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PROOF OF INSURANCE (2015) CLOSEDLAYNE -2 OP ID: HB CERTIFICATE OF LIABILITY INSURANCE f 11110)ATDIYYYY, 11110114 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 Easter%++yy Surety Ins.Svcs.lnc 56 Mayhew Way Walnut Creek „, CA 94597 Kevin P. Easterly INSURED C C Layne Bt Sons C. Craig Layne 213 Richmond Street El Segundo, CA 90204 925- 977 -9220 INPXJMP td” 925 - 977 -9224 PHONE FAX PPVC- 19AI ENM (A)C, No NAIC q 12203 35076 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. _ �„ TYPE OF INSURANCE A�i;C,1SUSR POLICY NUMBER POLICY EFF � PMLicYYFxP j LIMITS N w tM_ 192ff_Y..yX% ..�_m GENERAL LIABILITY 1•- I EACH OCCURRENCE � $ 1,000,0 - A I� X COMMERCIAL GENE LAMAGL OALNILb L LIABILITY X X 100528482 04/14!14 t 04/14/15 PREMISES (Ea gccurrgnce) $ 50,0 CLAIMS -MADE j X � OCCUR MED EXP (Any one person) $ EXCIUd GEN'L AGGREGATE LIMIT APPLIES PER AUTOMOBILE LIABILITY ANY AUTO ALLOWNED t SCHEDULED AUTOS j (AUTOS H NON -OWNED HIRED AUTOS AUTOS EXCESS LIAB X occuR XL66037002 B X _.... .. , CLAIMS MADE C I � DED X =RETENTION $ � WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C ANY PROPRIETORIPARTNERIEXECUTIVE Y N N A X ""I "a1" OFFICERIMEMBER EXCLUDED? , (Mandatory in NH) If ves. describe under PERSONAL & ADV INJURY $ 1,0C GENERAL AGGREGATE �$ 2,0( PRODUCTS - COMP /OP AGG ; $ 2,0( t $ COMBINH) SINGLE LIMIT r BODILY INJURY (Per person) $ ` BODILY INJURY (Per accident) $ PROM I °RTY DAMAGE ) or rr+ndenl) is $ EACH OCCURRENCE_ $ 4,0( 04/14114 04114/15 AGPGRd,MAIF, $ 4,0( X vwaiHiu- uln -I TORY LIMITS < EP. 02/01/14 I'fk /01(`/1s � EL EACH ACCIDENT $ 1, EL DISEASE EA EMPLOYEE( $ 1, 1 I E L DISEASE - POLICY LIMIT i $ 1, DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) PROJECT: WATER DIVISION CARPET REMOVAL AND REPLACEMENT. JOB NO. 13 -21. CITY OF EL SEGUNDO, ITS OFFICIALS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED PER THE ATTACHED ENDORSEMENT FORMS CG2010 0704 AND CG2037 0704. THIS INSURANCE IS PRIMARY AND NON — CONTRIBUTORY. WAIVERS OF SUBROGATION APPLY. *10 DAYS NOTICE OF CANCELLATION FOR NON — PAYMENT OF PREMIUM. CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245 ACORD 25 (2010/05) ELSEGUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC"Ri CERTIFICATE OF LIABILITY INSURANCE =o7j 2 � 2 0 16 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AL NO RIGHii UPON iTIE CffATIFIcATI! HOC-66R7"iHii BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT TER THE COVERAGE AFFORDED BY THE POLICIES REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, BETWEEN THE ISSUING INSURER(S). AUTHORIZED UO d-" I. A statement on this cartlilemilo does not confer rights to the U. Farm General Inaurarleo (,,arvipany 26161 EL SEGUNDO, CA 90245 EXCLUMONS AND CONIPO rMNS Or SUCH POLICIES LIMIIS SHOWN MAY HAVE HEIM RVOUCI�t� 13Y PAID CLAIMSL TO ALL THE TERMS, 11 F� OCCUR M6-MAO NYEIV CLAI ANY AUTO SCHEDULE AUTOS AUTOS D DOILY INJURY (P—dd—n NON4VVNFO 2111-9368-1320-75W 0412312014 0312612016 uw HIRED AUTO AUTOS 470-73a7-FOO-75 0810812014 0610612019 MORMLIALIAR OCCUR TI NII e EA ` uSSn III PTI* N OF OPERA t1nN S,m"m DNS /"EHIoLEuJAmo m*^ddillanal".m uk^Sch~d.l~° y ba xoomowx /wuunco THE CITY npS�ncouwuO. ITS ornusne.opp/um�.swpu�ssa.xosw�.^momuuwrenow�meoxnmoomowx /wounsoo, - ~ CERTIFICATE HOLDER CANCELLATION CITY CLERK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF EL SEGUNDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. EL SEGUNDO, CA 9024�'N,, ACORD 28 (2014/01) The ACORD name and logo are registered marks ofACORD 1001486 132849,9 02-04-2014 CERTIFICATE OF LIABILITY INSURANCE �WW iWiWoW�;" 01/02/201 5 - T AT(ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIPMATE il6i—)gi—iHi� THIS CERTIFICATE IS ISSUED AS A MATTLIft OF INFORM D CE10IFICATIS DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDSO BY THE POLICIES BELOW, THIS CERTIFICATE OF fNSURANCC DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESWATWE OR PRODUCER ANOTHE CPRTIFICATE HOLDER, IMPORTANT� If the cvibfi�ata ­­I�tol(Iftf is n ADOITIONAL INSURED, tho olio lee must 0 tR to the terms and conditions Of the policy, certain Policies may require an ondorsament. A statement on this certificate does not confer rights to the Cerfli4cato holdor In 11014 of With ondorawn all, 1), 'Ilia" REMON WASFI Ramon wanh 62 StateFjrm " 432 MAIN ST . . . . ........... . .. . . . .. ...... ELSEGUNDO, CA 90246 pAi CC L YNE&,O $ �MIITI MU101 Automobile Insurance Comp4oy 213 RICHMOND ST .. 2ts1T0 EL SEGUNDO, CA 90245 . . ....... nobs ir "ra ct,,tt l wy I INAT THL OF I N 5 Id RAN C IL 1, N S R 57� r MAq I` � V7L I UEE N I q 3 U C 0 TO I'H 1- 1 N 91) R E, 0 NAM if)—A TAFm -5 c y WTI: INDRATEU NOt"trNWANGING ANY PFOUJI'mcww, TERM OR CONOI100N 0 ANY (1014RAGIr OR CrOIER 00CUME!Nt WW IM RFSPE.01 TO WHIC'dl CERTPF�CATF' MAY' K ISM.)ED OR MAY PERTAIN, r III, INSURANCE ffrONIXO BY THE Pf)IJCW'.t; HEREN IS SUBJECT TO ALI Tlfl.�' It -11JUCED BY PAID CLAIMS E-ACWWONS ANI) C6 rA I fl)N�q oll SLINf NXICIES LZT5 1HOWN MAY HAVE 8P1.tN PqI;. vwl w I YYq I AMNVA P VV& IWT. COMMERCIAL GENERAL LIAOIL3TY � CAAW8,MAJ71--, [ I nrxlur� LIMITASIPLIf � �4 rY P �Ajcy !xa 1 67U . . . . . ......... A AUTOMOBILE LIABILITY ANY AW 0 x ALI, r"JII:0 ALI PAR 6161 VC.'d?6 N0N,0VMk..0 HIN AUT013 UMBRELLA I IAR Ae 0 0, 0 0 R EXCgfia U 00AVL0YrnWUA1NtA1y 90 LA Mork i2-2-6846F19-76C I — 1191204 wl — 2016 zwA!w4,p Ra, F U KrIT- 284-6408-EO7-75E 11/07/2014t.0 1111112111 yw"URY ppdrwwn), DOUILYINJUNY(ftrw- Mf� I'A%O, LA 09 . ......... DESCRIPTION OF OPERATION81 LUCA tIONS I VCHOL98 tACORO 101, AddRIOnfil R4—rke ElchaduI4,may b6MRAChOd 0—space Is r6quired) ADDITIONAL INSURED: THE CITY OF EL SEGUNDO, IT OFFICERS, OFFICIALS, EMPLOYEES, AGENTS.111* VOLL110 CITY CLERK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF EL SEGUNDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 360 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS, EL SEGUNDO, CA 90246 J Na 1909•2014 ACORD CORPORATION, Alt clijbIs reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION CG 20 10 07 04 0 ISO Properties, inc., 2004 Page 1 oi 1 13 001110VAP011 kyll 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 111 t III! IN � !I � 1 10013 W Talllll.. . CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 04-10 Page 1 + THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY, WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT 11 jjj�� III Iti 1:1111mrom"1111011— rhe Company agrees to waive any right of recovery against any person or organizafion, as W"WhANA900"54. 061"AilkN ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11- Page 1 of 1 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION 9088031 -14 RENEWAL NA 0- 23 -53 -02 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE APRIL 15, 2014 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING FEBRUARY 1, 2015 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME C C LAYNE & SONS INC 213 RICHMOND ST EL SEGUNDO, CA 90245 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03 %. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ��'° APRIL 17, 2014 AUTHORIZED REPRESS TA IVE d' PRESIDENT AND CEO SCIF FORM 10217 (REV.1 -2012) 2570