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PROOF OF INSURANCE (2006) CLOSEDDATE ACORM CERTIFICATE OF LIABILITY INSURANCE 11/28/05Dnr) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton 8 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 INSURERS AFFORDING COVERAGE 714 427 -6810 INSURED INSURER A_ Trav oers_P_ro_ perry Casualty Co of Am_ - -- INSURER B: Hartford Fir@ Ins. Co. PO Box 57057 INSURER c: Fireman's Fund Insurance Co. Irvine, CA 92619 -7057 INSURER D: Underwriters at Lloyd's London INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURLD NAMtU ACuvr run inc rv�, , �• ••• -- •-- - WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -- - - - - - --- - POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER AT M LIMITS NT R J. - A GENCO LIABILITY lP63050OD4092TIL05 11/30/05 11130106 EACH OCCURRENCE $1,000,000. FIRE DAMAGE (Any one fire)-- $1100 0 _„_ __- X II CLAIMS MADE a OCCUR INDP. CONTRACTORS MED EXP (Any one person) $5 000 X CONTRACTUAL INCLUDED PERSONAL 8 ADV INJURY $1,000,000 d GENERAL AGGREGATE $21000,000 �BFPD, XCU _ - - II�� - - -._ -- _- PRODUCTS - COMP /OPAGG $2,000,000 PRO - POLICY X X I LOC - B 'AUTOMOBILE LIABILITY 57UENTL0126 11/30/05 11130106 COMBINED SING LE LIMIT $1,000,000 (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS � i I BODILY INJURY (Per accident) $ X..l NON -OWNED AUTOS (PerOa cident)AMAGE $ AUTO ONLY - EA ACCIDENT - -_— $ GARAGE LIABILITY �', — THAN EA ACC $ ANY AUTO ( - -- 1 OTHER AUTO ONLY: AGG $ C ExcESS LIABILITY XAE00087315487 11130105 11/30/06 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 OCCUR n CLAIMS MADE Professional Llab. is Excluded i— $ _ $ DEDUCTIBLE -' $ RETENTION $ ORY R41 OTH- LIMIT — -- WORKERS COMPENSATION AND II, E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY it E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ D OTHER Professional IP1059400 (11/30/05 11130106 $1,000,000 per claim $2,000,000 annl aggr. Liability i DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL 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) City of El Segundo Attn: Ken Putnam 350 S. Main Street El Segundo, CA 90245 -0989 SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIWXWjK=X90x TO MAIL 30- .— DAYSWRITTEN N OTIC E TO TH E CERTIFICATE H OLDER NAMED TO TH E LEFTjWAx K REPRESENTATIVE Arnon f- noonReTIntJ 19RA ACORD 25 -S (7/97)1 of 2 #M144533 ^" AMS 25.3 (07197) 2 of 2 #M144533 POLICY NUMBER: P63050OD4092TIL05 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 E1 Segundo Attn: Ken Putnam 350 S. Main Street El 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 JAN -31 -06 09:08 FROM -RBF CONSULTING 9484648676 T -662 P.02/02 F -752 pp t.CK 111'IbA 1 t ur LIAC31L1 Y IN,UKANLk >ttaFco 07/11 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE thated Captive Ins. acoksrs MOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 17151 mewhope at., Ste 211 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW toUnta1n Valley CA 92708 Phone: 714 -702 -8370 Fax :714 -708 -2300 INSURERS AFFORDING COVERAGE NAIC 6 INBVRED I INSuRERA. V.S. IF14411SY and Gaarant r452 5olL eI P�irkwAy. vtne CA 92718 wSuRER C INSURER D G V vtTlnu r-a THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTW ITHSTANOWVG ANY REQUIREMENT. TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT WfTH RESPECT TO WHICH THIS CERTIFICATE MAY iE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN a SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AOGRMATR LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ TYP OF E POLICY NUMBER oiCF'� DA7� fftPIRATION LIMITi 7 ORNERAL WLBIWIV COMrAERCLAL GENERwI. 6^11161T1 FACN OCCURRI%CE i C7WRERTEO R I 5 MED EAP n one rnon) S CLAIMS MADE F7 OCCUR PERSONAL Y ADY IIJURY 5 GENERAL AGGREGATE S Gem AGGREGATfL LIMIT APPLIES PER- PROOUCTS • COMPJOP AGG S ri POLICY iECT L0C AUTOMMILE LIARIUTY COMBINED SINCL.E LIMB (EO Stt WNIQ 1 ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTOS 110DILY INJURY (Per person) 1 BODarmuRY (Per scueen{I : MIRED AUTO$ NOHOW NED AUTOS PROPERTY DAMAGE (Per xmeenq 1 i GARAGE LIABILITY AUTO ONLT -EA ACCIDENT S OTKER THAN EA ACC S ANY AUTO I AuTOONLY. AGO EACESWURARREI.LAUANP.M EACNOCCuRREnCE S AGGREGATE i OCCUR CLAINSMAOE S : DEDUCTIBLE = RETENTION i WORKERS COMPENSATION AND X TORY MR R E.L.EACNACCIDENT 11 00000 A EI PLOYERS• WARIWTY ANY PROPRIETOrtIPwRrnER/EAECuTNE OFPICERAIEM8ER UCLUDF09 D123W00118 07/01/05 07/01/06 E L DISEASE - EA EMPLOY $1000000 E L OISEASE - PoucY LSnrT 11000000 W es, asclia ww.r SPECIAL PROVISIONS POr)w OTHER nrAwr� MACArrrAT,Ars.LAeATIArr.UN -KLAN r EsCLUSIONS ADDED By ENDORSEMENTI3PRCUA -PROVISIONS •10 days notice of cancellation for non-payment of premium. City of El Segundo 8ublsc Works peyt., AdBwn Office of city Clark 350 south Main Street E1 Segundo CA 92045 -0989 ciTy ,us a „Guia ANY OF TN6 ABOVE pESCRIEED POLICIES RE CANCELLED BEFORE THE IsPIRATIC DATE THEREOF. TNi rSSUIHG INSURER Wn.L ENDEAVOR TO MAIL *30 DA►S WRITTEN NOTICE TO THE CERTIFICATE NOLAER NAMED TO THE LEFT. OUT PAILURB TO DO 50 SHwL6 IMPOSE NO OBLIGATION OR LIABIuTY OF ANY ILIRP UPON THE INSURER. ITS AGENTS OR ■erresorTAnves _ �. /7 N It JAN -31 -06 06:06 FROMFRSF CONSULTING pa ra n CCINSULTING TO: Mona Schilling FAx No: (310) 615 -0529 COMPANY: El Segundo City Clerk PHONE NO: DATE; 1/31/2006 9:01 AM 9494546676 T -662 P.01/01 F -751 Fax Cover Shoot FROM: Linda Polm PfiONI: NO' (949) 330 -4139 FAX NO: (949) 454 -8576 JN: TOTAL PAGES' 2 tp+cauawc Coven &AVI Subject: Certificate of Insurance for City of El Segundo MESSAGE: Please find attached current Certificate of Insurance for the City of El Segundo. Please call If I can be of further assistance. Thank you, Linda POIm Insurance/Contract Administrator RBF Consulting 14725 Alton Parkway Irvine, CA 92618 -2027 Direct; (949) 330 -4139 Fax: (940) 454 -8576 THIS DOCUMENT CONTAINS PROPRIETARY INFORMATION. NO PORTION OF THIS DOCUMENT MAY BE EXTRACTED OR REPRODUCED FOR ANY PURPOSES WITHOUT THE ADVANCE PERMISSION OF RBF CONSUI.TING If mere ale any gwe9tions. or if you do nol rece.ve all documents. Please call us. PLANNING r OE5IGN @ C0145TRUPTI97N 14725 Alton Parkway, Irvine, CA 92618.102/ e P O Bow 57057, liwne, CA 92619 -7057 a 949 472.3S05 a FAX 949.472 6373 offices located Illroupout California. AAZOna & Nevada 9 www REIF com