PROOF OF INSURANCE (2009) CLOSED3890 .
ACORDra CERTIFICATE OF LIABILITY INSURANCE —7
DATE (MM /DD/YYYY)
12/9/2008
PRODUCER
Executive Strategies, Inc.
g
1246 Berkshire Road
Grosse Pointe Park, MI 48230 -1035
313 881 -8069
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 Two Roads Professional Resources
5122 Bolsa Ave, Suite 112
Huntington Beach, CA 92649
INSURER A: Padaral Inourance Company /Chubb Ins Group
DATE MM /DD//YV E
INSURER B: Lloyd's of London
LIMITS
INSURER C:
INSURER D:
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•L
NSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE MM /DD//YV E
PDATEYMM /DDAY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 11000, 0
DAMAGE To RFNTED'-
PREMISES Ea occurence
$ 1 1 000, 000
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one person)
$ 10 0
CLAIMSMADE CI OCCUR
PERSONAL & ADV INJ URY
$ 1,000,000
A
Blanket Contra
3584 -90 -31
06/01/08
06/01/09
X
acutal liability
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$ .2,000, 00
POLICY PRO LOC
JECT
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$ 11000, 000
ANYAUTO
(Ea accident)
BODILY INJURY
$
ALL OW NED AUTOS
1X
SCHEDULED AUTOS
(Per person)
BODILYINJURY
$
A
X
HIREDAUTOS
73535793
06/01/08
06/01/09
NON - OWNEDAUTOS
(Peraccident)
PROPERTY DAMAGE
$
ri
(Peraccident)
GARAGE LIABILITY
AUTOONLY - EAACCIDENT
$
OTHERTHAN EAACC
$
ANYAUTO
$
AUTOONLY: AGG
EXCESS /UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$ 5.000.000
X1 OCCUR CI CLAIMSMADE
$
79848512
06/01/08
06101109
$
A
DEDUCTIBLE
$
RETENTION $
WORKERSCOMPENSATIONAND
X I TORY IMI/ OER
E.L. EACH ACCIDENT
$ 1,000,000
71723777
06/01/08
06101109
E.L. DISEASE - EA EMPLOYE
$ 1.000,0 00
A
ANY PROPRIETOR /PARTNE R/EXECUTIVE
ANY
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE- POLICY LIMB
1 $
If yes, describe under
SPECIAL PROVISIONS below
OTHER Staffing
$1,000,000 Aggregate
B
Services E &O
MPL1010722.08
10/10/08
10/10/09
Limit of Liability
Crime Incl 3rd Pt
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
The City of E1 Segundo, its officials and employees are additional insureds
under general and auto liability as respects work done by the insured for the
certificate holder. General liability coverage is primary and non contributory
over the insurance the City of E1 Segundo may have.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of El Segundo DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 39_ DAYS WRITTEN
Attn : Maryam Jonas NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
MJonas @elsegundo. org IMPOSE NO OBLIGATION OR L
350 Main Street REPRESENTATIVES.
El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE
ACORD 25 (2001108)
J 8 9 19 .
GENERAL LIABILITY
ADDITIONAL INSURED ENDORSEMENT
CITY OF EL SEGUNDO
In consideration of the premium charged and notwithstanding any Inconsistent statement in the policy to which this
endorsement Is attached or any endorsement now or hereafter attached thereto, it agreed as follows:
1. ADDITIONAL INSURED. The City of El Segundo, its officers, agents and employees are included as additional
insured with regard to liability and defense of suits arising from 'your work" performed by or on behalf of the
named insured regardless of whether liability is attributable to the named Insured or a combination of the named
and the additional Insured.
2. CONTRIBUTION NOT REQUIRED. Any other insurance maintained by the City of El Segundo is e=68 of this
Insurance and will not contribute with it.
3. SEVERABILITY OF INTEREST. This insurance applies separately to each Insured against whom claim Is
made or suit Is brought except with respect to the company's limits of liability. The Inclusion of any person or
organization as an insured does not affect any right which such person or organization would have as a
claimant If not so Included.
4. CANCELLATION NOTICE. With respect to the Interests of the City of El Segundo, this insurance may not be
canceled, reduced in coverage or limits or non - renewed, except after thirty (30) days prior written notice by
REOISTERED.OR.CER[IiID "L has been given to the Public Works Director of El Segundo addressed as
follows: Public Works Departrnent, El Segundo City Hall, 350 Main Street, El Segundo, CA 90245
S. APPLICABILITY. The Insurance pertains to the operations and/or tenancy of the named insured under all
written agreements In force with the City of El Segundo unless checked hero'( ) In which one only the
following specific agreements with the City of El Segundo are covered:
6. MAILING ADDRESS: Completed endorsements shall be issued to the City of El Segundo as follows:
PUBLIC WORKS DEPARTMENT
EI Segundo City Hall
350 Main Street
El Segundo, CA 90245
7. CLAIMS: Underwriters representative for claims pursuant to this insurance:
Except as stated above, nothing heroin shall be held to waive, alter or extend any ofthe limb. conditions, agreements, or
exclusions of the policy to which this endorsement Is attached.
1 Randall L. Pryor (printAlype name), warrant that I have authority to bind the below- listed insurance
company and by my signstwe hereon do so bind this company to this endorsement.
•. Signature;
Authorized Re sentaeve
Mahe' d m the City P x sy) cePY
TITLE: near '- i - manager
9. OROMIZATION' ISG International Inc
ADDRESS: 204 Cedar St., Cambridge, MD 21 61 3
TELEPHONE: 410-228-6464
w„ (area code) (telephone number)
Page 1 of 2
F~ -upgro w^V" Pma, vF a 1o�aooA
ORNEM UAKITY
ADDITIONAL INSUIRED ENDORSEMENT
CITY OF EL SEGUNDO
(CONTINUED)
10. kmkdw(abeab as applamble)-
x 0 Broad form Liability I[Worsomard
O Broad Form Property DwruW
x O perso, k*"
x 1 I 111depuldem Co"back"
x 1) premb".0w Opervoons
0EX ,, k'"Ward
11 ColmpwA- Hacerd
x 1) ProduclalComplalod Operadoes,
Waftrareft Lhaft
94NW kmpw% Legal Liabift
x 11 VoMnMMM LWOMY
O Owned Aulonobfin
Non-Ow AutomalWas
MW Aulamobiks
x 1) RM Legal Liability
11. Typecoveraw. General Liability
M LbnftofU%bW. $1 Mil per occurrence/ $2 Mil Aggregate
I& Polay Pw : F ew 6/1/08 r 6/1/09
10-
14. Deductible 438*114nondRalawlion (cMdWdd# n/a
of$ — *PPNO 10—ovierage. J) Per CWM () Oar Occuranm
IL 01IMPnWisiom:
14. Nmm$L-Aumdww,#A*"&. Two Roads Professional Resources Inc;
Huntington Beachr CA 92649
IT. kwww"Compow. Federal Insurance Co.
It poky Mwor. 35849031
It. Eridomemurt Number. n / a
20. offoo*ft Dab a' Endorsement 10/14/08
Page 2 of 2
MWOMMMNOTMENO WAM WP
38.9 n