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PROOF OF INSURANCE (2006) CLOSEDACORDM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /D 09/27/2005 2005) PRODUCER (661)834 -6222 FAX (661)281 -4992 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Walter Mortensen Insurance, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #9026 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4701 Stockdale Hwy. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Bakersfield, CA 93309 INSURERS AFFORDING COVERAGE NAIC # INSURED Crimson Resource Management, Corp. INSURER A: ALLSTATE INSURANCE CO. 410 17th Street #1010 INSURER& STATE COMPENSATION IN Denver, CO 80202 INSURER C: INSURER D: INSURER E: envconr_ce YVVKKS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I�V811l1�THSTANDING 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. ILT R DD' INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS EACH OCCURRENCE $ rOF THORIZEDREPRESENTATIVE chael Moore AAI MTM GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE F-1 OCCUR DAMAGE TO RENTED $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- J LOC ECT PRODUCTS - COMP /OP AGG $ AuTOMOEIEt UNA9161TY ANY AUTO 048724603 06/01/2005 06/01/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ALL OWNED AUTOS A SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ H ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY OCCUR FI CLAIMSMADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND 145369005 04/0172005 04/01J2006 TH- X WcsTATU- OR B 1VMPLOYERV LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 1 ,000,000 OFFICER /MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E L. DISEASE - POLICY LIMIT $ 1 000,000 SPECIAL PROVISIONS below OTHER =x`10 day cancellation will apply for non - payment of premium DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ACORD 25 (2001/08) CACORD CORPORATION 1988 _� -19 4----- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of El Segundo Public Works Department EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Steve Fi nton , P.E. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 350 Main Street ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. El Segundo, CA 90245 -3813 rOF THORIZEDREPRESENTATIVE chael Moore AAI MTM ACORD 25 (2001/08) CACORD CORPORATION 1988 _� -19 4----- 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 26 (2001/08) AGO-RD. CERTIFICATE OF LIABILITY INSURANCE OP ID DAoMMDNM PRODUCER THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7►tta: Steve Tinton, P. Z. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 350 Main Street Lockton C=Vanies of Colorado HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8110 Z Union S.ve Suits #700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Deaver CO 80237 -2984 Phone: 303 -414 -6000 Tax:303- 865 -6000 INSURERS AFFORDING COVERAGE NAICN INSURED INSURER A. TZDZRAL INS CO 20281 INSURER B: 11/02/04 C 14, iimfoin California 1De nv1 =tC0880 2 , #1010 11 Denver 2 INSURER c: $1,000,000 INSURER D: $ 10,000 INSURER E: $1,000,000 COVERA0ES 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. 7►tta: Steve Tinton, P. Z. 350 Main Street POUCY NUMBER pA M LIMITS GENERALLIABIUTY EACH OCCURRENCE $_1,000,000 • Z Z COMMERCIALGENERALL"IuTY CLAIMS MADE ® OCCUR 37107933 11/02/04 11/02/05 PREMISES Esoxurancs $1,000,000 MED EXP (Any ore pera«I) $ 10,000 PERSONAL aADVINJURY $1,000,000 GENERALAGGREGATE $2,000,000 GE NL AGORE(iATE UMIT APPLIES PER: PRODUCTS - COMPIOP AGG $1,000,000 POLICY JECT LOC AUTOMOBILE LIABILITY AUTO BIN ED (E dent) E LIMIT s BODILY INJURY (Per Person) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) i HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE (Per accIdent) _ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO S • EXCESSNMBRELLA LIABILITY X7 OCCUR ❑ CLAIMSMADE 79796804 11/02/04 11/02/05 EACH OCCURRENCE $810001000 AGGREGATE $6,000,000 s i H DEDUCTIBLE z RETENTION $10,000 t WORKERS COMPENSATION AND ) EMPLOYERS' LIABILITY E.L. EACH ACCIDENT 5 ANY PRDPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RZ: Pipeline Relocation Douglas Street Gap Closure, Intsrmodal Transit Center i Railroad Grade Separation Project. The City of Z1 Segundo, its officials and mWloyees are additional insureds but only as respects work performed by the named insured. Coverage provided is primary and son- contributory. Policy will not be canceled or materially altered until GEK I FK;A 1 E KULUEK ZLSZG= SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT10 City of Zl Segundo Public forks Department DATE THEREOF, THE ISSUING INSURER WILL 111B6i11BY*0 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 7►tta: Steve Tinton, P. Z. 350 Main Street aRReeelswleee►' Zl Segundo Cif 90245 -3813 .wvKV w lavv gruel ® ACORD CORPORATION 1988 I POLICY NUMBER: 37107933 COMMERCIAL GENERAL LIABILITY CG 2010 03 97 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 Person or Organization: City of El Segundo, Its officials and employees (If no entry appears above, Information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) Who Is M Insured (Section II) 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 ongoing operations performed for that insured. CG 2010 03 97 Copyright, Insurance Services Office, Inc., 1996 23877% 09/13/2005