PROOF OF INSURANCE (2008) CLOSEDFEB -20 -2008 11:45 From:ISU VANSA BIB7622242 To:3106150529 P.2/3
ACM. CERTIFIL. ,tTE OF LIABILI"N INSL.:ANCE o2 2D TO
PROOUCOR
RossotoJre 9r Casualty
operty i Casuai InsUSanae Ageney,
6180 Laurel Canyon Blvd. 6270
N. Roll ood CA 91606-
THIS CERTIFICATE I SURD AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
MOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
aLTER THE COVERAGE AFEMIR BY THE PORRId BELOW.
INSURERS AFFORDING COVERAGE
INWRpII
Siaetra Systeas, Inc.
147 Richmond Street
>Ll Segundo CA 50245-
NBURE land Casual Co
NsURERROak River Insurance Cc,
INSuaEac
OWSRALNASRN
X ORCIALOEMB ^LLLIABILITY
�TCLAIMSMADB FiJOCCUR
NiURFRF_
l'i'd'/ � ;'.i 1 � •7
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVMSTANDING ANY
RFAUIREMENT, 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 POUCISS
AGGREGATE LIMITS SHOWN MAY HAVE "9N IEDUCHP AID CLAIMS.
TYM W NWRAMM
POLICY NYNo"
Epp T"
LiJa1RA
LIMITS
OWSRALNASRN
X ORCIALOEMB ^LLLIABILITY
�TCLAIMSMADB FiJOCCUR
99840805993
07/10/2007
07/10/2008
EACHOC
a 1,000,000
PONDAMAOE M sm"M
1,000,000
MEONOLP A ar .nm
1 10,000
ONAL G AM IhAaY
• 1,000,000
E
• 2,000,000
OBN'L AoaREOAY1 LMN 1 APPLIES ►698
X Y 10c
-09NMqALA0W9A7
PR -a AOe
• 2,,000,000
A
ANTOMOMLOLUIMUTY
ANYAUTO
ALL ONMBO AUTOi
WHeOULBD AUTOS
"mr) AUTOS
NON -OWNPA AUTOS
99840845993
07/10/2007
/ /
/ /
07/10/2008
/ /
/ 1
COMBNEOSNGLIILIMIT
1 000, 000
BODILY "RY
IMF p.I.Pn)
1
X
BDOILY MUURY
(PV mode ►
1
X
PROPERTY DAMAGE
w
1
LUMNLITY
AUTO
/ /
/ /
AUTO ONLY - BA ACCIOSNT
•
7AWNY
CTHSR THAN 161%0
AUTO ONLY' _A0144
1
i
LUIMNTV
OCCUR CLAIMS MAW
DEDUCTIBLE
R ION i
/ /
/ /
�jCURRENC
1
AGOREOATE
i
i
1
H
�U°a AND
2200006817 -081
02/13/2008
02/13/2009
X
M.L SACH A CIOeNT
1 1,000,000
E L OISEA R ACA 6MP Ve01
1,000,000
E.L. ONIEAN - POLI Y LIMff
1 1,000,000
OTNBR
OMRIPI OP OPMATMMA)CA'nUMV ENKLOB1WCL MUM ADMO sY ENDOIIE6NENTnpdQAL PROIMgNE
oparatione of the na"d insured parloxw" for aortirLasto holder
R CANCKUTION
WOULD ANY OP The AM1VS MON510 POIJCga IN CANCOLUM SM'ORR TUB
City Of E1 Segundo, it's officials ""RAT" DATE TNBRW. THIS MUINO IN"M NALL 100 1108 TO MAIL
and employees 30 DAYS WNTTIIN NOT" TO THS cMITOMYE HOLDER NAMED TO TIRL LW, BUT
Attn: City Clerks office PMLDR6 TO DO 60 MALL IMPOSM NO OBILIMTION ON LMIW.ITY OF ANY RND UPON TNI
350 Main Street MU ITS 6x98 TMOIL
El Segundo, CA 90245 AYTN I,T
^mow ON IimiN % a ACORID CORPORATION 1986
c. INSOM SMIA+ 91.1cTROMIC wen FORMS, P.B. 1012
FEB-20 -2008 11:45 From:ISU VANSA 8187622242 To:3106150529 P.3/3
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(w) must be andamed. A statement on this
certificate does not confer rights to the certificate holder in Neu of such andorsemeM(s).
N SUBROGATION IS WAIVED, subject to the terms and condltlons 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
andorsement(s).
DISCLAIMER
The Cenificate of Insurance on the reverse side of this form does not constitute a Contract between the issuing
Insurer(s), authorized representative or producer, and the certificate holder, nor does it alfirrnstively or negatively
amend, extend or alter the coverage afforded by the policies listed thereon.
AGORD 2" (7M7)
k; IN>sOM betel 01 wP I a 2
FES -20 -2008 13:27 From:ISU VANSA
POLICYNUMBER:' PPS40845993
8187622242 To:3106150529 P.2/2
COMMERCIAL GENERAL LIABILITY
CO 20 10 10 01
THIS ENOORSWENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement nmditles Insurance provided under the foNowinp:
COMMERCIAL GENERAL LMBILITY
SCHEDULE
Name of Perswt or Organk son; - -
City of El Segundo, it's officials
Attnz City Clarks Office
350 main Street
E1 Segundo, CA 90245
and employees
(if no entry appears above, Infomaton required to complete this endorsement will be shown In the DOCIar0kne se
applicable to this endomement.)
A, esotion N - Who N on Insured Is emended to
imdude es on Mewed the person or orpa kwo
shown in the 9dwWW but only with respect 10
INbilky ante ft out of your onpoNv operations psr-
forrned for that hrsured.
L with rasped to the insurance aflbrded to these
eddlibnal Ineurads, the tbftMng m iduslon Is
added:
2.En"kne
This MteUranoe does not apply to "bodily In-
juM a, .,proporiv diewoww"after:
(1) All work, kroludlnp metertala parrs or
equipment Unishad In connection with
such Wok on the project (other than
esrvbs, mdrAwwws or repairs) to be
pw rw,. ed by or on beha0 of the addl-
dorms kwursd(s) at the site of the oov
Bred opwolwA has been Completed:
or
(2) That portion of -your work- ad of which
the Injury or damaps arkres has been
put to Its (Mended use by any person or
orgent"M otter than another oar
tractor or subcontractor on"Oul In
perfornI t0 operations for a principal se
a part of the same project.
CO 201010 01 180 Pnopertlss, Inc., 2000 Pape 1 of 1