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PROOF OF INSURANCE (2013) CLOSEDOP HF . 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. IM'P,6R_`fA_N_T: '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 enclorsement(s). CONTACT PRODUCER 951-676-3365 NAME, Heidi Farman! ------- United Agencies, Inc. (M) PHONE FAX -676-3020 CA License #0252636 951-676-3020 IArCNrt,X-xI051_676-3365 (A/C N.) 951 27403 Ynez Rd., Ste. 110 A6URLSS: hfarmani@unitedagenci,es.com Temecula, CA 92591 PRODUCER BELLB-1 Ryan E. Hollander CUSTOMER ID C /wavnEo Bell Building Maintenance Co Mrs. Yang Chonhee 517O Sepulveda 8hd,#1UV Sherman Oaks, CA914O3 COVERAGES CEPT|F|CA U AFFORDING COVERAGE weunsnA'pm*server Insurance Compainy�_ INSURER o. Century nV mSuRsR C, _ NguRsnP: INSURER E; [ON NUMBER: ._�mmoo 36951 /x/s IS ro osenrv THAT THE pouo/so or |wsyeamcs uanEo esI OW HAVE BEEN mouEo To THE |muunEo w*mEo xaovs FOR THE pouc, pemuo /wo/uArso NOTWITHSTAN DING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 'zx//r/oxrs MAY BE /ssuso on MAY psnr*/w. THE |msun*mcs xrronosD BY THE Pouc|so oseonmso HenE|w IS SUBJECT ro ALL THE TERMS, L X(A IJmONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TYPE OF INSURANCE LIMITS oswswuuArM /r/ X rowwpnnxx ucwcumI meun, �w/wx 110^us X occun ^,w. *x.x'u^/I,/Iw^*uox,m X � Aorowoauc1.mmun ANY A,- I( ~/' vmm^vnn uc/Louuomunu x»aoAUnox wnw�owwro^uHou uMsReuwuwa oocon EXCESS LIAB CLAIMS-MADE ----- � EACH OCCURRENCE 1�00,001 X X 011110M2 01110113 100�0 / person) w 6,00 PERSONAL uxovINJURY m 1,000,001 GENERAL AGGREGATE |m _2,000}001 .pnoouora - uoMpIO 1 paoa|� ,0��� , 00( .0 -------� WOnK11HnoCOMpewoArmw AND CAI p OYsnruAb/l, nr YIN �orv/oomr n,wsmsxe,�nvs [-- w/^ '*w'w�new�uucr / J (m�mwm,mwm e VEHICLES tAtloch ACORI) 10 1, Additional Flouiaoks Srhoduto, It more space is required) "The City of f" I Seoundo and Its Officals and Employees are additional insured dw rounder In relkion to those operations, usei, occupations, act$, and aojvifles described generally above with regard to operations )erformed by 'of ol"I behalf of the, ninned inSUred where required by contracNEXT PAGE CERTIFICATE HOLDER CANCELLATION _ ELSEGUN 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. PUBLIC WORKS 150 ILLINOIS ST AUTHORIZED REPRESENTATIVE EL SEGUNDO, CA 90245 —/20, @1qD8-%VO9ACORD CORPORATION, All rights reserved. AcORD%s(%VV9/Oy) The ACORD name and logo are registered marks oyACORD COMBINED SINGLE LIMIT $ (Ea acm»rw BODILY INJURY (Per parson) $ PROPERTY DAMAGE S (Per accident) EACH OCCURRENCE S wCC 0004991 05102111 , 05/02112 E 1. EACH ACCIDEN 1- 1,000,0( e VEHICLES tAtloch ACORI) 10 1, Additional Flouiaoks Srhoduto, It more space is required) "The City of f" I Seoundo and Its Officals and Employees are additional insured dw rounder In relkion to those operations, usei, occupations, act$, and aojvifles described generally above with regard to operations )erformed by 'of ol"I behalf of the, ninned inSUred where required by contracNEXT PAGE CERTIFICATE HOLDER CANCELLATION _ ELSEGUN 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. PUBLIC WORKS 150 ILLINOIS ST AUTHORIZED REPRESENTATIVE EL SEGUNDO, CA 90245 —/20, @1qD8-%VO9ACORD CORPORATION, All rights reserved. AcORD%s(%VV9/Oy) The ACORD name and logo are registered marks oyACORD 114,1 011 CGL 1816 0106 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE. READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - PRIMARYAND NON'- - TRIRUTORY COVERAGE This endorsement modifies insurance provided under the following: CONTRACTORS LIMITED CLAIMS MADE GENERAL LIABILITY COVERAGE FORM CONTRACTORS LIMITED CLAIMS MADE AND REPORTED GENERAL LIABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organization (s): City of El Segundo rg Its officials, officers, employees, agents and volunteers 350 Main Street El Segundo, CA 90245 SCHEDULE Location(s) Of Covered Operations ARIOUS LOCATIONS PER CONTRACT WITH THE AVE INSURED. A. Section II — Who Is An Insured Is amended to 2. That portion of "your work" out of which the include as an additional insured the person(s) or injury or damage arises has been put to its organization(s) shown in the Schedule, but only intended use by any person or organization with respect to liability for "bodily injury', "property other than another contractor or subcontractor damage" or "personal and advertising injury" engaged in performing operations for a principal caused, in whole or in part, by: as a part of the same project. 1. Your acts or omissions; or C. It is agreed that the insurance provided for the 2. The acts or omissions of those acting on your benefit of the above additional insured(s) shall be behalf; primary and non - contributory, only with in the performance of your ongoing operations for respect to liability for "bodily injury", "property the additional insured(s) at the location(s) damage" or "personal and advertising injury" designated above. caused, in whole or in part, by: B. With respect to the insurance afforded to these 1. Your acts or omissions; or additional insureds, the following additional 2. The acts or omissions of those acting on your exclusions apply: behalf; This insurance does not apply to "bodily injury" or in the performance of your ongoing operations for "property damage" occurring after: the additional insured(s) at the location(s) 1. All work, including materials, parts or equipment designated above. furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CGL 1816 0106 Includes copyrighted material of Insurance Services Office, Inc. with its Page 1 of 1 permission. U 150 Properties, Inc.,2004 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER RIGHTS OF RECOVERY AGAINST OTTERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE ame of Person or Organization: NY PERSONS OR ORGANIZATION AS REQUIRED BY WRITTEN CONTRACT TO BE PROVIDED WAIVER F SUBROGATION. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or ,'your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of I HOLDER CODE , SEGUN BELLr PAGE 2 ,NOTEPAD: INWIM'S NAfmE %Wil Building Maintenance Co. OP ID: "`, DATE 01109112 Coverage is primary & non-contributory; waiver of subrogation applies.