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PROOF OF INSURANCE (2013) CLOSEDClient #: 1255108 305A1 ENT =27,w2 D/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 13 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. IMPOATANT:'ff the CertaflCaf"oh O)der is an ADDITIONAL INSURED, the policy(les) 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 ondoirsomont(S). PRODUCER NAME: Vanessa Maldonado _ _ BB &T Insurance Services PHONE rx t A/C, No, Ext): 714 578- 7256Af N,o 877- 297 -1116 of Orange County E -MAIL vmaldonado @bbandt.com 680 Langsdorf Drive Suite 100 AODRESS: COVERAGE " _ "" �� °_ Fullerton, CA 92831 INSURER A: James River Insurance Company 12203ca INSURED ..... ...... .m INSURER B: Zurich American InSUra........ nce Co 16535 A -1 Enterprises Inc. dba A -1 Fence Company 2831 E. La Cresta Ave. Anaheim, CA 92806 INSURER C : INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. UFA, TYPE OF INSURANCE A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I •1 OCCUR X BI /PD Ded: $5,000 GEN'L AGGREGATE LIMIT APPLIES PER: [ POLICY ] -ALL t- AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS [7 UMBRELLA LIAB EXCESS LIAB LOC SCHEDULED AUTOS NON -OWNED AUTOS OCCUR CLAIMS -MADE POL CY NUMBER 000202726 , .. ........... .. _ ............ ....�.Wo.E: �U. ..........l..R.Er.E.NT.Ia.N. _m....�..m �........ B WORKERS COMPENSATION WC966159200 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER /MEMBER EXCLUDED? F7 N/A (Mandatory in NH) If ves. describe under LIMITS 2/01 /2012112/01 /20134 EACH OCCURRENCE $1,000,000 MED EXP (Any one person)_', $Excluded PERSONAL & ADV INJURY $1 7900,000 . ............................... GENERAL AGGREGATE $2,000'000 PRODUCTS - COMP /OPAGG $230001000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PAUPERTYOAMAGE .................. .... $ $ EACH OCCURRENCE $ AGGREGATE $ 1/01/2013101/01 /20140 X IW RYIIIMT DENT E.L. D EACH SEASECIEA EMPLOYEE...1. ,�_...�...�.�� _..-_.�w_ ...� ._��..._. E.L. DISEASE- POLICY LIMIT $1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Covered CA Operations Performed By Or On Behalf of the Named Insured. The City of El Segundo, its officers, officials, employees, agents, and volunteers are named additional insured as respects general liability and this insurance is primary and noncontributory with any other insurance of the additional insured; and waiver of subrogation applies as respects workers compensation as required by written contract, per endorsements attached. (See Attached Descriptions) City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 150 Illinois Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1 021 321 8/M9887010 VLMAL DESCRIPTIONS (Continued from Page 1) Should any policy be cancelled before the expiration date, BB &T Insurance Services will mail 30 (thirty) days written notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non - payment of premium. SAGITTA 25.3 (2010/05) 2 of 2 #S10213218/M9887010 POLICY NUMBER: 000202726 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Organ izati on s : Locations Of Covered Operations Where required by written contract or agreement All operations of the Named Insured's, 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a prin- cipal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: 000202726 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Opera - Or Or anization s : tions Where required by written contract or agreement All operations of the Named Insured's. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tions) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location desig- nated and described in the schedule of this endorse- ment performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 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 1/1 /13 (DATE) Policy No. WC966159200 of the Zurich American Insurance Company issued to A -1 Enterprises Inc Premium (if any) $ at 12:01 A.M. standard time, forms a part of Endorsement No. (NAME OF INSURANCE COMPANY) 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 % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN - WC 252 (4 -84) WC 04 63 06 (Ed. 4-84) .lob Description Page 1 of 1 Business Phone: 714.577.67i11F—ML, 1206 E. Yorba Llnd -a Blvd. Fax: 714- 577.0047 :.� � _ �Business S FlBalth Ins Svcs PlacBntia, CA 92870 APC No.� Paul Kinan INSR�_ S!�FrF_,..,_.._,._ `. _, ,,,,,_ A,. NoticanWf a Mn9 Co of merlca _..i _ '; awwD A -1 FENCE' COf11PANY 2545 2831 E- La Cresta Ave. B; Anaheim, CA 92806 -1817 c r O '...�....m.....�.,..,_- m _�, , COVER GES r , CERTIFICATE NLCIAAABEta REVISION NUMBER- INDICATED THIS IS CERTIFY THAT THE I�OLICIES CIF INSL#RANCE L #STED BEL BEEN ISSL)ED TO TINE INSURED NAMED ABOVE FOR T #1'E POLICY PERIOD CERTIFICATE NOTWITHSTANDING ISSUED ANY RI OI#lt 1ENT TERdua CrR O4 NDlTdf N ti7F A##Y CONTFdAi T OR C#THER DOCUMENT WITH RESPECT 70 WHICH 'THIS MIRY PERTAIN THE INSURANCE AFFORDED SY THE' FCiCIOIES IDE CRIBEO HEREIN IS SUBJECT TO ALI. THE TERM'S,. ig BXCLUS ONS AND CONDITIONS OF'mSUCH #SEWS LIMITS SHC)4yN MIAY HAVI SEEN RE L E Y T?p1#D CLAIMS Y BE #SSUI =D OR TYPE OF >MPSURAt#CE � E. -,-.- v.«. ��, ,.�.�..,„....,.- „.- .....,..... J.!ENERAL LIABILITY M� - -� ° °� Mme' POL, Y' LIMITS P .,. .... mm COMMRCIAL GENERAL LIABILITY EACH G0,D. # #1�i CLAIMS-MADE OCCUR FAMESLP4r u!c q an# j MED E](P IArty !wnn peq$L $ _. _ w ...... PERSONAL d ADV INJURY 5 GEN 4POLICY AGGREGATE L q"IESPER: p GENEIL AGGREGATE g � IOC PRO PRODUCTS CLMPIDP AGO s AUTOMOBILE LIABILITY $ _.— C I NGL LrII� i A X ANY AUTO X ACP BAZ 2542860196"tHI _ 1,00O�OOti ALL OWNED ®�'” SCHEDULED 08/29/2012 (%9129/2013 BODILY INJURY (Par person) $ AUTOS AUTOS HIREDAUTOS NON-OWNED BOOLY INJURY (Per saMex) b a .- AUTOS PITOPE' bi'1"YL}MAIa4kII",�_�...'. -.-." S.. ..., .. T—w e EXCESS LA U OCCUR .� SL B EACIHOCCURRENCE � S MADE ® , � ¶ L ��._�..- ....IT..... -I. J �LA&M'S• _ AOOR3EI.*AT�E DED VI ETENTYO #3 _ ___. -- — , $. WORKERS Cd3MrPB�FPS44T�N � 5.�.�.., AND EMPLOYERS' LIABILITY W " STATU- OTH- ANYPROPAIETORMARTNER&XECU9rVE YIN _�,QR,YLihlIT,S I .I EACI r ACCIDCIIT _ nNe mev�" �dIVF9 �,.�...,.......... -.. E L DISEASE «EA Em $ (MwdalMIrIBEREMCLLIDEDT NIA Il�rolz. Eart rrn�den � PI ne^�� A _.. ^, 0 CITYEL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF EL SEGUNDO ACCORDANCE WITH THE POLICY PROVISIONS. RECREATION & PARKS FAX: 310- 647.4223 AUTHORIZED REPRESENTATIVE 401 SHELDON STREET Paul Kinan ACORD 25 201 Q /05 01988 -2010 ACORD CORPORATION. All rights reserved. i The ACORD name and logo are registered marks ofACORD CA 24 48 (02 -99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Person(s) or Organization(s): N � so (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Copyright, Insurance Services Office, Inc., 1998 CA 20 48 (02 -99) ACP BAZ 26-4- 2060196 LNHY 12216 AGENT COPY CA2048029900 0240 25 0000152