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PROOF OF INSURANCE (2011) CLOSED4007. A` °'�" CERTIFICATE OF LIABILITY INSURANCE D MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 12/02/2009YI PRODUCER 714- 685 -3200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LEGENDS ENVIRONMENTAL INS.SVCS,LLC 2165 N GLASSELL STREET ORANGE, CA 92865 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DAOL CM EFFECTIVE M/DDM'W p EExx DATE MRP RATIO LICENSE #OC79875 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN SAFETY CASUALTY INSURANCE RINCON CONSULTANTS, INC. INSURER B: S 3,000,000 790 EAST SANTA CLARA STREET # 103 INSURER C: X COMMERCIAL GENERAL LIABILITY VENTURA, CA 93001 INSURER D: 12/17/2011 °BEMIS T�Ea ocTcupen o INSURER E: -+v 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILj N�� TYPE OF INSURANCE POLICY NUMBER DAOL CM EFFECTIVE M/DDM'W p EExx DATE MRP RATIO LIMITS AUTHORIZED REPRESENTATIVE GENERAL LIABILITY EACH OCCURRENCE S 3,000,000 A X COMMERCIAL GENERAL LIABILITY ENVO07375 -08 -03 12/17/2008 12/17/2011 °BEMIS T�Ea ocTcupen o $ 1 00,000 MED EXP (Anyone person) $ 10,000 CLAIMS MADE � OCCUR X CONTRACTORS POLL PERSONAL & ADV INJURY 3 3,000,000 GENERAL AGGREGATE S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS - COMPIOP AGG S 3,000,000 POLICY r I JEC LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea a.idenl) ALL OWNED AUTOS BODILY INJURY 3 SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) S PROPERTY DAMAGE (Per accident) 3 GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ OTHER THAN EA ACC 3 ANY AUTO S AUTO ONLY AGG EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE 5 AGGREGATE S OCCUR CLAIMS MADE S DEDUCTIBLE 3 RETENTION 5 S WORKER'S COMPENSATION AND yyC STATU• 0TH. EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERlEXECUTIVE YIN TORY IMITS ER EL EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (Mandatory in NH1 If yes, describe under EL DISEASE - EA EMPLOYEE 5 EL DISEASE - POLICY LIMIT i SPECIAL PROVISIONS below A PROFESSIONAL LIABILITY ENVO07375 -08 -03 12/17/2008 12/17/2011 RETRO DATES: 12/9/94 (PL) 12/17/08 CLAIMS MADE TRANS. COV. 1,000,000 / 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE CITY OF EL SEGUNDO, IT OFFICIALS, AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED WITH RESPECTS TO WORK PERFORMED FOR THEM BY THE NAMED INSURED. `EXCEPT 10 DAYS NOTICE FOR NONPAY OF PREMIUM awvrr�zu•r. �.rw•� -+. r•�ar���ar,raran «wnv LO Icvvwv II U 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIL00MMAKMAIL 30 DAYS WRITTEN CITY OF EL SEGUNDO ATTN: KIMBERLY CHRIST SE , P NNING MGR. NOTICE TO THE CERTIFICATE HOLDER NAMED T THE LEFT X 350 MAIN TREET A *'AXdKNX tXI�IG�D00WJW *XW X Dft>�X1tXX EL SEGUNDO, CA 90245 QklYai�l x*x1CXXX e AUTHORIZED REPRESENTATIVE «wnv LO Icvvwv II U 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4007. .f 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 This Certificate of Insurance 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. 4007 . , THIS END0RSEMEN1' CIgANGES THE POLICY, PLEASE RE4L; 17 CAREFULLY, ENV 98 036 11 04 PRIMARY NON CONTRIBUTORY INSURANCE ENDORSEMENT This Endorsement shall not serve fo increase FOR SPECIFIED AROJECI our limits of insurance, as described in SECTION III - LIMITS OF INSURANCE, In consideration of the payment of premiums, it is hereby agreed as follows. THE CITY OF EL SEGUNt?O, I AND EMPLOYEES FFICIAI.S, Solely with respect to the specified project listed below and subject to all terms, conditions and exclusions of the policy, this insurance shall be considered primary to the Additional Insured fisted below if other valid and collectible insurance is available to the Additional Insured for a loss we cover for the Additional Insured under COVERAGE A It is also agreed that any other insurance maintained by the additional insured shall be non - contributory. VARIOUs All other terms, conditions and exclusions under the policy are applicable to this Endorsement and remain unchanged. ENV 98 036 11 04 CopyrightOc 2005 American Safety Casualty Insurance Company Page 1 of 1 THIS ENDORSEAIENT CHANGES THE POLICY `t.i.1/ . PLEASE READ IT CAREFULLY. ASCIC - ENA' 01 009 06 07 ADDITIONAL INSURED COVERAGE ENDORSE, MENT This Endorsement shall not serve to increase our limits of insurance, as described INSURANCE section of this policy. ed in the LIMITS OF It is agreed the following changes are incorporated into the policy. The following shall be added to SECTION 1, COVERAGE A., par. 1.: Any person shown as an Additional Insured on a certificate of insurance issued b Provided such person is required to be named as an Additional Insured in a written contract with you, shall to coverage hereunder solely for "claims,, or "suits" for "bodily injury" Your authorized representative negligence and not out of the negligence of any other person or entity, The limits of insurance provided e entitled Y J re or 'property damage" arising solely out of your Additional Insured shall be limited to the lesser of the limits of insurance required in a written contract with limits of insurance as described in the LIMITS OF INSURANCE section(s) under the policy. No obligation e to such or indemnify under the policy is provided to any Additional insured for "claims" or "suits" directly or you, fe the from' the status, actions or inaction, including to a indirectly for defense Additional Insured, its agents, consultants, servants, contractors or subcontractors (other than the Nam ctly "arising (without limitation} for vicarious, derivative or strict liability of said except for the actions or inactions of the Named Insured. Named Insured), We will have no duty to defend any insured, other than the Named Insured, except when the sole allegation that insured is vicarious liability for the sole negligence of the Named Insured and not the negligence of person u entity. gallon against 9 any other All terms, conditions and exclusions of the policy, including, but not limited to, any deductible or self - insure shall apply to such Additional Insured, d retention, All other terms, conditions and exclusions under the policy are applicable to this Endorsement and remain unchanged. THE CITY OF EL SEGUNDO, ITS OFFICIALS, AND EMpLOyEES ENV 01 009 06 07 Copyright© 2007 American Safety Casualty Insurance Company Page 1 of 1 ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 01/08/2010 PRODUCER 949. 348. 7400 FAX 949.348.2373 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurance Solutions ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR License #0746539 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 26522 La Alameda, Suite 190 Mission Viejo, CA 92691 INSURERS AFFORDING COVERAGE NAIL # INSURED RINCON CONSULTANTS INC INSURERA: Hartford Fire Ins Co 19682 790 E. SANTA CLARA STREET 103 INSURER B. VENTURA, CA 93001 INSURER C: INSURER D: INSURER E: 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$R DD POLICY NUMBER POLICY EFFECTIVE POT CYO IDIRATION LIMITS L R 3R TYPE OF INSURANCE AUTHORIZED REPRESENTATIVE [,, El Segundo, CA 90245 Ton Al essandra BRITTK l .1. AlfwT \A \I wO L&. GENERAL LIABILITY EACH OCCURRENCE $ PRAEM SES Eat occurrence $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE F� OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY JJEE� LOG AUTOMOBILE LIABILITY 72UEC305944 01/07/2010 12/17/2010 COMBINED SINGLE LIMIT $ (Ea accident) 1 r 000 ' X ANY AUTO BODILY INJURY $ ALL OWNED AUTOS (Per person) A SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ H AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR n CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION 72WECFZ9243 02/01/2009 02/01 /2010 X I TORY LIMITS I I ER E. L. EACH ACCIDENT $ 1, WO, AND EMPLOYERS' LIABILITY ECUTIVEa E.L. DISEASE - EA EMPLOYE 00 S 1,0, A OFFICERPRIETORPARTNERE (Mandatory In NH) E.L. DISEASE - POLICY LIMB $ 1 M describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I HICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVIS DNS City of E1 Segundo, its otl�ficals, and employees are named as additional insured per the Business Auto overage From HA 99 16 03 02 attached to the policy. k1O Days written notice for non-paimnt of Premium. AGUKLI Zs IZUUV/UTI The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of El Segundo IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Attn • Planning Manager 350 Main Street REPRESENTATIVES. AUTHORIZED REPRESENTATIVE [,, El Segundo, CA 90245 Ton Al essandra BRITTK l .1. AlfwT \A \I wO L&. AGUKLI Zs IZUUV/UTI The ACORD name and logo are registered marks of ACORD 0 N 0 0 M d N rn N W N r 0 0 0 0 a� ssse a� I� aaaE �e i! a i� a� ifs s A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72 WEC FZ9243 Endorsement Number: Effective Date: 02/01/09 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: RINCON CONSULTANTS, INC. 790 E. SANTA CLARA VENTURA, CA 93001 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be premium otherwise due on such remuneration. SCHEDULE Person or Organization ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US Countersigned by Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 02/02/09 5 % of the California workers' compensation Job Description BLANKET WAIVER Authorized Representative Policy Expiration Date: 02/01/10 POLICY NUMBER: 72UECJ05944 EFFECTIVE DATE: 01/07/2010 COMMERCIAL AUTOMOBILE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declara- bons is amended to include: (1) Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership, joint venture or limited liability company (b) That is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other policy, or (d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization. B. Employees as Insureds Paragraph A.1. - WHO IS AN INSURED - of SECTION 11 - LIABILITY COVERAGE is amended to add: d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.1. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. 2. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. The OTHER INSURANCE Condition is amended by adding the following: If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. Form HA 9916 03 02 Page 1 of 3 ® 2001, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission.) 3. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees ". Coverage is excess over any other collectible insurance. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $50,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss'; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident ", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees ", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 5. PHYSICAL DAMAGE - ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph AA.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provided a limit of $50 per day and a maximum limit of $1,000. 6. LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, if a long -term leased "auto" is a covered "auto" and the lessor is named in the policy as a Loss Payee, we will pay in the event of a total "loss" your additional legal obligation to the lessor for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the lease. "Outstanding balance" means the amount you owe on the lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees. 7. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 8. SOUND RECEIVING AND TRANSMITTING EQUIPMENT - BROADENED COVERAGE Paragraphs BA.c. & d. - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE do not apply to equipment designed solely for receiving or transmitting sound and accessories used with such equipment, provided such equipment is permanently installed in the covered "auto" at the time of the "loss" or such equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss ", and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto ". 9. EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A. - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR - WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. Form HA 99 16 03 02 Page 2 of 3 11. TWO OR MORE DEDUCTIBLES Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident ", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 14. HIRED AUTO - COVERAGE TERRITORY Paragraph e. of GENERAL CONDITIONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos ", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 15. WAIVER OF SUBROGATION TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - of SECTION IV - BUSINESS AUTO CONDITIONS is amended by adding the following: We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. 16. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these. 17. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. Form HA 99 16 03 02 Page 3 of 3