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PROOF OF INSURANCE (2007) CLOSED
ACORD,M CERTIFICATE OF LIABILITY INSURANCE Page 1 of 3 09/19DATE /2007 PRODUCER 877 - 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willie North America, Inc. 26 century Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TYPE OF INSURANCE POLICY NUMBER P. 0. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED Tetra Tech, Inc. (ISO) INSURERA:ACE American Insurance Company 22667 -012 17770 Cartwright Rd. Ste 550 Irvine, CA 92614 -5850 INSURERB:American International Specialty Linea In 26883 -001 INSURER C: PREMISES E occurence $ 1,000,000 INSURER D: X COMMERCIAL GENERAL LIABILITY 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. INSR LTR DD' INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD[YYI POLICY EXPIRATION DATE M DO LIMITS A X GENERAL LIABILITY HDOG2059214A 10/1/2006 10/1/2007 EACH OCCURRENCE $ 11000,000 PREMISES E occurence $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [i] OCCUR MED EXP (Any one person) $ 100,000 PERSONAL SADVINJURY $ 11000,000 X Contract Liab. X X,C,U Coverage GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP /OPAGG $ 2,000,000 POLICY X JE X LOC A X AUTOMOBILE X LIABILITY ANY AUTO ISAH08222629 10/1/2006 10/1/2007 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILYINJURY (Per person) $ X ALLOWNEDAUTOS SCHEDULEDAUTOS BODILY INJURY (Per accident) $ X X HIREDAUTOS NON- OWNEDAUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTO ONLY: AGG A EXCESS /UMBRELLA LIABILITY XOOG23714966 10/1/2006 10/1/2007 EACH OCCURRENCE_ $ 5,000,000 X OCCUR EI CLAIMSMADE AGGREGATE $ 51000,000 $ DEDUCTIBLE $ X RETENTION $ 50.000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WLRC44465279 10/1/2006 10/1/2007 X TORY LIMITS OER E.L. EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE SCFC44465280 10/1/2006 10/1/2007 E.L. DISEASE - EA EMPLOYEE $ 11000,000 OFFICER/MEMBEREXCLUDED? It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 11000,000 B OTHER 1952583 10/1/2006 10 1 2007 $5,000,000. Each Claim Professional $5,000,000. Aggregate Pollution /E &O Legal $ 250,000. Retention Claim Liabilitv I iMax. Claim durincr policy ear DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS All States Covered, except Only "Stop Gap" in OH, ND, WA, WV, WY, PR, USVI CERTIFICATE HOLDER CANCELLATION ACORD 25 (2001/08) Coll:2115404 Tp1:668860 Cert:9499f691 ©ACORDCORPORATION1988 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of EL Segundo Attn: Dan Garcia, Asst. City Engineer REPR EN TIV . AUTH ESENTjTIVE 350 Main Street EL Segundo, CA 90245 ACORD 25 (2001/08) Coll:2115404 Tp1:668860 Cert:9499f691 ©ACORDCORPORATION1988 WI11IS -F CERTIFICATE OF LIABILITY INSURANCE Page 2 of 3 09/19/2007 PRODUCER 877- 945 -7378 Willie North America, Inc. 26 century Blvd. P. 0. Box 305191 Nashville, TN 372305191 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Tetra Tech, Inc. (ISG) 17770 Cartwright Rd. Ste 550 Irvine, CA 92614 -5850 INSURERA:ACE American Insurance Company 22667 -012 INSURERS: American International Specialty Lines In 26883 -001 INSURER C: INSURER D: INSURER E: DESCRIPTION OF OPERATION5 ILOCATION5IVENICLtSItACLU5wN5 AL)UVU t5T tNUUKbtmtN I lartUTAL rKUVIOIUNO Commercial Property Policy No. YU2L9L435456016 10/1/06 - 10/1/07 Issuing Carrier: Liberty Mutual Fire Insurance Company Business Personal Property Including Valuable Papers, Special Form $5,000,000. Limit Project Start Date: 9/01/2007 Project End Date: 12/31/2011. Re: 3.1 MG Tank Seismic Evaluation. It is agreed that City of EL Segundo, its officials and employees are included as Additional Insureds as respects to General Liability and Auto Liability as required by contract. It is further agreed that such insurance as is afforded shall be Primary with any other insurance in force for or which may be purchased by Additional Insureds as required by contract. Coll:2115404 Tpl:668860 Cert:9499691 Page 3 of 3 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 The Certificate 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 affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Co11:2115404 Tp1:66ee6o cert:v4vvbvi Policy No: HDOG2059214A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization (s): Location(s) Of Covered Operations City of EL Segundo, its officials and employees Re: 3.1 MG Tank Seismic Evaluation. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) 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 intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as apart of the same project. CG 2010 07 04 © ISO Properties, Inc., 2004 POLICY NUMBER: HDOG2059214A COMMERCIAL GENERAL LIABILITY CG20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - 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) Location And Description of Completed Operations Or Organization(s) City of EL Segundo, its officials and employees Re: 3.1 MG Tank Seismic Evaluation. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1