PROOF OF INSURANCE (2005) CLOSEDDATE
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 11/29/040/YV)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton $ Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. O. Box 10550 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Ana, CA 92711 -0550
714 427 -6810
INSURED
RBF Consulting
PO Box 57057
Irvine, CA 92619 -7057
ERAGES
INSURERS AFFORDING COVERAGE
1INSURER A Travelers Property Casualty Co of Am
INSURER B: Hartford Fire Ins. Co.
! INSURERC Fireman's Fund Insurance Co
INSURER D. Underwriters at Lloyds of London
INSURER E:
IVY
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.
IT R
LT
TYPE OF INSURANCE
POLICY NUMBER UPDATE
MFFDDIYY) POLICY M EXPIRATION
LIMITS
A
GENERAL LIABILITY
P63050OD409204
j 11/30/04
11/30/05
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any one fire)
$1.000,000
X �COMMERCIAL GENERAL LIABILITY
li
MED EXP (Any one person)
$5 OOO
— CLAIMS MADE �7 OCCUR
INDP. CONTRACTORS
PERSONAL & ADV INJURY
$1000000
X 'CONTRACTUAL
INCLUDED
GENERAL AGGREGATE - _ -
-- --.... —._.
$2_ ,000,000- -
_ _
X ,iBFPD — XCU
---._. - - - -.
GEN'LAGGREGAT_ELIMITAPPLIESPER:
PRODUCTS - COMP /OPAGG
$2,000,000 -
- - -I'
POLICY PRO - �( LOC
B
AUTOMOBILE LIABILITY
-
57UENTLO126 1 11130/04
11/30105
COMBINED SINGLE LIMIT
$1,000,000
(Ea accident)
X ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
( Per
$
AUTOS
person)
BODILY INJURY
$
X_SCHEDULED
X HIRED AUTOS
X NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
-- —
j
I
(Per accident)
GARAGE LIABILITY
',
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
ANY AUTO
$
$
AUTO ONLY: AGG
C
EXCESS LIABILITY
XSM00086597721 11/30/04
11/30/05
EACH OCCURRENCE - -.
$101000,000-
_
X OCCUR I -_ CLAIMS MADE
Professional Liab.
AGGREGATE
$1O,OOO OOO__ _
$
i
is Excluded
_ DEDUCTIBLE
fi
-
$
RETENTION $
$
WORKERS COMPENSATION AND
!
WC STATU- i O B
E.L. EACH ACCIDENT
S
EMPLOYERS' LIABILITY
E.L. DISEASE -EA EMPLOYEE
$
!
E.L. DISEASE -POLICY LIMIT
$
D
OTHER Professional
PI049400 11130/04 11/30/05
$1,000,000 per claim
Liability
$2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
General Liability policy excludes claims arising out of the performance of professional
services
Re: All Operations of Named Insured
City of El Segundo is Additional Insured as respects to General Liability.
(See Attached Descriptions)
ACORD 25 -S (7/97)1 of 2 #M115917
c
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES B E CANCELLED BEFORE TH E EXPIRATION
City of El Segundo
DATE THEREOF, THE ISSUING INSURER WILL %XPffi =X3PMAIL30-- DAYS WRITTEN
Attn: Ken Putnam
NOTICE TOTHE CERTIFICATE HOLD ER NAM ED TOTHELEFT, BxjMALVW Q.V"AAkXXXX
350 S. Main Street
IWWMX AWAAMODOW9M ARM 9XARXNXXXAXOPfP "X AWJMU3WA0M JORX
El Segundo, CA 90245 -0989
ARFOWK300=X
AUTHORIZED REPRESENTATIVE
- - - - - ------
ACORD 25 -S (7/97)1 of 2 #M115917
c
DESCRIPTIONS (Continued from Page 1)
Priamry and Non - Contributing coverage applies to GL.
(AI /PR/X)
AMS 25.3 (07/97) 2 of 2 #M115917
POLICY NUMBER: P63050OD409204 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 El Segundo
Attn: Ken Putnam
350 S. Main Street
E1 Segundo, CA 90245 -0989
(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.
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