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PROOF OF INSURANCE (2013) CLOSEDDATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE,l_� 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 Dealey, Renton & Associates 199 S Los Robles Ave Ste 540 Pasadena, CA 91101 526 844 -3070 INSURED Fernald, Inc. 4821 E. 2nd St. Long Beach, CA 90803 562- 439 -3555 INSURER B: INSURER D: INSURER F: INSURER(S) AFFORDING COVERAGE COVERAGES CERTIFICATE NUMBER: 974175488 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„ iNs..m... ......m .. -. . DL UBR POLICY E PMID Y EXP - - LTR TYPE OF INSURANCE IN R WVD I POLICY NUMBER MM /DDNYFF YY MM /DD/YYXY LIMITS A GENERAL LIABILITY Y 8074531-647 /17/2012 1/17/2013 EACH OCCURRENCE $1.000,000 CANiACI TOAFRTrI COMMERCIAL GENERAL LIABILITY PREM15E (Ca opcvrerroce) $1,000,000 CLAIMS -MADE 1XI OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 TE 000 GEN'L AGGREGATE LIMIT APPLIES . ES PER: PRODUCTS COMP /OP AGG . -. ................. .......... $2 000 000 ........ .. ., .... POLICY "Y" PRO. LOC $ B AUTOMOBILE LIABILITY Y BA7454L275 1/17/2012 /17/2013 COMUMD SINGLE LIMIT {Ea accident) .. ..... 1, 000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X X NON -OWNED PROPEkTl'DAd41ACx>w HIRED AUTOS AUTOS (Per accident X NoOwned Auto $ UMBRELLA LIAB OCCUR .. ............. %% EACH OCCURRENCE .ee, ......._.... $ ,,,,. .. .... -m„ ..,. EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION .H- AND EMPLOYERS' LIABILITY YIN VICITINA - ANY PROPRIETOR /PARTNER /EXECUTIVE E L EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? ❑ N / A - (Mandatory in NH) EL DISEASE EA EMPLOYEE $ If yes, describe under ..... ...... ".'....'........... DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT 1 $ C Professional Liability 105409913 /24/2011 124/2012 $1,000,000 Per Claim $2,000,000 Annual Aggr DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) General Liability excludes claims arising out of the performance of professional services. RE: City of El Segundo TI -- *The City of El Segundo, its officials, officers, agents, certified volunteers and employees are named as additional insured as respects general & hired /non -owned auto liability for claims arising from the'operations of the named insured as required per contract or agreement. kor-K I Irrl:A I r "ULULK L;ANU L.L.A I Ir„ N Hsu LfaV1'I U L1aV Tor Non- Favmr)'t of rrem City of El Segundo* Attn: City Clerk 350 Main Street El Segundo CA 90245 -0989 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 11 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 6807453L647 COMMERICAL GENERAL LIABILITY ISSUE DATE:2 /9/2012 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGA T O 'i'S): City of E1 Segundo* Attn: City Clerk 350 Main Street E1 Segundo CA 90245 -0989 PROJECT /LOCATION OF COVERED OPERATIONS: *The City of El Segundo, its officials, officers, agents, certified volunteers and employees -- RE: City of E1 Segundo TI PROVISIONS A The following is added to WHO IS AN INSURED (Section ll): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for bod- ily injury", '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 oper- ations; 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 person or organization has assumed liability in a contract or agreement. CG D3 82 09 07 The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render- ing of or failure to render any "professional services ". e. 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 Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF 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, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission Page 1 COMMERICAL GENERAL LIABILITY Coverage 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 additional 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; after you have entered into that "contract or agreement requiring insurance" for such additional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when the additional insured is also an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the project, or at the location, shown in the Schedule above, performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal 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 under which you are required to include the person or organization shown in the Schedule as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury" 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 effect; and c. Before the end of the policy period. CG D3 82 09 07 Page 2 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission POLICY #: BA7454L275 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions ofthe Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 2/9/2012 Named Insured: Fernald, Inc. Countersigned By: SCHEDULE �_,_ thorized Representative .................... Name of Person(s) or Organization(s): *The City of E1 Segundo, its officials, officers, agents, certified vol ers and employees -- RE: City of E1 Segundo T� (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 ACO °® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 02113/201 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Shawn Nobles ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 22931 Triton Way #231 _Laguna Hills, CA 92653 INSURERS AFFORDING COVERAGE NAIC # INSURED .... INSURER A• EMPLOYERS CASUALTY CO. FERNALD, INC. INSURER B: 4821 E. 2ND ST. INSURERC m'' LONG BEACH, CA 90803 ER D ...... ._......w ..... ---- .............. 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. NSRt _..,...m a POLICY... NSA, DO I.. NUMBER w�m. FFECTIVQPOLICY EXPIRATION ......._.. POLICY E LIMITS _. GENERAL LIABILITY .._... EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY I P,mREMISES (�"� ue�.rasurarru-eJ $_ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ _ m,m... - GENERAL. _.... AGGREGATE $ .. ., GF.. LIMIT APPLIES PER: PRODUCT 5 COMPlOP AGG $ PRO'- POLpCY OC �..�.- ..� „.. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) _..... __.__.__,.., .. ....._ . -...._ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $....... . .... ........... ........._........� ........ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ ... . .. $ DEDUCTIBLE RETENTION $ IT.. mm ITIT $ A X YIN 7�.RY.LIMIT -E ANY EEXLDED PROPRIETOR/PARTNER/EXECUTIVE 115488502 ..�,FR ^.. .......'.. 06/08/2011 06/08/2012 L EACH ACCIDENT $1 000 000 (Mandatory In NH) If yes, describe under 1 000 000 .E L:,,,DI9EASE EA EMPLOYE '. $,,,,, �� a� _. ..,,.., SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1 000000' OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS DESIGN SERVICES CERTIFICATE HOLDER r” rANrFI I ATtr)KI CITY OF EL SEGUNDO ATTN: CITY CLERK 350 MAIN ST EL SEGUNDO, CA 90245 -0989 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ACORD 25 2009101 0 ) 1988 -2009 ACORD CORPORATION. All rights reserved. O The ACORD name and logo are registered marks of ACORD