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PROOF OF INSURANCE (2012) CLOSED00 ° ' DATE (MM /DD /YYYY) 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. the tO�Rms and If the conditions the lder is an policies ADDITIONAL may an endorsement. ONAL trDre sust state ment endorsed. If SUBROGATION IS WAIVED, subject to on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME Bri.a s_a1_ .,..m P &H Brokers Inc. PHONE.... FA'X -- 1055 Ex'anklin Avenue (AICJNP <Ext),5,1...h ..,41.4....86,04 ..- �.WCt 001!6.7 I -. 3t� ' .,1(1 ".7 J, EMAIL Suite 200 Darden City NY 11530 UNSU §C ii�SAPOIDINF,COVERAGE NAIC# pNSURERA:C.omme.ice,,.a,L1d ....._ aduaImTV. .[n_9 ..CL?.........-- --..._ ..9.41Q INSURED GV f l:,riwil °<>t7merlta.L. Serv.J.c(..y s Szlr; . pNStaR�RC:N W ....... d /1'b /a. I,V . ] ci l l t y Services INSURER D: 718 N. llxriLota Street w® O ran.gt.:.. ('A. 92863 INSURER E: .... .,.,. .,_ ........ .....,..:..�,.,. ��.._......®.. INSURER F: COVERAGES CERTIFICATE U 43857663 REVISION NUMBER: THIS IS TO CERTIFY .. L.OW HAVE BEEN ha,:(6k'.C) I tiJ lI }1� INSURED NAMED ABOVE a� OR TFIE I L�I,h�,� THAT THE POLICIES OF INSURANCE I_ISII•D 13E � ' _ + 7 IL��) 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. INS TYPE OF INSURANCE IIVD R sU-RR POLICY NUMBER .. _. .. �, ....,. ...... POLICY EFF POLICY EXP ......mm.._.,, _(MM /44(YXYY, IMM /DDIYVYY _.. LIMITS A GENERAL LIABILITY Y' Y PROP'7("33((r G 7/1/20_11 7/1/2012 I AC.1 -I OCCURRENCE: $2,000,000 X COMMERCIAL GENERAL LIABIU 6AMAGE "I O YtENrrD -- . ....__ PREMISES (Eagccurrenre) $300 000 CLAIMS -MADE OCCUR MED EXP A n ..Y. one e .c .._,.. _..P .rson) $1211, 000....... ........ X Vol l Irrc luderi PERSONAL 1,ADV INJURY `�2, 000, 000 x l,e.ud A. ,be Moo ri.... GENE IRAI_ A("CaI�EGA C-I. fGt0, 000, 000 / / .,Y...� ...d 1E I IIMI f � APPLIES : _... /JP„ _...�.� R<� O DII� C L.- ....'f ..P. ICP�3O1 Mw,pIP'PTOLEI fiA®I UC ._ w ..$� „ 2w , 0. 0_ 0, 000 df- ' � AL - POLICY _1JO__ AUTOMOBILE LIABILITY Y Y P IG 3:itr, 7/ 1/2011 7 /7 ........ ...._.... 12 (F i acckd"'irt) _... -- _„ 1, 000, 000 x ANY ALITO BC. IDII...Y IMAJI i.Y (Per person) $ ., a BODILY INJURY Per accident _.. _ . .....me�, ALI OVVIVII.:D ;CI II UI71.( -1::1 .... AI.11 C7 :v All COS ( ) PG !{ I- NON OWNED .z ICJI,a R r7UAMACrE IItI) AUTOS X AUIOS UMBRELLA LIAB X OCCR Y Y ,.: p rlja r._a ..s . . 3rpr y .....-- ....�. 111 /.�, raa l._! .2 .0_._:1..�2 � AC H OCCI RRI NL F �.._ - 9 9U000,..000 EXCESS LIAB CLAIMS -MADE AGGREGATE ()00, r, ooa A X .,....,m..�....m.m... . X m IDiV$1r1 000 ..�..,., WORKERS 4' INS Ni I C.�... _.�...,m,,.....e.,,,..� /_� - ...... �, N �'. Pl o' h , �f. �! r, ......q...,�,..,...? 7/1/201.1 1 / 2 01.1 � a / 7_ � 2 01 2 .,..,,,... � rrdRY I I Nl7 � . �...- ,��.. � .....�. [ V ND I:MFn_ OCERS' IV A ION N/A VV C; ACC Gill I,1 -1. CU I I OIUY R �n IE +F�IIZ1iN IA I NrlHVIE...XECUTIV 1 y r r L Aryl d I1 r .. l k Ei (Marldatory In NI "{) �•� '� 1° 1 DISI'.A,A A R -N[ 1 OY I $ 1 , w)F , (ioC1 If yes, deserbe under _ ._ .._,., _ LbI Cltll [ION OI - P-I�AI IC7N lacicrw L 171 I::A OLICY IMI r $1 UvkO r1pG .- .. -_._ I r.r�,r:�ri L r.ul r: ^. ri 1; uz an�i�^ivC.,...,...,. ,.,,...,. .. LYU k3C11.� ..... ,. . m..,.w._ .. .._...._...... .,,,,� ..-._.� .. ........ .... ... .._.......,,_LS1...„,,,, _...,.OL IMI .,., ..._ -(j - -_- _.. -. -- / q pl :.. ^J'1'^1 ;d 7/1/2011 //1/2012 r. 1r��.a.p.ad I= "raa�rn�i. Incl.. 111:SCRI TION0 061 : ITRmmA.nm oI.g� S 1I.00A'r1ONSlVOIRCII.I; ma (A4a:..h ._ AwG,., O tl11P1, .Additional -Remarks S�e,..h.ee.t.P.ule, if mora .... .�,...�.. ..m. ,_.,m.� „ �.,,»... � .._.�,,.....�..�.._.,m.._._... ,.�.._.....,.. .... space is rucNwlrr:ci) Re: City of. E,1. Segundo M(. :A.d., 350 Ma.l ri. Sty. -c t :CaV C .Job W251009, Cc.rt::. 1`1111929. C:.i..ty of E L Segl_Lra o, it „s o:t f 7 c:i_ra._I_s arid. rarrrpJ oyees cil fu na.rned as Ad.d:.i..ti oral. lrlsu eds o:r7 a l_)rJ Fia..r'y tend. n.orr- c:orlt y'i btit:o.ry )aas. s w ..tla rc =,sporty:; to a.l.l po:l..Ic;i.e (.1xce.rt. Worker's C'cnuprxn.sa.Li : rn as requ.il,ed by w:r. °itl en contract. CERTIFICATE HOLDER y ®— CANCELLATION 3 i) Days Notice of ari.ce.11atiori � W 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. 350 Main Street El Segundo CA 90245 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ENDORSEMENT NO. 12 d This endorsement, effective 12:01 AM, July 1, 2011 Forms a part of Policy No: PROP7633866 Issued to: LVI Environmental Services, Inc. and all subsidiary companies By: COMMERCE AND INDUSTRY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, WAIVER OF SUBROGATION - SPECIFIC PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICY SCH Name of Person or Organization: BLANKET WHERE REQUIRED BY WRITTEN CONTRACT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) It is hereby agreed that SECTION IV, Conditions, paragraph 9. Subrogation is amended to include the following: We agree to waive this right of subrogation against the person or organization shown in the Schedule above to the extent that you had, prior to an occurrence or claim, a written agreement to waive such rights. All other terms, conditions, and exclusions shall remain the same. NOTICE: Pf.%.iW!' C0,21i Will IN, - PAI'US APE t use natu Dine tes,_ ere applicable) .�,�._.. EXEMPT R,,, g ( r e 'wVk,44 '^ % i fl° k l °a; R i G RATES 78011 (� lid:'dilr��1� ° i �a ace Services PAGE 1 OF Cil"2 �ti,�� «w �r,Po�p�� awn °'� �r ion. R r r Ices Office, I , 1992