PROOF OF INSURANCE (2007) CLOSED1 � �
DATE (MMOD/YY)
ACORD. --CERTIFICATE OF LIABILITY INSURANCE 05/31/06
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
PRODUCER
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
NSR TYPE OF INSURANCE POLICY NUMBER
LTR
Oealey, Renton &Associas
LIMITS
A GENERAL LIABILITY BKO1382123
06/01/06 106/01/07
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any one firs)
ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
840
CLAIMS MADE I X OCCUR
RECEIVE
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
HCOVERAGE CAFFOR
99 S Los Robles Ave Ste
GENERAL AGGREGATE
$2000,000
PRODUCTS - COMP/OP AGG
1$2000,000
ALTER
THE ED BY THE POLICIES BELOW.
Pasadena, CA 91101
626 844 -3070
IjUN 0 2 2906
COMBINED SINGLE LIMIT
(Ea acaderd)
INSURERS AFFORDING COVERAGE
INSURED
$
I INSURER A:
United States Fidelity & Guaranty
Case Land Surveying
$
;INSURERS:
St- Paul Protective Insurance CO.
614 N. Eckhoff
Public Works
,INSURER C:
U.S. Specialty Insurance Company
Orange, CA 92868
Engineering
INSURER D:
OTHER THAN EA ACC
$
ANY AUTO
INSURER E:
COVERAGES
A EXCESS LABILITY BKO1382123
106/01/06 106/01/07
EACH OCCURRENCE
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.
NSR TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POLICY EXPIRATION
OA MMIDD/YY D /YY
LIMITS
A GENERAL LIABILITY BKO1382123
06/01/06 106/01/07
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any one firs)
$300,000
j X 'COMM ERCIP.L GENERAL LIABILITY
CLAIMS MADE I X OCCUR
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2000,000
PRODUCTS - COMP/OP AGG
1$2000,000
IGEN'L AGGREGATE LIMITAPPLIESPER:
— POLICY PR OT- LOC
A _AUTOMOBILE LIABILITY 1: BKO1382123
ANY AUTO �,.
1 06/01106 ! 06101/07
COMBINED SINGLE LIMIT
(Ea acaderd)
$1 OOO,OOO
r
BODILY INJURY
(Pr P—)
$
._, ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Pr accident)
$
X HIRED AUTOS
X NON-OWNED AUTOS
PROPERTY DAMAGE
(Pr amdent)
$
_
GARAGE LIABILITY '',
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A EXCESS LABILITY BKO1382123
106/01/06 106/01/07
EACH OCCURRENCE
$4,000,000
OCCUR 17 CLAIMS MADE
AGGREGATE
S4,000,000
$
_
$
_ DEDUCTIBLE
$
RETENTION $
B WORKERS COMPENSATION AND BW02172602
101/01/06 01/01/07
X WC STATIT I :DTI+ ER
EMPLOYERS' LABILITY
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
C OTHER Professional US051110501 06120/05 06/20/06
$1,000,000 per claim
Liability
$1,000,000 annl aggr.
DESCRIPTION OF OPERATION &LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Center St., Lomita St., Sierra St. Maryland St. & Bungalow Dr., El
Segundo (06 -ELS -323)
City of El Segundo, its officials, and employees are named as additional
insureds as respects general liability for claims arising from the
operations of the named insured.
GtK I1tIGAlt KULUtK ADDITIONAL INSURED; INSURER LETTER: CANCELLATION Ten Day Notice for Non-PaXment of Premium
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of El Segundo DATE THEREOF, THE ISSUING INSURER WIKXWXNXM TO MAIL 30_ DAYS WRITTEN
Attn: Contract Administrator NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT
Maryam Jones stmsa xxaeaomuotamtpax xeumllesaic
350 Main Street xxxxoneVAIKIM
EI Segundo, CA 90245 AUTH`OR^IZED REPRESENTATIVE n
ACORD 25-5 (7197)1 of 1 #M161768 HHM O ACORD CORPORATION 1988
1'6':7 : -
Policy Number: BKO1382123
Owners Lessees or Contractors (Form B)
ADDITIbNAL INSURED
Change(s) Effective: 05/31/06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY. This endorsement modifies insurance policy under the following:
LIABILITY COVERAGE PART:
Schedule
Name of Person or Organization:
City of E1 Segundo
Attn: Contract Administrator
Maryam Jones
350 Main Street
E1 Segundo, CA 90245
SECTION II - WHO IS AN INSURED is amended to include as an insured the
person or organization shown in the Schedule, but only with respect to liability
arising out of "your work" for that insured by or for you.
RE: Center St. , Lomita St., Sierra St. Maryland St. & Bungalow Dr. , El
Segundo (06 -ELS -323) City of E1 Segundo, its officials, and employees
are named as additional insureds as respects general liability for
claims arising from the operations of the named insured.
PRIMARY INSURANCE:
IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED
SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS
INSURANCE.
CL/BF 22 40 03 95