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PROOF OF INSURANCE (2011) CLOSED" ' CERTIFICATE OF LIABILITY INSURANCE OP ID VV DATE(MM /DD/YYYY) HUNTE -2 03/09/11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stephens and Long Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE THIS NOT ATE DOES B AMEND, EXTEND OR 1091 NOShoreline Blvd I POBox 39 ALTER THECOVERAGE AFFORDED POLICIES BELOW, ...... w._v Mountain View CA 94042 Phone: 800 - 964 -8121 Fax: 650 - 964 -0816 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Westchester surplus Lines Ins 10172 INSURER B: afeco Insurance Company 24740 John L. Hunter and Associates INSURER 13310 Firestone Blvd. Ste. A2 INSURER Sante Fe Springs CA 90607 - ®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 TNSR 00 11 _ , , ,,,,,,,,,LI,,,,, POLICY E FLCitw�E POLroCY Eke RATNOIk 4 LT R NSRO TYPE OF INSURANCE POLICY NUMBER DATE MWDD/YYYYL DATE JMWDD(YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2­, 000, 000 A X COMMERCIAL GENERAL LIABILITY G24032644003• 'DAMAGE 10RENTED q 08/05/10 08/05/11 PREMISES (Ea $ 50, 000 CL,41M5 MADE � OCCUR .m _ - MEDEXP (Anyone person) $5®000 PERSONAL & ADV INJURY s2,000,000 X Prof /Pol Prof/Pollution — GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PRODUCTS - COMP /OPAGG s2,000,000 POLICY PRO- LOC ; AUTOMOBILE LIABILITY �X 02CE1863244 COMBINED SINGLE LIMIT $1,000,000 B ANY AUTO 08/05/10 08/05/11 (Ea accident) u. ALL OWNED AUTOS „I BODILY INJURY $ SCHEDULED AUTOS (Per person) HIREDAUTOS - BODILY INJURY $ NON -OWNED AUTOS (Per accident) ...... .. _ e, .._. PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO 7 1­11­111111 ,, ,,,,,,,,,,,,,,,,, , OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ A OCCUR CLAIMSMADE G24084322002 08/05/10 08/05/11 AGGREGATE $ 1,000,000 DEDUCTIBLE , RETENTION $ $ WORKS S S LSA IDN AND EMPLOYERS' LIABILITY a jj �I'ORM_LtM1T5 � ER Y / N _ 1�... „,,,�„_ ANY PROPRIETOdV'PARTNERIEXECUTIV EL EACH ACCIDENT $ ON"FIDFRIMiEM IER EXCLUDFO ? ��„ ..., ...... � � w. 10 NH (Mandatory I E L DISEASE - EA EMPLOYE $ If Y desaft under SPECIAL PROVISIONS below SE - POLICY LIMIT $ E L DISEASE OTHER A Pollution Liab and G24032644003 08/05/10 08/05/11 Limit 2,000,000 Professional Liab Clms Made DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate Holder is named as additional insured as required by written contract. Per ENV3101 & ENV3143 Attached. ** *Reprint of cert issued 8/6/10 *Except 10 Days Notice of Cancellation for Non - Payment of Premium CERTIFICATE HOLDER CANCELLATION 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 City of E1 Segundo 6 Attn: Rebecca Sum1 REPRESENTATIVES. 350 Main St. AUTHORlIZEDREPRESEN'TAT'IVE r ACORD 25 (2009101) C _ 1988 -2009 AMR -(5-ORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 1,4 .. a .p ..,,.. �,. .. _.�_ .,_ _._ _ _ .. at w n:'fiv =• ti U „.rP ,0 0 � John L, Hunter a Associates, Inc. �l ply'v 24032 CC 5 1111Q :c�... ou'i05)2'lltl 08,105/2011) .. .I .,...... . Westchester Surplus Lines Insurance Company ...�....._, Insect Iho Lc n y nomber. Tw romainder or the mfc,rnlal rr Is I be com lOod uiil wha” IN � r w � , , i , �• p y ®y oi>do,sumrnl ls,usund subacquonl to 16r. rxrpsrol!on ul th,a Pc!icS' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON-CONTRIBUTORY) This endorsement modifies insurance provided under-the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: rrr. e1pniago rr; Any person or organization that Is an owner of real property or personal prop" on whtch you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you., w such request Is made prior to commencement of operations. (B6no�ntry appears aoiae, Ir"��a�m�at(i�rr �etiui�edmmlc� ccarnpgete whis nrioetr�a�ttenC m.. shp�rn in �Fae l�cl�ati as applicable to this endorsement.) SECTION II - WHO IS AN INSURED is amended to include: A. SECTION II • WHO 13 AN INSURED is amended to include as an insured Elie person or organization shown In the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional Insureds, thefollowing exclusion Is added: 2. Exclusions / This insurance does not apply to bodily Injury�r property damage-111ccurring after (1) All work, including materials, parts or equipment f nlshed in connection with such work, on the project (other than service, mainionancl or repairs) to be performed by or on behalf of the additional Insured(s) at the site of ie covered operations has been completed; or (2) That portion of your work oul of which the injury or amage arises has been put to its intended use by any person or organization o -er than another contractor or subcontractor engaged in performing operations for 1 principal as a part of the some project. C. The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV -: 1CA (09 -04) piYC' awte. w ¢xjpyfeghI(,Id wvp,au 40 *f Pl uerarI" O uliu'"aw Jry %WI rfa 'Nuo " ar 1 hl�nle:t p3ti6f(e Ef �. ...'�_. - V Y ,� ri xp hirYIX John L. Hunter & Associates Inc_ 7pr t N,, 311 I ,,..... ....,...�...... m,.,,,,. .»„.._ ._..�....._...�, W„ .,,...,,,,Y,..amP , w .. ..� ... nM L?pw 4 p 62d 4 0Y n3. 26 44003 J 0n "0r� +1u0� 5d /2010 TO 08105120.11 /k�Z66V@ �eB Q yp09 Ab i�Wp.Yr Chaly��ifGpP 8✓ { „T��m,h+ e(;anldr{,Alp} J Westchester Surplus Lines Insurance Company i l8ctl !lie policy number. The rematndernf vieuilmmedon i3 lobe compiled Onlywhan this midolsement Is issued aubsequcnl io the preparation or lhr. policy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAL) IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART S'CHEU!L Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, Information required to completethls endorsement will be shown In the Deelaratlons as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We wave any right of recovery we may have against the person or organize lion shown In the Schodule above becaiuse of payments we make for injury or dafrwags arising out of your ongoing operations or your work done under a contract with that poison or organi°zatlon and Included in °(he products- comptated operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. �-..J�N` -3 M ial;���uWir 8o ii�.Ii.i i a t�,t,',rc', a�'(r1lwVe,r nl IIvrrM d'al” 0 suvi raioIa�TM : u ai ,�:,�,� u.".' +d� �«�, Ili'ic �,6i h uW ia�mn; s a an�. o ",��'Ie '1 ��:�i ti POLICYHOLDER COPY Sc ISSUE DATE: 03 -09 -2011 THE CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO CA 90245 -3813 P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GROUP: POLICY NUMBER: 1113148 -2011 CERTIFICATE ID: 132 CERTIFICATE EXPIRES: 01 -01 -201 01 -01- 2011/01 -01 -201 SC This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer, We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Re presentative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2011 -03 -09 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: THE CITY OF EL SEGUNDO ENDORSEMENT #1600 - JOHN L. HUNTER, PRIES, SECRETARY TREASURER - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01 -01 -2000 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER JOHN L. HUNTER & ASSOCIATES, INC. 6131 ORANGETHORPE AVE STE 350 BUENA PARK CA 90620 SC [MS6,CNj PRINTED : 03 -09 -2011 (REV.8-2010)