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PROOF OF INSURANCE (2009) CLOSED391 e J AG R ®TM I�j�".R�� Al G L �A�t�l� A�S��M��i►E g /15 2009 PRODUCER (973) 890 -0900 FAX: (973) 812 -9860 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C &H AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 783 North Riverview Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 324 Totowa NJ 07511 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: The Ins Cc of State of PA S & L Specialty Contracting, Inc. INSURER B: National Union Fire Ins, of PA 315 South Franklin Street INSURER C: Syracuse, NY 13202 -2481 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 TTHE(INSURANCE AFFORDED CONDITION BY ITHE POLICIES DESCRIBED EOO EREINOIS SUBJECT TO ALL THE OTERMS, EXCLUSIONS (AND CONDITIONS OFO SUCH Y POLICIES. ITE LIMITS SHOM MAY HAVE BE q REDUCED INSR AOD'L TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY POLICY NUMBER GL2052493 POLICY EFFECTIVE DATE MMIDDIYY 12/01/2008 POLICY EXPIRATION DATE MMIDDIYY 12/01/2009 LIMITS EACH OC URRENCE S _ 2,000,000 pDR A E ER 1111 e 5 50,000 MED EXP (Any one ereon S A CLAIMS MADE ® OCCUR PERSONAL & ADV INJURY _S2,000,000 S 4,000,000 S 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: O Y X P D LQg AUTOMOBILE LIABILITY CAS263188 12/01/2008 12/01/2009 COMBINED SINGLE LIMIT (Ea acddeM) $ 1,000,000 X ANY AUTO A ALL OWNED AUTOS BODILY INJURY (Per person) $ X X SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY (Per accident) $ X NON -OWNEDAUTOS — PROPERTY DAMAGE (PeraWdent) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ _ OTHER THAN C AUTO ONLY: AG S ANY AUTO $ EXCESSIUMBRELLA LIABILITY X OCCUR El CLAIMS MADE BE015872729 12/01/2008 12/01/2009 EACH 'E $ 2,000,000 AGGREGATE S 2,000,000 S S B DEDUCTIBLE A X RETENTION -- S io 000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? WC4990794 California 12/01/2008 12/01/2009 X T U- % $ E.L. EACH ACCIDENT S 1 , 000 , 000 E.L. DISEASE - EA EMPLOYE4 6 1,000,000 E.L. DISEASE - POLICY LIMIT I S 1,000,00 If yes, describe under PROVISIONS SpEaAL el OTHER DESCRIPTION OF OPERATIONSI LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPEC1AL PROVISIONS RE: City of E1 Segundo, Residential Sound Insulation Program, Group 30, Contract No. 3903. Additional Insured 8ndorsements CG 20 SO (07 -04) & CG 20 37 (07 -04) attached. ** See attached for Cancellation Clause ** REVISED - Replaces Certificate issued on 2/6/2009. CERTIFICATE HOLDER %iA1V\iCLLAI IVn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of E1 Segundo EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAMAM MAIL City Hall 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMPO TO THE LEFT, M 305 Main Street( 1��( 6iFa�IXiIaNiaSa4Xai6K�S1Ku24i4 %�1GYiJki6lXDXui(dWiNB�C El Segundo, CA 90245 XXMWZ THORIlED REPRESENTATIVE chael Culnen /CHRIS ACORD 26 (2001108) ©ACORD CORPORATION 1988 P.— 1 M9 i mQn,) r. --- nn� 1J 1 'c 2ME POLICY NUMBER: GL 2052493 ,: COMMERCIAL GENERAL LIABILITY Cr, 20 37 07 04 THIS ENDORSEMENT CHANGES TIME POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL I U - OWNERS, LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE ^Name Of Additional Insured Person(s) Or 4rgarliz�tlon4s) _ Location And Description Of completed Op rations WHERE REQUIRED BY "WRITTEN CONTRACT"a AS IDENTIFIED BY CONTRACT Inforrria[ ion required to_aomplete. this Schedule. if not shown above, will be shown in the Declarations. Section 11 -- Who Is An Insured is amended to include as tin additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dnntage" caused, in whole or in part, by "your work" at the location closignated and described in the schedule of this endorsernont performed for that additional 'insured and included in the "products completed operations hazard ". CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 'I of 1 11 POLICY NUh4BER: GL 2052493 COiVidlERM&t_ GENERAL CG 20 LIABILITY THIS ENDORSEMENT CHANGES TKE POLOC` , PLEASSE READ OT CAREFULLY. INSURED: S & L SPECIALTY CONTRACTING, INC. By INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA d''F,N DE fl A U?il:AL b�N URCD — OWNE p LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGAMizxrm This e.ndorserrient modifies insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured PerSO'.1(s) WHERE REQUIRED BY "WRITTEN CONTRACT" a r A. Section It — UUho is An Insured is arnendOd to include as an additional insumd the persoil(s) or organfzation(s) shown in the Schedule, bui only vrith respect to liability for "bodily injury (properly damage" or ,personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the locatlorr(s) des'g- nated above. trocailon . of- Covered C3 aerations AS IDENTIFIED BY CONTRACT I B, iNith respect to the insurance afforded to these additlanal insurods, the following additional exclu- slprts 043,p4r. This Insurance does not apply. to "bodily Injury" or "property damage" occurring after: f. All wgrk, Including materials, parts or .equip - men1 furnished in connection with such 'worlc, on the projt -t (other than service, maintenance or repails-) to_ be performed by or on behalf of the additional insureds) at the location of the covered operations has been completed; or 2. That portion of ".your work" out. of which the injury or damage arises has been put to Its bZ- tended use by any:peroon or organization other than another contractor or subcontractor en- gaged in parfon'nin9 opsr0fOns for a principal as:a part of the Sallie project. CG 70 i0 07 04 LD 15() Properties, inc., 2004 Page 1 of t ra