PROOF OF INSURANCE (2004) CLOSEDAC -0- CERTIFICATE OF LIABILITY INSURANCE 02/24/2004
DATE
2003'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Brokers, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
725 S. Figueroa Street, 35th Fl.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
CA License #0714705
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURERS AFFORDING COVERAGE
Los Angeles CA 90017
(213) 689 -0065
INSURED
MARCOR Remediation, Inc.
INSURER A: Zurich American Insurance CO
INSURER B: Steadfast Insruance Co.
1018517
16027 Carmenita Road
INSURER
Cerritos CA 90703.2208
INSURER D
rnvconnoc (`A
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATEMW
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
X I COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX I OCCUR
GLO 2987026 -01
02/24/2003
02/24/2004
EACH OCCURRENCE
$ 1000 000
FIRE DAMAGE (Any one tiLeL
MED EXP (Any one person)
1,000 000
$ 5 000
PERSONAL & ADV INJURY
$ 1,000,000
GENERALAGGREGATE
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
PRODUCTS - COMP /OP AGG
$ 1 000 000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
MCS90 Endorsement
BAP 3652557 -07
02/24/2003
02/24/2004
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY
(Per person)
$ XXXXXXX
X
X
BODILY INJURY
(Per accident)
$ XXXXXXX
X
X
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
ANY AUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
AUTO ONLY: AGG
$ XXXXXXX
$ XXXXXXX
B
EXCESS LIABILITY
X OCCUR 7 CLAIMS MADE
UMBRELLA
DEDUCTIBLE FORM
X RETENTION $ 10,000
SEO 2153684 -05
02/24/2003
02/24/2004
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
$ XXXXXXX
XXXXXXX
$ XXXXXXX
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
NOT APPLICABLE
WC S_1_1 OTH-
Aa(
$ XXXXXXX
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$ XXXXXXX
E.L. DISEASE - POLICY LIMIT
$ XXXXXXX
B
OTHER
Prof/Environmental Consul. Liability
(Claims Made)
PEC 3654494 -05
02/24/2003
02/24/2004
Each Claim $10,000,000 Aggregate $20,000,000
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
Prof /Environmental Includes coverage for asbestos, lead & UXO coverage.Re: The City of El Segundo is listed as Additional Insured, with regards to PPI,
additional insured clause only applies as respects Contractor's Environmental Liability and Completed Operations.
CFRTIFICATF I-IAI nFR I X I ADDITIONAL INSUIRED- INSURER LETTER- CANCFLLATI0N
1222652
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of El Segundo
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -3Q_ DAYS WRITTEN
150 Illinois Street
El Segundo CA 90245.4352
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
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 -S (7/97) ` o /LORD CORPORATION 1988