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PROOF OF INSURANCE (2011) CLOSEDcuenun inoluo Amon- CERTIFICATE OF LIABILITY INSURANCE 1/12912010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOtt PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BBST Insurance Services of CA Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 680 Lanosdorf Drive Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fullerton, CA 92831 NAIC e INSURERS AFFORDING COVERAGE INSURER A. James River Insurance Company 12203 INSUrRD A -1 Enterprises Inc. 27847 INSURER B: Insurance Company Of the West dba A4 Fence Company INSURER C: 2831 E. La Cresta Ave. INSURER D: Anaheim, CA 92806 INSURER E COVERAGES THE POLICIES OjE INSURANCE CE CONDITION OF AN�CON TRACT OR OTHER INSURED DOCUMENT WITH ABOVE PECT T WHICH 41THIS CERTIFICATE MAY BE ISSUED OR DING MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, IXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLIC E LIMITS POLICY EFFECTIVE XFi RA .r...- ..e..,re POLICY NUMBER n AM A I GENERAL LIABILITY Mx COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR BUPD Ded:5.000 nFNL AGGREGATE LIMIT APPIJES PER: DMOBRE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS AGE LIABILITY ANY AUTO EXCESS I UMBRELLJI LIABILITY OCCUR F-1 CLAIMS MADE DEDUCTIBLE B i VRS"MRS COMPE"BATION AND WSDSM316300 EIMPLOYEVZ LIABILITY _ ANY CIRIVE r n NH1 EXCLUDED? n nlba M des Maier C p IMSI OTHER 12101 12009 1701120`10 0110112010 10110112011 INJURY CCOMBINEDrcSINGLE LIMIT I $ BODILY INJURY $ (PerDelsoo) BODILY INJURY = (peraaridwd) pRopERTy nAMAGE s OTHER THAN AUTO ONLY: E.L. EA DE�TION OF OPERATIONS l LOCATION / VENICLEs I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Re: Skateboard Park, 405 E. Grand, El Segundo, CA as City of El Segundo, Its officers, officials, employees, and volunteers are named additional insured respects general liability and this insurance is primary and noncontributory with any other Insurance of the additional Insured as required by written contract, per the endorsement attached. IERTIFICATE HOLJJER 7 SHOULD ANY OF jHfEDESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. INSURER Mal - DAYS YYltn IF.N City of EI Segundo NOTICE TO THE C HOLDER NAMED TO THE City Hall 350 Main St. EI Segundo, CA 90245 eu HORLMDREPWE �ji' laJcl�� ® ACORD 25 (2009!01) 1 of 2 #545529341M4470148 1988.2009 ACORD CORPORATION. All rights reserved. The ACRD name and logo are registered marks of ACORD MJpAg IMPORTANT if the certificate holder is an ADDITIONAL INSURED, the poffcy(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 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 after the coverage afforded by the policies listed thereon. ACORD 25 (2009101) 2 of 2 ff545asasarnw+ry Iwo POLICY NUMBER: 00020272 -3 COMMERCIAL GENERAL LIABILITY CG 2010 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 Persons) Blanket as required by written contract City of EI Segundo 350 Main'St. El Segundo, CA 90245 .Z4 f...nmnipfp- this schedule. if not shown above, Will be shown in the Declarations. I 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 lnW'. "property damage" or `personal and advertising injury' caused, in whole or in part, by. 1. Your acts or omissions; or 2. The ads 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. Ail 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 operations has been completed; or 2. That portion of "your world 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 20 14 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 Policy No. 00020272 -3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGF PARTS Any coverage provided to an Additional insured scheduled in endorsement CG 2410 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 noncontnbutory 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. AP6031 US 45-07 Page 1 of 1 01/26/2010 09:20 6306013 AIFENCE PAGE 06 oATa w�nonr► ACORD„ CERTIFICATE Of LIABILITY INSURANCE s"Ww 7M CERTIFICATE IS 15b= AS A MATTER OF p�FOFMMTION Mac" usfness Health Inswance SeMsres. Inc ONLY AND CONFERS NO RIGHTS UCDN THE CEgr1E KATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. FJCTErtD OR 1206 E Yorba Linda Blvd ALTER THE CDYERAGE AFFORD D THE 10WFS BELOW. Placentia, CA 92870 INSURERS AFFORDING COVERAGE wsuw -!e wogw dt 23787 AarllO A-1 fence Company 116lIw 2831 E. La Cresta Ave moo: Anaheim, CA 92806 c ;OVERAAEs kM THE POl ICII SOF k6URA�tCE�L.��mEnu n oEO�A'TMC1 OR OTHER OOCUMEDi�T TO NpiICM 7�i119GEIR7� 1�E MAISSUFA OR e xe.,�• evr� �9ielus A►IC CONDnIONSOF SUCN ;CMWjA"jWM.� u L11POOPMMRA9PLIL'5 PLk� Al ANYAtJrO ALLOWMeoAYms A x acmmomw ACP 2512880196 x "W00= x lowavrrEaAVnw agxAaRW�UrY AMIA1rrp i mom WORRY �� OCCUR � Qxwx Woe OMUCT" REIi"w >; YIOItl[OIROOMORMRMU MA10 elrLOrdiaY"U" pe�sotiKa.mr>ruu" J s s DROOUC78.COa� ►ipa i 1 �p0,�wll,H sow UMR 4 ! 1,000, 000 8!29109 08129/10 °"°`I i' a�gRY.oAVAOE r orur• fig ACCORNr I �TWw RAO= I y AM s !! -- 7 Is Orl�l" fL.EACKACGOW I RL gCCA4F;� RI�LOIF� 7 ,'L hitahm."Lar uwrr I s 10 Day Notice far non - payment of :Premium. City of Ei Segundo, its officer, officials, employees, agents and volunteers are hereby named as additional insured. City of El Segundo c/o City Hall 350 Main Street El Segundo, CA 90245 rMaOA �,r/ pFYaQlapVe OS+:.fliEO �OL1C110 Ot N1ROii00lrollE 711EiJa0tRA710B oR1ETtrl�lAR IrE Rx �aa OR Iowa 30 04" !ele = r MD1fOLTO w1E tllt1YCL7t MO1oRA NJ/ID 7011! 1@G N . 1 , 01/26/2010 08:20 6306013 AIFENCE PAGE 0� IMPORTANT if the osrtifrcale holden is an ADDITIONAL INSUREO. the poNcy('s) must be endorsed. A Moment on this cefficale does not confer rights to the ceAlfidle holder in peu of such tndomernent(O H SUBROGATION 15 WAIVED. subject to the krms and oond"Ons of the policy. Oettain D*K" may require an endorsernent A statement on Ws oerl6mle does not corder rights to the pertirm0le hOtae'r in Neu of such endorsemenf(s). DISCLAIMER the CWftate of Insurance on the reverse side of Iris tom► dots rot eonsdhde a cotllraCl bew8w the issuing insure*).Otftft'sed repiesentaeve or predum, and the oertikelee� der. nor n,� itatflmmtivey or negatively Amend. extend or aher the eovwge afforded by Ire polidrn