VEHICLE'S (ACORD 14't, Addlllonal'.. Remarks Schedule„ may be attached if more space is required) Re KHA Project 4094342017 - El Segundo "EMT & TDM; Rita Garcia. The City of El Segundo, its officials & employees are named as Additional Insureds with respects to General Liability where required by Written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' Written notice (except 10 days for nonpayment of premium) Will be provided to the Certificate Holder. Waiver of Subrogation in favor of Additional Insured(s) Where required by written contract & allowed by law. CERTIFICATE HOLDER CANUtzLLAIIUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo CA 90245-0000 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 526-81 -69 COMMERCIAL GENERAL LIABILITY CG20101219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following, COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location($) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO Information required to complete this Schedule, if not shown above, will be shown in the Declarations„ CG 20 10 12 19 A Insurance Services Office, Inc., 2018 Page 1 of 2 ❑ A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) C designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 0 Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER: 526-81 -69 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR. CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organiation(s) ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Location And Description Of Completed Operations PER THE CONTRACT OR AGREEMENT. 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(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance 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. B. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below. This endorsement, effective 12:01 AM 04/01/2024 Issued to KIMLEY-HORN AND ASSOCIATES, INC. By NEW HAMPSHIRE INSURANCE COMPANY forms a part of Policy No. WC 015-89-3685 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. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST, UNDER ANY WRITTEN CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE OCCURRENCE OF LOSS. This form is not applicable in Kansas for private construction contracts as defined in K.S.A. 16-1801 through K.S.A 16-1807 or public construction contracts as defined in K.S.A. 16-1901 through 16-1908, except where permitted by statute or other applicable law, such as for use in wrap-up insurance programs. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. This form is not applicable in California, Kentucky, New Hampshire, New Jersey, Texas, or Utah. WC 00 03 13 Countersigned by ....�. Authorized Representative