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PROOF OF INSURANCE (2005) CLOSEDHARRAND -01 WECA DATE (MMIDD/YYYY) ACORDr. CERTIFICATE OF LIABILITY INSURANCE 1 9/2/2004 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER (510) 547 -3203 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Diversified Risk Insurance Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR THE COVERAGE AFFORDED BY THE POLICIES BELOW. License #0529776 ALTER 5900 thristie Avenue Emeryville, CA 94608 INSURERS AFFORDING COVERAGE NAIC # A: Atlantic Specialty Insurance Company INSURED Harris and Associates Inc. INSURER B: Hartford Fire Insurance Co. Attn: Tracy Rapozo INSURER 120 Mason Circle INSURER c: American Guarantee & Liability Concord, CA 94520 -1238 INSURER D: Alaska National Insurance Company INSURER E: Continental Casualty Co. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID POLICY EFFECTIVE POLICY EXPIRATION LIMITS INSR DD' POLICY NUMBER 1,000,00 EACH OCCURRENCE $ GENERAL LIABILITY A X X GENERAL LIABILITY 71$-00 -8245 -0000 81112004 81112005 PREMISES Ea o $ _ 50,00 5,00 COMMERCIAL CLAIMS MADE X OCCUR MED EXP (Any one ne pe rson) persorso n) $ 1,000,00 X "X" "C" "U„ PERSONAL & ADV INJURY $ 2'000'00 X Severability of interest GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC COMBINED SINGLE LIMIT $ 1,000,00 AUTOMOBILE LIABILITY 57UENUL6878 811/2004 8/112005 (Ea accident) B X X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ (Per accident) X NON - OWNEDAUTOS PROPERTY DAMAGE $ Per accident) AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY EA ACC $ OTHER THAN ANY AUTO AUTO ONLY: AGG $ EACH OCCURRENCE $ 5,000,00 EXCESS /UMBRELLA LIABILITY AUC- 9305561 -02 5,000,00 8/1/2004 811/2005 AGGREGATE $ C X OCCUR CLAIMS MADE DEDUCTIBLE $ RETENTION $ X WC STATU• OTH- TORY LIMITS ER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 04HWD40007 1,000,00 8/1/2004 8/1/2005 E.L. EACH ACCIDENT $ 1,000'00 D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED') E.L. DISEASE - POLICY LIMIT $ 1 �000�QQ If yes, describe under SPECIAL PROVISIONS below OTHER E Professional Liability AEA113822501 81112004 81112005 Per Claim: 5,000,00 5,000,00 E See Remarks on next pg. AEA113822501 8/1/2004 8/1/2005 Aggregate: DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS a 10 day notice will apply. In the event of cancellation for non - payment of premium, Re: Plaza El Segundo Infrastructure Improvement Costs ( #042 - 0285.01) Waiver of Subrogation is included as respects Workers' Compensation. CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of El Segundo DATE THEREOF, THE ISSUING INSURER WILLXVdJXMMMAIL 3O DAYS WRITTEN City Clerk's Office NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B 350 Main Street, Room 5 �X El Segundo, CA 90245 -3895 Xm QrXAM AUTHORIZED REPRESENTATIVE -- - - -- - -- -- - - - - -- -- -- ACORD CORPORATION 1988 © ACORD 25 (2001108) 336 3 ueom&mn.ni WECA PAGE 1 OF 1 REMARKS For Professional Liability coverage, the Aggregate Limit Is the total insurance available for all covered claims reported within the policy period. A $150,000 deductible applies to each and every claim submitted under the policy. POLICY #: 718 -00- 8245 -0000 INSURED: Harris and Associates, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART WHO IS AN INSURED — (Section II) is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought that such person or organization be added as an additional insured on your policy. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The person or organization is only an additional insured with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused by "your work" for that additional insured. 2. The insurance provided to the additional insured is limited as follows: a) This endorsement shall not increase the limits stated in Section III — LIMITS OF INSURANCE. b) The insurance provided to the additional insured does not apply to "bodily injury ", "property damage ", or "personal and advertising injury" arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: I. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications: and II. Supervisory or inspection activities performed as part of any related architectural or engineering activities. c) This insurance does not apply to "bodily injury: or "property damage" caused by "your work" included in the "products- completed operations hazard" unless you are required to provide such coverage for the additional insured by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought and then only for the period of time required by such contract or agreement and in no event beyond the expiration date of the policy. 3. Subpart (1)(a) of the Pollution exclusion (Section I — Coverages, part 2. f. of the Commercial General Liability Coverage form) does not apply to you if the "bodily injury" or "property damage" arises out of "your work" performed on premises which are owned or rented by the additional insured at the time "your work" is performed. 4. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary or non- contributory basis. 5. As a condition of coverage, each additional insured must: a) Give us prompt written notice of any "occurrence" or offense which may result in a claim and prompt written notice of "suit ". Page 1 of 2 b) Immediately forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with policy conditions. c) Tender the defense and indemnity of any claim or "suit' to any other insurer which also insures against a loss we cover under this endorsement. This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For Name of Person or Organization: purposes of this requirement, the term "insures against" refers to any self - insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured with a defense and/or indemnity under that policy of insurance. d) Agree to make available any other insurance that the additional insured has for a loss we cover under this endorsement. City of El Segundo, its officers, officials and employees Re: Plaza El Segundo Infrastructure Improvement Costs ( #042 - 0285.01) Page 2 of 2 POLICY #: 57UENUL6878 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: 9/2/04 Named Insured: Harris and Associates Inc. (,fie horized Representative SCHEDULE Name of Person(s) or Organization (s): City of El Segundo, its officers, officials and employees Re: Plaza El Segundo Infrastructure Improvement Costs ( #042 - 0285.01) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Subject to all other terms and provisions of the policy, such insurance as provided by this endorsement shall be deemed primary, but only with respect to work performed by or for the named insured in connection with the above described contract. Any other insurance maintained by the Additional Insured(s) shall be excess and non - contributory. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1