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PROOF OF INSURANCE (2004) CLOSEDDate: 7/1/03 Time: 4:02 PM TO: @ 13106150529 Page: 002 -005 A RD-, CERTIFICATE OF LIABILITY INSURANCE 'YY, THIS CERTIFICATE IS 1SSUED AS A MATTER OF INFORMATION PRODUCER Commercial Lines ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OI Ann Msurence & Financial Services ALTER THE COVERAGE _AFFORDED BY THE POLICIES BELOW. 21250 Hawthorne Blvd., Suite 600 Torrence, CA 905034110 INSURED JCM- Facilities Planning dI Management 11 Golden Shore, Suite S50 Long Beach, CA 90802 INSURERS AFFORDING COVERAGE INSURER A: Evanston Insurance Company INSURER B. Hartford Insurance Co. of the Midwes INSURER c: Granite State insurance Company INSURER D: INSURER H: E0814994 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWI IHSTANDIN MAY PERTAIN, E INSURANCE M OR CONDITION BY THE POLIQ SE DESCRIBED HEREIN ISENSUBiIECr To ALL THE TERMS, EXCL��AND CONDITIONS IF SU O POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Nm TYPEOPINSURANCE POLICY NUMBER POLICY EEFECPIVE POUCYEXPIRATION LIMITS GENERAL LIABILITY E0814994 04/01/03 y _M 04/01)04 CH OCCURRENCE CH $1,000AN FIRE DAMAGE (Any me fire) f X COMMERCIAL GENE PAL LIAB]I.= CLAIMS MADE 91 OCCUR MED BXP (Any one —' PERSONAL ✓i• ADV I NJURY f CHNERALAGGREGATE E2 O00 PRODUCTS - COMP /OPAGG E GENT. AGGREGATE LIM IT APPLIES PER: PR POLICY M 1R(Ir LOC B AVromosiLELIABILITY 67UECUN2677 04/01p�� /03 �A 04/01/04 COMBINED SINGLE LIMIT (Ht Celdml) 51,000,000 ANY AUTO ALL OWNED AUTOS BODILY INJURY (PCT I%rgR) f X SCHHDULEDAUTOS X HIRED AUTOS BODILY INJURY der e�ciden!) E X NON- OWNHDAUTOS PROPERTY DAMAGE (Per incident) f AUTO ONLY - BA ACCIDENT f GARAGE LIABILITY ANYAUTO OTHERTHAN RA ACC AUTOONLY: AGO E f EACH OCCURRENCE E EXCESS LIABILITY OCCUR ❑ CLAIMS MADE —' AGGREGATE E E L DEDUCTIBLE T C RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 0995943 �q 04/01/03 �A 04/01/04 X WC STATU- CITH- ' B.L. EACH ACCIDENT E1 AMON H.L. DISRASH - EA HMPLOTHE E 1,009,000 B.L. DISBASB - POLICY UMrT f 1 000 090 A OTHER Professional E)814994 04/01/03 04101/04 $2,000,000 each claim Liability DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLE S/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS it is understood and agreed that this insurance Is primary and any other insurance maintained by the additional Insured shall be excess only and not contributing with this Insurance. City of El Segundo, its officers, officials, employees and volunteers (See Attached Descriptions) City of El Segundo 350 Main Street El Segundo, CA 90245 ACORD 25 -S (7/97) 1 of 3 #b493294 SHOULD ANV OFTHEABOVE DESCRIBED POLICIES BE CANCELLED BF.FORETHE EXPIRATION GATE THEREOF, THE ISSUING INSURER WILI.XXXIII1691MMAH 30 DAYS WRBTEN NOTECETOTHE CERTIFICATE HOLDER NAMED TOTHELEPr, B AVI' ZEDREPREWNTATIVE FACILIPLAN SZB 0 ACORD CORPORATION 1988 .1/- 3 /�-�,' Date: 7/1/03 Time: 4:02 PM TO: @ Page: 005 -005 POLICY NUMBER: E0814994 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES or CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of E1 Segundo 350 Main Street El Segundo, CA 90245 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations 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 "your work" for that insured by or for you. City of E1 Segundo, Installation of ADA Compliant Automatic Doors, City Library and Recreation Park Joslyn Center. Job Number 03129.00, Contract #3162 City of E1 Segundo, its officers, officials, employees and volunteers are named as additional insured per the endorsement attached. PRIMARY INSURANCE: IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS INSURANCE. CG 20 10 11 85 Date: 7/1/03 Time: 4:02 PM To: @ 13106150529 page: 004 -005 AMS 2b.3 (07/97) 3 of 3 #493294 Date: 7/1/03 Time: 4:02 PM To: @ 1310615052 Page: 003 -005 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(es) 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 WANED, 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 7be Certificate of Insurance on the reverse side of this form 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 26-S (7)97) 2 Of 3 # 4 `J J l tf 4 DATE (MWDDIYY) ArDRD., CERTIFICATE OF LIABILITY INSURANCE 04101/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Commercial Lines HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR & Financial Services ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ABD Insurance 21250 Hawthorne Blvd., Suite 600 Torrance, CA 90503 -4110 INSURED JCM- Facilities Planning & Management 11 Golden Shore, Suite 550 Long Beach, CA 90802 INSURERS AFFORDING COVERAGE INSURER A: Evanston Insurance Company INSURERS Hartford Insurance Co. of the Midwes INSURER C. Granite State Insurance Company INSURER D: INSURER E: _ :OVERAGES ED TO THE INSURED NAMED B T THE POLICY IO INDICATED. NOTWITHSTANDING INSURANCE THE POLICIES OF LISTED T OR OT R DOCUMENTWITHRESPECC TO WI HTHISCERTIIF CA MAY ISSUED OR ANY REQUIREMENTT RM OLICOND E ON OF ANBCONTRACE 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. ICY EFFECTIVE POLAICY EXPIRATION LIMITS ISR TYPE OF INSURANCE POLICY NUMBER / EACH OCCURRENCE $2000000 .A GENERAL LIABILITY E0819365 04/01/04 04101105 - FIRE DAMAGE (Any one fire) $50000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE 41 OCCUR PERSONAL 8 ADV INJURY $_ _ X BIIPD Ded:1 OOOO — GENERAL AGGREGATE $2 000 OOO PRODUCTS - COMP /OP AGG $ GEWL AGGREGATE LIM IT APPLIES PER: PRO- LOC POLICY X B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS AGE LIABILITY ANY AUTO EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION _ $ --+-- C WORKERS COMPENSATION AND WC1745443 EMPLOYERS' LIABILITY A OTHER professional JE0819365 04101/04 104101105 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIC OTHER THAN EA AUTO ONLY: EACH OCCURRENCE AGGREGATE 04/01104 04101105 X E.L. EACH C�C $1 E.L. DISEASE -EA EMPLOYEE $1 E.L. DISEASE - POLICY LIMIT $� 04101104 04101105 I $2,000,000 each claim DESCRIPTION OF OPERATIONS /LOCATIONSA/EHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: Job Number 02197.00, Phase II. City of El Segundo, its officers, officials, employees and volunteers are named as Additional Insured per the endorsement attached. City of El Segundo 350 Main Street El Segundo, CA 90245 ACORD 25 -S (7197)1 of 2 #M566305 SHOULD ANYOF TH E ABOVE D ESCRISED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X. j (RllijyMXTP MAIL 30-- DAYSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, Bk33f°NX )TftIQ**J11INX1(XX INPX>16X jTX1p1(l�l(XKlfl)IIXjPQIIjDIR XJ�X AUTH981ZED REPRESENTATIVE FACILIPLAN GMF © ACORD CORPORATION 1988