PROOF OF INSURANCE (2005) CLOSEDCOVERAGES
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.
- - - -- -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
POLICY NUMBER DE MM /DD/YY DATE MM /DD/YY
LTR NSR TYPE OF INSURANCE AT
GENERAL LIABILITY
A X X COMMERCIAL GENERAL LIABILITY 57UUNUN5845 05/25/04 05/25/05
CLAIMS MADE � OCCUR
LIMITS
EACH OCCURRENCE $ lOOOOOO
PREMISES(Eaoccurence) $ 300000
MED EXP (Any one person) $ 10000
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE
$ 2000000
GENT AGGREGATE LIMIT APPLIES PER:
X7 POLICY JECT LOC
PRODUCTS - COMP /OPAGG
Emp Ben.
$ 2000000
1,000,000
A
REPRESENTATIVES.
AUTOMOBILE
LIABILITY
ANY AUTO
57UUMM5845
05/25/04
05/25/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
(Per accident)
$
X
X
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS /UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBEREXCLUDED?
57WEGY5897
12/01/03
12/01/04
_
TORY LIMITS ER
E.L. EACH ACCIDENT
$ 1000000
E.L. DISEASE - EA EMPLOYEE
$1000000
E.L. DISEASE - POLICY LIMIT
$1000000
If yes, describe under
SPECIAL PROVISIONS below
OTHER
B
Errors & Omissions
6 -14 -01 Retro Date
RENL OF H70312635
06/14/04
I
06/14/05
1
$1000000
$5000
Limit
Deductible
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is additional insured with respect to liability
arising
out of insured's operations per page 10 & 11 of form HG00011001.
*10 Day Notice of Cancellation for Non Payment of Premium
GtK I WIGA I t MULL)CM
- - - -- -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
ELSE 350
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
City of El Segundo
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Attn : Patti Kight
REPRESENTATIVES.
350 Main St, Room 5
pUTHO ATIVE
E1 Segundo CA 90245 -3895
rn wrnon �`nDDnDATIAW 1QRR
ACORD 25 (2001/08) -
V� I
w ,
However, no person or organization is an insured with
respect to:
a, "Bodily injury" to a co= employeig" of the person
operating the watercraft; or
b. "property damage" to property owned by rented to,
in the charge of or occupied by you or the employer
of any ,person who is' an insured under this
provision.
6. The following are also an Insured when you have
agreed, in writing, in a contract or agreement that
another person or organization 'be added as an
additional insured on your policy, provided the injury or
damage occurs subsequent to the execution of the
contract or agreement.
However, no such person or organiz.ation'is an insured'
under this provision if such person or organization is
included as an insured by an endorsement issued by
us and made a part of this Coverage part.
a. Any person or organization (referred to below as
vendor), but only with respect to "bodily injury" or
"property damage" arising out of "your products"
which are distributed or sold in the regular course of
the vendor's business, subject to the following
additional exclusions:
(1) The insurance afforded the vendor does not
apply to:
(a) "Bodily injury" or "property 1tamage" for which
the vendor is obligated to pay damages by
reason of the assumption of liability In a
contract or agreement. This exclusion does
not apply to liability for damages that the
vendor would have in the absence of the
contract or agreement;
(b) Any express warranty unauthorized by you;
(c) Any physical or chemical change in the
product made Intentionally by the vendor;
(d) Repackaging, unless unpacked solely for the
purpose of inspection, demonstration,
testing, or the substitution of parts under
instructions from the manufacturer, and then
repackaged in the original container
(e) Any failure to make such inspections,
adjustments, tests or servicing as the vendor
has agreed to make or normally undertakes
to make in the usual course of business, In
connection with the distribution' or sale of the
products;
(f) Demonstration,' installation, servicing or
repair operations, except such,operations
performed at the vendor's premises in
connection with the sale of the product;
page 10 of 16
(g) Products which, after distribution or sale by r'
you, have been labeled or relabeled or used
as a container;, part or ingredient of any other
thing or substance by or for the vendor.
(2) This insurance does not apply to any insured
person or organization, from whom you have
acquired such products; or any ingredient, part
or container, entering Into, accompanying or
containing' such products,
t
b. Any person or organization', from whom you lease
equipment; but only with respect to their liability
arising out of the maintenance, operation or use by
you of equipment leased to you by such person or
organization. A person's or organization's status as
an insured under this paragraph ends when their
contract or agreement with you for such leased
equipment ends.
With respect to the insurance afforded these
additional insureds, the following additional
exclusions apply:
This Insurance does not apply:
1. To any "occurrence" which takes place after the
equipment lease expires;
2. To "bodily injury" or "property damage" arising
out of the sole negligence of such person or
organization.
c. Any person or organization from whom you lease
land or premises, but only with respect to liability
arising out of the ownership, maintenance or use of
that part of the land or premises leased to you.
With respect to the insurance afforded additional
these
additional insureds the following
exclusions apply:
This insurance does not apply to:
1. Any "occurrence" which takes place after you
cease to lea" that land;
2. Structural alterations, new construction_ or
demolition operations performed by or on behalf
of such person or organization.
d, Any architect, engineer, or surveyor, but only with
respect to liability arising out of your premises or
ongoing operations performed by you or on your
behalf.
With respect to the insurance afforded these
additional insureds, the following additional
exclusions apply:
This Insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" arising out of the rendering of or the failure to
render any professional services by or for you,
including:
1. The preparing, approving, or failing to prepare or
approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders' or
drawings and specifications; and
2. Supervisory, Inspection, architectural or
engineering activities.
HG 00 0110 01
w,
an
e. Any other person or rgani atio gh d ' Is not but
insured under paragraphs a
only with respect to your operations, "your work" or
facilities owned or used by you.
No person or organlzabon is an Insured with respect to the
conduct of any Current or past partnership, joint venture or
limited liability Company that is not shown as a Named
insured in the Declarations.
SECTION III — LIMITS of INSURANCE
1. The Limits of insurance shown in the Declarations and
the rules below fix the most we will pay regardless of
the number of:
a. Insureds
b. Claims made or "suits" brought, or
c. Persons or organizations making claims or bringing
"suits ".
2. The General Aggregate Limit is the most we will pay for
the sum of:
k11
d.
5.
a.
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages
because of "bodily injury" or "property damage"
included in the "products- completed operations
hazard "; and
c. Damages under Coverage B.
The Products - Completed Operations Aggregate Limit
Is the most we will pay under Coverarge A for damages
because of "bodily injury' and "property damage"
included In the " products - completed operations
hazard ".
Subject to 2. above, the Personal and Advertising
Injury Limit is the most we will pay under Coverage B
for the sum of all damages because of all "personal
and advertising injury" sustained by any one person or
organization.
Subject to 2. or 3. above, whichever applies, the Each
occurrence Limit is the most we will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage G
because of all "bodily injury" and "property damage"
arising out of any one "occurrence ".
Subject to 5. above, the Damage To Premises Rented
To You Umit is the most we will pay under Coverage A
for damages because of "property damage" to any one
premises, while rented to you, or in the 'case of
damage by fire, lightning or explosion, while rented to
you or temporarily occupied by you with permission of
the owner.
In the case of damage by fire, lightning or explosion,
the Damage to Premises Rented To You Limit applies
to all damage proximately caused I)y the same event,
whether such damage results from fire, lightning or
explosion or any combination of these.
HG 00 01 10 01
7. Subject to 5. above, the Medical Expense Limit is the
most we will pay' under Coverage C for all medical
expenses because of "bodily injury, sustained' by any
one person.
The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to any
remaining period of less than 12 months, starting with the
beginning of the policy period shown in the Declarations,
unless the policy period is extended after issuance for an
additional period of less than 12 months. In that case, the
additional period will be deemed part of the last preceding
period for purposes of determining the Limits of Insurance.
SECTION tV COMMERCIAL GENERAL LIABILITY
CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the Insured or of the
insured's estate will not relieve us of our obligations
under this Coverage Part.
2. Duties In The Event of occurrence, Offense, Claim
Or Suit
a. You must see to it that we are notified as soon as
practicable of an "occurrence" or an offense which
may result in a claim.
(1) To the extent possible, notice should include:
(a) How, when and where the "occurrence" or
offense took place;
(ty) The names and addresses of any injured
persons and witnesses: and
(c) The nature and location of any injury or
damage arising out of the "occurrence' or
offense.
(2) This Condloon applies only when such
"occurrence" or offense is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A manager, if you are a limited liability
company,
(4) An "executive officer" or insurance manager,
if you are a corporation; or
(5) Any trustee, if you are a trust.
b. If a claim is made or "suit" is brought against any
insured, you must: -
(1) immediately record the specifics of the claim or
"suit" and the date received; and
(2) ``Notify us as soon as practicable.
You must see to it that we receive written notice of
the claim or "suit" as soon as practicable.
Butt his c ondition 'will not be considered breached
unless the breach occurs after such claim or "suit"
Is known to anyone listed in 2.a.(2) above.
Page' 11 of 16