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PROOF OF INSURANCE (2008) CLOSEDDATE r RDTM CERTIFICATE OF LIABILITY INSURANCE 04/14108D RODUC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION P ER RODUC ,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 INSURERS AFFORDING COVERAGE 714 427 -6810 INSURED INSURER A: Travelers Property Casualty Co of Am RBF Consulting INSURER B: National Union Fire Ins Co of Pittsb _ PO Box 57057 INSURER C: Underwriters at Lloyd's of London Irvine, CA 92619 -7057 1 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. INTR POLICY EFFECTIVE POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER DATE MMIDD /YY DATE MM /OD/YY A GENERAL LIABILITY 63050OD4092TIL07 11/30/07 11/30/08 EACH OCCURRENCE _, $1 000,000 FIRE DAMAGE (Any one fire) $1,000,000 X COMMERCIAL GENERAL LIABILITY - - " -- CLAIMS MADE CI OCCUR INDP. CONTRACTORS MED EXP (Any one person) $10,000 X rnNTRACTUAL INCLUDED PERSONAL &ADVINJURY $1 OOOOOO GEN'L AGGREGATE LIMITAPPLIES PER: PRO- LOC POLICY X ECT A AUTOMOBILE LIABILITY 81094966499 X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS X NON -OWNED AUTOS _GARAGE LIABILITY I ANY AUTO B EXCESS LIABILITY OCCUR CLAIMS MADE Pofessional Liab. is Excluded DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C IOTHER Professional IP1079400 Liability _GENERAL AGGREGATE $21000,000 I PRODUCTS - COMP /OP AGG $2,000,000 11130/07 11/30/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 B$ $ _ BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ AUTO ONLY - EA ACCIDENT OTHERTHAN EA ACC AUTO ONLY: AGG $ $ 11/30!07 11/30/08 EACH OCCURRENCE $10 000 000 AGGREGATE $10,000,000 -- - -- $ is E.L. EACH ACCIDENt E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 11/30/07 11/30/08 $1,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS General Liability policy excludes claims arising out of the performance of professional services Re: JN 10- 106141, Aloft Hotel MND City of El Segundo, its officials, and employees are additional insured as (See Attached Descriptions) L`FRTICICATF Hni nFR I I ADDRIONAL INSURED; INSURER LETTER: CANCELLATION City of El Segundo Attn: Mary Lewis, Sr. Admin. Assist. Planning & Building Safety Dept. 350 Main Street El Segundo, CA 90245 -3813 SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIgX 5fYL=X=TO MAIL 3QDAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TO THE LEFT, JIj$kW)WX)00*0&'Mk © ACORD CORPORATION 1988 ACORD 25 -S (7/97)1 of 2 #S222980/M212212 RLL AMS 25.3 (07197) 2 of 2 #S222980/M212212 POLICY NUMBER: 63050OD4092TIL07 COMMERCIAL GENERAL LIABILITLY ISSUE DATE: 04/14/08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABAILTILY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S) City of El Segundo, its officials, and employees PROJECT /LOCATION OF COVERED OPERATIONS: JN 10- 106141, Aloft Hotel MND 1. WHO IS AN INSURED — (Section II) is amended b) The insurance provided to the additional in- to include the person or organization shown in the sured does not apply to "bodily injury", "prop - Schedule above, but: erty damage" or "personal injury" arising out a) Only with respect to liability for "bodily injury ", of the rendering of, or failure to render, any "property damage" or `personal injury "; and professional architectural, engineering or sur- veying sAices, including: b) If, and only to the extent that, the injury or damage is caused by acts or omissions of I. The preparing, approving, or failing to you or your subcontractor in the performance prepare or approve, maps, shop draw - of "your work" on or for the project, or at the ings, opinions, reports, surveys, field or- location, shown in the Schedule. The person ders or change orders, or the preparing, or organization does not qualify as an addi- approving, or failing to prepare or ap- tional insured with respect to the independent prove, drawings and specifications; and acts or omissions of such person or organiza- ii. Supervisory, inspection, architectural or tion. engineering activities. 2. The insurance provided to the additional insured c) The insurance provided to the additional in- by this endorsement is limited as follows: sured does not apply to "bodily injury" or a) In the event that the Limits of Insurance of "property damage" caused by "your work" this Coverage Part shown in the Declarations and included in the "products- completed op- "written exceed the limits of liability required by a erations hazard" unless a contract "written contract requiring insurance" for that requiring insurance" specifically requires you additional insured, the insurance provided to to provide such coverage for that additional the additional insured shall be limited to the insured, and then the insurance provided to limits of liability required by that written con- the additional insured applies only to such tract requiring insurance ". This endorsement "bodily injury" or "property damage" that oc- shall not increase the limits of insurance de- curs before the end of the period of time for scribed in Section III — Limits Of Insurance. which the "written contract requiring insur- ance requires you to provide such coverage CG D2 47 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITLY or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance', whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if a "written contract requiring insurance" for that ad- ditional insured specifically requires that this in- surance apply on a primary basis or a primary and non - contributory basis, this insurance is pri- mary to "other insurance' available to the addi- tional insured which covers that person or organi- zation as a named insured for such loss, and we will not share with that "other insurance'. But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible `other insurance', whether pri- mary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional in- sured under such 'other insurance'. 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence' or an offense which may result in a claim. To the extent possible, such notice should include: i. How, when and where the "occurrence' or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the 'occurrence' or offense. b) If a claim is made or "suit' is brought against the additional insured, the additional insured must: I. Immediately, record the specifics of the claim or "suit and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of "other insurance' which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance' available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage' oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, Inc. CG D2 47 08 05 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID RC DATE(MM1DONYYY) 1 RBFCO -1 03/04/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION POLICY NUMBER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE United Captive Ins. Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 17151 Newhope St., Ste 211 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fountain Valley CA 92708 Sr. Admin. Assist. Phone: 714 -708 -4370 Fax: 714- 708 -2300 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: U.S. Fidelity and Guaranty Co. 25887 INSURER B: COMMERCIAL GENERAL LIABILITY CLAIMS MADE FI OCCUR INSURER C: RBF Consulting 14725 Alton Parkway Irvine CA 92718 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. IN LTR YNSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM /DD/YY POLICY EXPIRATION DATE MM /DD/YY LIMITS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL GENERAL LIABILITY Sr. Admin. Assist. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR EACH OCCURRENCE $ PREMISES (Ea occurence) $ CA 90245 -3813 COMMERCIAL GENERAL LIABILITY CLAIMS MADE FI OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP /OP AGG S POLICY jE O- LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMB (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S EA ACC OTHER THAN $ ANY AUTO S AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F_] CLAIMS MADE AGGREGATE $ S $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE D123WO0157 7 01 07 0 / / 0 7 /O1 /OS X TORY LIMBS OTH E.L. EACH ACCIDENT $lOOOOOO E.L. DISEASE- EA EMPLOYE $ 1000000 OFFICER /MEMBER EXCLUDED? It yes, describe under E.L. DISEASE - POLICY LIM IT $1000000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *10 days notice of cancellation for non - payment of premium. Re: JN 10- 106141, Aloft Hotel MM r�rrn%,ri lG nVLUCK (-aIUCFI I aTinPJ `° (""'two) © ACORD CORPORATION 1S C ITYEL5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN City of El & Building Segundo Planning Safety Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Mary Lewis, Sr. Admin. Assist. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 33C 'Hain Street RroRF*3ZNTA-.i ,-.3 El Segundo CA 90245 -3813 AUTHORIZED REPRESENTATIVE Mark Barrie `° (""'two) © ACORD CORPORATION 1S