PROOF OF INSURANCE (2011) CLOSEDAGE
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.
ERAL LIABILITY 6301158P020 11/9/2010 11/9/2011 L M EO ACH
COMMERCIAL GENESIAJ LIABILIIIY RE I
ICLAIMS MADE OCCUR E
I991 �'Tezr. w T-1■.IT �' IA Yz
AGGREGATE LIMIT APPLIES PER: I II I 1 PRODUCTS -
AUTOMOBILE LIABILITY
8101158P020
11/9/2010
11/9/2011
COMBINSINGLE LIMIT
$1,000,000
ANYAUTO
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per Pa —)
i
I#RED AUTOS
BODILY INJURY
NON -OWNED AUTOS
(PeramWeM)
$
PROPERTY DAMAGE
i
...............
(Per adW)
ai
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
i
OTHER THAN EA /ACC
i
ANY AUTO
i
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
Is
OCCUR J,,,, j CLAIMS MADE
AGGREGATE
i
DEDUCTIBLE s
RETENTION i I I i
WORKERS COMPENSAT10N AND UB1302P790 11/9/2010 11/9/2011 WCSTATU- oTH'
EMPLOYERS' LIABM.ITY E.L. EACH ACCIDENT it 00 0 0
E.L. DISEASE - EA EMPLOYE jjaQAA
E.L. DISEASE - POLICY LIMIT ;
OTHER ED977441111 11/9/2010 11f 9/2011 Per Claim $1,000,000
?rofessional Liability Annual Aggregate $1,000,000
laims Made
1', DESCRIPTION OF OPERATIONMACATIONSWJWLES !EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
General Liability policy excludes claims arising out of the performance of professional services..
Independent Contractors are included as respects to General Liability,
Re: Provide permit processing and other planning services City of E1 Segundo, its officials and employees are
additional insured as respects to General Liability as required by written contract. Primary and Non - Contributing
coverage applies to GL as required by written contract. (GL- AI /PR) (Industry)
rE HOLDER A0WT1OH U. INSURED; INSURER LETTER' CANCELLATION � _
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE 'THEREOF, THE ISSUING INSURER
City of El Segundo WILL MAIL 30 DAYS WRITTEN NOTICE TO THE
Attn: Director of P1a lnih" and Building CERTIFICATE HOLDER NAMED TO THE LEFT.
Safety
350 Main Street
E1 Segundo CA 90245
"'" AUTHORIZED REP RESETNTATI - X -' A
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the
COMMERCIAL GENERAL LIABILITY COVERAG
1. The following is added to SECTION II -- WHO 15
AN INSURED:
Any person or organization that you agree in a
"written contract requiring insurance" to include as
an additional Insured on this Coverage Part, but:
a. Only with respect to liability for "bodily injury",
"property damage" or "personal injury"; and
b. If, and only to the extent that the injury or
damage is caused by acts or omissions of
you or your subcontractor In the performance
of "your work" to which the "written contract
requiring insurance" applies. The person or
organization does not qualify as an additional
insured with respect to the independent acts
or omissions of such person or organization.
The insurance provided to such additional insured
is limited as follows:
c. In the event that the Limits of Insurance of
this Coverage Part shown in the Declarations
exceed the limits of liability required by the
"written contract requiting Insurance ", the in-
surance provided to the additional insured
shall be limited to the limits of liability required
by that "written contract requiring insurance ".
This endorsement shall not increase the limits
of insurance described in Section 111 - Limits
Of Insurance.
d. This insurance does not apply to the render-
ing of or failure to render any "professional
services" or construction management errors
or omissions.
e. This insurance does not apply to "bodily in-
jury" or "property damage" caused by "your
work" and included in the "products -
completed operations hazard" unless the
"written contract requiring insurance" specifi-
cally requires you to provide such coverage
for that additional insured, and then the insur-
ance provided to the additional insured ap-
►I" A ILL11:
plies only to such "bodily injuiY' or "property
damage' that occurs before the end of the pe-
riod of time for which the "written contract re-
quiring insurance" requires you to provide
such coverage or the end of the policy period,
whichever Is earlier.
2. The following is added to Paragraph Ca. of SEC-
TION IV - COMMERCIAL GENERAL LIABILITY
CONDITIONS:
The insurance provided to the additional insured
is excess over any valid and collectible "other In-
surance", whether primary, excess, contingent or
on any other basis, that is available to the addi-
tional insured for a loss we cover. However, if you
specifically agree in the "written contract requiring
insurance" that this insurance provided to the ad-
ditional insured under this Coverage Part must
apply on a primary basis or a primary and non-
contributory basis, this insurance is primary to
"other insurance" available to the additional in-
sured which covers that person or organization as
a named insured for such loss, and we will not
share with that "other insurance ". But this insur-
ance provided to the additional insured still is ex-
cess over any valid and collectible "other insur-
ance", whether primary, excess, contingent or on
any other basis, that is available to the additional
insured when that person or organization is an
additional insured under any "other insurance ".
3. The following is added to SECTION IV - COM-
MERCIAL GENERAL LIABILITY CONDITIONS:
Duties Of An Additional Insured
As a condition of coverage provided to the addi-
tional insured:
a. The additional insured must give us written
notice as soon as practicable of an "occur-
rence" or an offense which may result in a
claim. To the extent possible, such notice
should include:
CG D414 04 08 0 2008 The Travelers Companies, Inc. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
1. How, when and where the "occurrence"
or offense took place;
Ii. The names and addresses of any injured
persons and witnesses; and
Ill. The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suit" is brought against
the additional insured, the additional insured
must:
I. Immediately record the specifics of the
claim or "suit" and the date received; and
II. Notify us as soon as practicable.
The additional insured must see to It that we
receive written notice of the claim or "su€r as
soon as practicable.
c. The additional insured must immediately send
us copies of all legal papers received in con-
nection with the claim or "suit", cooperate with
us in the investigation or settlement of the
claim or defense against the "suit ", and oth-
erwise comply with all policy conditions.
d. The additional insured must tender the de-
fense and indemnity of any claim or "suit" to
any provider of other insurance which would
cover the addlbonal Insured for a loss we
cover. However, this condition does not affect
whether this insurance provided to the addi-
tional Insured is primary to that other insur-
ance available to the additional insured which
covers that person or organization as a
named insured.
4. The following Is added to the DEFINITIONS Sec-
tion:
"Written contract requiring insurance" means that
part of any written contract or agreement under
which you are required to include a person or or-
ganization as an additional Insured on this Cover-
age Part, provided that the "bodily injury" and
"property damage" occurs and the "personal in-
jury" is caused by an offense committed:
a. After the signing and execution of the contract
or agreement by you;
b. While that part of the contract or agreement is
in effect; and
c. Before the and of the policy period.
Page 2 of 2 0 2008 The Travelers Companies, Inc. CG D414 04 08