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PROOF OF INSURANCE (2015) CLOSEDGarcia Asset Management, Inc. Agreement No. 4600 Agreement No. 4625 CERTIFICATE OF LIABILITY INSURANCE 5/15/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT': If the certificate holder is an ADDITIONAL INSURED„ the poll y('les)must he endorsed. If SUBROGATION IS WAIVED, sula)ect 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 endorsements. PRODUCER M Shani Callaway WLbT3TON & ASSOCIATES Pa W (909)581-7218 (909)Se1-7228 8570 Utica Avenue Ste # 200 INSURER(SI AFFORDING COVERAGE NAIC0 Rancho Cucamonga CA 91730 '..INSURERA.-Liberty Mutual Insurance �� INSURED INSURERS: Garcia Asset Management, DBA: Empire Building INSURERC: 2821 W. valley Blvd. INSURERD: INSURER E: Alhambra CA 91803 INSURER,F COVERAGES CERTIFICATE NUMBER:CL1421200939 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF ruax I wm POLICY NUMBER f F Opt LIMITS GENERAL UABILWY EACH OCCURRENCE $ 1,000,000 PTTX,r7'T MTM X COMMERCIAL GENERAL LIABILITY P'td LM1I����°• irr $ 500,000 A CLAIMS-MADE lil OCCUR BLO(15)55970914 /7/2014 /7/2015 MED EXP(Anv one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 QU,NrtYVa,.arrEQAFLLU0'llAFPLIL„' PER PRODUCTS-COMPIOPAGG $ 2,000,000 f r�o, X I<AICY L L” $IRIT AUTOMOBILE LIABILITY Im v �rrlurr'wt s ANY AU 1­0 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS BODILY INJURY(Per accident) NOWOMED U Y a lv+ $ HIREDATOS AUTOS IParsrridpnt X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETNTInNt SA(15)55970914 /7/2014 /7/2015 $ WORKERS COMPENSATION v ,ST, OTH- AND EMPLOYERS'LIABILITY YIN Tnav r iiTC Fe ) t. LF `.m $ ANY PROPRIETORIP R I ❑ NIA L ACCIDENT OFFICERIMEMBER EXCLUDED? -(Mandatory In NH to reCka.,Lh^v_ Lr7'vf. $ If yyees describe under `' '- ..___ ______.__.___ . .. ........ DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Certificate holder is named as additional insured as respects general liability, subject to policy terms and conditions. *Cancellation provision reverts to 10 days notice in the event of non-payment of premium. CERTIFICATE HOLDER CANCELLA11ON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cleak ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo , AUTHORIZED REPRESENTATIVE 350 Main Street I "°4 El Segundo, CA 90�! I Shani Callaway/SHANIC ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION, All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD Coverage Is Provided In: Policy Number: .III t" The Ohio Casualty Insurance Company -a stock company BLO (15) 55 97 0914 � 11 m Policy Period: INSURANCE Policy Change Endorsement From 02/07/2014 To 02/07/2015 Endorsement Period: From 05/30/2014 to 02/07/2015 12:01 am Standard Time at Insured Mailing Location Named Insured&Mailing Address Agent Mailing Address&Phone No. GARCIA ASSET MANAGEMENT (909) 581-7218 ® 2821 W VALLEY BLVD WINSTON &ASSOC INS BRKRS INC ® ALHAMBRA, CA 91803 8570 Utica Ave Ste 200 Rancho Cucamonga, CA 91730-4862 CHANGES TO POLICY - TRANSACTION # 6 SOME mlffiffi This Policy Change Endorsement Results In A Change In The Charges As Follows: Additional Premium $622.00 s MEN Total Additional Charges $622.00 Crfidd Act of Terrorism Coverage $979.00 (included) Nate. This is not a hill Description of Change(s) ` Additional Interested Parties . , The following additional interest is added to the policy per CG2010 0413. CG2037 0413 & CG8883 0412 . The City of El Segundo, its agents officers, officials, employees and volunteers. Servicing Office Southern California and Issue Date 06/05114 Authorized Representative To report a claim, call your Agent or 1-800-362-0000 DS 70 27 01 08 08/05/14 55970914 N0212495 280 GCAFPPNO AGENT COPY 000828 PAGE 1 OF 8 Coverage is Providers fn: Policy Number: Liberty The Ohio Casualty Insurance Company -a stock company BLO (15) 55 97 0914 Policy Period: IN1, 11RAN� From 02/07/2014 To 02/07/2015 Policy Change Endorsement Endorsement Period: From 05/30/2014 to 02107/2015 12:01 am Standard Time at Insured Mailing Location Named Insured Agent GARCIA ASSET MANAGEMENT (909) 581-7218 WINSTON & ASSOC INS BRKRS INC POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 01 04 13 Commercial General Liability Coverage Form - Occurrence *CG 20 10 04 L3 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization *CG 20 37 04 13 Additional Insured - Owners, Lessees or Contractors - Completed Operations CG 2147 1207 Employment-Related Practices Exclusion CG 2165 1204 Total Pollution Exclusion with a Building Heating, Cooling and Dehumidifying Equipment Exception and a Hostile Fire Exception CG 21 67 1204 Fungi or Bacteria Exclusion CG 21 70 01 08 Cap on Losses From Certified Acts of Terrorism CG 21 76 0'L 08 Exclusion of Punitive Damages Related to a Certified Act of Terrorism CG 21 86 12 04 Exclusion - Exterior Insulation and Finish Systems CG 21 88 01 07 Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) CG 2279 04 13 Exclusion - Contractors -Professional Liability CG 24 26 04 13 Amendment of Insured Contract Definition CG 32 34 01 05 California Changes CG 70 02 01 01 General Endorsement CG 8494 12 08 Exclusion - Consolidated Insurance Programs Wrap-Up CG 8499 01 12 Non-Cumulation Of Liability Limits Same Occurrence CG 88 10 04 13 Commercial General Liability Extension CG 88 60 1208 Each Location General Aggregate Limit CG 88 75 1208 Exclusion - Earth Movement CG 88 77 '12 08 Medical Expense At Your Request Endorsement *CG 88 83 04 12 Amendment of Other Insurance Condition - Designated Persons or Organizations CG 88 86 1208 Exclusion - Asbestos Liability CG 90 41 01 13 Amendment Of Coverage B Personal And Advertising Injury IL 00 t7 11 98 Common Policy Conditions IL 00 21 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) Servicing Office Southern California and Issue Date 06/05/14 Authorized Representative To report a claim, call your Agent or 1-800-362-0000 DS 70 27 01 08 06/05/14 55970914 ND212495 280 GCAFPPNO AGENT COPY 000828 PAGE 2 OF 8 Coverage is Provided fn: Policy Number: Liberty The Ohio Casualty Insurance Company -a stock company BLO (15) 55 97 0914 1� 111c"1 Policy Period: INSURANCE From 02/07/2014 To 02/07/2015 Policy Change Endorsement Endorsement Period: From 05/30/2014 to 02/07/2015 12:01 am Standard Time at Insured Mailing Location Named Insulted Aged GARCIA ASSET MANAGEMENT (909) 581-7218 WINSTON & ASSOC INS BRKRS INC POLICY FORMS AND ENDORSEMENTS - CONTINUED This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE IL 02 70 08 It California Changes - Cancellation and NonRenewal LC 87 10 OS 00 Punitive or Exemplary Damages Exclusion wd Servicing Office Southern California and Issue Date 06/05/14 Authorized Representative To report a claim, call your Agent or 1-800-362-0000 DS 70 27 01 08 06/05/14 55970914 N0212495 280 GCAFPPNO AGENT COPY 000828 PAGE 3 OF 8 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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): Rim ® CITY OF EL SEGUNDO, ITS AGENTS, 0,0, EMPLOYEES & VOLUNTEERS 350 MAIN ST N 8 O EL SEGUNDO, CA 90245 Locatlon(s) Of Covered Operations TBD 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 B. With respect to the insurance afforded to include as an additional insured the person(s) these additional insureds, the following addi- or organization(s) shown in the Schedule, but tional exclusions apply: only with respect to liability for "bodily in- This insurance does not apply to "bodily in- jury", "property damage" or "personal and jury" or" property damage" occurring after: advertising injury caused, in whole or in part, by: 1, All work, including materials, parts or equipment furnished in connection with 1. Your acts or omissions; or such work, on the project (other than ser- 2. The acts or omissions of those acting on vice, maintenance or repairs) to be per- m your behalf; formed by or on behalf of the additional in the p fformance of your ongoing,""" insured(s) at the location of the covered operatons�for the additional insured(s) at the operations has been completed; or location(s) designated above. 2. That portion of "your work" out of which " However: the injury or damage arises has been put 1. The insurance afforded to such additional to its intended use by any person or or- insured only applies to the extent permit- ganization other than another contractor ted by law; and or subcontractor engaged in performing operations for a principal as a part of the 2. If coverage provided to the additional in- same project. sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 M Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. �r Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 : PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART ii SCHEDULE Name Of Additional Insured Person(s) Or Organlzatlon(s) Q man= CITY OF EL SEGUNDO, ITS AGENTS, 0,0, EMPLOYEES & VOLUNTEERS 350 MAIN ST EL SEGUNDO, CA 90245 ® Location And Description Of Completed Operations To be determined " To be determined 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 B. With respect to the insurance afforded to include as an additional insured the person(s) these additional insureds, the following is or organization(s) shown in the Schedule, but added to Section III -Limits Of Insurance: only with respect to liability for "bodily in- If coverage provided to the additional insured jury" or "property damage"",/, aused, in whole is required by a contract or agreement, the or in part, by "Youc wcr ""�e''at the location des- most we will pay on behalf of the additional ignated and described in the Schedule of this insured is the amount of insurance: endorsement performed for that additional 1. Required by the contract or agreement; insured and included in the "products-com- pleted operations hazard". or However: 2. Available under the applicable Limits of Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permit- ted by law; and This endorsement shall not increase the ap- 2. If coverage provided to the additional in- plicable Limits of Insurance shown in the Dec- sured is required by a contract or agree- larations. ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 88 83 04 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION w DESIGNATED PERSONS OR ORGANIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ,, SCHEDULE Name Of Additional Insured Person(s) Or, rganlzatlon(s): CITY OF EL SEGUNDO, ITS AGENTS,,. 0,0, EMPLOYEES & VOLUNTEERS Address 350 MAIN ST City State Zip EL SEGUNDO, CA 90245 (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) With respect to coverage afforded by this endorsement, the provisions of the policy/,-apply unless modified by the endorsement. A. The following is added to Paragraph a. Primary Insurance of Condltlon/4. Other Insurance under Section IV -Commercial General Liability Conditions: However, when the person or organization shown in the Schedule of this endorsement has been added as an additional insured to this Coverage Part by attachment of an endorsement, we will not seek contribution from the "person's or organization's own insurance" provided that: (1) You have agreed in a written contract that this insurance is primary and non-contri butory; and (2) The "bodily injury', "property damage" or "personal and advertising injury" is: a. Committed subsequent to the execution of such contract; and b. This policy covers the "bodily injury", "property damage" or "personal and advertising in- jury" B. For the purposes of this endorsement the following is added to Section V -Definitions "Person's or organization's own insurance" means general liability coverage for damages for which the person or organization shown in the Schedule of this endorsement is designated as a Named Insured. m 2012 Liberty Mutual Insurance CG 88 83 04 12 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1 DATE(MM/DD/YYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 5/16/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Advanced Risk Solutions NAE' ..�-_.....E................................................................................................„,................................F;AX.. ...................................................................................... 12980 Metcalf, Suite 490 PHON � acl .......................................................... ......................................................( .. qts,........................................................................... Overland Park, KS 66213 E-MAtL ................. AFFORDING_ RAGE NAIC# INSURER A: Lumbermen's Underwritlno Alliance .. ------ ......... ..nce www.advancedrisksolutions.com INSURE ... �_.�� �.._�_ �� �._. INSURED TSEPEO, Inc. L/C/F INSURER .................................................................................................................................................................................................. Kalifornia Business Staffing, Inc. INS.U-.R.._E.�R..O.. .................................................................................................................................................................................................................................. 480 W. Alluvial C 0 INSURER INSURER D . ....................�W............................._ --._._._....-._._._._._._....._.�-................, FresnoCA 9365 .....,.,...................................�.........��, ,,........,.,,.. INSURER F: COVERAGES CERTIFICATE NUMBER; 20212676 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN9R ___...... TYPE OF INSURANCE.... U .. POLICY ...,..,,. ^... '^. 9 POLICY EFF POLICY EXP NUMBER IMMIDDIYWY) IMMIDDIVYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ....._....._--- _ �.I $ CLAIMS-MADE OCCUR pRMC 'FC IF --m rci ..M MED EXP(Anv one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY 1:1 JECT F LOC PRODUCTSCO„M„P/OP AGG $..................................................................... OTHEW $ -AUTOMOBILE LIABILITY ..COMBINED INQLE I LIMIT $.... .... .... '... ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED HIREDAUTOS AUTO -- tP.rk_ N 4VD1 AMAaE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADEWAGGREGATE $ DED. .,,. RETENTION$ A WORKERS COMPENSATION 431447 1/1/2014 1/112015 ,/ STEATUTE ERH AND EMPLOYERS'LIABILITY - - ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE-_EA EMPLOYE '$ 1,000,000' If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE POLICY LIMIT $ 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THIS CERTIFICATE CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER. Covers all employees of the insured as respects the employers agreement(PEO)with Kalifornia Business Staffing,Inc. Kalifornia Business Staffing,Inc.employees assigned to Garcia Asset Management Inc.,dba Empire Building&Environmental Services,2821 W.Valley Blvd.Alhambra,CA 91803, CERTIFICATE HOLDER CANCELLATION A *) `,� C C3Clerk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90246 +. AUTHORIZED REPRESENTATIVE I Robert M Gagne ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 20212676 CLIENT CODE: TRI PASQUALE MANISCALCO 5/16/2014 10:18:51 AM (CDT) Page 1 of 1 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 05-21-2014 at 12:01 A.M. standard time, forms a part of (DATE) Policy No. 431447 (Effective 01-01-2014) Endorsement No. of the Lumbermen's Underwriting Alliance (Carrier Code 18376) issued to TRI-STATE EMPLOYMENT SERVICES (ETAL) Premium (if any) $ N/A K. e Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organizatjbia Job Description City Clerk �� Duct cleaning. City of El Segundo u . 350 Main Street � ) El Segundo, CA 90245 4, R TSE PEO, Inc. L/C/F Kalifornia Business Staffing, Inc. 480 W. Alluvial Fresno, CA 93650 DATED: 05-21-2014 WC 262 (Ed.4-84) r "�lYV mormo eu'.1u! wW«na nu,;;hu-ar.�+"wuatiawa*.p,^ro u�ro4m uu^u P�mR u;W Vtip auo n~A pm4;'vIW°u q n•„lourg:°dautllam uYeWm�"°`V';a11gtlC ft �� rtm,u6Nmyr rwamdanu.uritrmm. o-Y w1a'4rwWm&Iron !Uw W%N c f l ar r^Y"ati_11,4lm I-avry u�ry vom'm9 V 1 W,fl OTOnI-A✓'rtdnarvaau 0 !*N,w0N a9 du �'ke re°rmrl+u�"u h"a^oYV++?aw+,:uoa.um !' 'PIIIVMI1,av,CA"��"��"W1W �:"�mumdv7r�aWH�¢wwuma'm: � A,6't'vnuNvaud u�`.m,, a1114.110 �f o mrvc'u", (.B'flMl FAX7 1' In" ";a1Aea m '* bl,bq wNr^ t1w, Mv 9 IN I um au A a 1 :r1w+ 4a>e alnrhnd I moor. 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THIS CERTIFICATE DOES NOT AMEND, EXTEND OR O192 S ROSEMEAD BLVD, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PASADENA,CA 91107 INSURERS AFFORDING COVERAGE NAIC# m.. ...� ....�......... ...... R19URED INSURER A SWIG FArm General Ineunnm Company 25151 2b151 Garcia Asset Management DBA ,INSURER .. Empire Building 8 Environmental Services INSURER c: 2821 W.Valley Blvd. L Alhambra,CA.91003 INSURER Q INSURERE- ........ ..._.._.......... .......m�. ...,.�..,,.. .,...... COVERAGES THE MICRO NEENINUED T5 TRE IN TIRED NAMED ABOVE FOR THE POLICY PERIM INORA-176 ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR 0'04ER DOCUMENT MATH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAI'R THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH � ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. W��Aaaa1R POLICIES.AGGREGATE.��... ...� ..... .m... POLICY v I, E Ec� FiY� n NUMBER OATS MMAIOI'dYMfY. OATS A OWIERAL LIABILITY EACH OCCURRENCE $ CC MORCIeII.GENERAL LLASWTY ^Pa _.... CLAIMS MADE "" OCCUR _MED ExP(AM..� PERSONAL a ADV WIRY $ _ _ GENERAL AGGREGATE ..... ...... _.._,,,.. GEML AGGREGAtfi LIMIT APPLVES.E PE9T�: PRODUCTS-COMPoOPAGO $ PRO x POLICY LOC $ A X AUTOMOIBLE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 i"Ew` ANY AUTO 480 0715403.75 02/8312014 021032015 (Ee ecddeM ALL OWNED AUTOS BODILY INJURY '..SCHEDULEDAUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OIANEDAUTOS (Per Dodds s PROPERTY DAMAGE 1 (Pe(accidanU QARAQj LIABILITY' AUTO ONLY-EA ACGOENT $ ANY AUTO EA ACC S OTHER THAN .,........ AUTO ONLY: AGO S EACE.aS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RE7FT&TIOTN T i $ WORKERS COMPENSAT10N AHD TO L - I ER EMMLOM1lTWSIUARKUY ... -- ANYPROPR1ETON-AFTH EROL"MCU`nV90 EL EACH AOCIOENT $. OFFICERATEA WR EXCLUDED? Menda"IA NH) E.L.DISEASE-EA EMPLOYEr $ desato under E.L.DISEASE•POLICY LIMIT 1. OTHER OESCAWnONOF OPERATIONS ILOCATIONS d'VIM1.1SIEXCLUSNINS AOOEOaYENDORSEMENT'ISPECIALPROMMNiS A' ERTIFI A H L CANCELLATION 1 k SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY CLERK W...',.,g DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR To MAIL 30 DAYS WRITTEN CITY OF EL SEGUNDO f 350 MAIN STREET EL SEGUNDO CA 90245 NoncETOTHa.DEItlTVTDATENOILTIYa TD THE LEFT,BUT FAILURETo G NT 30 SHALL R IMPOSE NO 'RON UABLRY OF' CN+ON'THE INSURER,ITS AGENTS OR P"RESON TIVE AUTHOR EPRE "VE i ACORD 25(2009101) ®19 r 009 A ORD C R TION. All rights reserved. The ACORD name and logo are registered ITlaPT4 I ACORD 1001488 132849.3 D4-M2002 https://sfnet.opr.statefartn.org/im_core/jsps/pages/imageViewer.faces 6/9/2014