PROOF OF INSURANCE (2010) CLOSED (2)305TINAGAt
Cllent#. 1269805
ACORD- CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIODN"'Y)
10114/2009
PRODUCER
BB &T Insurance Services
of Orange County
680 Langsdorf Drive Suite 100
Fullerton, CA 92831
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
TINA GALL
3945 HOLLYLINE AVE.
Sherman Oaks, CA 91423
INSURERA: Hartford Fire Insurance Company
19682
INSURER B:
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
INSURERC:
07/23/2009
INSURER D:
EACH OCCURRENCE
INSURER E:
DAMAGE TO RENTED
uvcrwvca
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
LTR
01
N
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE D
POLICY EXPIRATION
DATE (MMIQ
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
72SBALD8291
07/23/2009
07/23/2010
EACH OCCURRENCE
$1.000.000
DAMAGE TO RENTED
$300,000
MED EXP (Any one person)
$10,000
CLAIMS MADE D OCCUR
PERSONAL & ADV INJURY
$1.000.000
GENERAL AGGREGATE
$2 00O 000
1E11 AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
s2,000,000
POLICY PROT LOC
A
AUTOMOBILE LIABILITY
72SBALD8291
07123/2009
07/2312010
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
(Per accident)
$
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
ANY AUTO
$
EXCESS /UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
$
DEDUCTIBLE
WC STATU- OTH-
ER
$
RETENTION $
WORKERS COMPENSATION AND
E.L. EACH ACCIDENT
$
EMPLOYERS' LIABILITY
ANY PROPRIETgOEWPARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE
$
OFFIFWry nMNH� EXCLUDED?
E.L. DISEASE - POLICY LIMIT
$
I1IfMMy�ees describe under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of El Segundo is named as Additional Insured, as respects
General Liability, as required by written contract per attached policy form SS 00 08 04 05 pg 10 -17
City of El Segundo
350 Main Street
El Segundo, CA 91
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ In DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2009101) 1 of 2 #S41854961M4185492 W " °° " "' ^"" "" "" "' _-
The ACORD name and logo are registered marks of ACORD VASCO
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 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 25 (2009101) 2 of 2 #S41854961M418549Z
725Mi -b 82.91
BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage e. A trust, you are an insured. Your trustees
We will not pay expenses for "bodily injury": are also insureds, but only with respect to
their duties as trustees.
a. Any Insured 2. Each of the following is also an insured:
To any insured, except "volunteer workers ".
a. Employees And Volunteer Workers
b. Hired Person
Your "volunteer workers" only while
To a person hired to do work for or on behalf
o performing duties related to the conduct of
f any insured or a tenant of any insured.
your business, or your "employees ", other
c. Injury On Normally Occupied Premises than either your "executive officers" (if you
To a person injured on that part of are an organization other than a
premises you own or rent that the person partnership, joint venture or limited liability
normally occupies. company) or your managers (if you are a
d. Workers' Compensation And Similar limited liability company), but only for acts
Laws within the scope of their employment by
you or while performing duties related to
To a person, whether or not an the conduct of your business.
"employee" of any insured, if benefits for
However, none of these "employees" or
"bodily bodily injury' are payable or must be "volunteer workers" are insureds for:
provided under a workers' compensation
or disability benefits law or a similar law. (1) "Bodily injury" or "personal and
e. Athletics Activities advertising injury":
To a person injured while practicing, (a) To you, to your partners or
instructing or participating in any physical members (if you are a partnership
exercises or games, sports or athletic or joint venture), to your members
contests. (if you are a limited liability
company), or to a co- "employee"
f. Products - Completed Operations Hazard while in the course of his or her
Included with the "products- completed employment or performing duties
operations hazard ". related to the conduct of your
g. Business Liability Exclusions business, or to your other
"volunteer workers" while
Excluded under Business Liability Coverage. performing duties related to the
C. WHO IS AN INSURED conduct of your business;
1. if you are designated in the Declarations as: (b) To the spouse, child, parent,
a. An individual, you and your spouse are brother or sister of that co-
insureds, but only with respect to the "employee" or that "volunteer
conduct of a business of which you are the worker" as a consequence of
sole owner. Paragraph (1)(a) above;
b. A partnership or joint venture, you are an (c) For which there is any obligation
insured. Your members, your partners, and to share damages with or repay
their spouses are also insureds, but only with someone else who must pay
respect to the conduct of your business. damages because of the injury
described in Paragraphs (1)(8) or
c. A limited liability company, you are an (b) above; or
insured. Your members are also insureds, (d) Arising out of his or her providing
but only with respect to the conduct of your or failing to provide professional
business. Your managers are insureds, but health care services.
only with respect to their duties as your
managers. If you are not in the business of
d. An organization other than a partnership, providing professional health care
joint venture or limited liability company, you services, Paragraph (d) does not apply
are an insured. Your "executive officers" and to any nurse, emergency medical
directors are insureds, but only with respect technician or paramedic employed by
to their duties as your officers or directors. you to provide such services.
Your stockholders are also insureds, but only (2) "Property damage" to property:
with respect to their liability as stockholders. (a) Owned, occupied or used by,
Page 10 of 24 Form SS 00 08 04 05
(b) Rented to, in the care, custody or
control of, or over which physical
control is being exercised for any
purpose by you, any of your
"employees ", "volunteer workers ",
any partner or member (if you are
a partnership or joint venture), or
any member (if you are a limited
liability company).
b. Real Estate Manager
Any person (other than your' employee' or
"volunteer worker "), or any organization
while acting as your real estate manager.
Temporary Custodians Of Your
Property
Any person or organization having proper
temporary custody of your property if you
die, but only:
(1) With respect to liability arising out of the
maintenance or use of that property; and
(2) Until your legal representative has
been appointed.
d. Legal Representative if You Die
Your legal representative if you die, but
only with respect to duties as such. That
representative will have all your rights and
duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of
yours which is a legally incorporated entity
of which you own a financial interest of
more than 50% of the voting stock on the
effective date of this Coverage Part.
The insurance afforded herein for any
subsidiary not shown in the Declarations
as a named Insured does not apply to
injury or damage with respect to which an
insured under this insurance is also an
insured under another policy or would be
an insured under such policy but for its
termination or upon the exhaustion of its
limits of insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form,
other than a partnership, joint venture or
limited liability company, and over which you
maintain financial interest of more than 50% of
the voting stock, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However:
a. Coverage under this provision is afforded
only until the 180th day after you acquire
or form the organization or the end of the
policy period, whichever is earlier; and
BUSINESS LIABILITY COVERAGE FORM
b. Coverage under this provision does not
apply to:
(1) "Bodily injury" or "property damage"
that occurred; or
(2) "Personal and advertising injury"
arising out of an offense committed
before you acquired or formed the
organization.
4. Operator Of Mobile Equipment
With respect to "mobile equipment" registered in
your name under any motor vehicle registration
law, any person is an insured while driving such
equipment along a public highway with your
permission. Any other person or organization
responsible for the conduct of such person is
also an insured, but only with respect to liability
arising out of the operation of the equipment, and
only if no other insurance of any kind is available
to that person or organization for this liability.
However, no person or organization is an insured
with respect to:
a. "Bodily injury" to a co-"employee" of the
person driving the equipment; 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.
5. Operator of Nonowned Watercraft
With respect to watercraft you do not own that
is less than 51 feet long and is not being used
to carry persons for a charge, any person is an
insured while operating such watercraft with
your permission. Any other person or
organization responsible for the conduct of
such person is also an insured, but only with
respect to liability arising out of the operation
of the watercraft, and only if no other
insurance of any kind is available to that
person or organization for this liability.
However, no person or organization is an
insured with respect to;
a. "Bodily injury" to a co- "employee" 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. Additional Insureds When Required By
Written Contract, Written Agreement Or
Permit
The person(s) or organizations) identified in
Paragraphs a. through f. below are additional
insureds when you have agreed, in a written
Form SS 00 08 04 05 Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
(e) Any failure to make such
permit issued by a state or political
inspections, adjustments, tests or
subdivision, that such person or organization
servicing as the vendor has
be added as an additional insured on your
agreed to make or normally
policy, provided the injury or damage occurs
undertakes to make in the usual
subsequent to the execution of the contract or
course of business, in connection
agreement, or the issuance of the permit.
with the distribution or sale of the
A person or organization is an additional
products;
(f) Demonstration, installation,
insured under this provision only for that
servicing or repair operations,
period of time required by the contract,
except such operations performed
agreement or permit.
at the vendor's premises in
However, no such person or organization is an
connection with the sale of the
additional insured under this provision if such
product;
person or organization is included as an
(g) Products which, after distribution
additional insured by an endorsement issued
or sale by you, have been labeled
by us and made a part of this Coverage Part,
or relabeled or used as a
including all persons or organizations added
container, part or ingredient of any
as additional insureds under the specific
other thing or substance by or for
additional insured coverage grants in Section
the vendor; or
F. — Optional Additional Insured Coverages.
(h) "Bodily injury" or "property
a. Vendors
damage" arising out of the sole
Any person(s) or organizations) (referred to
negligence of the vendor for its
below as vendor), but only with respect to
own acts or omissions or those of
"bodily injury' or "property damage" arising
its employees or anyone else
out of "your products" which are distributed
acting on its behalf. However, this
or sold in the regular course of the vendor's
exclusion does not apply to:
business and only if this Coverage Part
The exceptions contained in
"bodily
provides coverage for bodily injury or
Subparagraphs d
O or (f); or
"property damage" included within the
"products- completed operations hazard ".
(ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor
tests or servicing as the vendor
is subject to the following additional
has agreed to make or normally
undertakes to make in the usual
exclusions:
course of business, in
This insurance does not apply to:
connection with the distribution
(a) "Bodily injury" or "property
or sale of the products.
damage" for which the vendor is
(2) This insurance does not apply to any
obligated to pay damages by
insured person or organization from
reason of the assumption of
whom you have acquired such products,
liability in a contract or agreement.
or any ingredient, part or container,
This exclusion does not apply to
entering into, accompanying or
liability for damages that the
containing such products.
vendor would have in the absence
b. Lessors Of Equipment
of the contract or agreement;
(b) Any express warranty
(1) Any person or organization from
whom you lease equipment; but only
unauthorized by you;
with respect to their liability for bodily
(c) Any physical or chemical change
injury", "property damage" or
in the product made intentionally
"personal and advertising injury"
by the vendor;
caused, in whole or in part, by your
(d) Repackaging, except when
maintenance, operation or use of
unpacked solely for the purpose of
equipment leased to you by such
inspection, demonstration, testing,
person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
(2) With respect to the insurance afforded
to these additional insureds, this
insurance does not apply to any
"occurrence" which takes place after
you cease to lease that equipment.
c. Lessors Of Land Or Premises
(1) 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.
(2) With respect to the insurance afforded
to these additional insureds, this
insurance does not apply to:
(a) Any "occurrence" which takes
place after you cease to lease that
land or be a tenant in that
premises; or
(b) Structural alterations, new
construction or demolition
operations performed by or on
behalf of such person or
organization.
d. Architects, Engineers Or Surveyors
(1) Any architect, engineer, or surveyor, but
only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury' caused, in whole
or in part, by your acts or omissions or
the acts or omissions of those acting on
your behalf:
(a) In connection with your premises;
or
(b) In the performance of your
ongoing operations performed by
you or on your behalf.
(2) With respect to the insurance afforded
to these additional insureds, the
following additional exclusion applies:
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:
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
e. Permits Issued By State Or Political
Subdivisions
(1) Any state or political subdivision, but
only with respect to operations
performed by you or on your behalf for
which the state or political subdivision
has issued a permit.
(2) With respect to the insurance afforded
to these additional insureds, this
insurance does not apply to:
(a) "Bodily injury", "property damage"
or "personal and advertising
injury" arising out of operations
performed for the state or
municipality; or
(b) 'Bodily injury" or "property damage"
included within the "products -
completed operations hazard".
f. Any Other Party
(1) Any other person or organization who
is not an insured under Paragraphs a.
through e. above, but only with
respect to liability for "bodily injury",
"property damage" or "personal and
advertising injury" caused, in whole or
in part, by your acts or omissions or
the acts or omissions of those acting
on your behalf:
(a) In the performance of your
ongoing operations;
(b) In connection with your premises
owned by or rented to you; or
(c) In connection with "your work" and
included within the "products -
completed operations hazard ", but
only if
(i) The written contract or written
agreement requires you to
provide such coverage to
such additional insured; and
(ii) This Coverage Part provides
coverage for "bodily injury" or
"property damage" included
within the "products -
completed operations hazard ".
(2) With respect to the insurance afforded
to these additional insureds, 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
architectural, engineering or surveying
services, including:
Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits
Of Insurance.
Flow this insurance applies when other
insurance is available to an additional insured
is described in the Other Insurance Condition
in Section E. — Liability And Medical Expenses
General Conditions.
No person or organization 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.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We Will Pay
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. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily injury" and
"property damage" included in the
"products- completed operations hazard" is
the Products - Completed Operations
Aggregate Limit shown in the
Declarations.
b. Damages because of all other 'bodily
injury", "property damage" or "personal
and advertising injury", including medical
expenses, is the General Aggregate Limit
shown in the Declarations.
This General Aggregate Limit applies
separately to each of your 'locations"
owned by or rented to you.
"Location" means premises involving the
same or connecting lots, or premises
whose connection is interrupted only by a
street, roadway or right -of -way of a
railroad.
Page 14 of 24
This General Aggregate limit does not
apply to "property damage" to premises
while rented to you or temporarily
occupied by you with permission of the
owner, arising out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, the most we will pay for the sum of all
damages because of all "bodily injury",
"property damage" and medical expenses
arising out of any one 'occurrence" is the
Liability and Medical Expenses Limit shown in
the Declarations.
The most we will pay for all medical expenses
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b. above, the most we will pay for
the sum of all damages because of all
"personal and advertising injury" sustained by
any one person or organization is the Personal
and Advertising Injury Limit shown in the
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Limit is the most we will pay under Business
Liability Coverage 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 by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or
organization who is an additional insured
under this Coverage Part is the lesser of
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or political
subdivision; or
b. The Limits of Insurance shown in the
Declarations.
Such amount shall be a part of and not in
addition to the Limits of Insurance shown in
the Declarations and described in this Section.
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
if more than one limit of insurance under this
(1) Immediately send us copies of any
policy and any endorsements attached thereto
demands, notices, summonses or
applies to any claim or "suit ", the most we will pay
legal papers received in connection
"suit ";
under this policy and the endorsements is the
with the claim or
single highest limit of liability of all coverages
(2) Authorize us to obtain records and
applicable to such claim or "suit ". However, this
other information;
paragraph does not apply to the Medical Expenses
(3) Cooperate with us in the investigation,
limit set forth in Paragraph 3. above.
settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply
against the "suit"; and
separately to each consecutive annual period and to
(4) Assist us, upon our request, in the
any remaining period of less than 12 months, starting
enforcement of any right against any
with the beginning of the policy period shown in the
person or organization that may be
Declaretions, unless the policy period is extended
liable to the insured because of injury
after issuance for an additional period of less than 12
or damage to which this insurance
months. In that case, the additional period will be
may also apply.
deemed part of the last preceding period for purposes
d. Obligations At The Insured's Own Cost
of determining the Limits of Insurance.
No insured will, except at that insured's own
E. LIABILITY AND MEDICAL EXPENSES
cost, voluntarily make a payment, assume
GENERAL. CONDITIONS
any obligation, or incur any expense, other
1. Bankruptcy
than for first aid, without our consent.
Bankruptcy or insolvency of the insured or of
e. Additional Insured's Other Insurance
the insured's estate will not relieve us of our
If we cover a claim or "suit" under this
obligations under this Coverage Part.
Coverage Part that may also be covered
2. Duties In The Event Of Occurrence,
by other insurance available to an
Offense, Claim Or Suit
additional insured, such additional insured
"suit"
must submit such claim or to the
a. Notice Of Occurrence Or Offense
other insurer for defense and indemnity.
You or any additional insured must see to
However, this provision does not apply to
it that we are notified as soon as
the extent that you have agreed in a
practicable of an "occurrence" or an
written contract, written agreement or
offense which may result in a claim. To
permit that this insurance Is primary and
the extent possible, notice should include:
non - contributory with the additional
(1) How, when and where the "occurrence"
insured's own insurance.
or offense took place;
f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any
Claim Or Suit
injured persons and witnesses; and
Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury
any additional insured only when such
or damage arising out of the
"occurrence ", offense, claim or "suit" is
"occurrence" or offense.
known to:
b. Notice Of Claim
(1) You or any additional insured that Is
if a claim is made or "suit" is brought
an individual;
against any insured, you or any additional
(2) Any partner, if you or an additional
insured must:
insured is a partnership;
(1) Immediately record the specifics of the
(3) Any manager, if you or an additional
claim or "suit" and the date received;
insured is a limited liability company;
and
(4) Any "executive officer" or insurance
(2) Notify us as soon as practicable.
manager, if you or an additional
You or any additional insured must see to
insured is a corporation;
it that we receive a written notice of the
(5) Any trustee, if you or an additional
claim or "suit" as soon as practicable.
insured is a trust; or
c. Assistance And Cooperation Of The
(6) Any elected or appointed official, if you
Insured
or an additional insured is a political
You and any other involved insured must:
subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to
you and any additional insured.
3. Financial Responsibility Laws
a. When this policy is certified as proof of
financial responsibility for the future under
the provisions of any motor vehicle
financial responsibility law, the insurance
provided by the policy for "bodily injury"
liability and "property damage" liability will
comply with the provisions of the law to
the extent of the coverage and limits of
insurance required by that law.
b. With respect to "mobile equipment" to
which this insurance applies, we will
provide any liability, uninsured motorists,
underinsured motorists, no-fault or other
coverage required by any motor vehicle
law. We will provide the required limits for
those coverages.
4. Legal Action Against Us
No person or organization has a right under
this Coverage Form:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
insured; or
b. To sue us on this Coverage Form unless
all of its terms have been fully complied
with.
A person or organization may sue us to recover
on an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this insurance or that are in excess of the
applicable limit of insurance. An agreed
settlement means a settlement and release of
liability signed by us, the insured and the
claimant or the claimant's legal representative.
5. Separation Of Insureds
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned
in this policy to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
a claim is made or "suit" is brought.
6. Representations
When You Accept This Policy
By accepting this policy, you agree:
(1) The statements in the Declarations
are accurate and complete;
(2) Those statements are based upon
representations you made to us; and
(3) We have issued this policy in reliance
upon your representations.
b. Unintentional Failure To Disclose
Hazards
If unintentionally you should fail to disclose
all hazards relating to the conduct of your
business at the inception date of this
Coverage Part, we shall not deny any
coverage under this Coverage Part
because of such failure.
7. Other Insurance
If other valid and collectible insurance Is
available for a loss we cover under this
Coverage Part, our obligations are limited as
follows:
a. Primary Insurance
This insurance is primary except when b.
below applies. If other insurance is also
primary, we will share with all that other
insurance by the method described in c.
below.
b. Excess Insurance
This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(1) Your Work
That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work ";
(2) Premises Rented To You
That is fire, lightning or explosion
insurance for premises rented to you
or temporarily occupied by you with
permission of the owner,
(3) Tenant Liability
That is insurance. purchased by you to
cover your liability as a tenant for
"property damage" to premises rented
to you or temporarily occupied by you
with permission of the owner,
(4) Aircraft, Auto Or Watercraft
If the loss arises out of the maintenance
or use of aircraft, "autos" or watercraft to
the extent not subject to Exclusion g. of
Section A. — Coverages.
(5) Property Damage To Borrowed
Equipment Or Use Of Elevators
If the loss arises out of "property
damage" to borrowed equipment or
the use of elevators to the extent not
subject to Exclusion k. of Section A. —
Coverages.
Page 16 of 24 Form SS 00 08 04 05
(6) When You Are Added As An
Additional Insured To Other
Insurance
That is other insurance available to
you covering liability for damages
arising out of the premises or
operations, or products and completed
operations, for which you have been
added as an additional insured by that
insurance; or
(7) When You Add Others As An
Additional Insured To This
Insurance
That is other insurance available to an
additional insured.
However, the following provisions
apply to other insurance available to
any person or organization who is an
additional insured under this Coverage
Part:
(a) Primary Insurance When
Required By Contract
This insurance is primary if you
have agreed in a written contract,
ip� written agreement or permit that
5J this insurance be primary. If other
insurance is also primary, we will
share with all that other insurance
by the method described in C.
below.
(b) Primary And Non - Contributory
To Other Insurance When
Required By Contract
If you have agreed in a written
contract, written agreement or
permit that this insurance is
primary and non - contributory with
the additional insured's own
insurance, this insurance is
primary and we will not seek
contribution from that other
insurance.
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an
additional insured.
When this insurance is excess, we will
have no duty under this Coverage Part to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit'. If no other
insurer defends, we will undertake to do
so, but we will be entitled to the Insured's
rights against all those other insurers.
BUSINESS LIABILITY COVERAGE FORM
When this insurance Is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self -
insured amounts under all that other
insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
c. Method Of Sharing
If all the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable limit of
insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicable limits of insurance of all Insurers.
Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or
part of any payment, including
Supplementary Payments, we have made
under this Coverage Part, those rights are
transferred to us. The insured must do
nothing after loss to impair them. At our
request, the insured will bring "suit" or
transfer those rights to us and help us
enforce them. This condition does not
apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver
Of Subrogation)
the insured has waived any rights of
covery against any person or
organization for all or part of any payment,
including Supplementary Payments, we
have made under this Coverage Part, we
also waive that right, provided the insured
waived their rights of recovery against
such person or organization in a contract,
agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
Tina Gall
& ASSOCIATES
Professional Planning Services
October 14, 2009
818/205 -9878 3945 Hollyline Avenue
FAX 818/205-9892 Sherman Oaks
tinagall @aol.com California 91423-4603
Ms. Angelina Garcia
Fiscal Services Manager /Interim Accounting Manager
City of El Segundo
350 Main Street
El Segundo, CA 90245
Subject: Workers' Compensation Insurance —Tina Gall
Dear Ms. Garcia:
1 do not possess Workers' Compensation Insurance as I am an independent
contractor. I do not have any employees. In the past, this insurance requirement
has been waived.
Should you have any additional questions or need further information, please
contact me.
Sincerely,
Tina Gall
Community Development Block Grant Consultant
City Of -• • •
INTERDEPARTMENTAL CORRESPONDENCE
DATE: August 5, 1998
TO: Cindy Mortesen, City Clerk
FROM: Bret B. Bernard, AICP, Director Planning & Building Safety
BY: Tina Gall, CDBG ConsultanA -6"')
SUBJECT: Insurance Requirements
In response to (the attached) correspondence dated July 27 and August 3, 1998 from Patti
Adlen of your office, please be advised that I, at my discretion, and under authority granted
to me, with the review and acknowledgment of the City Attorney, waive the Workers
Compensation and Errors and Omissions insurance requirements for Diana Cho and
Associates and, separately for Tina Gall, as stipulated in Section XXII, entitled, "Insurance ",
respectively, in the Professional Service Agreements for both consultants.
xc: Mark Hensley, City Attorney
Tim Grimmond, City Manager
Attachments: July 27, 1998 Memorandum from City Clerk
August 3, 1998 Memorandum from City Clerk
PAcdbg \crspnd\memos\Ins8.5