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PROOF OF INSURANCE (2009) CLOSEDgnr,nlENT ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 728/2009 PRODUCER BB &T Insurance Services of CA, Inc 680 Langsdorf Drive Suite 100 Fullerton, CA 92831 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED A -1 Fence Company 2831 E. La Cresta Ave. Anaheim, CA 92806 INSURER A: .James River Ins Co(Lemac) 12203 INSURER B: National Union Fire Ins Co of Pitt. 19445 INSURER C: INSURER D: CLAIMS MADE FE OCCUR X BI /PD Ded:5,000 INSURER E: GOVEKAUt, 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR A NSR TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY POLICY NUMBER 000202722 POLICY EFFECTIVE D DD 12101/08 POLICY EXPIRATION DA MM D 12/01/09 LIMITS $1,000.000 DAMAGE TO RENTED DAMAGE TO RENTED S (Ea occurrence) $50 000 MED EXP (Any one person) $Excluded CLAIMS MADE FE OCCUR X BI /PD Ded:5,000 PERSONAL BADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 POLICY X JE O LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ 1 R ANY AUTO $ B XCESS/UMBRELLA LIABILITY BE015872689 12/01/08 12/01/09 EACH OCCURRENCE $5 000 000 AGGREGATE s5,000,000 X OCCUR FI CLAIMS MADE $ DEDUCTIBLE WC STATU- OTH- T FR $ X RETENTION $ 0 WORKERS COMPENSATION AND E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY E.L. DISEASE - EA EMPLOYEE $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: School Drive Adjacent to Camp Eucalyptus; El Segundo, CA City of El Segundo, its officers, officials, employees, are named additional insured as respects general liability and this Insurance is primary and noncontributory with any other insurance of the additional insured, as required by written contract per endorsements attached. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of El Segundo DATE THEREOF, THE ISSUING INSURER WILL 000MRJUt MAIL a n DAYS WRITTEN 150 Illinois Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,M(xRil( El Segundo, CA 90245 7M( 9Q1iR) 1R7016i0Ji: CR1t0[ JQR7GlEkK1IIX7QRXU1XX1NR7GIRlQ1lRIlOt {�7fID@H(iCRibliFR�0�6(i(XX RR91iH6RDDk9[1V7F AUTHORIZED REPRESENTATIVE n 4dQQ ACORD 25 (2001108) 1 of 2 #S3890848/M3127172 nrwrrto ___ _ __._. _. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 -S (2001108) 2 of 2 #S3890848/M3127172 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Or anization s : Locations Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — 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: 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 operrations has been completed: or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Any coverage provided to an Additional Insured scheduled in endorsement CG 2010 or endorsement CG 2037 (when either is attached to this policy) shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless: 1) a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis; or 2) prior to a loss, you request in writing and we agree that this insurance shall apply on a primary and non - contributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US 05 -07 Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE OP ID IVIR L _........__....., LTR A1FEN -1 07/28/09 PRODUCER POLICY NUMBER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION POLICY EXPIRATION DATE MMIDDIYYYY LIMBS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Business & Health Ins Svcs GENERAL LiAO[LRY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1206 E. Yorba Linda Blvd. Paul Ainan EACH OCCURRENCE 'S Placentia CA 92870 $ Phone:714- 577 -6700 8ax:714- 577 -0047 INSURERS AFFORDING COVERAGE NAIC# INSURED S INSURERA: Nationwide insurance Co 23787 CLAIMS MADE D OCCUR INSURER B: A -1 Fence Ccm4p any S INSURER G: 2831 E. La INSURER D: Anaheim CA 92806-1817 INSURER E: GENERAL AGGREGATE L; V V r- KAlat3 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSVEO 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRd TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MMIDDlYYYY POLICY EXPIRATION DATE MMIDDIYYYY LIMBS REPRESENTATIVES. GENERAL LiAO[LRY AUTHORIZED REPRESENTATIVE 150 Illinois Street Paul Ainan EACH OCCURRENCE 'S —_ _, PREMISES Ea occurence $ CO M MERCIAL GENERAL LIABILITY MED EXP (Any one person) S CLAIMS MADE D OCCUR PERSONAL A ADV INJURY S GENERAL AGGREGATE 3 PRODUCTS • COMP /OP AGG 3 GENL AGGREGATE LIMIT APPLIES PER: POLICY I Em LOC AUTOMOBILELUrBILITY COMBINED SINGLE LIMIT (En accident) $1 000,000 A X 7C ANY AUTO BODILY INJURY (Per person) $5,000 A ALL OWNED AUTOS ACP 2502860196 08/29/08 08/29/09 X SCHEDULEDAUTOS X HIRED AUTOS BODILY INJURY (Peraccidanl) $ ]( NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY • EA ACCIDENT $ R OTHER THAN EA ACC AUTO ONLY: AGG __ $ I H ANY AUTO $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ _ AGGREGATE S OCCUR 0 CLAIMS MADE S S DEDUCTIBLE 3 RETENTION $ WORKERS COMPENSATION I ER E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTNCy E.L. DISEASE • EA EMPLOYE S OFFICER/MEMBER EXCLUDED? U (Mandatary In NH) E.L. DISEASE - POLICY LIMIT $ U yea, describe under SPECIAL PROVISIONS below OTHER .DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS 10 day notice for non payment. Res School Drive Adjacent to Camp Eucalyptus El Segundo, CA. City of El Segundo, its officials and employees are hereby named as additional insured. GERTIFICATE MULUtK SHOULD ANY OF THE ABOVE OESCRISEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN _ NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. City of El Segundo AUTHORIZED REPRESENTATIVE 150 Illinois Street Paul Ainan 1 Se do CA 90245 -3813 ' nn l.Abf)AMATIf1 \1 All .1 ..1,,1e reeenie rt ACORP 25 (20UVIU7) - -- - - -- -- - - - - The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the Issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25