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PROOF OF INSURANCE (2025 - 2025)'"� - -- -- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) r- 4/30/2024 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). ER PRoocMt Diablo Blvd 9#230 (mac N Sandy Peters CONTACT �a 369uredPartners Design Professionals Insurance Services, LLC PH -NAME; 66 m1m901 a) .-._ E MAIL Lafayette CA 94549 ADOREss., Ceq!?e ii r�ml�roAssuredPartners corn __ INSURERISI AFFORDING COVERAGE `. NAI'C ' Crum & Forster Specialty Insurance Company 44520 INSURED GALEASS-01 INSURER B : Gale/Jordan Associates, Inc. 310-316-4377 INSURERC: _...._m..._....�..�..................... . 3868 Carson Street, Suite .,...... URER D I�Ms.......................................-.........�......., �aa�......_.... Torrance CA 90503-5613 INSURERE: INSURER F : 1%nvCMAn0Q rCOTICIPATC NII IMRFR• )nQrr:IA97a RFVISION 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. ........ —___....... ................ ..Y E ......... ... S ..CE .. .. ....... '�UBR �..� POLICY EFF POLICY' E'X'P LIMIT I NSR 'I"LT" "' m"" .... TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD/YYYY R A X COMMERCIAL GENERAL LIABILITY Y Y EPK147560 4/28/2024 4/28/2025 EACH OCCURRENCE $10.000.000 X CLAIMS -MADE OCCUR pYiEMpuF,S I a occuRlenrO�,- . 10..0,000 $ 1 _mm X Contractual Lie b MED EXP (Any one person -$m5'000 m— „ _ Included AL & ADV INJURY PERSON ...._ $ 3u000 000 ........... .. .... GEN'L AGGREGATE LIMIT API-.__...—...___�- PLIES PER: GENERAL AGGREGATE -. mmm00 $10.....,000,0....... _....... X..m POLICY PRO JECT LOC PRODUCTS -COMP/OP AGG $ 10 000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y EPK147560 4/28/2024 4/28/2025 OaBINEDS INGLELIMIT COMBINED S $ 1,000,000 .............. ANY AUTO BODILY INJURY (Per person) $ .. OWNED SCHEDULED ...............— BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED X NON -OWNED PR $ AUTOS ONLY AUTOS ONLY (PERTYDAMAGE -�••••• - X NoOw'nad Auto $ UMBRELLA LIAB OCCUR wEACH OCCURRE NCE $ �,m .... . , „ EXCESS LIAB C.L-A-I.M.S_-MA--.D..E. AGGREGATE $ TION $ $DED COMPENSATION IAWORKERS UTE $ �OT Y/N ......... OFFICER/MEMBER ANYPROPRIETOEXCLUDED?ECUTIVE ❑ NIA ., CCIDEN_T EL. a$ ............................_. (Mandatory in NH) D 9EASEm-mEA EMPLOYEE EDISEASE $�- If yes, describe under ON OF OPERATIONS below E L DISEASE POLICY L-� IMIT $ l Liability & EPK147560 4/28/2024 4/28/2025 Per Claim/$3,000,000 $3,000,000/agg Imt Pollution Liab Y EPK147560 4I2B/2024 4/28/2025 Per Claim/$3,000,000 $3,000,000/agg Imt il! Deductible 5,000 each claim" DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Auto Liability is follow -form to the General Liability. Insured owns no comppany vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. "PL Deductible each claim: $5,000 & CPL Deductible each pollution conditlom $5,000 RE: All Operations -- City of El Segundo, its officers, agents and employees are named as additional insured as respects general and auto liability as required per written contract. CERTIFICATE HtJLUI-K L ANk tLLAa IVWII3U Udy NULIL:C Will UC JCIIL LU IIUIUCI 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, Public Works Dept. 350 Main Street El Segundo CA 90245 U 19135-ZU15 AGURL7 CUIMPUKA I IUN. All rignis reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Policy # EPK147560 61 - , ", - Cat & FOSTE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONALR i - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS,POLLUTION LIABILITY COVERAGE PART SCHEDULE me Of Additional Insured Person(s) or Organization(s) Blanket when specifically required in a written contract with the named insured. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability caused, in whole or in part, by "your work" for that insured which is performed by you or by those acting on your behalf. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, EN0111-0211 Page 1 of 1 Policy # EPK147560 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s Blanket when specifically required in a written contract with the named insured A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by you, or by those acting on your behalf. This insurance shall be primary and non-contributory, but only in the event of a named insured's sole negligence. B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of "your work" performed under a designated project or contract with that person(s) or organization(s). C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, EN0118-0211 Page 1 of 1 ACORO® DATE (MMfDOmYY) .,� CERTIFICATE OF LIABILITY INSURANCE 02/01/2024 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 pol"Iey(ies) must 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; EJMS Insurance Services PHONE FAX PO Box 33289 E MAIL ...__. Los Gatos„ CA 95031 _INSURERS I AFFORDING COVERAGE NAIC 0 INSURER A Chubb National Insurance Company 10052 INSURED gale/jordan associates 3868 W. Carson Street, Suite 328 Torrance, CA 90503 CERTIFICATE NUMBER: INSURER C : INSURER D : F: RFVI.4wlnN NI IMRFR, 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. -.. ...,_ ...�.. Y,1?VWVD.°..e... - m....._. ,.....,� _...... .....,........ _ ....... .._.. _ _.. _.,,.. ( POLICY NUMBER,,,,,,,,,,,, TYPE OF INSURANCE MOA 0CC}dYk'YYFY AAAOoI pCN.XT' DfYYYY LIMBS GENERAL LIABILITY EACH OCCURRENCE $ �persl COMMERCIAL GENERAL LIABILITY I��MV rr n $ �one „j CLAIMS -MADE E] OCCUR - - MMED EXPO(Any ,$ LL I PERSONAL & ADV INJURY $ GENERALAGGREGATE �$ GEN L AGGREGATE LIMIT APPLIES PER f PRODUCTS - COMP/OP AGG $ ..... --- PRO- �� POLICY] l OC Is TAUTOMOBILE _._ LIABILITY j COMBINED SBNGL.E.. LIMIT aILzYid _BODILY ANY AUTO AUTO � INJURY person) I $ ALL SCHEDULED OWNED AUIOS AUTOS � BODILY INJURY (Per -, HREDTOS Nu Os PROPERTY .DAMA. GP $ON-0WED UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS AAA E AGGREGATE $ _aa- ---- -- DED RETENTION $ $ WORKERS COMPENSATION A AND EMPLOYERS' LIABILITY (25)7178-54-63 2/01/2024 �2/01/2025 WCSTATU Oti4i-; .X _TQRYt,IM �.�._._... JL13 y.ANY ._._ ... _ YIN. 1PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � � Y N I A E L EACH A $1a000sO1..._ --•- (Mande ory in NH E.L DISEASCCIDENT E EA EMPLOYEE$ 1,000,000 If yes. describe un r DESCRIPTION OF OPERATIONS below-. I ........_._.�...-.-,,,.a..�,-,. _ -..9 wegbq �, .., .n.....01 .,,� �.... E L DISEASE - POLICY LIMIT N $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Christopher K Gale - President: Excluded / Thomas A Jordan - Secretary / Treasurer: Excluded law-.1L111:810 City of El Segundo, Public Works Dept. 350 Main St. El Segundo, CA 90245-3813 CANCELLA 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 REPRESENTA Daniel J Cloud Y r 01988-2010 ACOR ORPORATION. Il rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number GALEIJORDAN ASSOCIATES, INC. Policy Number Number: 25 7115-54w53 Podil y Perrod -Symbol,, Effective Date of Endorsement 02/01 /2024 TO 02101 /2025 02/01 /2024 Issued By (Name or Insurance Company) Chubb National Insurance Company Insert the golicy number. The remainder of the Wormation is to be completed only when this endorsement is issued subsequent to the preparation of the oils . 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 named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described 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 Name of person or organization: ( X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: 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: WC 90 03 75 (05/18) Insured Copy