PROOF OF INSURANCE (2014) CLOSEDHIGHPOI OP ID: TO
w -
CE TIFICA TE F LIABILITY INS A►I CE DATE(M Y)
09/119/13 9/13
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(les) 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 endorsementtal.
PRODUCER
AAA Club Services, LLC
P.O. Box 25443
Santa Ana, CA 92799 -5443
Shari Huggins
PROW. .... 888 16 -2402 n
88-416 -2402 PHONE Auto Club Insurance A e
c LLC
213- 741 -3005 ,a,rW „d.. r.,,,
NAIC 0
INSURED
23720 Poser Lane
West Hills, CA 91304
INSURER A: CNA
C:
E:
COVERAGES CERTIFICATE NUMBER- 1 e�ilclnal w iaaceo.
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.
IN'SIT • _ . -
CYDE UOR
L'TR TYPE OF INSURANCE M Y� MME IYYY LIMITS
POLICY NUMBER
GENERAL LIABILITY
EACH OCCURRENCE
$ 11000100
A
COMMERCIAL GENERAL (ABILITY
X
5085364820
08/23/13
08/23/14
m
DAMAx„_
EP
300,O' O
_n
CLAIMS -MADE OCCUR
...�
MED ay one
000
_Xj Business Owners
.,......_._.... ,�.��. —m ...
PERSONAL & ADV INJURY
_
�. -- ........-___ µ
$ 1,000,00
GENERAL AGGREGATE
2,00'0,00
N'LPOCPRO- AGGREGATE LIMIT APPLIES PER:
PRODUCTS COMP /OP AGG
$ 2 „000,00
X LOC
I
� .. - -.... ,.
. - --
$
AUTOMOBILE
LIABILITY
COMBI NEO SINGLE Lim T'
I
1,000,00
A
ANY AUTO
X
5085354851
08/23/13
08/23/14
BODILY INJURY (Per person)
$
X
� �
AUTOS AUTOSULED
BODILY INJURY (Per accident)
$
HIRED AUTOS NON -OWNED
AUTOS
R'i Y DAMAGE Im ”
Para Id
$
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
$
I S -MADE
X
AGGREGATE
�$
DAD RE °rENTION$
$
WORKERS COMPENSATION
TATU
X OTH-
AND EMPLOYERS' LIABILITY Y / N
A
ECUTIVE
5085355'000
08/23/13
08/23/14
E L EACH ACCIDENT„
1,0 ®0,.00
OFFICER/MEMBER ER EXCLUDED?
N / A
$
(Mandatory in NH)
If es desc &kae under
E L DISEASE EA EMPLOYr'F'
$ 1,000,00i:
�... u
U S RI'PTION OF OPERATIONS below
E.L. DISEASE -POLICY
YLIMIt
1,000.,00
A
Professional Liab
X
426600839
08/23/13
08/23/14
Limits 1,000,00
Retention 1,00
DESCRIPT$ON OF OPERATIO S 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
The City of El Se un(o is named as Additional Insured.
*10 DAB
NOTICE F CANCELLATION APPLIES FOR NON - (PAYMENT OF PREMIUM ONLY.*
City of El Segundo
Attn: City Clerk
350 Main Street
El Segundo, CA 90
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
Shari Huggins
U 1988 -2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
u
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED -LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
Coverage afforded under this extension of coverage endorsement does not apply to any person or organization
covered as an additional insured on any other endorsement now or hereafter attached to this Policy.
1. ADDITIONAL INSURED — BLANKET VENDORS
WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to
below as vendor) with whom you agreed, because of a written contract or agreement to provide insurance,
but only with respect to "bodily injury" or "property damage" arising out of "your products" which are
distributed or sold in the regular course of the vendor's business, subject to the following additional
exclusions:
1. The insurance afforded the vendor does not apply to:
a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of
the assumption of liability in a contract or agreement. This exclusion does not apply to liability for
damages that the vendor would have in the absence of the contract or agreement;
b. Any express warranty unauthorized by you;
c. Any physical or chemical change in the product made intentionally by the vendor;
d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or
the substitution of parts under instructions from the manufacturer, and then repackaged in the original
container;
e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to
make or normally undertakes to make in the usual course of business, in connection with the
distribution or sale of the products;
f. Demonstration, installation, servicing or repair operations, except such operations performed at the
vendor's premises in connection with the sale of the product;
g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or substance by or for the vendor; or
h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or
omission or those of its employees or anyone else acting on its behalf. However, this exclusion does
not apply to:
(1) The exceptions contained in Subparagraphs d. or f.; or
(2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally
undertakes to make in the usual course of business, in connection with the distribution or sale of
the products.
2. This insurance does not apply to any insured person or organization, from whom you have acquired such
products, or any ingredient, part or container, entering into, accompanying or containing such products.
3. This provision 2. does not apply to any vendor included as an insured by an endorsement issued by us
and made a part of this Policy.
4. This provision 2. does not apply if "bodily injury" or "property damage" included within the "products -
completed operations hazard" is excluded either by the provisions of the Policy or by endorsement.
2. MISCELLANEOUS ADDITIONAL INSUREDS
WHO IS AN INSURED is amended to include as an insured any person or organization (called additional
insured) described in paragraphs 2.a. through 2.h. below whom you are required to add as an additional
insured on this policy under a written contract or agreement but the written contract or agreement must be:
1. Currently in effect or becoming effective during the term of this policy; and
2. Executed prior to the "bodily injury," "property damage" or "personal and advertising injury," but
Only the following persons or organizations are additional insureds under this endorsement and coverage
provided to such additional insureds is limited as provided herein:
a. Additional Insured — Your Work
�r
That person or organization for whom you do work is an additional insured solely for liability due to
your negligence specifically resulting from your work for the additional insured which is the subject of
the written contract or written agreement. No coverage applies to liability resulting from the sole
negligence of the additional insured.
The insurance provided to the additional insured is limited as follows:
(1) The Limits of Insurance applicable to the additional insured are those specified in the written
contract or written agreement or in the Declarations of this policy, whichever is less. These Limits
of Insurance are inclusive of, and not in addition to, the Limits of Insurance shown in the
Declarations.
(2) The coverage provided to the additional insured by this endorsement and paragraph F.9. of the
definition of "insured contract" under Liability and Medical Expenses Definitions do not apply
to "bodily injury" or "property damage" arising out of the "products- completed operations hazard"
unless required by the written contract or written agreement.
(3) The insurance provided to the additional insured does not apply to "bodily injury," "property
damage," or "personal and advertising injury" arising out of the rendering or failure to render any
professional services.
b. State or Political Subdivisions
A state or political subdivision subject to the following provisions:
(1) This insurance applies only with respect to the following hazards for which the state or political
subdivision has issued a permit in connection with premises you own, rent, or control and to
which this insurance applies:
(a) The existence, maintenance, repair, construction, erection, or removal of advertising signs,
awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway
openings, sidewalk vaults, street banners, or decorations and similar exposures; or
(b) The construction, erection, or removal of elevators; or
(2) This insurance applies only with respect to operations performed by you or on your behalf for
which the state or political subdivision has issued a permit.
This insurance does not apply to "bodily injury," "property damage" or "personal and advertising
injury" arising out of operations performed for the state or municipality.
c. Controlling Interest
Any persons or organizations with a controlling interest in you but only with respect to their liability
arising out of:
(1) Their financial control of you; or
(2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations
performed by or for such additional insured.
d. Managers or Lessors of Premises
A manager or lessor of premises but only with respect to liability arising out of the ownership,
maintenance or use of that specific part of the premises leased to you and subject to the following
additional exclusions:
This insurance does not apply to:
(1) Any 'occurrence" which takes place after you cease to be a tenant in that premises; or
(2) Structural alterations, new construction or demolition operations performed by or on behalf of
such additional insured.
e. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver but only with respect to their liability as mortgagee, assignee, or
receiver and arising out of the ownership, maintenance, or use of a premises by you.
This insurance does not apply to structural alterations, new construction or demolition operations
performed by or for such additional insured.
f. Owners /Other Interests — Land is Leased
An owner or other interest from whom land has been leased by you but only with respect to liability
arising out of the ownership, maintenance or use of that specific part of the land leased to you and
subject to the following additional exclusions:
This insurance does not apply to:
(1) Any "occurrence" which takes place after you cease to lease that land; or
(2) Structural alterations, new construction or demolition operations performed by or on behalf of
such additional insured.
g. Co -owner of Insured Premises
A co -owner of a premises co -owned by you and covered under this insurance but only with respect to
the co- owners liability as co -owner of such premises.
h. Lessor of Equipment
Any person or organization from whom you lease equipment. Such person or organization are
insureds only with respect to their liability arising out of the maintenance, operation or use by you of
equipment leased to you by such person or organization. A person's or organization's status as an
insured under this endorsement ends when their written contract or agreement with you for such
leased equipment ends.
With respect to the insurance afforded these additional insureds, the following additional exclusions
apply:
This insurance does not apply:
(1) To any "occurrence" which takes place after the equipment lease expires; or
(2) To "bodily injury," "property damage" or "personal and advertising injury" arising out of the sole
negligence of such additional insured.
Any insurance provided to an additional insured designated under paragraphs b. through h. above does
not apply to "bodily injury" or "property damage" included within the "products- completed operations
hazard."
3. The following is added to Paragraph H. of the BUSINESSOWNERS COMMON POLICY CONDITIONS:
H. Other Insurance
4. This insurance is excess over any other insurance naming the additional insured as an insured
whether primary, excess, contingent or on any other basis unless a written contract or written
agreement specifically requires that this insurance be either primary or primary and
noncontributing.
4. LEGAL LIABILITY — DAMAGE TO PREMISES
A. Under B. Exclusions, 1. Applicable to Business Liability Coverage, Exclusion k. Damage To
Property, is replaced by the following:
k. Damage To Property
"Property damage" to:
1. Property you own, rent or occupy, including any costs or expenses incurred by you, or any
other person, organization or entity, for repair, replacement, enhancement, restoration or
maintenance of such property for any reason, including prevention of injury to a person or
damage to another's property;
2. Premises you sell, give away or abandon, if the "property damage" arises out of any part of
those premises;
3. Property loaned to you;
4. Personal property in the care, custody or control of the insured;
5. That particular part of any real property on which you or any contractors or subcontractors
working directly or indirectly in your behalf are performing operations, if the "property
damage" arises out of those operations; or
6. That particular part of any property that must be restored, repaired or replaced because "your
work" was incorrectly performed on it.
Paragraph 2 of this exclusion does not apply if the premises are "your work" and were never
occupied, rented or held for rental by you.
Paragraphs 1, 3, and 4, of this exclusion do not apply to "property damage" (other than damage
by fire or explosion) to premises:
(1) rented to you:
(2) temporarily occupied by you with the permission of the owner, or
(3) to the contents of premises rented to you for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to Damage To Premises Rented To You as described in
Section D — Liability and Medical Expenses Limits of Insurance.
Paragraphs 3, 4, 5, and 6 of this exclusion do not apply to liability assumed under a sidetrack
agreement.
Paragraph 6 of this exclusion does not apply to "property damage" included in the "products -
completed operations hazard."
B. Under B. Exclusions, 1. Applicable to Business Liability Coverage, the last paragraph of 2.
Exclusions is deleted and replaced by the following:
Exclusions c, d, e, f, g, h, i, k, I, m, n, and o, do not apply to damage by fire to premises while rented
to you or temporarily occupied by you with permission of the owner or to the contents of premises
rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this
coverage as described in Section D. Liability And Medical Expenses Limits Of Insurance.
C. The first Paragraph under item 5. Damage To Premises Rented To You Limit of Section D.
Liability And Medical Expenses Limits Of Insurance is replaced by the following:
The most we will pay under Business Liability for damages because of "property damage" to any
one premises, while rented to you, or temporarily occupied by you, with the permission of the owner,
including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the
Damage to Premises Rented to You limit shown in the Declaration.
5. Blanket Waiver of Subrogation
We waive any right of recovery we may have against:
a. Any person or organization with whom you have a written contract that requires such a waiver.
6. Broad Knowledge of Occurrence
The following items are added to E. Businessowners General Liability Conditions in the
Businessowners Liability Coverage Form:
e. Paragraphs a. and b. apply to you or to any additional insured only when such 'occurrence," offense,
claim or "suit" is known to:
(1) You or any additional insured that is an individual;
(2) Any partner, if you or an additional insured is a partnership;
(3) Any manager, if you or an additional insured is a limited liability company;
(4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation;
(5) Any trustee, if you or an additional insured is a trust; or
(6) Any elected or appointed official, if you or an additional insured is a political subdivision or public
entity.
This paragraph e. applies separately to you and any additional insured.
7. Bodily Injury
Section F. Liability and Medical Expenses Definitions, item 3. "Bodily Injury" is deleted and replaced
with the following:
"Bodily injury" means bodily injury, sickness or disease sustained by a person, including death,
humiliation, shock, mental anguish or mental injury by that person at any time which results as a
consequence of the bodily injury, sickness or disease.
8. Expanded Personal and Advertising Injury Definition
a. The following is added to Section F. Liability and Medical Expenses Definitions, item 14.
Personal and Advertising Injury, in the Businessowners General Liability Coverage Form:
h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but
only if such discrimination or humiliation is:
1. Not done intentionally by or at the direction of:
a. The insured; or
b. Any "executive officer," director, stockholder, partner, member or manager (if you are a
limited liability company) of the insured; and
2. Not directly or indirectly related to the employment, prospective employment, past employment or
termination of employment of any person or person by any insured.
b. The following is added to Exclusions, Section B.:
(15) Discrimination Relating to Room, Dwelling or Premises
Caused by discrimination directly or indirectly related to the sale, rental, lease or sub -lease or
prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the
direction of any insured.
(16) Fines or Penalties
Fines or penalties levied or imposed by a governmental entity because of discrimination.
c. This provision (Expanded Personal and Advertising Injury) does not apply if Personal and
Advertising Injury Liability is excluded either by the provisions of the Policy or by endorsement.
9. Personal and Advertising Injury Re- defined
Section F. Liability and Medical Expenses Definitions, item 14, Personal Advertising Injury, Paragraph c.
is replaced by the following:
c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room
dwelling or premises that a person or organization occupies committed by or on behalf of it's owner,
landlord or lessor.