PROOF OF INSURANCE (2006) CLOSEDTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUIREMENT, 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.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
P
POATR1 XPI p
POLICY
mm
LIMITS
A
GENERALLIABILrTY
GL0904316300
11109105
11/09/06
EACH OCCURRENCE
31,000,009
COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (My one lka
$1,000,000
CLAIMS MADE L_X] OCCUR
INP. CONTRACTORS
$10,000
•
CI NTRACTUAL
INCLUDED
PERSONAL & ADV INJURY
$1000.000
•
lgFPD XCU
GENERAL AGGREGATE
s2,000 000
GEN'L AGGREGATE LIMITAPPLIESPER:
PRODUCTS - COMPIOPAGG
$2,000000
POLICY PRO LOC
A
AUTOMOBILE LIABILITY
AP9 16200
11/09/05
11109106
COMBINED SINGLE LIMIT
$1,000,000
X
ANY AUTO
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
X
HIRED ALTOS
BODILY INJURY
$
X
NON -OWNED AUTOS
(Paraoddanl)
PROPERTY DAMAGE
$
(Paracddenq
GARAGE
LIABILITY
AUTO ONLY • EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$ T
AUTO ONLY: AGG
$
EXCESS LIABILITY
EACH OCCURRENCE
$
IT OCCUR 0 CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
REUNTICN $
....w a
$
5...,
..
WORKERS COMPENSATION AND
°6 ZP'80936177
11/09/05
11/09/06
X WC S TU- o E
_ W...�
EMPLOYERS LIABILITY
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -EA EMPLOYE
', $1 000 000
_9
�.__.—
..._
E.L. DISEASE - POLJCYLIMT
_. - - -. -�
$1 000 000
OTHER Professional._ -....�
_...
®PR9415196
11/09/05
i/_0_5
11/09/06
$1,000,000 per claim
!ability
$1,000,000 anal aggr.
_....
DESCRIPTION OF......... .
PnON of Opg"TIONSILOCATtoNafMICLE CLUSIONS ADDED BY 15NDORSEMENTISPECLAL PROVISIONS
General Liability policy excludes claims arising out of the performance of professional
services
Re- Provide permit processing and other planning services
dw .
Tw Oftifflute o ° sa $ the p III
City of El Segundo, its officials and employees are additional
Insured as
(SaG Attached Descriptions)
CERTIFICATE H'l7LtIER In rNAL ISI R D IaE tLt Ta R._.
-- CANCELLATION ' '. 0
SH OULD AHYOFTH E ABOVE D ESCRIBED POLICES BE CANCELLED BEFORE TH E EXPIRATION
City Of El Segundo
DATE THEREOF, THE ISSUING INSURER WIt4XfflMXW TOMAILAD DAYSWRITTEN
Director of Planning
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHELEPT,
and Building
350 Main Street
El Segundo, CA 90245
AUT ORPBDREPRES ATIVE
�
ornszn 7r5; t7►s71a of l fLQ- 4'%ftA11M4A9R7K
�,ro .._�'',,,,�,���
RI 1 0 ACO'RD CORPORATION 1988
��� a
c r r
A. ' °+ liT. �. 1Mm P= T ",FyG r M Ri+A., OAk "y
io
14r
Poli No. Eff. I1ate of Pal E .Date of Pol
Eff Date ofEnd
Producer
Add'l Prem
'
Return Prem.
GL0904316300 17 /09/05 11/09/06
11109/
Dealey nton
$ N/A
$ N/A
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization whom you are required
to add as an additional insured on this policy wider a written contract or written agreement
B. The insurance provided to additional insureds applies only to "bodily injury", "property damage" or "personal and advertis-
ing injury" covered under Section 1, Coverage A, BODELY INJVRY AND PROPERTY DAMAGE LIABELM and
Coverage B, PERSONAL AND ADVERTISING INXURY LIAR , but only if
1. The "bodily injury" or "property damage" results from your negligence; and
2. The "bodily injury", "properly damage" or "personal and advertising injury" results directly from:
a. Your ongoing operations; or
b. "Your work' completed as included in the "products - completed operations hazard', performed for the additional
insured, which is the subject of the written contract or written agrecrucaat
C. However, regardless of the provisions of paragraphs A. and B. above:
1. We will not extend any insurance coverage to any additional insured person or organization:
a. That is not provided to you in this policy; or
b. That is any broader coverage than you are required to provide to the additional insured person or organization in
the written contract or written agreement; and
2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of:
a. The Limits of Insurance provided to you in this policy; or
b. The Limits of Insurance you are required to provide in the written contract or written agreement.
D. The insurance provided to the additional insured person or organization does not apply to:
1. 'Bodily injury", "property datnage" or "personal and advertising injury" that results solely from negligence
of the additional insured, or
2. 'Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to
render any professional architectural„ engineering or surveying services including
U-G -1175 A CW (9103)
Page 1 of 2
RoMm
am
a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; and
b. Supervisory, inspection, architectural or engineering activities.
E. The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
2. We receive written notice of a claim or "suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured also has rights as an insured or additional insured.
P. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other in-
surance available to any additional insured person or organization unless the other insurance is provided by a contractor
other than you for the same operations and job location. Then we will share with that other insurance by the method de-
scribed in paragraph 4.c. of SECTION TV - C I MEBCIAI, d l'r�,NE1tA 1.'1 U ITX CONDITIONS.
Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as writ-
ten.
U -GL- 1175 -A CW (9/43)
Page 2 of 2
j��