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PROOF OF INSURANCE (2014) CLOSEDCC)IOR CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 3/19/2014 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 Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 1255 Battery Street, Suite 450 San Francisco CA 94111 INSURED CSGCONS -01 CSG Consultants, Inc., Precision Inspection - CSG 1700 S Amphlett Blvd 3rd Fir San Mateo, CA 94402 COVERAGES CERTIFICATE NUMBER: 14720901 11 A: AFFORDING COVERAGE REVISION NUMBER: NAIL # 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. iLTR ..... . .. ..... . ...................MMIDDY/XYXX MMIDDIYYYX., TYPE OF INSURANCE.,INSR WVD POLICY NUMBER LIMITS • GENERALLIABIIJTY Y 680294MO850 12/4/2013 2/4/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL .. .(.. a �Gbllrren $300,000 CLAIMS -MADE X... OCCUR MED EXP (Any person) n) .. $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 ., POLICY PFd'C7. LOC $ ..... • AUTOMOBILE - ..., LIABILITY BA461 M7612 12/4/2013 2/4/2014 = DS[NGLE "I'll (Fail awont) $1;0 0 0 0 0 0 - - -- ..... --- ..., X ANY AUTO BODILY INJURY (Per person) $ - ALL OWNED _ SCHEDULED _ � BODILY INJURY (Per accident) ��� $ AUTOS AUTOS .. 'PROPERTY..DAMAr'iE... .. ..... NON -OWNED $ HIREDAUTOS AUTOS ,_1Peraccidenit $ • X UMBRELLA LIAR X OCCUR CUP4177T123 12/4/2013 2/4/2014 EACH OCCURRENCE $5.000,000 EXCESS LIAB CLAIMS -MADE "El AGGREGATE $5.000.000 RED RETENTION$ $ B WORKERS COMPENSATION 3300065922131 12/4/2013 12/4/2014 X WC STAiU OTH AND EMPLOYERS' LIABILITY Y I N uTQRY � � ? ITS k a ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT 51,000 000 ❑ NIA (Mandatory in NH) L DISEASE. EA EMPLOYEE $1.000,000 If y DESCRIPTION OF OPERADTIONS below E L DISEASE. POLICY Y LIMIT $1,000,000 C Professional Liability EP004731502 12/4/2013 2/4/2014 Each Claim $3,000,000 retro date: 1/1/1991 Aggregate $3,000,000 Deductible: $50,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) City of El Segundo, its officials and employees are included as additional insureds on Primary/Non - Contibutory basis on GL per CGD3820907. CERTIFICATE HOLDER CANCELLATION City of El Segundo attn: Sam Lee 350 Main Street El Segundo CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU�ITHORIZED REPRESENTATIVE M ill ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 680294MO850-TIL-13 ISSUE DATE: 10-25-12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the follcwing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S)OR ORGANIZATI,ON"(S PER SCHEDULE ON FILE WITH A O PROJECTILOCATION OF COVERED OPERATIONS: PROVISIONS A. The following is added to WHO IS AN INSURED The insurance provided to such additional insured (Section II): is limited as follows: The person or organization shown in the Sched- d. This insurance does not apply to the render- ule above is an additional insured on this Cover- ing of or failure to render any "professional age Part, but only with respect to liability for"bod- services". ily injury", "property damage" or"personal injury" e. The limits of insurance afforded to the addi- caused, in whole or in part, by your acts or omis- tional insured shall be the limits which you sions or the acts or omissions of those acting on agreed in that"contract or agreement requir- your behalf: ing insurance" to provide for that additional a. In the performance of your ongoing opera- insured, or the limits shown in the Declara- tons; tions for this Coverage Part, whichever are b. In connection with premises owned by or less. This endorsement does not increase the rented to you;or limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage C. In connection with "your work" and included Part. within the "products-completed operations hazard". B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL Such person or organization does not qualify as LIABILITY CONDITIONS(Section IV): an additional insured for"bodily injury", "property damage" or "personal injury" for which that per- However, if you specifically agree in a"contract or son cr organization has assumed liability in a con- agreement requiring insurance"that, for the addi- tract or agreement. tional insured shovrn in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 C 2007 The Travelers Comparies,Inc. Page 1 of 2 Includes;he copyrighted maleral of insurance Services Office,Inc.,with its permission COMMERCIAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or injury"arising out of"your work" on or for the pro- a primary and non-contributory basis, this insur- ject, or at the location, shown in the Schedule ance is primary to other insurance that is avail- above, performed by you, or on your behalf, un- able to such additional insured which covers such der a "contract or agreement requiring insurance" additional insured as a named insured, and we with that additional insured. We waive these will not share with the other insurance, provided rights only where you have agreed to do so as that: part of the"contract or agreement requiring insur- (1) The "bodily injury" or "property damage" for ance"with that additional insured entered into by which coverage is sought occurs;and you before, and in effect when, the"bodily injury" or"property damage" occurs, or the "personal in- (2) The "personal injury" for which coverage is jury"offense is committed, sought arises out of an offense committed; D. The following definition is added to DEFINITIONS after you have entered into that "contract or (Section V): agreement requi-ing insurance" for such addi- tional insured. But this insurance still is excess "Contract or agreement reeuiring insurance" over valid and collectible other insurance, means that part of any contract or agreement un- whether primary, excess, contingent or on any der which you are required to include the person other basis, that is available to the additional in- or organization shown in the Schedule as an ad- sured when the additional insured is also an addi- ditional insured on this Coverage Part, provided tional insured under any other insurance. that the"bodily injury" and"property damage"oc- curs, and the"personal injury"is caused by an of- C. The following is added to Paragraph 8. Transfer fense committed: Of Rights Of Recovery Against Others To Us . after you have entered into that contract or in COMMERCIAL GENERAL LIABILITY CON- DITIONS(Section IV): agreement; We waive any rights of recovery we may have b. While that part of the contract or agreement is against the additional insured shown in the in effect; and Schedule above because of payments we make c. Before the end of the policy period. for"bodily injury", "property damage" or"personal Page 2 of 2 ©2007 The Travelers Companies,Inc. CG D3 82 09 07 Includes tie copyrighted material of Insurance Services Office,Inc.,with its permission Policy #BA-461M7612-13 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Farm apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE-This endorsement broadens coverage.However,coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the coverage Part,and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The foliowing listing is a general cover- age description only. Limitations and exclusions may apply to these coverages.Read all the provisions of this en- dorsemeni and the rest of your policy carefully to determine rights,duties,and what is and is not covered. A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO EQUIPMENT-INCREASED LIMIT C. EMPLOYEES AS INSURED 1. WAIVER OF DEDUCTIBLE-GLASS D. SUPPLEMENTARY PAYMENTS --INCREASED J. PERSONAL EFFECTS LIMITS K. AIRBAGS E. TRAILERS-INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP F. HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES-INCREASED LIMIT A. BLANKET ADDITIONAL INSURED performing duties related to the conduct of ° The following is added to Paragraph A.1.,Who is your business. m— An Insured, of SECTION 11 - LIABILITY COV- 2. The following replaces Paragraph b. in B.S., ERAGE: Other Insurance, of SECTION IV - BUSI- Any person or organization who is required under NESS AUTO CONDITIONS: a written contract or agreement between you and b. For Hired Auto Physical Damage Cover- that person or organization, that is signed and age, the following are deemed to be cov- e; executed by you before the "bodily injury" or Bred"autos"you own: "property darnage" occurs and that is in effect (1) Any covered "auto" you lease, hire, during the policy period,to be named as an addi- tional insured is an "insured" for Liability Cover- = age, but only for damages to which this insurance (2) Any covered"auto"hired or rented by x= applies and only to the extent that person or or- your "employee" under a contract in ganization qualities as an "insured" under the that individual "employee's" name, -°- Who Is An Insured provision contained in Section with your permission, while perform- °_ II ing duties related to the conduct of e� B. EMPLOYEE HIRED AUTO your business. However,any"auto"that is leased, hired, 1. The following is added to Paragraph A.1., rented or borrowed with a driver is not a Who Is An Insured, of SECTION II - LF covered"auto". ABILITY COVERAGE; C. EMPLOYEES AS INSURED An "employee" of yours is an "insured" while operating a covered "auto" hired or rented The following is added to Paragraph A.1.,Who Is under a contract or agreement in that "em- An Insured, of SECTION 11 - LIABILITY COV- ployee's" name, with your permission, while ERAGE: CA T4 20 07 10 02010 The Travelers Indemnity Company.All rights reserved, Page 1 of 3 Includes copyrighted material of Insurance services Office,Inc.with its permission. 001639 COMMERCIAL AUTO Any"employee"of yours is an "insured"while us- (3) If a repair or replacement results in better ing a covered"auto"you don't own,hire or borrow than like kind or quality,we will not pay for the in your business or your personal affairs. amount of betterment. D. SUPPLEMENTARY PAYMENTS— INCREASED (4) A deductible equal to the highest Physical LIMITS Damage deductible applicable to any owned 1. The following replaces Paragraph A.2.a.(2)of covered"auto SECTION it—LIABILITY COVERAGE: (5) This Coverage Extension does not apply to: (2) Up to $3,000 for cost of bail bonds (in- (a) Any "auto" that is hired, rented or bor- cluding bonds for related traffic law viola- rowed with a driver; or tions) required because of an "accident" (b) Any "auto" that is hired, rented or bor- we cover. We do not have to furnish rowed from your"employee". these bonds. G. PHYSICAL DAMAGE — TRANSPORTATION 2. The following replaces Paragraph A.2.a.(4)of EXPENSES—INCREASED LIMIT SECTION 11—LIABILITY COVERAGE: (4) All reasonable expenses incurred by the The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of "insured" our request, including y the loss of earnings up to $500 a day be- SECTION III — PHYSICAL DAMAGE COVER- AGE: cause of time off from work. We will pay up to $50 per day to a maximum of E. TRAILERS—INCREASED LOAD CAPACITY $1,500 for temporary transportation expense In- The following replaces Paragraph CA. of SEC- curred by you because of the total theft of a cov- TION I—COVERED AUTOS: ered"auto"of the private passenger type. 1. "Trailers" with a load capacity of 3,000 H. AUDIO, VISUAL AND DATA ELECTRONIC pounds or less designed primarily for travel EQUIPMENT—INCREASED LIMIT on public roads. Paragraph C.2.. Limit Of Insurance, of SEC- F. HIRED AUTO PHYSICAL DAMAGE TION III —PHYSICAL DAMAGE COVERAGE is The following is added to paragraph A.4., Cover- deleted. age Extensions, of SECTION ill — PHYSICAL 1. WAIVER OF DEDUCTIBLE--GLASS DAMAGE COVERAGE: The following is added to Paragraph D., Deducti- Hired Auto Physical Damage Coverage ble, of SECTION III — PHYSICAL DAMAGE If hired "autos" are covered "autos" for Liability COVERAGE; Coverage but not covered "autos" for Physical No deductible for a covered "auto" will apply to Damage Coverage, and this policy also provides glass damage if the glass is repaired rather than Physical Damage Coverage for an owned "auto", replaced. then the Physical Damage Coverage is extended ,l, PERSONAL EFFECTS to "autos"that you hire, rent or borrow subject to the following: The following is added to Paragraph A,4., Cover- age Extensions, of SECTION III — PHYSICAL (1) The most we will pay for "loss" in any one DAMAGE COVERAGE: "accident" to a hired, rented or borrowed "auto"is the lesser of: Personal Effects Coverage (a) $50,000; We will pay up to $400 for"loss" to wearing ap- (b) The actual cash value of the damaged or parel and other personal effects which are: stolen property as of the time of the (1) awned by an"insured"; and "loss';or (2) In or on your covered"auto". (c) The cost of repairing or replacing the This coverage only applies in the event of a total damaged or stolen property with other theft of your covered"auto". property of like kind and quality. No deductibles apply to Personal Effects cover- (2) An adjustment for depreciation and physical age. condition will be made in determining actual cash value in the event of a total'loss". Page 2 of 3 @ 2010 The Travelers indemnity Company.All rights reserved, CA T4 20 07 10 Includes copyrighted material of Insurance Services Office,Inc.with!is permission COMMERCIAL AUTO 0 K. AIRBAGS (2) Any; The following is added to Paragraph B.3., ExCIU- (a) Overdue lease or loan payments at the Mons, of SECTION 111 — PHYSICAL DAMAGE lime of the"loss"; COVERAGE: (b) Financial penalties imposed under a Exclusion 3.a.does not apply to "loss"to one or lease for excessive use, abnormal wear more airbags in a covered "auto"you own that in- and tear or high mileage, hate due to a cause other than a cause of"loss" (c) Security deposits not returned by the les- set forth in Paragraphs A.I.b. and A.1.c., but sor; only, a. If that"auto"is a covered "auto"for Compre- (d) Costs for extended warranties,Credit Life Insurance, Health, Accident or Disability hensive Coverage under this policy; Insurance purchased with the loan or b. The airbags are not covered under any war- lease;and ranty;and (e) Carry-over balances from previous loans c. The airbags were not intentionally inflated. or leases. We will pay up to a maximum of$1,000 for any M. BLANKET WAIVER OF SUBROGATION one"loss". The following replaces Paragraph A.S., Transfer L. AUTO LOAN LEASE GAP Of Rights Of Recovery Against Others To Us, The following is added to Paragraph AA.,Cover- of SECTION IV — BUSINESS AUTO CONDI- age Extensions, of SECTION III — PHYSICAL TIONS: DAMAGE COVERAGE: S. Transfer Of Rights Of Recovery Against Auto Loan Lease Gap Coverage for Private Others To Us Passenger Type Vehicles We waive any right of recovery we may have In the event of a total"loss"to a covered"auto"of against any person or organization to the ex- the private passenger type shown in the Schedule tent required of you by a written contract axe- or Declarations for which Physical Camage Cov- cuted prior to any "accident" or "loss", pro- erage is provided,we will pay any unpaid amount vided that the"accident"or"loss"arises out of due on the lease or loan for such covered "auto" the operations contemplated by such con- less the following: tract.The waiver applies only to the person or ° (1) The amount paid under the Physical Damage organization designated in such contract. Coverage Section of the policy for that"auto"; and ° ° e h� Cllm J- mC CA T$20 07 10 02010 The Traveters indemnity Company.All rights reserved. Page 3 of 3 Includes copyrlrghted material of Insurance Services Office,Inc.with its permission 00964D WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10A(Ed 07-07) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be®2.00 % of the total policy premium otherwise due on such remuneration. The minimum premium for this endorsement is$ 3r)n on Schedule Person or Organization °"°` Job Description ALL ORGANIZATIONS FOR HOM T 'E WAIVER OF SUBROGATION IS ALL CALIFORNIA OPERATIONS ISSUED ° This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12/04/2013 Policy No. 3300065922-131 Endorsement No. 1 Insured CSG CONSULTANTS, INC. Premium $ Insurance Company Cypress Insurance Company WC 99 04 10A (Ed 07-07)