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PROOF OF INSURANCE (2008) CLOSEDClient #: 6255 RBFC0NSUI ACORD. CERTIFICATE OF LIABILITY INSURANCE 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 04/14/ 4114/ 08 8D/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 10550 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Ana, CA 92711 -0550 GENERAL LIABILITY 714 427 -6810 INSURERS AFFORDING COVERAGE INSURED RBF Consulting PO Box 92 Irvine, CA A 92 619 -7057 INSURER A: Travelers Property Casualty Co of Am INSURER B: National Union Fire Ins Co of Pittsb INSURER C: Underwriters at Lloyd's of London INSURER D: INSURER E: X COMMERCIALGENERALLIABILITY CLAIMS MADE I OCCUR COVERAGES 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. INSR L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M D /Y Y) POLICY EXPIRATION DATE (MMIDDfYYI LIMITS A GENERAL LIABILITY 63050OD4092TIL07 11/30/07 11/30/08 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $1,000,000 X COMMERCIALGENERALLIABILITY CLAIMS MADE I OCCUR INDP. CONTRACTORS MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY _ $1,000,000 X CONTRACTUAL INCLUDED X BFPD, XCU GENERAL AGGREGATE _ s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $2,000,000 POLICY IF V-71 PR0 LOC A AUTOMOBILE LIABILITY X ANY AUTO 8109496B499 11130/07 11130/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) X HIRED AUTOS X NON -OWNED AUTOS $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS LIABILITY BE9834351 11/30107 11/30/08 EACH OCCURRENCE $10,000,000 X1 OCCUR L—J CLAIMS MADE Professional Liab. AGGREGATE _ $10,000,000 $ is Excluded _ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY -- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE _ $ E.L. DISEASE -POLICY LIMIT _ $ C OTHER Professional P1079400 11130107 11130/08 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS General Liability policy excludes claims arising out of the performance of professional services Re: JN 10- 106141, Aloft Hotel MND City of El Segundo, Its officials, and employees are additional Insured as (See Attached Descriptions) City of El Segundo Attn: Mary Lewis, Sr. Admin. Assist. Planning & Building Safety Dept. 350 Main Street El Segundo, CA 90245 -3813 SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WIWX5f9=X§M TO MAIL 3D_ DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTHELEFT,JM k ATIVE A%,Urcu za -a Invr►1 of 2 #5222980IM212212 RILL ©ACORD CORPORATION 1988 AMS 25.3 (07197) 2 of 2 #S2229801M212212 POLICY NUMBER: 63050OD4092TIL07 COMMERCIAL GENERAL LIABILITLY ISSUE DATE: 04/14/08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABAILTILY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S) City of El Segundo, its officials, and employees PROJECTILOCATION OF COVERED OPERATIONS: JN 10- 106141, Aloft Hotel MND 1. WHO IS AN INSURED — (Section II) is amended b) The insurance provided to the additional in- "prop to include the person or organization shown in the sured does not apply to "bodily injury", - Schedule above, but: erty damage" or "personal injury" arising out a) Only with respect to liability for `bodily injury", " of the rendering of, or failure to render, any professional architectural, engineering or sur- „ property damage or personal injury'; and veying services, including: b) If, and only to the extent that, the injury or damage is caused by acts or omissions of I. The preparing, approving, or failing to you or your subcontractor in the performance prepare or approve, maps, shop draw - ings, opinions, reports, surveys, field or- of "your work" on or for the project, or at the ders or change orders, or the preparing, location, shown in the Schedule. The person or organization does not qualify as an addi- approving, or failing to prepare or ap- tional insured with respect to the independent prove, drawings and specifications; and acts or omissions of such person or organiza- ii. Supervisory, inspection, architectural or tion. engineering activities. 2. The insurance provided to the additional insured c) The insurance provided to the additional in- by this endorsement is limited as follows: sured does not apply to "bodily injury" or "your a) In the event that the Limits of Insurance of "property damage" caused by work" and included in the "products- completed op- this Coverage Part shown in the Declarations exceed the limits of liability required by a erations hazard" unless a "written contract "written contract requiring insurance" for that requiring insurance" specifically requires you to provide such coverage for that additional additional insured, the insurance provided to the additional insured shall be limited to the insured, and then the insurance provided to limits of liability required by that "written con- ". the additional insured applies only to such "bodily injury" or "property damage" that oc- tract requiring insurance This endorsement curs before the end of the period of time for shall not increase the limits of insurance de- scribed in Section 111 — Limits Of Insurance. which the "written contract requiring insur- ance requires you to provide such coverage CG D2 47 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITLY or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance', whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if a "written contract requiring insurance" for that ad- ditional insured specifically requires that this in- surance apply on a primary basis or a primary and non - contributory basis, this insurance is pri- mary to `other insurance' available to the addi- tional insured which covers that person or organi- zation as a named insured for such loss, and we will not share with that "other insurance'. But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible `other insurance', whether pri- mary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional in- sured under such "other insurance ". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence' or an offense which may result in a claim. To the extent possible, such notice should include: i. How, when and where the "occurrence' or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence' or offense. b) If a claim is made or "suit' is brought against the additional insured, the additional insured must: I. Immediately. record the specifics of the claim or "suit and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit ", cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance' which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to `other insur- ance' available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage' oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 47 08 05 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID RC DATE(MM /DDIYYYY) 1 RBFCO -1 03/04/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE United Captive Ins. Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 17151 Newhope St., Ste 211 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fountain Valley CA 92708 POLICY EXPIRATION DATE MMIDD/YY LIMITS Phone:714- 708 -4370 Fax:714 -708 -2300 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: U.S. fidelity and Guaranty co. 25887 INSURER B: $ -fcCE6 PREMISES Ea occurence INSURER C: RBF Consulting 14725 Alton Parkway Irvine CA 92718 I INSURER D: INSURER E: COVERAGES 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDD/YY LIMITS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Mary Lewis, GENERAL LIABILITY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 350 tiain Street EACH OCCURRENCE $ -fcCE6 PREMISES Ea occurence $ AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY Mark Barrie f C CLAIMS MADE D OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPUES PER: PRODUCTS - COMP /OP AGO S POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT S ANYAUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGO EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE S OCCUR EI CLAIMS MADE S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND ATIJ X I TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1000000 A ANY PROPRIETOR /PARTNER/EXECUTIVE D123W00157 07 O1 /07 07/01/08 OFFICER /MEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYE $ 1000000 If yes, describe under E.L. DISEASE- POLICY LIMIT $ 1000000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *10 days notice of cancellation for non - payment of premium. Re: JN 10- 106141, Aloft Hotel MND /�L'�TIr'In ATr „vwr..n r_unr r-r-r r a rrnnr %` " ., © ACORD CORPORATION 1S CITYELS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN City of El & Building Segundo Planning Safety Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Mary Lewis, Sr. Admin. Assist. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 350 tiain Street REPR�3_NTATiV,iG. .1 El Segundo CA 90245 -3813 AUTHORIZED REPRESENTATIVE er•nnn oe r�nn�,na. Mark Barrie f C %` " ., © ACORD CORPORATION 1S