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PROOF OF INSURANCE (2009) CLOSED (2)Jan-14 -2009 04:26Pm From- WILLDAN 5629083515 T-993 P 002/005 F -504
AGORD, CERTIFICATE OF LIABILITY INSURANCE 10131108y
PRODUCER THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATIC
Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICK
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND (
P. O. Box 10550 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO'
Santa Ana, CA 92711 -0550
INSURERS AFFORDING COVERAGE
14427-6810
wsUReD INSURER A. Zurich American Insurance Co.
WIIIdan Engineering _ ,..,, L�? fl_. Al?
_.. _ _
2401E Katella Avenue, Ste. 300 INSURER C; XL
Anaheim, CA 92806 INSURER D:
INSURER E:
Insurance Co.
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAND
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SI
a,�nwn uev uevC I�GCwi OC h1,f :F111iV PAII'1 (:I 61f,RS-
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
DATE (MMiOD1YY)
LJMITS
A
GENERAL LIABILITY
GLO904316303
11/09/08
11/09 /09
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any onoflro)
51000000
IX
COMM ERCIAL GENERAL LIABILITY
CLAIMS MADE XI OCCUR
INDP. CONTRACTORS
MED EXP (Any ono person)
$10,000
PERSONAL B ADV INJURY
S1,000,000
X CONTRACTUAL
INCLUDED
X
BFPO XCU
GENERAL AGGREGATE
s2,000,000
-L AGGREGATE LIM ITAPPLIES PEP:
PRODUCTS -COMPiOPAGG
52000000
�GEN
POLICY X PRO LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
BAP904316203
11/09/08
11109/09
COMBINED SINGLE LIMIT
(Ea aWaant)
S1 000 000
i r
X
BODILY INJURY
(Per Penton)
£
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Par aceldant)
S
HIRED A! iTOS
NON-OWNED AUTOS
j X
PROPERTY DAMAGE
accident)
S
i(Per
GARAGE
LIABILITY
AUTO ONLY - EA ACCIDENT
S
OTHERTHAN EA ACC
AUTO ONLY: AGG
S
ANY AUTO
S
EXCESS LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
S
AGGREGATE
S
a
DEDUCTIBLE
a
RETENTION £
B
WORKERS COMPENSATION AND
WZP80967141
11/09/08
11/09/09
0TH-
X WC S IMITSVI
E.L. EACH ACCIDENT
S1 000 000
EMPLOYER' S* LIA131LITY
E.L,OISEASE - EA EMPLOYEE
51,000,000
E,L. DISEASE - POLICY LIMIT
21,000,000
C
OTHER Professional
DPR9614659
11/09/08
11/09109
$1,000,000 per claim
(Liability
$1,000,000 annl aggr.
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
General Liability policy excludes claims arising out of the performance of professional
services
Re: Provide permit processing and other planning services
City of El Segundo, its officials and employees are additional insured as
(See Attached Descriptions)
CERTIFICATE HOLDER ADDMONAL INSURED; INSURER LETTER: CANCELLATION Ten Day Hatice-for Non-Paympnt of Premium
I SHOULD ANYOFTH EABOVE D ESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATI
City of El Segundo DATE THEREOF, THE ISSUING INSURER WIC TOMAIL30 DAYSWRITT
Director of Planning and Building Safety NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTHELEFT,)B 5U
l 350 Main Street ���xerxxR��ceess xzanecam(xxcc
El Segundo, CA 90245 x�ae
TATIVE
ACORD 25 -S (7197)1 of 2 #M241865
7At1 -14 -2009 16 :15 5529083515
RLL Q ACORD CORPORATION
P.02
Jan-14-2009 04: 26pm From—WILLDAN 5629083515 T-893 P 003/005 F-504
p
KIRTTIONS G -n -U, el
respects to General Liability as required by written contract.
Primary and Non-Contributing coverage applies to GL as required by written
contract.
3L-AIIPR)
-)-(Industry)
AMS 25.3 (07197) 2 of 2 #M241865
1H41-14 -2009 15: 16 56290e3515 P.03
Policv No.
Eff. Darc of Pal
EzQ. Date Of P01
Eff. Date of End
Produces
Add'1 Prom
Rcnirn Prom.
GL0904316303
11/09/08
11/09/09
11/09/08
S N!n
N/A
Re
Rennton ton
TMS ENDORSEMENT CIANGES THE POLICY PLEASE READ IT CAREFULLY.
Tlus endorsement modifies insurance provided under the.:
Commercial General Liability Coverage Part
A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization whom you arc required
to add as an additional insured on this policy wider a written contract or written agreement
B. The insurance provided to additional insureds applies only to "bodily injury", "property damage" or "personal and advertis-
ing injury" covered under Section I, Coverage A, BODELY INJURY AND PROPERTY DAMAGE LIADMITY and
Coverage B, PERSONAL AND ADVERTISING INJURY 1LIABU.ITY, but only if:
1. The "bodily injury" or "property damage" results from your negligence; and
1 The "bodily injury", "properly damage" or ``personal and advertising injury" results directly (Torn:
a. Your ongoing operations; or
b. "'Your work" completed as included in the "products - completed operations hazard', performed for the additional
insured, which is the subject of the written contract or written agreement.
C. However, regardless of the provisions of paragraphs A. and B. above:
1. We will not extend any insurance coverage to any additional insured person or organization:
a. That is not provided to you in this policy; or
b. That is any broader coverage than you arc required to provide to The additional insured person or organization in
the written contract or written ugrecmcrlt; and
2. We will not provide'LimiTS of Insurance to any additional insured person or organization that exceed the lower of.
a. The Limits of Insurance provided to you in this policy; or
b. The Limits of Insurance you are required to provide in the written contract or written agreement.
D. The insurance provided to the additional insured person or organization does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" that results solely from negligence
of the additional insured, or
3. 'Bodily injury", `property damage" or "personal and adverri sing injury" arising out of the rendering or failure to
render any professional architectural, engineering or surveying services including
JAH -14 -2009 16 :16 5629083515
U -GL.1 175 -A CAS (9/03)
Page I oft
P.04
Jan-14-2009 04:27PM From-WILLDAN
5629083515 T -893 P 005/005 F -504
a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
'an _ _ __ ....... ....._._. _ _ _ _. ... . -..: - ._.....
b. Supervisory, inspection, architcerural or engineering activities.
E. The additional insured must see to it that:
1. We are notified as noon as practicable of an "occurrence" or offense that may result in a claim:
2. We receive written notice of a claim or "suit" ac soon as practicable; and
3. A request for defense and indmmity of the claim or "suit' will promptly be brought against any policy issued by
another insurer undcr which the additional insured also has rights as an insured or additional insured.
F. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other in-
surance available to any additional insured person or organization unless the other insurance is provided by a contractor
other than you for the same operations and job location. Then we will share with that other insurance by the method de-
scribed in paragraph 4.c. of SECTION TV - COMMICRCIA?L GENERAL LIABILITY CONDITIONS.
Any provisions in this Coverage Pan not changed by the terms and conditions of this endorsement conrinuc to apply as writ-
ten.
U -GL- 1175 -A CW (9/03)
Page 2 of 2
JAN -14 -2©09 16: IS 5529x83515 P.05
Jan -14 -2009 04:26Pm From -WILLDAN
Transmittal
r
CA. 45
DATE:
5629083515 T -893 P 001 /005 F -504
JOB NO.:
ATTENTION:
SUBJECT: �f-e` �j 14% CG O� �`t St1 ✓c,►"' -�-� --
ENCLOSED:
REMARKS:
The enclosed materials are being sent for.
7 PLEASE SIGN COPIES AND RETURN TO OUR OFFICE.
W I LLDAN ending
your
_ Engineering mach
an v" 7 - *f
COPIES TO: _G ..71-i(I I ,t; '2 c -e
dF As, y�ea� yon Y y'
1 0 G �� ` VERY TRULY YOURS,
�1���ise �a- +aura"' ►r��. �.u^..� Y�
WILLDAN ENGI E RING
Engineering I Geotochnical I Environmental I Financial I Homeland Security
562.908.6200 1 800.x99.4484 1 fax: 552.895.2120 1 13181 Crossroads Parkway North, Suite 405, Industry, CA 91746 -3443 I www.willdan.com
JPt1 -14 -2009 15: 16 5529083515 99%, P.01