PROOF OF INSURANCE (2010) CLOSED___1004 TIERWES -01
A °R °' CERTIFICATE OF LIABILITY INSURANCE
PRODUCER (888) 825.4322 THIS CERTIFICATE IS ISSUED AS A MATTER OF
ONLY AND CONFERS NO RIGHTS UPON THE
Bowermaster & Associates HOLDER. THIS CERTIFICATE DOES NOT AMEN[
P.O. Box 6026 1 ALTER THE COVERAGE AFFORDED BY THE PO
10805 Holder Street - Suite 350
Cvoress. CA 90630
INSURED Tierra West Advisors, LLC
2616 E. 3rd St.
Los Angeles, CA 90033
INSURERS AFFORDING COVERAGE
INSURERA. The Hartford Insurance G
INSURER B: Scottsdale Insurance Viol
INSURER C.
INSURER D'
FUDA
DATE (MWDDIY"
10/6/2009
EXTEND OR
NAIC #
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 Ii
I TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTNE
POLICYEXPIRATION
LIMITS
Attn: Greg Carpenter
)(dfrxdfdfr�frXTS
2'000'00
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
72SBANUSS48
8!1512009
811512010
EACH OCCURRENCE
$
PREMISES Ee occccurrence
$ 300,00
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
"$4,000,00
PRODUCTS - COMP /OP AGG
GEN'L AGGREGATE LIMIT APPLIES PER'.
X1 POLICY PRO- LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
72SBANU9848
811512009
8/1512010
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,00
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
SCHEDULED AUTOS
X
X
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY. AGG
$
ANY AUTO
$
EXCESS 1 UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
$
DEDUCTIBLE
X WC STATU- ER
TORY LIMITS ER
$
A
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
SPECIAL PROVISIONS below
72WECLP5008
8115/2009
x11512010
E.L. EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00
E.L. DISEASE - POLICY LIMIT
$ 1,000,00
B
B
OTHER
Commercial Errors & Omissions
Commercial Errors & Omissions
EKS3008178
EKS3008178
8115/2009
8/15/2009
8/1512010
8115/2010
Per Claim & Aggregate 2,000,00
Claims Made Form etention- $10,000 eac
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
10 day notice of cancellation for non - payment of premium.
The City of El Segundo, its officials and employees are named additional insured per attached SS0008. Coverage is also primary and
non - contributory per attached SS0008.
GtK 111-IUA I t MULLICK
- -- —
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILX*)b W)WfO MAIL 30 DAYS WRITTEN
City of El Segundo
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, I;f(X)W XMXXd(s)bVAXLL
Planning & Building Safety Department,
��(>{ dt�dkXa6XiIlE�rX�1( XrXrXdW4XIDO�J4 (�6i(AfCif�(Xci�lf�4)61(
Attn: Greg Carpenter
)(dfrxdfdfr�frXTS
AUTHORIZED REPRESENTATIVE
350 Main St
El Segundo, CA 90245-
ACORD 25 (ZUUUIU1) The ACORD name and logo are registered marks of ACORD
(6) When You Are Added As An
Additional Insured To Other
Insurance
That is other insurance available to
you covering liability for damages
arising out of the premises or
operations, or products and completed
operations, for which you have been
added as an additional insured by that
insurance; or
(7) When You Add Others As An
Additional Insured To This
Insurance
That is other insurance available to an
additional insured.
However, the following provisions
apply to other Insurance available to
any person or organization who is an
additional insured under this Coverage
Part:
(a) Primary Insurance When
Required By Contract
This insurance is primary if you
have agreed in a written contract,
written agreement or permit that
this insurance be primary. If other
insurance is also primary, we will
share with all that other insurance
by the method described in c.
below.
(b) Primary And Non - Contributory
To Other Insurance When
Required By Contract
If you have agreed in a written
contract, written agreement or
permit that this insurance is
primary and non - contributory with
the additional insured's own
insurance, this insurance is
primary and we will not seek
contribution from that other
insurance.
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an
additional insured.
When this insurance is excess, we will
have no duty under this Coverage Part to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit ". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurers.
Form SS 00 08 04 0
BUSINESS LIABILITY COVERAGE FORM
When this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self -
insured amounts under all that other
insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
c. Method Of Sharing
If all the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable limit of
insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicable limits of insurance of all insurers.
8. Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or
part of any payment, including
Supplementary Payments, we have made
under this Coverage Part, those rights are
transferred to us. The insured must do
nothing after loss to impair them. At our
request, the insured will bring "suit" or
transfer those rights to us and help us
enforce them. This condition does not
apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver
Of Subrogation)
If the insured has waived any rights of
recovery against any person or
organization for all or part of any payment,
including Supplementary Payments, we
have made under this Coverage Part, we
also waive that right, provided the insured
waived their rights of recovery against
such person or organization in a contract,
agreement or permit that was executed
prior to the injury or damage.
Page 17 of 24
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL ADDITIONAL INSURED
3. Additional Insured - Grantor Of Franchise
COVERAGES
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
If listed or shown as applicable in the Declarations,
the persons) or organization(s) shown in the
one or more of the following Optional Additional
Declarations as an Additional Insured -
Insured Coverages also apply. When any of these
Grantor Of Franchise, but only with respect to
Optional Additional Insured Coverages apply,
their liability as grantor of franchise to you,
Paragraph 6. (Additional Insureds When Required
Contract, Written Agreement or Permit)
4. Additional Insured - Lessor Of Leased
by Written
of Section C., Who Is An Insured, does not apply
Equipment
to the person or organization shown in the
a. WHO IS AN INSURED under Section C. is
Declarations. These coverages are subject to the
amended to include as an additional
terms and conditions applicable to Business
insured the person(s) or organization(s)
Liability Coverage in this policy, except as
shown in the Declarations as an Additional
provided below:
Insured — Lessor of Leased Equipment,
1. Additional Insured - Designated Person Or
but only with respect to liability for "bodily
"personal
Organization
injury", "property damage" or
and advertising injury" caused, in whole or
WHO IS AN INSURED under Section C. is
in part, by your maintenance, operation or
amended to include as an additional insured
use of equipment leased to you by such
the person(s) or organization(s) shown in the
person(s) or organization(s).
Declarations, but only with respect to liability
"property
b. With respect to the insurance afforded to
for "bodily injury", damage" or
"personal and advertising injury" caused, in
these additional insureds, this insurance
"occurrence"
whole or in part, by your acts or omissions or
does not apply to any which
the acts or omissions of those acting on your
takes place after you cease to lease that
behalf:
equipment.
a. In the performance of your ongoing
5. Additional Insured - Owners Or Other
Interests From Whom Land Has Been
operations; or
Leased
b. In connection with your premises owned
a. WHO IS AN INSURED under Section C. is
by or rented to you.
amended to include as an additional
2. Additional Insured - Managers Or Lessors
insured the person(s) or organization(s)
Of Premises
shown in the Declarations as an Additional
a. WHO IS AN INSURED under Section C. is
Insured — Owners Or Other Interests From
amended to include as an additional insured
Whom Land Has Been Leased, but only
the person(s) or organization(s) shown in the
with respect to liability arising out of the
Declarations as an Additional Insured -
ownership, maintenance or use of that part
Designated Person Or Organization; but only
of the land leased to you and shown in the
with respect to liability arising out of the
Declarations.
ownership, maintenance or use of that part of
b. With respect to the insurance afforded to
the premises leased to you and shown in the
these additional insureds, the following
Declarations,
additional exclusions apply:
b. With respect to the insurance afforded to
This insurance does not apply to:
these additional insureds, the following
(1) Any "occurrence" that takes place
additional exclusions apply:
after you cease to lease that land; or
This insurance does not apply to:
(2) Structural alterations, new
(1) Any "occurrence" which takes place
construction or demolition operations
after you cease to be a tenant in that
performed by or on behalf of such
premises; or
person or organization.
(2) Structural alterations, new
6. Additional Insured - State Or Political
construction or demolition operations
Subdivision — Permits
performed by or on behalf of such
a. WHO IS AN INSURED under Section C. is
person or organization.
amended to include as an additional
Insured the state or political subdivision
shown in the Declarations as an Additional
Page 18 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
insured — State Or Political Subdivision -
(e) Any failure to make such
Permits, but only with respect to
inspections, adjustments, tests or
operations performed by you or on your
servicing as the vendor has agreed
behalf for which the state or political
to make or normally undertakes to
subdivision has issued a permit.
make In the usual course of
business, in connection with the
n
b. With respect to the insurance afforded to
distribution sale the products;
these additional insureds, the following
(f) Demonstration, installation,
additional exclusions apply:
servicing or repair operations,
This insurance does not apply to:
except such operations performed
(1) 'Bodily injury", "property damage" or
at the vendor's premises in
"personal and advertising injury"
connection with the sale of the
arising out of operations performed for
product;
the state or municipality; or
(g) Products which, after distribution
(2) 'Bodily injury" or "property damage"
or sale by you, have been labeled
included in the "product - completed
or relabeled or used as a
operations" hazard.
container, part or ingredient of any
7. Additional Insured — Vendors
other thing or substance by or for
a. WHO IS AN INSURED under Section C. is
the vendor; or
amended to include as an additional
(h) 'Bodily injury" or "property
insured the person(s) or organization(s)
damage" arising out of the sole
(referred to below as vendor) shown in the
negligence of the vendor for its
Declarations as an Additional Insured -
own acts or omissions or those of
Vendor, but only with respect to "bodily
its employees or anyone else
injury" or "property damage" arising out of
acting on its behalf. However, this
"your products" which are distributed or
exclusion does not apply to:
sold in the regular course of the vendor's
(i) The exceptions contained In
business and only if this Coverage Part
Subparagraphs (d) or (f); or
provides coverage for "bodily injury" or
(ii) Such inspections,
"property damage" included within the
adjustments, tests or servicing
"products- completed operations hazard ".
as the vendor has agreed to
b. The insurance afforded to the vendor is
make or normally undertakes
subject to the following additional exclusions:
to make in the usual course of
(1) This insurance does not apply to:
business, in connection with
the distribution or sale of the
(a) 'Bodily injury" or "property
products.
damage" for which the vendor is
obligated to pay damages by
(2) This insurance does not apply to any
reason of the assumption of
insured person or organization from
liability in a contract or agreement.
whom you have acquired such
This exclusion does not apply to
products, or any ingredient, part or
liability for damages that the
container, entering into,
vendor would have in the absence
accompanying or containing such
of the contract or agreement;
products.
(b) Any express warranty
8. Additional Insured — Controlling Interest
unauthorized by you;
WHO IS AN INSURED under Section C. is
(c) Any physical or chemical change
amended to include as an additional insured
in the product made intentionally
the person(s) or organization(s) shown in the
by the vendor;
Declarations as an Additional Insured —
(d) Repackaging, unless unpacked
Controlling Interest, but only with respect to
solely for the purpose of inspection,
their liability arising out of:
demonstration, testing, or the
a. Their financial control of you; or
substitution of parts under
b. Premises they own, maintain or control
instructions from the manufacturer,
while you lease or occupy these premises.
and then repackaged in the original
container;
Form SS 00 08 04 05 Page 19 of 24
BUSINESS LIABILITY COVERAGE FORM
This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for that person or
organization.
9. Additional Insured — Owners, Lessees Or
Contractors — Scheduled Person Or
Organization
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owner, Lessees Or Contractors,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your acts or omissions or the
acts or omissions of those acting on your
behalf:
(1) In the performance of your ongoing
operations for the additional
insured(s); or
(2) In connection with "your work"
performed for that additional insured
and included within the "products -
completed operations hazard ", but
only if this Coverage Part provides
coverage for "bodily injury" or
"property damage" included within the
"products- completed operations
hazard ".
b. With respect to the Insurance afforded to
these additional insureds, this insurance
does not apply to "bodily injury", "property
damage" or "personal an advertising
injury" arising out of the rendering of, or
the failure to render, any professional
architectural, engineering or surveying
services, including:
(1) The preparing, approving, or failure to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications; or
(2) Supervisory, inspection, architectural
or engineering activities.
10. Additional Insured — Co -Owner Of Insured
Premises
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or Organization(s) shown in the
Declarations as an Additional Insured — Co-
Owner Of Insured Premises, but only with
respect to their liability as co -owner of the
premises shown in the Declarations.
Page 20 of 24
The limits of insurance that apply to additional
insureds are described in Section D. — Limits Of
Insurance.
How this insurance applies when other insurance
is available to an additional insured is described in
the Other Insurance Condition in Section E. —
Liability And Medical Expenses General
Conditions.
G. LIABILITY AND MEDICAL EXPENSES
DEFINITIONS
1. "Advertisement" means the widespread public
dissemination of information or images that
has the purpose of inducing the sale of goods,
products or services through:
a. (1) Radio;
(2) Television;
(3) Billboard;
(4) Magazine;
(5) Newspaper;
b. The Internet, but only that part of a web
site that is about goods, products or
services for the purposes of inducing the
sale of goods, products or services; or
c. Any other publication that is given
widespread public distribution.
However, "advertisement" does not include:
a. The design, printed material, information
or images contained in, on or upon the
packaging or labeling of any goods or
products; or
b. An interactive conversation between or
among persons through a computer network.
2. "Advertising idea" means any idea for an
"advertisement".
3. "Asbestos hazard" means an exposure or
threat of exposure to the actual or alleged
properties of asbestos and includes the mere
presence of asbestos in any form.
4. "Auto" means a land motor vehicle, trailer or
semi - trailer designed for travel on public
roads, including any attached machinery or
equipment. But "auto" does not include
"mobile equipment".
5. "Bodily injury" means physical:
a. Injury;
b. Sickness; or
c. Disease
sustained by a person and, if arising out of the
above, mental anguish or death at any time.
6. "Coverage territory" means:
Form SS 00 08 04 05