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PROOF OF INSURANCE (2013) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI 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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED, the policY(tes) must be endorsed. If SUSROGATION 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 Ileu of such ondorsotmonl s . PaooucER IOA Insurance Services 2180 Harvard Street #450 �_CQNTACT NAME Sacramento, CA 95815 "�� � '0 �a.377- _-09" ... .............r4 urc.Nal: s1s 473 -1797 IffIiaTf www.ioausa.com CA License #OE67768 wHe sler Landscape General Engineering, Inc. P.O. Box 2002 Orange CA 92859 COVERAGES CERTIFICATE NUMBER: JE944122 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. INSR.. ..............AOO'Lrsun POUcY'E�E" LTR TYPE OF INSURANCE l INSR VYVD POLICY NUMBER tMyRIdTkOuY kMO. LIMITS , -, GENERAL OCCURRENCE �S 1,000,00 A TEN11010 416/2012 4/8/2013 r �HOCC e 100,00 CO'MMER'CIA�t.GENERALLIAeIUTY � s �. CLAIMS -MADE OCCUR MED EXP Agy one person) is 5100 - - -- - - -- ._. PERSONAL SADVINJURY S 1,000,00 _Y' .C'DOYAch I..I,.Iabloty..„.,- „ GENERAL AGGREQATE S 2,000,00 GLE'L AGGREGATE LIMIT APPLIES PER PRODUCTS- COMP/OPAGG IS 2.000.000 POLICY f PRO. LCD" S B AUTOMOBILE LIABILITY BA8909048 4/6/2012 4/6/2013 C4 I I I a a tea) �, S 1000 00_ ,_/ ANY AUTO BODILY INJURY (Per person) _ _S ALL OANIED SCHEDULED AUTOS l { AUTOS BODILY INJURY (Par c ddent ) 5 aW M ' HIREDAUTOS i AU ED P E S J Comp Deductible $1,000 s Colt Deduotlbla oll 0 0 s C 71935D120ALI 4/6/2012 4/6/2013 EACH OC OCCURRENCE Ew 6� ✓ �kts Exc MADE 1.0 .000 DED RETENTIONS S - .. ................... -------- _..�,. S . D AN EMPLOYERS'LIAMITY YIN 900628412 61612012 6/612013 0 - Y R/EXECUTIVE 5.. -uuuu 1 000... OFFICERIMEMBE)EXCLUDED? NIA E,L. EACH AI:C ^DENT r9_ (Myandatory in NH E.L. DISEASE -IR EMPLOYEE',S O IDE C PTION OF OPERATIONS below _ wwwwwwww- E.L. DISEASE -POLICY LIMIT '. S 1,000,000 DESC'RtPnON OF OPERA'T'IONS I LOCATIONS Y VE'NICLES tAttactr ACORD tot, AddNronal Remarks Schedule, H more space Is required) RE: Evidence of Covdra�1 a for Proposals #42480 & 42474 City of El Segundo, its 0 ricers, officials, ernployees, agents and volunteers are Additional Insureds where required by -Titters contract per General Liability forms CG2010 (07.04) S CG2037 (07.04,) PfirnaryWoMing er form TEN0215 (11 -10); m n tiDUT4orai of�Subr�asliu�ap'to N�e�iss d Ca r, )C i for ) -f o f Prerrilui n in ggggfdaQ[& wi h 1116 n6kv nr0VJSJQr1_$, . ,!QgRTIFICATE HOLDER C T SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ell Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attm City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo CA 902 AUTHORIZED REPRESENTATIVE I,JLAJC Daniel Caudill ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ,'EP.'. v. 1,.941 ?2 CLIEITT 03DE7 IMISLA11 -0) (SAC) Rebecca FG =[er 1(15/2013 9;54:40 P11 Page I of 4 1/15/2013 COMMERCIAL GENERAL LIABILITY HOUSTON SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 2010 07 04 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Additional Insured Person(sj -7 Name � Or Organizations (s) Location(s) Of Covered Operations Only those parties required to be named as an ALL Additional Insured in a written contract with the Named Insured under this policy, entered into prior to the "loss" or "occurrence_ ". Information required to complete this Schedule, if not shown .... � .... Declarations, ,. wn above, will be shown in the A. Section It • 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) designated above. B. This insurance does not apply to "bodily injury", "property damage" occurring after. 1. All work, including materials, parts or equipment 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 to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Policy No. TEN11010 CG 2010 07 04 ISO Properties, Inc., 2004 PAGE 1 of 1 1/15/2013 COMMERCIAL GENERAL LIABILITY HOUSTON SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 07 04 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) Or Organizations (s): Location(s) Of Covered Operations . . . . . ................ Only those parties required to be named as an ALL Additional Insured In a written contract with the Named Insured under this policy, entered Into prior to the "loss" or "occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION 11 —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" or "property damage" caused, In whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional Insured and included In the "products - completed operations hazard". Policy No. TEN1 1010 CG 20 37 07 04 IS Properties, Inc., 2004 PAGE I of 1 , F, f " � �: � �, I,, , i 5 , � b , , , 1� , ", ) ,7 , �, 0 j I , / �'� . . � ", '. , ) . / � 1 , , ", � � . l i <, i ,, 1/15/2013 COMMERCIAL GENERAL LIABILITY HOUSTON SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEN021511 10 PRIMARY AND NON -CONTRIBUTING INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other insurance: Notwithstandingthe provlslonsof sub - paragraphs a, b, and c of this paragraph 4, with respect to the Third Party as defined below, It is understood and agreed that In the event of a claim or "suit" caused in whole or in part by the Named Insured's negligence, this insurance shall be primary and any other insurance maintained by the additional Insured named as the Third Party below shall be excess and non - contributory. This endorsement applies only to those third parties required to be named as an Additional insured as Primary and Non - Contributory coverage specified in a written contract with the !Named Insured under this policy, entered into prior to the "loss" or "occurrence ", The Third Party to whom this endorsement applies is: All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. � f, YE N0215 11 10 dnC" Utides copyright irura e[rGal E:Q' l;,� Uri jj[ ice Services (Wfi ce loin., Page 1 of 1 with its peumissio.:un , ,J ., , � ,C n. X1;4 P�V P,, A t bt ,' :, o ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION REP D1 TAT E 9006284 -12 -2 RENEWAL NF FUND 3- 62 -64 -57 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE JANUARY 18, 2013 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING JUNE 6, 2013 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME HEISLER LANDSCAPE EN RAL ENGINE PO BOX 2002 ORANGE, CA 92859 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, HEISLER LANDSCAPE GENERAL ENGINE 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: FEBRUARY 7, 2013 2570 AUTHORIZEp REPRESENTA NVE PRESIDENT AND CEO SCIF FORM 10217 IREV,1 -2012} OLD DP 217