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PROOF OF INSURANCE (2009) CLOSEDACOM CERTIFICATE OF LIABILITY INSURANCE 3 /09 M/DD/YY) 03/09/09 PRODUCER 1- 866- 220 -4625 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Holmes Murphy and Associates - Omaha ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POLICY NUMBER HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2637 South 158th Plaza ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 GENERAL LIABILITY Omaha, NE 68130 INSURERS AFFORDING COVERAGE INSURED Poet, Buckley, Schuh 4 Jernigan, Inc. d /b/a PBS4J INSURERA:Zurich American Insurance Company/#16535 INSURER B: Zurich American Insurance Company / $16535 INSURER c: steadfast Insurance Company /i126387 2001 NW 107th Avenue INSURER D: Miami, FL 33172 -2507 INSURER E: CAVFRAaFR 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 POLICY EXPIRATION LIMITS A GENERAL LIABILITY GLO 9139458 -02 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx—] OCCUR MED EXP (Any one arson ) $ 25,000 PERSONAL aAOVINJURY $ 1,000,000 X Contractual Liability GENERAL AGGREGATE 6 2,000,000 _ II GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- X LOC PRODUCTS - COMP /OP AGG $ 2,000,000 B AUTOMOBILE X LIABILITY ANY AUTO HAP 9139457 -02 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) 62,000,000 BODILY INJURY (Per person) 6 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) 6 X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) 6 X Contractual Liability GARAGE LIABILITY r— AUTO ONLY - EA ACCIDENT S — OTHER THAN EA ACC $ l I ANY AUTO $ AUTO ONLY: AGG C EXCESS LIABILITY 'AIIC 508762104 09/30/08 09/30/09 EACH OCCURRENCE 625,000,000 X OCCUR CLAIMS MADE AGGREGATE 6 25, 000, 000 $ I $ DEDUCTIBLE $ RETENTION $0 A WORKERS COMPENSATION AND WC 9139459 -02 09/30/08 09/30/09 X WCSTATU - I OTH- 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 OTHER It s $ DESCRIPTION OF OPERATK) NSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: Traffic Engineering Services - PSRH Preparation City of E1 Segundo its officials and employees are Additional Insureds on the General Liability on a Primary basis with respect to the operations of the insured on the above project. See attached for additional wording. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION El Segundo, City of DATE THEREOF, THE ISSUING INSURER WILL IXWI4MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, K933Y -=XlD 1l Attar Maryam Jonas X1111iS> fAAII�dY[ 1tiIJtI6i0�ALS4�[ II' Y�Iilllli�ill <XBif)f�IlicR =I�L`1RifRiIK% 350 Main Street NKM N goWK4 , XXXXXXX XXXXXXXXXXXXXxxxx�X%XXXXXX%XXXXXXXXXXXXX %X El Segundo, CA 90245 USA AUTHORIZED REPRESENTATIVE iJriJ�iC/ ACORD 25-S (TISIT1 lavansne O ACORD CORPORATION 1988 11301089 Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600 J 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. AGORD 25-5 (7187) 7 I SUPPLEMENT TO CERTIFICATE OF INSURANCE 03/DATE 09/09 NAMt Ur MUKtU: Post, Buckley, Schuh i Jernigan, Inc. d /b /a PBS&J Additional Insured on the General Liability a Auto Liability on a Primary & Non - Contributory basis, including completed operations "Where Required by Contract" (GL ONLY). General Liabiltiy Aggregate limit applies per Project Blanket Additional Insured Lessor /Loss Payee on the Auto Liability. Waiver of Subrogation on the General Liability Auto Liability, and Workers Compensation "Where Required by Contract". Umbrella follows form to the Additional Insureds on the General Liability. NOTICE OF CANCELLATION WORDING: SHOULD ANY OF THE DESCRIBED POLICIES ON THE CERTIFICATE BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL 30, 60 OR 90 DAYS WRITTEN NOTICE "WHERE REQUIRED BY CONTRACT" EXCEPT 10 DAYS NOTICE FOR NON- PAYMENT OF PREMIUK TO THE CERTIFICATE HOLDER NAMED ON THE ATTACHED CERTIFICATE. ACORD, CERTIFICATE OF LIABILITY INSURANCE 9/30/2009 DATE 1 3/9/2009 [MMfDDfYYYY) PRODUCER Lockton Companies, LLC -I Kansas City 444 W. 47th Street, Suite 900 Kansas City MO 64112 -1906 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (816) 960 -9000 D' NSR TYPE OF INSURANCE POLICY NUMBER INSURERS AFFORDING COVERAGE NAIC 0 INSURED POST, BUCKLEY, SCHUH AND JERNIGAN, INC. INSURER A: LLOYDS OF LONDON A XV 1307320 DBA PBS &J INSURER B: 2001 NW 107 AVENUE MIAMI FL 33172 -2507 INSURER C: XXXXXXX INSURER 0: COMMERCIAL GENERAL LIABILITY INSURER E: Ines c[:nllrlule V� INFNRANGE UOrN NOT CONSTITUTE A CONTRACT ■ETTNEEN THE ISSUING COVERAGES PD INAUDFR1S1 AGTN0SVFn eFFRCRFMTATNF AR onnnIIIFS ANn TNe r 11ITI—ATC un, me 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 LTR D' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS AUTHORIOVIDEPRESENTATIVE GENERAL LIABILITY EA H O RRENC XXXXXXX COMMERCIAL GENERAL LIABILITY NOT APPLICABLE DR AGES ( RENTED $ XXXXXXX MED EXP (Any one person) $ XXXXXXX CLAIMS MADE a OCCUR PERSONAL & ADV INJURY $ XXXXXXX GENERAL AGGREGATE $ XXXXXXX PRODUCTS - COMPIOP AGG $ XXXXXXX GEN'L AGGREGATE LIMIT APPLIES PER: POLICY M PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ XXXXXXX ANY AUTO NOT APPLICABLE Ea accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) $ XXXXXXX HIRED AUTOS BODILY INJURY (Per accident) $ XXXXXXX NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) XXXXXXX GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX OCCUR FI CLAIMS MADE NOT APPLICABLE AGGREGATE S XXXXXXX $ XXXXXXX UMBRELLA 1:1 $ XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ WORKERS COMPENSATION AND NOT APPLICABLE OC ST T- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ XXXXXXX ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEd S XXXXXXX OFFICERIMEMBER EXCLUDED? tt yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ XXXXXXX SPECIAL PROVISIONS below A OTHER LDUSA0800811 9/30/2008 9/30/2009 S 1,000,000 EACH CLAIM & A CLAIMS -MADE FORM $1,000,000 ANNUAL AGGREGATE. PROF ESSIONALMOLLUTION 11/11/1961 RETRODATE. LIABILITY j L DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: TRAFFIC ENGINEERING SERVICES - PSRE PREPARATION. CERTIFICATE HOLDER CANCELLATION 10467233 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 30 DAYS WRITTEN ATTN: MARYAM JONAS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 350 MAIN STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR EL SEGUNDO CA 90245 REPRESENTATIVES. AUTHORIOVIDEPRESENTATIVE ACORD 25 (2001108) For questions repsrdlnp this certificate, contact the number listed In the 'Producer' section straw. I w © ACORD CORPORATION 1988