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PROOF OF INSURANCE (2011) CLOSED4 1 Ca 3 ' 1 Project: #PW 10 -09 Constr new beach bathrm 6 liflgua>'d eAt A� V CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/14/201C PRODUCER SullivanCurtisMonroe Insurance Services THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 251 S. Lake Ave., Suite 150 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Pasadena, CA 91101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. License # OE83670 626- 792 -5522 www.SullivanCurtisMonroe.com 626 - 792 -6111 INSURERS AFFORDING COVERAGE NAIC # INSURED EMAE International, Inc. INSURER A: Great American Assurance Com an 13744 Milroy Place INSURER B: Peerless Insurance Company Santa Fe Springs CA 90670 -5131 INSURER C: Liberty Insurance Co. D: E: vv r �rv+vw 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 CONTR%CT 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. INSR DD'L DATE THEREOF, THE ISSUING INSURER WILL W)DO D00M MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BA0EX X*00 0)6XXXX POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY ✓' COMMERCIAL GENERAL LIABILITY GLP 2100621 12/4/2010 12/4/2011 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) 1=XCLUDED CLAIMS MADE [_y/1 OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY V' PRO LOC B AUTOMOBILE LIABILITY ANY AUTO BA8324958 12/4/2010 12/4/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ - ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG C EXCESS I UMBRELLA LIABILITY EXCLA1123321 12/4/2010 12/4/2011 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 OCCUR CLAIMS MADE $ Excess Follow Form $ DEDUCTIBLE $ RETENTION $ 10,000 WORKERS COMPENSATION WC STATU- I JOTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project: #PW 10 -09 Construction of a New Beach Bathroom Facility and Lifeguard Station at the El Segundo Beach. The City of El Segundo, its officers, officials, agents and employees and volunteers are included as additional insured with regard to liability and defense of suits arising from work performed by or on behalf of the named insured. Insurance is primary and non - contributory per attached forms. 30 -day notice of cancellation - notification to City Clerk City of El Segundo 350 Main St El Segundo CA 90246 via certified mail. un� ACD / ! Aki/ =l 1 ATIr K[ ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. CERT NO.: 8972763 CLIENT CODE: EMAEINT Martha Rund 12/14/2010 2:42:17 PM Page 1 of 10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of El Segundo 350 Main Street DATE THEREOF, THE ISSUING INSURER WILL W)DO D00M MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BA0EX X*00 0)6XXXX El Segundo CA 90245 XIKMpt )MXIe)OKXWADNtiEJlAWAXP X OKK X%0M =XXK • 10 Days for Non - Payment of Premium. AUTHORIZED REPRESENTATIVE Sheena Macbeth ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. CERT NO.: 8972763 CLIENT CODE: EMAEINT Martha Rund 12/14/2010 2:42:17 PM Page 1 of 10 12/14/201U 2:4:30 PM PST (GMT -8) FROM: insurancevisions.com -T0: 13106400489 Page: 4 of 11 12/14/2010 EMAE International, Inc. POLICY NUMBER: GLP 2100621 COMMERCIAL GENERAL LIABILITY CG 20 11 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the followin . COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Designation of Premises (Part Leased to You): 2. Name of Person or Organization (Additional Insured): Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional insured on this policy, under a written contract, lease or agreement currently in effect, or becoming effective during the term of this policy. 3. Additional Premium: Included (If no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN 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 the ownership, maintenance or use of that part of the prem- ises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. CG 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 ❑ CERT NO.: 8972763 CLIENT CODE: EMAEINT Martha Rund 121L112010 2:42:17 PM Page 3 of 10 12/14/2010 2:4h:30 PM PST (GMT-8) FROM: insurancevisions.com -T0: 13106400489 Page: 5 of 11 EMAE International, Inc. 12/14/2010 POLICY NUMBER: GLP 2100621 COMMERCIAL GENERAL LIABILITY CG 24 0410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket as required by written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMER- CIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or 'your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 O CERT NO.: 8972763 CLLENT CODE: EMAELNT Martha Rund 12/14/2010 2:42:17 PM Paae 4 of 10 12/14/2010 2:4b:30 PM PST (GMT -8) FROM: insurancevisions.com -T0: 131064OU489 Page: 6 of 11 12/14/2010 EMAE International, Inc. POLICY NUMBER: GLP 2100621 COMMERCIAL GENERAL LIABILITY CG 25 03 03 97 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PRGJEC ) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: As Required by Written Contract (If no entry appears above, information regwrea io coi as applicable to this endorsement.) A. For all sums which tha insured becomes legally obtigrated to pray as damages caused by 'occur- rences" under COVERAGE A (SECTION t), and for all medical expenses oauood by aocidonto under COVERAGE C (SECTION t), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above,, t. A separate Designated Construction Project General Aggregate Limit applies to each des- ignated construction project, and that limit Is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Consixuetlon Project Generai Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or ,,property damage" included in the "products - completed operations hazard ", and for medi- cal expenses under COVERAGE C regard- less of the number of! a. Insureds; b. Claims made or "suits" brought; or C. Persons or organizations rnaking claims or bringing "suits ". endorsatnent wilt be shown in 3. Any payments made under COVERAGE A for damage.- or under COVERAGE C for medical expenses shall reduce the Oesignated Con- struction Project General Aggrogate Limit for that designated construction project. Such payments shalt not reduce the Cameral Ag- gregate Limit shown in the Declarations nor shall they reduce any other Designated Con- struction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Ex- pense continue to apply However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Con- struction Project General Aggregate Limit. B. For all sums which the insured bocomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION f), which cannot be attributed only to ongoing operations at a sin- gle designated construction project shown in the Schedule above; 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Lirnit or the Producto Completed Operations Aggregate Limit, whichever is applicable; and CG 25 03 03 97 Copyright, insurance Services Office, Inc., 1996 CERT NO.: 8972763 CLLENT CO[]E: EMAELNT Martha R—d 12/14/2010 2:42:17 PM Pace 9 of 10 Page 1 of 2 0 12/14/2010 2:45:30 PM PST (GMT -8) FPOM: insurancevisions.com -T0: 13106400489 Page: '1 of 11 2. Such payments shall not reduce any Desig- nated Construction Project General Aggre- gate Lirrif. C. When coverage for liability arising out of the "products- completed operations haza(d" Is pro- vided, any payments for damages because of "bodily injury" or °property damage" included in the "products- completed operations hazard" will reduce the Products - Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the t)esignated Construction Pro- ject General Aggregate Limit, G, It the appilcable designated construction project has been abandoned, delayed, or abandoned and then restarted, or it the authorized contract- ing parties deviate from plans, blueprints, de- signs, gW.ifications or timetables, the project will still be deemed to be the same construction pro- ject. E, The provisions of Limits Of Insurance (SECTION 111) not otherwise modified by this endorsement shad continue to app#y as iAipulatod, Page 2 of 2 Copyright, Insurance Services Office, Inc,, 1996 CERT NO.: 8972763 CLIENT CODE: EMAEINT Martha Rund 12/14/2010 2:42:17 PM Pa— 6 of 10 CG 25 03 03 97 ❑ GLP 2100621 12/14/2010 EMAE International, Inc. GAC 3649CG (Ed. 11 061 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. PRIMARY NON - CONTRIBUTORY INSURANCE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM This insurance is primary to any other insurance held by third parties with respect to work performed by you under written contractual agreements with such third parties and any other insurance which may be available to such third parties shall be non- contributory. GAC 3649CG lEd.• 11/06) XS CERT NO.: 8972763 CLIENT CODE: EMAEINT Martha Rund 12/14/2010 2:42:17 PM Page 7 of 10 4103•,.. EMAE International, Inc. BA8324958 12/14/2010 COMMERCIAL AUTO GOLD ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SECTION II — LIABILITY COVERAGE A. COVERAGE 1. WHO IS AN INSURED The following is added: d. Any organization, other than a partnership or joint venture, over which you maintain ownership or a majority interest on the effective date of this Coverage Form, if there is no similar insurance available to that organization. e. Any organization you newly acquire or form other than a partnership or joint venture, and over which you maintain ownership of a majority interest. However, coverage under this provision does not apply: (1) If there is similar insurance or a self - insured retention plan available to that organization; or (2) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. f. Any volunteer or employee of yours while using a covered "auto" you do not own, hire or borrow in your business or your personal affairs, Insurance provided by this endorsement is excess over any other insurance available to any volunteer or employee. g. Any person, organization, trustee, estate or governmental entity with respect to the operation, maintenance or use of a covered "auto" by an insured, if: (1) You are obligated to add that person, organization, trustee, estate or governmental entity as an additional insured to this policy by: (a) an expressed provision of an "insured contract ", or written agreement; or (b) an expressed condition of a written permit issued to you by a governmental or public authority. (2) The "bodily injury" or "property damage" is caused by an 'accident" which takes place after: (a) You executed the "insured contract" or written agreement; or (b) the permit has been issued to you. 2. COVERAGE EXTENSIONS a. Supplementary Payments. Subparagraphs (2) and (4) are amended as follows: (2) Up to $2500 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "Insured" at our request, including actual loss of earning up to $500 a day because of time off from work. Includes copyrighted material of Insurance Services Offices, Inc. with its permission GECA 7Q1 (01/07) Page 1 of 3 C�/t�LW! 2763 CfjMWE: EMAEINT Ma�tj80S.CJ 010 2ArR �Tea9e(4P0 Io PGDM060D J07105 GCAOPPN 00004113 Pa9e 23 SECTION III — PHYSICAL DAMAGE COVERAGE A. COVERAGE The following is added: 5. Hired Auto Physical Damage a. Any "auto" you lease, hire, rent or borrow from someone other than your employees or partners or members of their household is a covered "auto" for each of your physical damage coverages. b.t The most we will pay for "loss" in any one "accident' is the smallest of: (1) $50,000 (2) The actual cash value of the damaged or stolen property as of the time of the "loss "; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. If you are liable for the "accident', we will also pay up to $500 per "accident" for the actual loss of use to the owner of the covered "auto ". c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by an amount that is equal to the amount of the largest deductible shown for any owned "auto" for that coverage. However, any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning. d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a driver and excess over any other collectible insurance for any covered "auto" that you hire with a driver. 6. Rental Reimbursement Coverage We will pay up to $75 per day for up to 30 days, for rental reimoursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto ". Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for a period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your materials and equipment from the covered "auto ". If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under paragraph 4. Coverage Extension. 7. Lease Gap Coverage If a long -term leased "auto' is a covered "auto" and the lessor is named as an Additional Insured — Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any difference between the actual cash value of the "auto" at the time of the loss and the `outstanding balance" of the lease. "Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; and lease termination fees. B. EXCLUSIONS The following is added to Paragraph 3 The exclusion for 'loss" caused by or resulting from mechanical or electrical breakdown does not apply to the accidental discharge of an airbag. Includes copyrighted material of Insurance Services Offices, Inc. with its permission GECA 701 (01107) Page 2 of 3 AGENT COPY CEO c�402763 C A14ME: EMAEINT Ma N&JStga7 010 2:42:17 PM Page 9 of 10 PGDMD60D J07105 GCAOPPM o0004i14 Page 24 4 � li � • � � r Paragraph 4 is replaced with the following: 4. We will not pay for "loss" to any of the following: a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment. b. Equipment designed or used for the detection or location of radar. c. Any electronic equipment that receives or transmits audio, visual or data signals. Exclusion 4.c does not apply to: (1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto "; or (2) Any other electronic equipment that is: (a) Necessary for the normal operation of the covered 'auto" or the monitoring of the covered "auto's "operating system; or (b) An integral part of the same unit housing any sound reproducing equipment described in (1) above and permanently installed in the opening of the dash or console of the covered "auto" normally used by the manufacturer for installation of a radio. D. DEDUCTIBLE The following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. SECTION IV. BUSINESS AUTO CONDITIONS A. LOSS CONDITIONS Item 2.a. and b. are replaced with: 2. Duties In The Event of Accident, Claim, Suit, or Loss a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive officers, partners, members, or legal representatives is aware of the accident, claim, "suit ", or loss. Knowledge of an accident, claim, "suit ", or loss, by other employee(s) does not imply you also have such knowledge. b. To the extent possible, notice to us should include: (1) How, when and where the accident or loss took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising uut of the accident or loss. The following is added to S. We waive any right of recovery we may have against any additional insured under Coverage A. 1. Who Is An Insured g., but only as respects loss arising out of the operation, maintenance or use of a covered "auto" pursuant to the provisions of the "insured contract ", written agreement, or permit. B. GENERAL CONDITIONS 9. is added 9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Your unintentional failure to disclose any hazards existing at the effective date of your policy will not prejudice the coverage afforded. However, we have the right to collect additional premium for any such hazard. COMMON POLICY CONDITIONS 2.b. is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. Includes copyrighted material of Insurance Services Offices, Inc. with its permission GECA 701 (01107) Page 3 of 3 AG CE(IQ4&2 72763 COMOWE: EMAEINT M- N &JWW4W9010 2:42:17 AGENT Y Page of 10 PGDMO600 J07105 GCAOPPN 00004115 Page 25 ISSUE DATE: 12 -17 -2010 CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO CA 90245 -3813 4103•.. CERTHOLDER COPY P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GROUP: 000044 POLICY NUMBER: 0025750 -2009 CERTIFICATE ID: 84 CERTIFICATE EXPIRES:01 -01 -2011 01 -01- 2010/01- 01-2011 NT JOB:PW 10 -09 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period that will expire or did expire as indicated above. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT 1!1600 - EHAB MAMOUN PRES,SEC,TRES - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01 -01 -2009 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER EMAE INTERNATIONAL CORPORATION 13744 MILROY PL SANTA FE SPRINGS CA 90670 NT [B17,SG] PRINTED : 12 -17 -2010 NT