Loading...
PROOF OF INSURANCE (2015) CLOSEDACC W" CERTIFICATE OF LIABILITY INSURANCE IDATE,MNV °D/YYYY) 6/27/2014 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 15 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 hdlder in lieu of such endorsement(s), PRODUCER Risk akratB les Company... NOA,hNtC CONTACT .... Risk S)rategles olrl ap p.... y 2040 lain treet, Suite 450 PHONE FAX Irvine, CA 9!214 ...........4s z4z 9240 N) ................ www.dsk -strategies.com CA DOI License No. OF06675 INSURER Citizens Insurance Co. of America 31534 ..... -- ........_ ......... .... --- -....- .................. INSURED INSURER B: Allmerica Financial Benefit Ins. Co. 41840 P2S Engineerin , Inc. ..... ..... 5000 . Sprin 9$., 8th Fl„ INSURER C: Hanover American Insurance Co. 3.6.034 Long Beech � 90815 INSURER D: Continental Casualty Co. 20443 CUVFRAGFS CFRTIFICATF NUMRFR rrrly rear' REVISION NUMRFR: 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 .... .......... ... .... -... ,_.AbbL1re69- _.- aoLICYEFF I�OL4CYEXP_� ., ......._._, TYPE OF INSURANCE INSO WVQ POLICY NUMBER LIMITS A COMMERCIAL GENERAL LIABILITY Y/ OB3914484603 7/1/2014 7/1/2015 EACH OCCURRENCE $ $1,000,00 ... CLA1MS-MADE ,/ OCCUR - C1A1W1AC�i".'1 C1 FdE�N�"CrN °-- PREMISES _(F-a IF- ----- $1,000,000 .MED EXP_(Any one person) $_ _ $10,000. .............. _ ... PERSONAL & ADV INJURY ....--- ._............_._.. $ $1,000,000 ,..... GEN'L AGGREGATE LIMIT APPLIES PER: IGENERA L AGGREGATE $ $2,000,000 ...... POLICY , JECT 1A LOC PRODUCTS „- COMPIOP,AGG $ $2,000,000 OTHER:. 1; $ B AUTOMOBILE . LIABILITY AW3912284203 7/1/2014 711/2015 COMBINED SINGLE LIMIr -(Ea accident)_ ...... $ $1,000,000 ANY AUTO BODILY INJURY (Per person) $ ,. -.- . -. ALL OWNED ------ SCHEDULED .... BODILY INJURY (Per accident) ---- ----- $ ..----- AUTOS AUTOS ` -- --- ......... .. ........... ............ ----.....------.....__.....----------------- NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS .. -_.% -. AUTOS ....(Per a gent)......... ...__ ................_________ - . _ $ A . UMBRELLA LIAB OCCUR 063914484603 7/112014 7/1/2015 EACH OCCURRENCE $410000 EXCESS LAS CLAIMS - MADE'.. "I ­ I "i ................ AGGREGATE $ $4,000,000' DED RETENTION $ � Z $ C WORKERS COMPENSATION WZ391226270 711/2014 7/1/2015 / PE oRH AND EMPLOYERS' LIABILITY YIN T .. .. . M ................... .. ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT $ $1,000,0Qd OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N I A ,,.., .,. .. EL DISEASE - EA EMP pYEE ...................... $1 OOO,OOO If yes, DESCRIPTION OF Or PERATIONS below E 1 DISEASE - POLICY LIMIT $1,000,000 D Professional Liability AEH288283306 3/7/2014 3/7/2015 Per Claim: $5,000,000 Aggregate: $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Projects as on file with the insured including but not limited to El Segundo ABF Contract. City of El Segundo, its officials and employees are named as additional insureds and primary/non- contributory clause applies to the general liability policy and a waiver of subrogation applies to the work comp policy-see attached endorsements. CERTIFICATE HOLDER CANCELLATION City of El Se undo City Clerk's gep artment ( Attn: Fiona Shilling 350 Mae n Street El Segundo CA 90245 -3313 ACORD 25 (2014101) 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 (BSTN) Mike Christian ©1988.2014 ACORD CORPORATION. All rights reserver?. The ACORD name and logo are registered marks of ACORD f� C%Pa`II" Nrw.> 20691P1.'7"7 iGYTVFPKre :➢xarn:Y vr+uun.19 6d27(24)14 8,.32r01 NR 0Pca "II'9 11?agy,. .D. of. a V 0 0 I POLICY NO.:OB3914484603 INSURED: P2S Engineering, Inc, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY SUPPLEMENTARY ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM 9. Additional Insurer! by Contract, Agreement or Permit Under SECTION II — LIABILITY, C. Who is An Insured, Paragraph 4. is added as follows: a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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, but only with respect to: (3) "Your work" for the additional insured(s) at the location designated in the contract, agreement or permit; or (4) Premises you own, rent, lease, control or occupy. This insurance applies on a primary basis if that is required by the written contract, agreement or permit. b. This provision does not apply: (1) Unless the written contract or written agreement has been executed or permit has been issued prior to the "bodily injury ", "property damage" or "personal and advertising injury"; (2) To any person or organization included as an insured by an endorsement issued by us and made part of this Policy; (3) To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily injury", "property damage" or "personal and advertising injury" arises out of the sole negligence of the lessor; (4) To any: (a) Owners or other interests from whom land has been leased which takes place after the lease for that land expires; or (b) Managers or lessors of premises if: (9) The occurrence takes place after you cease to be a tenant in that premises; or (ii) The "bodily injury", "property damage" or "personal and advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or (5) To "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services. This includes but is not limited to any professional services as an architect or engineer arising out of any construction agreement or activities under which any insured or anyone acting on any insured's behalf provides or provided service, advice, expertise or work. Construction includes, but is not limited to, the plan, conception, design, build, construct, assembly, development, safety, erection, formation, reconstruct, rehabilitation, repair, or any improvement made to real property. Construction also includes the hiring, supervision or management of any of these activities. However, this exclusion does not apply to liability arising out of an insured's presence at a jobsite that was not caused by professional activities listed in the above paragraph. c. Additional insured coverage provided by this provision will not be broader than coverage provided to any other insured. d. All other insuring agreements, exclusions, and conditions of the policy apply.. 11. Additional Insured by Contract, Agreement or Permit —Primary and Non - contributory The following is added to SECTION III — COMMON POLICY CONDITIONS: M. Other Insurance 1. Additional Insureds If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION Il - LIABILITY, Part C — Who is An Insured, is primary and non - contributory, the following applies: 391 -1586 02 11 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 1 of 3 CSAT ND.: 20691177 (LRM) Sherry Young 6/27/2014 8:32:01 AM (PDT) Page 2 of 5 If other valid and nmllec@de insurance is When this insurance is excess, me will have available 8u the Additional Insured for mloss oo duty under SECTION H— LUUB|LO-Y we cover under SECTION ||—LIABILITY, Part A. Coverages, i. Business Liability to Part /\. Coverages, Paragraph I,Business defend the insured against any ^suit''ifany Liability our obligations are limited as other insurer has o duty to defend the follows: insured against that .ouir.|fno other insurer a. Primary Insurance defends, we will undertake todoso, but we will beenOded tu the inewmd'm rights against This insurance is primary to other all those other insurers. insurance that in available to the Additional Insured which covers the When this insurance is excess nva, other Additional Insured aaa Named Insured. insu,unma, we will pay only our sham of the amount of the loss, if any, that exceeds the We will not seek contribution from any sum of: other insurance available to the Additional Insured except- (1) The unto> amount that all such other insurance would pay for the loss in the (1) For the sole nagHg000* of the absence uf this insurance; and Additional Insured; ^ (@) The total of all deductible and self- (2) When the Additional Insured is an insured amounts under all that other Additional Insured under another primary liability po|ioy� insurance. . �) VVhon�.���bo|mwapp|i*o� VVev�Ueham*m remaining loss, � any, with ' any other insurance that is not described in If this insurance is phma,y, our this Excess Insurance provision and was not obligations are not affected unkaeo bought specifically to apply in excess of the any of the other insurance is also Limits of Insurance shown in the primary. Then, we will share with all Declarations of this Coverage Part. that other insurance bythe method donohbedinb.(��below. C. ��gho��Y8ho�ng h. Excess Insurance If all of the other insurance permits contribution by equal ehomo, we will follow this method also. This insurance is excess over: Under this approach each insurer nonhibuUao (1) Any of the other insurance, whether equal amounts until it has paid its applicable limit primory, oxoosn, contingent or on of insurance or none of the |000 mmains, any other basis: whichever comes first. (a) That is Fire. Extended n it |f any of other insurance mnno d oea no t permit Coverage, Builder's FVsk, contribution by equal shams, we will contribute Installation Risk or similar by limits. Under this mod`ud, each insurer's share coverage for "your wod('; is based on the ratio of its applicable limit of (b) That is Fie insurance for insurance to the unue| applicable limits of premises rented to the insurance ofall insurers. Additional Insured or ]||. Aggregate Limit oy Insurance (Per Project) temporarily occupied by the o. For purposes of the coverage provided by this Additional Insured with endorsement, O. Liability and Medical permission m* the owner; Expenses Limits oK Insurance under Section U (o) That io insurance purchased by — Liability ia amended by adding the following: the Additional |msmed to cover The General Aggregate Limit under D. Liability the Additional |noumd^s liability and Medical Expenses Limits of Insurance an a h»neni for "property applies separately u,each uf "your projects" or dumage/' to premises rented to each location listed in the Declarations. the Additional Insured or uompomoh|y occupied by the b. For purposes of the coverage provided by this Additional Insured with endorsement F. Liability And Medical pomniuoiumofthoovner- or Expenses Definitions under Section |i ' Liability io amended by adding the following: (d) If the loss arises out of the maintenance or use nfminr a�. , a. Yourproject" means: "auhos^ or wobormo# to the i. Any premises, site orlocation at, on, or extent not subject to Exclusion in which 'your wmdf' is not yet g.nfSECTION U—LIABILITY, completed; and Part A. Coverages, 1. Business Liability. ii Does not include any location listed in ' the Declarations. 391'15860211 Includes copyrighted material of Insuranoe Services Offices, Inc., with its permission Page 2ny3 IIV. BlainilketWalweretS�u brogatkom - ji � CERT NO- 20691.1'77 (ravu) Sherry Young 612712014 8�,32.01 AN (Pepe) Paga 4 of 5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless otherwise stated. This endorsement effective o /1 t at 12:01 am standard times forms a part of Policy No. WZ39122 270 Of the FianoverArnerican Insurance Co. issued to: P2S Engineering, Inc. Premium if an $ M Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.000% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION WITH WHOM YOU AGREE IN WRITING TO WAIVE YOUR RIGHT TO RECOVER AGAINST THEM. YOU MUST AGREE TO THIS WAIVER PRIOR TO THE DATE OF LOSS Job Description: Projects as on file with the insured WC 252 040 84 CHR'lir MG.: 'l.'.(P6ab L1-1a (IRVN) Sher,:V rroungp 6/212014 a32 1 Nq OV90 P.9e 5 of