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PROOF OF INSURANCE (2008) CLOSEDvnvnarr. v.....
.CRM- CERTIFICATE OF LIABILITY INSURANCE 12/1410 °"�'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER
PRODUC ,Renton &Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
199 S Los Robles Ave Ste 540 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pasadena, CA 91101 INSURERS AFFORDING COVERAGE
626 844 -3070
INSURED INSURER A: Travelers Indemnity CO. of Connectic
KOA Corporation INSURER B: Travelers Property Casualty Co of Am
1055 Corporate Center Dr #300 INSURER c: American Automobile Ins. Co.
Monterey Park, CA 91754 INSURER D: ACE American Insurance Company
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, POLICY EFFECTIVE POLICY EXPIRATION
NSR POLICY NUMBER LIMITS
TYPE OF INSURANCE
A
GENERAL LIABILITY
68020751-840
06115107
06115108
EACH OCCURRENCE
$1 000.000
FIRE DAMAGE (Any one fire)
$1,000,000__
MED EXP (Any one person)
s5000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 41 OCCUR
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
PRODUCTS - COMP /OP AGG
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO
POLICY JECT LOC
BA2072L002
06115107
06115108
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
A
AUTOMOBILE
LIABILITY
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
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY: AGG
_
$
$
CUP6464YO33
06115107
06/15/08
EACH OCCURRENCE
$4 000 000
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
AGGREGATE
$4,000,000
DEDUCTIBLE
X RETENTION $O
WZP80954913
09119107
09119108
WC STATU- OTH-
X '
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1 000 000
G23631684002
03113107
03/13108
$2,000,000 per claim
$2,000,000 annl aggr.
D
OTHER Professional
lability
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of El Segundo, its officials, and employees are named as additional insured as
respects general liability for claims arising from the operations of the named insured.
CERTIFICATE HOLDER ADDRIONALINSURED INSURER LETTER:
CANCELLATION
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of El Segundo
Attn: Dan Garcia, Assistant City Engineer
350 Main St.
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -0 DAYSWRITTEN
NOTICE TOTHE CERTIFICATE HOLDER NAM EDTOTHELEFT, BUTFAILURE TO DO SO SHALL
IM POSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
El Segundo, CA 90245
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 -S (7197)1 of 1 #S2131001M203765
AAF © ACORD CORPORATION 1988
COMMERCIAL GENERAL LIABILITY
POLICY NUMBER: 6802075L840 ISSUE DATE: 12/14/07
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):
City of E1 Segundo
Attn: Dan Garcia, Assistant City Engineer
350 Main St.
E1 Segundo, CA 90245
PROJECT/LOCATION OF COVERED OPERATIONS:
All Operations of the Named Insured
1. WHO IS AN INSURED (Section II) is amended to
include the person or organization shown in the
Schedule above as an additional insured on this
Coverage Part, but:
This endorsement does not increase the lim-
its of insurance stated in the LIMITS OF IN-
SURANCE (Section III) for the Coverage
Part.
a. Only with respect to liability for "bodily injury", 3. The following is added to Paragraph a. of 4.
"property damage" or "personal injury"; and Other Insurance
CON In COMMERCIAL
(Section GENERAL
b. If the injury or damage arises out of the per-
formance by you or your subcontractor, of
"your work" on or for the project, or at the lo-
cation, shown in the Schedule above. Such
person or organization does not qualify as an
additional insured with respect to their inde-
pendent acts or for "bodily injury", "property
damage" or "personal injury" for which that
person or organization has assumed liability
in a contract or agreement
The insurance provided to the additional insured
by this endorsement is limited as follows:
a. This insurance does not apply to the render-
ing of or failure to render any "professional
services ".
b. The limits of insurance afforded to the addi-
tional insured shall be the limits which you
agreed to provide in a contract or agreement
requiring insurance for that additional in-
sured, or the limits shown in the Declarations
for this Coverage Part, whichever are less
However, if you specifically agree in a „ contract or
agreement requiring insurance” that, for addi-
tional insured shown in the Schedule, the insur-
ance provided to that additional insured under this
Coverage Part must apply on a primary basis, or
a primary and non - contributory basis, this insur-
ance is primary to other insurance that is avail-
able to such additional insured which covers such
additional insured as a named insured, and we
will not share with the other insurance, provided
that:
(1) The "bodily injury" or "property damage" for
which coverage is sought occurs; and
(2) The "personal injury" for which coverage is
sought arises out of an offense committed;
after you have entered into that contract or
agreement requiring insurance for such addi-
tional insured. But this insurance still is excess
over valid and collectible other insurance,
whether primary, excess, contingent or on any
CG D3 82 09 06 2006, The St. Paul Travelers Insurance Companies, Inc.
Includes copyrighted material of Insurance Services Offices, Inc, with its permission
Page t of 2
COMMERCIAL GENERAL LIABILITY
other basis, that is available to the additional in-
sured when the additional insured is also an addi-
tional insured under any other insurance.
4. The following is added to Paragraph 8. Transfer
Of Rights Of Recovery Against Others To Us
in COMMERCIAL GENERAL LIABILITY CON-
DITIONS (Section IV):
We waive any rights of recovery we may have
against the additional insured shown in the
Schedule above because of payments we make
for "bodily injury", "property damage" or "personal
injury arising out of "your work" on or for the pro-
ject, or at the location, shown in the Schedule
above, performed by you, or on your behalf, un-
der a "contract or agreement requiring insurance"
with that additional insured. We waive these
rights only where you have agreed to do so as
part of the contract or agreement requiring insur-
ance" with that additional insured entered into by
you before, and in effect when, the "bodily injury"
or "property damage" occurs, or the "personal in-
jury" offense is committed.
5. As respects the insurance provided to the addi-
tional insured by this endorsement, the following
definition is added to DEFINITIONS (Section V):
"contract or agreement requiring insurance"
means that part of any contract or agreement un-
der which you are required to include the person
or organization shown in the Schedule as an ad-
ditional insured on this Coverage Part, provided
that the "bodily injury" and "property damage" oc-
curs, and the "personal injury" is caused by an of-
fense committed:
a. After you have entered into that contract or
agreement;
b. While that part of the contract or agreement is
in effect; and
c. Before the end of the policy period.
All other terms of your policy remain the same.
The City of E1 Segundo, its officials, and employees are named as
additional insured as respects general liability for claims arising
from the operations of the named insured.
Page 2 of 2 2006, The St. Paul Travelers Insurance Companies, Inc.
CG D3 82 09 06
Includes copyrighted material of Insurance Services Office, Inc, with its permission.