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PROOF OF INSURANCE (2008) CLOSEDOP ID B DATE (MM /DD/YYYY) ACRD CERTIFICATE OF LIABILITY INSURANCE OP 1 05/29/08 PR T)UCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Powers and Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insuranbe Agents and Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O B 619043 ` Lic AnB02564 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . ox Roseville CA 95661 -9043 Phone: 916- 630 -8643 Fax: 800- 783 -0083 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Western Heritage Ins Co Lad's Eye Developmn et & Const. INSURER B: Lincoln General insurance co. dba: Consortium Unlimited dba : Vertex Communications INSURER C: 117 S. Bradford Avenue INSURER D: Placentia CA 92870 INSURER E: Cl1VF92A(:FC 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. 1N5K LTR FWD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM /DD DATE MM /DD LIMITS GENERAL LIABILITY EACH OCCURRENCE - - $1,000,000-- PREMISE�S (Ea occuren�ce) $100,000 A X X COMMERCIAL GENERAL LIABILITY SCP0649715 10/01/07 10/01/08 CLAIMS MADE X❑ OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2, 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 X POLICY PRO LOC JECT B AUTOMOBILE LIABILITY ANY AUTO 631000325502 08/21/07 08/21/08 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR EI CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE -- _. - -_ --- _ _. __- TORY LIMITS ER E:L. EACH-ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If es, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *10 day NOC applies for non - payment of premium. Certificate holder is included as an Additional Insured under Commercial General Liability policy per endorsement WHI21 -0479, subject to a written contract between the Named Insured and the Additional Insured. * *Endorsement to follow from company, subject to approval. (see attached notepad) t:FRTIFICATF HDLDFR CANCELLATION CITYOFE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN City of El Segundo Attn : City Clerk 350 Main Street 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 El Segundo CA 90245 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988 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) re:atructured cabling for voice and data for the County of Los Angeles nop Western Heritage lnsaPd#IC* ComDnny ATTACHED TO AND ENDORSEMENT EFFECTIVE DATE CITY OF EL SEGUNDO LOS ANGELES COUNTY FORMING A PART OF POLICY NUMBER I 12:01 A.M. STANDARD TIME) NAMED INSURED AGENT NO. EL SEGUNDO CA 90245 LAD'S EYE DEVELOPMENT & CONSTRUCTION COMPANY SCP0649715 05/28/2006 CONSORTIUM UNLIMITED, DBA VERTEX COMMUNICATIONS, DBA (The above Information is required only when this endorsement Is Issued subsequent to preparation of the policy.) 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 FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization Location(s) Of Covered Operations CITY OF EL SEGUNDO LOS ANGELES COUNTY ATTN: CITY CLERK 350 MAIN STREET EL SEGUNDO CA 90245 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION 11 - WHO IS AN INSURED is amended to include as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with re- spect 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 addi- tional insureds, the following additional exclusions. apply: All other Terms and Conditions of this Policy remain unchanged. WHI 21 -0479 (02/05) This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 subcontrac- tor engaged in performing operations for a principal part of the same project. AUTHORIZED REPRESENTATIVE I DATE COMMUNICATIONS, INC. City of El Segundo City Clerk 350 Main Street El Segundo, CA 90245 June 2, 2008 To whom it may concern: Vertex Communications does not carry worker's compensation insurance due to not having any direct employees. The State of California does not require that proprietors /partners /executive officers be covered under this type of insurance. Vertex uses Express Personnel, for all employees hired that are not proprietors /partners /executive officers or members of the corporation, which carries its own worker's compensation insurance. If you have any questions regarding this please feel free to give me a call at (714) 996 -2600 Sincerely, Michelle Roldan Office Manager 117 S. Bradford Ave. Placentia, CA 92870 - Bus. 714.9962600 — Fax 714.572.1064