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PROOF OF INSURANCE (2010) CLOSEDClient#: 54522 DATE ACORDTM CERTIFICATE OF LIABILITY INSURANCE 03125109D ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis Ins. Srvcs of CA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ?HIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2030 Main Street, Suite 350 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Irvine, CA 92614 -7248 949 729 -0777 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Property Casualty Co of Am 36161 KOCHER SCHIRRA GOHARIZI CONSULTING INSURER B: OneBeacon America Insurance Company 20621 111 N JACKSON ST STE 121 INSURER C: US Specialty Insurance Company 29599 GLENDALE, CA 91206 -4371 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. POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR N TYPE OF INSURANCE POLICY NUMBER DATE MM D D E MD A GENERAL LIABILITY 6807483L990 01124109 01/24/10 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED x300 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR MED EXP (Any one person) s5,000 2 OOO Ann GEN'L AGGREGATE LIMIT APPLIES PER: PR POLICY LOC A AUTOMOBILE LIABILITY 68074831-990 01/24/09 01124110 ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO A EXCESS /UMBRELLA LIABILITY CUP8156Y204 01124109 01124/10 X OCCUR 0 CLAIMS MADE H DEDUCTIBLE X RETENTION so B WORKERS COMPENSATION AND 406019028 09101108 09101109 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below `` JOTHER Professional US081299101 11121108 11/21/09 PERSONAL & ADV INJURY S GENERAL AGGREGATE 94,000,000 PRODUCTS - COMP /OP AGG s4,000,000 COMBINED SINGLE LIMIT sINCLUDED (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S AUTO ONLY: AGG I EACH OCCURRENCE I AGGREGATE I E.L. EACH ACCIDENT E.L. DISEASE - EA EMP E.L. DISEASE - POLICY $1,000,000 Per Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ALL OPERATIONS INCLUDING BUT NOT LIMITED TO PLUNGE ELECTRICAL. GENERAL LIABILITY: CITY OF EL SEGUNDO, ITS OFFICIALS AND EMPLOYEES ARE NAMED ADDITIONAL INSURED PER ATTACHED PRIMARY AND NON - CONTRIBUTORY ENDORSEMENT. !HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF EL SEGUNDO DATE THEREOF, THE ISSUING INSURER WILL XNNjMRXjt MAIL 'AA DAYS WRITTEN ATTN: DAN GARCIA, ASST CITY ENG. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,XXXRpIM�pDOlpppOQf1QXK 350 MAIN STREET M =ptXR7CXMxnnRIQRX*AK1D XKAXXXIXQX KXKKWXXP 7 KX)IXKK KMXX El Segundo, CA 90245 R AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 1 of 2 #453533 CCL a ACORD CORPORATION 1988 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 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 25 -S (2001/08) 2 of 2 9455533 COMMERCIAL GENERAL LIABILITY POLICY NO. 68074831-990 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to include as an additional insured on this Coverage Part, but only with respect to liability for "bodily injury", "property damage" or "personal 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 premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard ". Such person or organization does not qualify as an additional insured 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 such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. e. This insurance does not apply to the rendering of or failure to render any "professional services ". f. The limits of insurance afforded to the additional insured shall be the limits which you agreed in that "contract or agreement requiring insurance" to provide for that additional insured, or the limits shown in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insurance is primary to other insurance that is available 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 ". But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with such person or organization entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. CG D3 8109 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY "personal injury" is caused by an offense 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 CG D3 81109 07 © 2007 The Travelers Companies, Inc. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission.