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PROOF OF INSURANCE (2025)
DATE (MM/DDIY V YY) AC"/RO CERTIFICATE OF LIABILITY INSURANCE 41%�" 6/20/2024 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 CONTACT ... . NAME Gre gun COLS eClalilsf Greyling Ins. Brokerage/EPIC t)---------------------------------------------- AD9 FAX nN ".770 756 y_ 3780 Mansell Road, Suite 370 77-- 75-- 6599 6599 E MAIL Alpharetta GA 30022 D(z( s� " 9re lingcerts�greyiallrlgOm .._. INSURED Geosyntec Consultants, Inc. 900 Broken Sound Parkway NW, Suite 200 Boca Raton, FL 33487-0000 INSURERS) AFFORDING COVERAGE— NAIC # INSURER National Union Fire Ins Co of Pittsburg. 19445 INSURER B,. Everest National Insurance Company 10120 Assurance Co (U.S) Inc INSURER C Allied World,,,,,,,,, .......... ................. --- ......... 19489 ... INSURER D: New Hampshire Insurance Company 23841 CnVFRAr:FS CFRTIFICATF NIIMRFR• 7953595d1 RFVISInN NUMRFR! 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. ."... _ _ �.. m._. — ILTR TYPE OF INSURANCE ADG1L U C POLICY NUMBER POLICY ""FF 'A D fkRor pp LIMITS A l COMMERCIAL GENERAL LIABILITY X C GL5268179 4/1/2024 4/1/2025 EACH OCCURRENCE j"$ 2,000,000 X ` CLAIMS MADE OCCUR }h�v1A rL id RERr'rb � .....— �accurfrru?i�.t�I,.. 500 000 )?�Riakl"DES tea ,' .$ MED EXP I ..25 000 (Any onemperson) ... ................ PERSONAL & ADV INJURY $ 2 000 000 -- --- GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 000 000 m PRO POLICY LOC PRODUCT S - COMP/OP AGG $ 4 000 000 .X" " "I OTHER. $ A AUTOMOBILE LIABILITY CA4489673 4/1/2024 4/1/2025 UUMBINED SINGLE LIMIT (I a accsctl'nlw $ 2 000 000 A h CA4489674 (MA) 4/1/2024 4/1/2025 _ ""' "' ,,,, - X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY IN JURY (Per accident) $ AUTOS ONLY AUTOS X HIRED NON -OWNED PROPLoY DAMAGE $ AUTOS ONLY AUTOS ONLY ,GPrt ra ctlntl) .,rr,,,,.... .................................. B UMBRELLAX XC3EX00336241 4/1/2024 4/1/2025 EACH OCCURRENCE $ 10,000000 X EXCESLIABAB COLAIMS MADE' AGGREGATE $10,000,000 DE D I RETENTION $ Is p WORKERS COMPENSATION WC015893709 (AOS) 4/1/2024 4/1/2025 CX UTE EORiH A AND EMPLOYERS'LIABILITY Y/N WC015893710 CA ( ) 4l1/2024 4/1/2025 111. "_ NYPROPRIETOR/PARTNER/E' ECU I — E L. EACH ACCIDEN T 0 ry OFFICER/MEMBER EXCLUDED. LJ, ( N / A ---- (Mandatory m NH EMPLOYEE E.L. DISEASE- EA E $ 2,000,00 0 ''. es, describe under DESCRIPTION OF OPERATIONS below _ E L. DISEASE POLICY LIMIT $ 2,000,0 00 C Professional Liability (PL)/ 03122723 4/1/2024 4/1/2025 Each Act $8,000,000 Contractors Pollution Liab (CPL) Aggregate $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Stormwater Permit Implementation Assistance; August 13/2016. THe City of El Segundo, its officers & employees are named as Additional Insureds with respects to General & Automobile Liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary & non-contributory where required by written contract. Waiver of Subrogation is applicable where required by written contract & allowed by law. City of El Segundo Public Works 350 Main Street El Segundo CA 90245-3813 IL91LI 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 !�- ©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 -79 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 Organization(s) Location And Description Of Completed Operations 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. 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 B. With respect to the insurance afforded to organization(s) shown in the Schedule, but only these additional insureds, the following is with respect to liability for "bodily injury" or added to Section III — Limits Of Insurance: "property damage" caused, in whole or in part, If coverage provided to the additional insured is by "your work" at the location designated and required by a contract or agreement, the most described in the Schedule of this endorsement we will pay on behalf of the additional insured performed for that additional insured and is the amount of insurance: included in the "products -completed operations 1. Required by the contract or agreement; or 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. 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 (D Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: 526-81-79 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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 Person1s) I Or Organization(s) Location(s) 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 0 Insurance Services Office, Inc., 2018 Page 1 of 2 0 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) 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. C. 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 -79 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 12 19 * Insurance Services Office, Inc., 2018 Paae 1 of 1