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PROOF OF INSURANCE (2011) CLOSEDDATE (MM /DD/YY) ACORD�, CERTIFICATE OF LIABILITY INSURANCE 4 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Dealey, Renton &Associates P. 0. Box 10550 ALL ERTHEHCOVERAGE AFFORDED BYO THE POLICIES BELOW. Santa Ana CA 92711 -0550 �,onsulting d Pweolx 57057 Irvine CA 92619 -7057 CAVERAGES INSURERS AFFORDING COVERAGE C INSURERA: Travelez INSURER B: Underwri INSURER c: Fireman' INSURER D: INSURER E: HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TV 'IM6 iivz�uxnu ivea•,nu - .- _ - -_ OTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE ERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGA POLICY EFFEC I HOWPOLICY EXPIRATION BEEN REDUCED BY PAID CLAIMS. LIMITS INSR TYPE OF INSURANCE POLICY NUMBER DATE (M LTR A GENERAL LIABILITY 6 3 0 5 0 0 D4 0 9 2 11/30/2010 11/30/2011 EACH OCCURRENCE $1. 0 0 0 0 0 0 FIRE DAMAGE (Any one fire) $1 000, 000 X COMMERCIAL GENERAL LIABILITY CLAIt .SS MADE X ontractual MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE $10 000 $1,000, 000 $ X BFPD XCU PRODUCTS - COMP /OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO POLICY LOC 8109496B499 11/30/2010 11/30/2011 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ }{ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ AUTO ONLY - EA ACCIDENT $ LIABILITY ANY AUTO OTHER THAN _� ACC AUTO ONLY: AGG $ (RAGE $ SSE00048285639 11/30/2010 11/30/2011 EACH OCCURRENCE $10,000,000 C EXCESS LIABILITY }{ OCCUR EI CLAIMS MADE AGGREGATE $10 O 00, 000 Professional $ Liability is $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Excluded WC STATU- OTH- $ E.L. EACH ACCIDENT_ $ _ __ __ ___ __ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER Professional Liability PI109400 11/30/2010 11/30/2011 Per Claim Annl Aggr. $1,000,000 $2,000,000 B Claims Made DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS General Liability policy excludes claims arising out of the performance of professional services. General Liability includes coverage for Independent Contractors. Re: Raytheon Specific Plan EIR; RBF JN 10- 107917 City of E1 Segundo, its officials and employees are additional insured as respects to General Liability as required by written contract. Primary and Non - Contributing coverage applies to GL as required by written contract. Ly_7 City of E1 Segundo Attn: Masa Alkire 350 Main Street E1 Segundo, CA 90245 ACORD 25 -S (7197) ULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER TO L 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED THE LEFT. AUTHORIZED Q N 1988 DATE (MMIDDIYY) ACORQ. CERTIFICATE OF LIABILITY INSURANCE 3/24Z2011 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pealey, Renton &Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ?. 0. Box 10550 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Ana CA 92711 -0550 INSURERS AFFORDING COVERAGE INSURED RBF Consulting PO Box 57057 Irvine CA 92619 -7057 A:Travelex B: Fireman' c:Underwri D: COVERAGES HE OTWITHSTANDING ERTIFICATE TERMS, INSR POLICIES OF INSURANCE LISTED ANY REQUIREMENT, MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS TYPE OF INSURANCE BELOW HAVE BEEN ISSUED TO TERM OR CONDITION OF ANY PERTAIN, THE INSURANCE AFFORDED OF SUCH POLICIES. AGGREGATE POLICY NUMBER THE INSURED NAMED CONTRACT OR OTHER BY THE LCYEFFECTIHO ABOVE FOR DOCUMENT WITH POLICIES DESCRIBED OLIO EXPIRATION BEEN DATE fMMIDDIYYI THE POLICY PERIOD RESPECT TO WHICH HEREIN IS SUBJECT REDUCED BY PAID LIMITS INDICATED. THIS TO ALL THE CLAIMS. 11/30/2011 $1 000,000 GENERAL LIABILITY 6 3 0 5 0 0 D4 0 9 2 11/30/2010 EACH OCCURRENCE FIRE DAMAGE (Any one fire) $1 000 000 MED EXP (Any one person) $10 000 • COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR PERSONAL & ADV INJURY $1,000 000 GENERAL AGGREGATE $ • ontractual • BFPD XCU PRODUCTS - COMP /OP AGG $ 2 000 O O O GEN'L AGGREGATE LIMIT APPLIES PER: LlPOLICY j{ PRO- LOC 8109496B499 11/3 0/2010 11/30/2011 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ $ SSE00048285639 11/30/2010 11/30/2011 EACH OCCURRENCE $10,000,000 B EXCESS LIABILITY AGGREGATE $10.0 0 0,000 Professional $ }{ OCCUR CLAIMS MADE Liabilit is $ DEDUCTIBLE $ RETENTION $ EX 1 ed WC STAT U- OTH- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER Professional Liability PI109400 11/30/2010 11/30/2011 Per Claim $1,000,000 Annl Aggr. $2,000,000 C Claims Made DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS eneral Liability policy excludes claims arising out of the performance of professional services. eneral Liability includes coverage for Independent Contractors. Re: Raytheon Specific Plan EIR; RBF JN 10- 107917 city of E1 Segundo, its officials and employees are additional insured as respects to General Liability as required by written contract. Primary and Non - Contributing coverage applies to GL as required by written contract. CERTIFICATE HOLDER ADDITIONAL IN ED; I SURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER City of E1 Segundo 9ILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE Attn: Masa Alkire ERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO 350 Main Street HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON E1 Segundo, CA 90245 HE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIV O ACORD CORPO TION 1988 ACORD 25-S (7/97) IR COMMERCIAL GENERAL LIABILITY 63050OD4092 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIA131LiTY COVERAGE PART c) The Insurance provided to the addltional in- sured does not apply to " bodily tnjury" or property damage" caused by "your work" and included In the "products- completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional Insured applies only to such "bodily injury" or "property damage" that oc- curs before the and of the period of time for which the "written contract requiring insur- ance requires you to provide such coverage 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 the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non- Contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization 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 In- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 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: 1, WHO IS AN INSURED — (Section 11) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) if, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your warlc" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional Insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown In the Declarations exceed the limits of liability required by the "written contract requiring insurance ", the in- surance provided to the additional Insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of Insurance described In Section IiI — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury ", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectures, engineering or sur- veying services, including: 1. The preparing, approving, or falling to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and II. Supervisory, inspection, architectural or engineering activities. CGD246O1305 V 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. How, when and where the "occurrence" or offense took place: ii. The names and addresses of any Injured persons and witnesses; and Ill. 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 "sult and otherwise comply with ail 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. Whiie that part of the contract or agreement is in effect; and c. Before the end of the policy period. iillliowe Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 RBFCO -1 OP ID: KH A� R DATE (MM0D /YVYY) CERTIFICATE OF LIABILITY INSURANCE 06/30111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY EXTEND OR ALTER THE COVERAGE AFFORDED ATE THE POLIC EIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). — T —T PRODUCER 714 -708 -4 United Captive Ins. Brokers 714 -708 -2 17151 Newhope St., Ste 211 Fountain Valley, CA 92708 Mark Barrie United States Fidelity & INSURED RBF Consulting INSURER B: Guaranty Corn 14725 Alton Parkway INSURER C : _. Irvine, CA 92618 INSURER D : INSURER E : NAIC # 5887 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES O F 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFIR POLICY EXP LIMITS INSR TYPE OF INSURANCE POLICY NUMBER MMIDD /YYYY MM /DD /YYYY LTR GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ AMA R NT D PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ _ PRODUCTS - COMP /OPAGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC $ COMBINED SINGLE LIMIT Ea accident AUTOMOBILE LIABILITY BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N A ANY PROPRIETOR /PARTNER /EXECUTIVE D1 23W00213 07/01111 07101112 N A OFFICERIMEMBER EXCLUDED? / X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 (Mandatory In NH) If yes, describe under UESCRIPI ION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Re: Raytheon Specific Plan EIR: RBF JN 10- 107917 ceurtt =l I eTIAN CITYELS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo Attn: Masa Aikire AUTHORIZED REPRESENTATIVE 350 Main Street El Segundo, CA 902 - 798 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD