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PROOF OF INSURANCE (2011) CLOSED (2)A " CERTIFICATE OF LIABILITY INSURANCE 12ATE(M 2/YYYY) 010 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 endorsements . PRODUCER NAME: CONTACT Jerry Noyo'la Ames and PHONE . (770)552-4225 _ � FAX AIC.No u E-MAIL 0Norhrid a Parkway ADDRESS.l? noY ola @amesg ough.com � ) A.RODU Suite 102 CUSTOCER 00001398 ER �t 1111. , ., .,. Atlanta GA 30350 INSURER(S)AFFORDINGCOVERAGE NAICR _ -------- _ INSURED INSURER A Traveler Y s Indemnity Co. of CT 2 „56,82 INSURERc:Travelers Property.. Csua,1t,y 25658 Kimley -Horn and Associates, Inc. .eNSIaRER,s••Tr a v eler s Ind,ert Casualty Co. 25674 P.O. Box 33068 INSURERD:Phoenix Insurance Oompany Company 25623 INSURER Insurance Company m,19437 _, Raleigh NC 27636 INSURERF:Travelers Pro g. Cas. Co America 25674 COVERAGES CERTIFICATE NUMBER: *10 -11 (Kimley Jessica) 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” I A00 i§UI`i( 1111 POLICY NUMBER MOLIC/YYYY MOLIC YYY.�,_, ,_,..... ..- 1111... . TR TYPE OFINSURANCE p LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 (SAMAEiC iEIViD _ . 1111 X COMMERCIAL GENERAL LIABILITY PREMISE „S jEapcaurrence� $ 1,000,000 2 1/010 12/1/2011 A .CLAIMS -MADE OCCUR P- 630- 8193B99A- TCT -10 12 / MEDEXP {Anyoneperson) $ 10 000 1111. _ .. PERSONAL &ADV INJURY $ 1, 000, 000 ..� GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 1,000,000 PRO POLICY X X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X., (Ea accident) $ 1,000,000 ANY AUTO - .. ,. 1111 ... , , P8105724B497IND 10 12/1/2010 12/1/2011 BODILY INJURY (Per person) $ - - - - B ALL OWNED AUTOS • -- - -- BODILY INJURY (Per accident) 1 $ SCHEDULED AUTOS _ _,,,___ ����.. .... PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ ... X NON -OWNED AUTOS Underinsured motorist BI split $ 111-1111111 . -...- Uninsured motorist property $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB -­CLAIMS-MADE AGGREGATE $ 5,000,000 _ [­­ -1111 1111. DEDUCTIBLE $ 1111,,, C X RETENTION $ 10,000 PSM- CUP.- 8193B99A- TIL -10 +2/1/2010 12/1/2011 $ D WORKERS COMPENSATION PNUB- 8193B99A -10 12/1/2010 12/1/2011 WCSTATU OTH- AND EMPLOYERS' LIABILITY YIN X I TOBY, LIMITS I _ .M F=.R,.1, -, ANY PROPRIETOR/PARTNER /EXECUTIVE� - El. EACH ACCIDENT $ 500,00d OFFICER/MEMBER EXCLUDED? L':..J' N/A - -- .NI ° °- - -- ^� F (Mandatory n NH NUB- 8193B99A -10 (CA) 12 /1/2010 12/1/2011 rY ) E.L. DISEASE EA EMPLOYE $ 500000 If yes, describe under — DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 E Professional Liability D16o17332 12/9/2010 12/1/2011 Per Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: All City of E1 Segundo Projects. The CIty of E1 Segundo, its officials & employees are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation & professional liability. This insurance is primary & non - contributory where required by written contract. Waiver of Subrogation is applicable where required by written contract & allowed by law. CERTIFICATE HOLDER. rANrFI I ATHIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of E1 Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Insurance Administrator 350 Main Street AUTHORIZED REPRESENTATIVE E1 Segundo, CA 90245 -3813 Matias Ormaza /NOYOLA j ACORD 25 (2009/09) ©1988 -2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD Policy Number: P-630-8193B99A-TCT-10 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL,LIABILITY COVERAGE PART 1. The following is added to SECTION 11 —WHO IS plies only to such "bodily injury" or"property AN INSURED: damage"that occurs before the end of the pe- Any person or organization that-you agree in a riod of time for which the"written contract re- "written contract requiring insurance"to include as quiring insurance" requires you to provide an additional insured on this Coverage Part, but: such coverage or the end of the policy period, a. Only with respect to liability for"bodily injury", whichever is earlier. "property damage"or"personal injury';and 2. The following is added to Paragraph 4.a. of SEC- b. If, and only to the extent that, the injury or TION IV—COMMERCIAL GENERAL LIABILITY damage is caused by ads or omissions of CONDITIONS: you or your subcontractor.in the performance The insurance provided to the additional insured of "your work" to which the "written contract is excess over any valid and collectible "other in- requiring insurance" applies. The person or surance", whether primary, excess, contingent or organization does not qualify as an additional on any other basis, that is available to the addi- insured with respect to the independent acts tional insured for a loss we cover. However, if you or omissions of such person or organization. specifically agree in the"written contract requiring The insurance provided to such additional insured insurance"that this insurance provided to the ad- is limited as follows: ditional insured under this Coverage Part must apply on a primary basis or a primary and non- c. In the event that the Limits of Insurance of contributory basis, this insurance is primary to this Coverage Part shown in the Declarations "other insurance" available to the additional in- exceed the limits of liability required by the sured which covers that person or organization as written contract requiring insurance", the in- a named insured for such loss, and we will not surance provided to the additional insured share with that 'other insurance". But this insur- shall be limited to the limits of liability required ance provided to the additional insured still is ex- by that "written contract requiring insurance". cess over any valid and collectible "other insur- This endorsement shall not increase the limits ance", whether primary, excess, contingent or on of insurance described in Section III — Limits any other basis, that is available to the additional Of Insurance. insured when that person or organization is an d. This insurance does not apply to the render- additional insured under any"other insurance". ing of or failure to render any "professional 3. The following is added to SECTION IV — COM- services" or construction management errors MERCIAL GENERAL LIABILITY CONDITIONS: or omissions. Duties Of An Additional Insured e. This insurance does not apply to "bodily in- As a condition of coverage provided to the addi- jury" or "property damage" caused by "your tional insured: work" and included in the "products- completed operations hazard" unless the a. The additional insured must give us written "written contract requiring insurance" specifi- notice as soon as practicable of an "occur- cally requires you to provide such coverage rence" or an offense which may result in a for that additional insured, and then the insur- claim. To the extent possible, such notice ance provided to the additional insured ap- should include: CG D414 04 08 ©2008 The Travelers Companies,Inc. Page 1 of 2 005835 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" any provider of other insurance which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover. However,this condition does not affect persons and witnesses; and whether this insurance provided to the addi- iii. The nature and location of any injury or tional insured is primary to that other insur- damage arising out of the"occurrence"or ance available to the additional insured which offense. covers that person or organization as a b. If a claim is made or"suit" is brought against named insured. the additional insured, the additional insured 4. The following is added to the DEFINITIONS Sec- must: tion: i. Immediately record the specifics of the "Written contract requiring insurance" means that claim or"suit"and the date received;and part of any written contract or agreement under ii. Notify us as soon as practicable. which you are required to include a person or or- ganization as an additional insured on this Cover- The additional insured must see to it that we age Part, provided that the 'bodily injury" and receive written notice of the claim or"suit" as "property damage" occurs and the "personal in- soon as practicable, jury"is caused by an offense committed: c. The additional insured must immediately send a. After the signing and execution of the contract us copies of all legal papers received in con- or agreement by you; nection with the claim or"suit",cooperate with b. While that part of the contract or agreement is us in the investigation or settlement of the in effect;and claim or defense against the "suit", and oth- erwise comply with all policy conditions. c. Before the end of the policy period. d. The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 D 2008 The Travelers Companies,Inc. CG D4 14 04 08 �4' 14 AMES & GOUGH November 22, 2010 Re: Updated Certificate of Insurance Dear Certificate Holder: You are receiving a new certificate of insurance from Kimley-Horn and Associates because they are consolidating all of their insurance policy expiration dates to December 1St anniversary. There has been no change in insurer, no reduction in coverage or change in policy limits. The enclosed certificate replaces any certificates you have received in 2010. If you have any questions, please give us a call. Best Regards 4 rry; yo tiles Gough 450 Northridge Parkway, Suite 102 A Atlanta, GA 30350 Telephone: (770)330-8327 A Facsimile: (866)550-4082