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PROOF OF INSURANCE (2011) CLOSEDACORDTM CERTIFICATE OF LIABILITY INSURANCE (MM/D 1Y POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRrD LTR 1DATE 2/14/2010YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 10550 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Ana, CA 92711 -0550 10/01110 10/01/11 714 427 -6810 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Property Casualty Co of Am 25674 RM Architecture INSURER B: XL Specialty Insurance Co. DAMA{'.�E TCi IR'LNTrr.I: Rubio Medina Architect AIMS MADEERALXLIABILITY CUR INSURER C: 56 Chantilly Ave MED EXP (Any one person) on) S10 000 PERSONAL & ADV INJURY INSURER D: Irvine, CA 92620 'arising out of INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRrD LTR $ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM / POI XPP IRA O'daD' D LIMITS • GENERAL LIABILITY 680219M6172 10/01110 10/01/11 EACH OCCURRENCE $1 000 000 X. COMM policy DAMA{'.�E TCi IR'LNTrr.I: AIMS MADEERALXLIABILITY CUR excludes claims MED EXP (Any one person) on) S10 000 PERSONAL & ADV INJURY $1,000,000 'arising out of GENERAL AGGREGATE s2,000,000 the performance GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG 52,000,,000 of professional POLICY I:,w LOC (services • AUTOMOBILE LIABILITY ANYAUTO BA219M6196 10/01/10 10/01/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY ''.. SCHEDULED AUTOS (Per person) $ X BODILY INJURY (Per accident) S HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT IS ANY AUTO OTHER THAN EA ACC I S S AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S $ DEDUCTIBLE S IRETIEtMNHON 'S WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PRO PRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S If yes, describe under SPECIAL PROVISIONS below E . DISEASE - POLICY LIMIT $ B OTHER Professional DPS9688573 10/01/10 10/01/11 $1,000,000 per claim Liability $1,000,000 arm agg Claims Made $0 deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: Construction Management Services. The City of El Segundo, its officers, officials, employees, agents, representatives and certificated volunteers are Additional Insured as respects to General Liability coverage as required by written contract, (See Attached Descriptions) City of El Segundo Attn: Maryam Jonas 350 Main Street El Segundo, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL RDKjdAt ARj(§t MAIL 30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,jQkRRIlt K IR+ �ttai�i4kP�I 'X�bt�B�Kpd�lsX9?d°�(�Gtl[�IK �IrIFG'b�kEt NC��bfk xx W ACORD 25 (2001108) 1 of 2 #S277238/M277223 TMN © ACORD CORPORATION 1988 DESCRIPTIONS (Continued from Page 1) Coverage afforded the Additional Insured is Primary and Non-Contributory as respects to General Liability coverage, AMS 25.3 (2001/08) 2 of 2 #S277238IM277223 Architecture+ Planning+ Interiors December 16, 2010 Maryam Jonas, Principal Engineer City of El Segundo Public Works Department 350 Main Street El Segundo, CA Re: RM Architecture Verification Maryam, This letter is to confirm that RM Architecture is a sole proprietor firm with no other employees besides me. If you have any questions please feel free to contact me at 949 302.7256 or at rmarchitect@cox.net. RM Architecture 56 Chantilly, Irvine, CA 92620 P: 949 302.7256 F: 949 857.0544 COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS This endorsement modifies insurance provided under the followings COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard ". Such person or organization does not qualify as an additional insured for "bodily injury ", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which cover- C. age as an additional insured specifically is added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any "professional services ". f. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF after you have entered into that "contract or agreement requiring insurance ". But this insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with such person or organization entered into by you before, and in effect when, the "bodily CG D3 81 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission. COMMERICAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- sonal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include a person or organization as an additional insured on this Cov- erage Part, provided that the "bodily injury" and "property darnage" Occurs, and the "personal in-, jury" is Caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effeot; and c. Before the end of the policy period. Page 2 of 2 0 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission.