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PROOF OF INSURANCE (2015) CLOSEDACCMEP CERTIFICATE OF LIABILITY INSURANCE © D 2 /l2/12 /D 12D1 s DIYYYY) 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(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 endorsement(s). ....PRODUCER 1- 818 -539 -2300 CONTAZT Robert Half Certificates NAME: Arthur J. Gallagher & Co. PHONE "uuuuuuuu " " " " " "" FAX Insurance Brokers of California, Inc. License #0726293 (n,(,P.AR.. MI. 818 -539 -1463 AdC No3 818- 539 -1801 505 North Brand Boulevard, Suite 600 E-MAIL S roberthalf certificatesoajg.com Glendale, CA 91203-3944 INSURER(S) AFFORDING COVERAGE NAIC# ............. ..........................._._. INSURER A: FEDERAL INS CO 20281 .......................... INSURED INSURER B: INSURANCE CO OF THE STATE OF PA 19429 Robert Half International Inc. including AccountempB "- "_______ """" 06/01/15 IN SURE RC: LI BERTY MUT INS CO 2303043 2613 Camino Ramon INSURER D: LIBERTY SURPLUS INS CORP 10725 San Ramon, CA 94583 INSURER E: INSURER F: CnVFRAnFR CERTIFICATF NIIMRFR• 43n21 n99 QPVISIAM MIIMRCQ• 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. IL"�R. POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE I POLICY NUMBER '. M1M PYYYY MMIDD. A GENERAL LIABILITY X �X 35796687 0610111 06/01/15 EACHOCCURRENCE ''.,$2,000,000 X COMMERCIAL GENERAL LIABILITY 2,000,000- _ .aa�unrenr.,n $ "Pfi�MIS _ CLAIMS -MADE IK OCCUR MED EXP (Any one person) $ 10,000 • Stop Gap Employer Liab ',PERSONAL &ADVINJURY $2,000,000 • in OH, WA, WY, ND ''...GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 POLICY LOC I lEmployer Liability $1,000,000 A AUTOMOBILE LIABILITY X X 73233217 067 01 1 06/01/15 COMBINED SINGLE LIMIT Ba °ugg4t f1n. ..... 1,000,000 ANY AUTO BODILY INJURY (Per person) $ I ALL OWNED SCHEDULED .. AUTOS AUTOS .... -... uu - BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS Oi20PER1Y DA6'dAGE:. (;Pntocrud�nl__ $ 1,000 dad. 1,000 ded. Comp. Ded: $1,000 $Coll. Ded: $1, A X UMBRELLA LIAB X OCCUR X X 79217107 06/01/1' 06/01/15 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE AC",I�Fp£t >AI'E $ 5,000,000 DED X RETENTION $ 0 $ B WORKERS COMPENSATION X '.,WC 06/01/1 06/01/15 X WCSTATU- OTH- B AND EMPLOYERS' LIABILITY AFFICER RIETOREXCLUERIEXECUTIVE YIN gee attached su lementa. / 06/01/15. .".._�._ ..................... E.L, EACH ACCIDENT $ 1, 000, 000 B OFFICERMIEMBER EXCLUDED? N (Mandatory ) m NH NIA ..049901191- AOS/049901195- AQ6 O1 /1 / ' 06/01/15 - ,.- ...... ................... ..._ E.LDISEASE- EAEMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below " """ .........................._� E.L, DISEASE - POLICY LIMIT $ 1, 000, 000 C r.:me F.'.. ',y+" 'AA S50002 1 �.aC Loss r , '� , ' D 'Professional Liability E05N41941010 03/31/1, 03/31/15 PerClaim /Aggregate 5,000,000 A 'Personal Property w/ TIB 35796687 06101114 06/01/15 Property Limit 500,000 DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is deemed Additional Insured on the above referenced General Liability, Auto Liability and Excess Liability policies on a primary and non - contributory basis as required by written contract for liability arising out of Named Insureds' acts or omissions. Please refer to attached Chubb General Liability form 80 -02 -2367 for scope of Additional Insured status. Rights of Subrogation have been waived with respects to General Liability, Auto Liability, Excess Liability and Workers Compensation coverages as required by written contract executed prior to loss. CERTIFICATE HOLDER P V e'V " CANCELLATION X a M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of EL Segundo �� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN k , ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street � AUTHORIZED REPRESENTATIVE EL Segundo, CA 90245 USA g ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 28 (2010108) The ACORD name and logo are registered marks of ACORD paglen 43023.055 00 ENDORSEMENT Named Insured ROBERT HALF INTERNATIONAL INC Agent Name ARTHUR J. GALLAGHER & CO. INS.BROKERS OF CA INC. 0-16 ' N be cy um r (14) 7323 -32 -17 Effective Date: 0 ) .1 12A1 A.M., Standard Time Agent No. 09920 -999 I. LIABILITY A, BROAD FORM INSURED Paragraph A.I. - WHO IS AN INSURED of Section II, LIABILITY COVERAGE, is amended to add: d. Any organizat :.on you newly acquire or form, other than a partnership o :: joint venture, and over which you maintain ownership or a majority interest. However, coverage under this provision does not apply: 1., If there is similar insurance available to that organization: or 2, To "bodily injury" or "property damage" that occurred before you acquired or formsd the organization, coverage is effective on the acquisition or formation date and is offered only until the end of the policy period during which the acquisition or formation took place. However, the insurance provided by this provision does not apply to any subsidiary or organization stated in d. above that is an insured under any other automobile liability policy for which coverage has been specifically placed or an insured under any other automobile policy where that policylimits of insurance have been exhausted or that carrier has become insolvent. e. Any employees of yours while using a covered "auto" you do not own, hire or borrow in your business or your personal affairs. B. Person and Organization As Insureds Under A Written Insured 16 -02 -0210 (Ed. 1 -01) Policy Number (14) 7323 -32 -17 ENDORSEMENT Named Insured ROBERT HALF INTERNATIONAL INC Effective Date: 06 -01 -14 12:01 A.M., Standard Time Agent Name ARTHUR J. GALLAGHER & CO. INS . BROKERS Agent No. 09920-999 OF CA INC. Contract Any person or organization with respect to the operation, maintenance or use of a covered "auto ", provided that you and such person or organization have agreed under an express provision in a written "insured contract ", written agreement or a written permit issued to you by a cgovernmental or public authority to add such person or organization to this policy as an "insured ". However, such person or organization is an "insured" only: (1) with respect to the operation, maintenance or use of a covered "auto "; and (2) for "bodily inj-lry" or "property damage" caused by an "accident" which takes place after: (a) You executed th= "insured contract" or written agreement; or (b) The permit has 'peen issued to you. C. FELLOW EMPLOYEE EXCLUSION Under Section II - Liability Coverage, B., Exclusions, Paragraph 5, Fellow Employee, does not apply if the bodily injury results from the use of a covered auto you own or hire. Coverage is excess over any collectable insurance. D. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS Paragraph 2, Coverage Extensions, a. Supplementary Payments of Section II - Liability Coverage, subparagraphs (2) and (4) are replaced with the following: (2) Up to $2,500 for the cost of bail bonds (including bonds for relate traffic law violations) required because of an accident we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit, including substantiated loss of earnings up to $500 a day because of time off from work. 16 -02-0210 (Ed. 1 -01) Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY Who Is An Insured JUNE 1. 2014 to -JUNE 1. 2015 JUNE 1. 2014 3579 -66 -87 SFO Robert Half International Inc. (see Named Insured Endt) Federal Insurance Company JUNE 1. 2014 Under Who Is An Insured, the following provision is added: Scheduled Person Or Subject to all of the terms and conditions of this insurance, any person or organization Organization shown in the Schedule, acting pursuant to a written contract or agreement between you and such person or organization, is an insured; but they are insureds only with respect to liability arising out of your operations, or your premises, if you are obligated, pursuant to such contract or agreement, to provide them with such insurance as is afforded by this policy. However, no such person or organization is an insured with respect to any: assumption of liability by them in a contract or agreement. This limitation does not apply to the liability for damages for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. a damages arising out of their sole negligence Liability Insurance Additr" nat to re -S_qh_@At,)1od Pe o a Or OrgaNzOon Continued Form 80- 02- 2367(Rev. 8 -04) Endorsement Page 1 Liability Endorsement (continued) Schedule Additional Insured - any person, party or entity for whom the Insured has agreed, prior to loss, to provide coverage as respects the Insured's operations and/or facilities owned or used by the Insured. All other terms and conditions remain unchanged. Liabilit _ Insurance Ado'i i nal Insured - Scheduled Person Or Or anization -_____ Last DBae Form 80- 02- 2367(Rev. 8 -04) Endorsement Page 2 Robert Half International Policy Number: 35796687 June 1 2014 - June 1 2015 Conditioins (continued) Transfer Or Waiver Of We will waive the right of recovery we would otherwise have had against another person or Rights Of Recovery organization, for loss to which this insurance applies, provided the insured has waived their rights Against Others of recovery against such person or organization in a contract or agreement that is executed before such loss. To the extent that the insured's rights to recover all or part of any payment made under this insurance have not been waived, those rights are transferred to us, The insured must do nothing after loss to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. This condition does not apply to medical expenses. Liability Insurance Form 80.02.2000 (Rev. 4.01) Contact Page 24 of 32 1 "A k Jf WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on inception date of the policy unless 'a different date is indicated below. (The following 'attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 06/0112014 forms a part of Policy No. SEE BELOW Issued to ROBERT HALF INTERNATIONAL INC. By THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA Premium I NCLUDED We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule THE PREMIUM FOR THE ENDORSEMENT IS INCLUDED ANY PERSON OR ORGANIZATION TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE OCCURRENCE OF LOSS. RHI /PROTIVITI: WC 049901191 -AOS WC 049901192 -IL, KY, NC, NH, UT WC 049901193 -NJ, PA WC 049901194 -AZ, GA, VA WC 049901195 -CA WC 049901196 -FL WC 049901197 -MA, WI WC 027527602 -ME BENCHMARK: WC 049901198 -NV WC 049901199 -IL WC 049901201 -CA PROTIVITI GOVERNMENT SERVICES: WC 049901202 -AOS WC 049901203- IL,NH, UT WC 049901204 -PA WC 049901205 -GA, VA WC 049901206 -CA WC 049901207 -MA, NJ WC 027527603 -FL This form is not applicable in California, Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee, Texas, Utah, or Washington. WC 00 03 13 Countersigned by (Ed. 04184) Authorized Representative " A ALTERNATE EMPLOYER ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 0610112014 forms a part of Policy No. SEE BELOW Issued to ROBERT HALF INTERNATIONAL INC. By THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA This endorsement applies only with respect to bodily in- jury to your employees while in the course of special or temporary employment by the altemate employer in the state named in the schedule. Part One (Workers Com- pensation Insurance) and Part Two (Employers Liability Insurance) will apply as though the alternate employer is insured. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law if we are not permitted to pay the benefits directly to the persons en- titled to them, will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate em- ployer to share with us a loss covered by this endorse- ment. Premium will be charged for your employees while in the course of special or temporary employment by the al- ternate employer. The policy may be cancelled according to its terms without sending notice to the alternate employer. Part Four (Your Duties If Injury Occurs) applies to you The insurance afforded by this endorsement is not in- and the alternate employer. The alternate employer will tended to satisfy the alternate employer's duty to secure recognize our right to defend under Parts One and Two its obligations under the workers compensation law. We and our right to inspect under Part Six. Schedule Alternate Employer ANY ALTERNATE EMPLOYER OF YOUR EMPLOYEES RHI /PROTIVITI: WC 049901191 -AOS WC 049901192 -IL, KY, NC, NH, UT WC 049901193 -NJ, PA WC 049901194 -AZ, GA, VA WC 049901195 -CA WC 049901196 -FL WC 049901197 -MA, WI WC 027527602 -ME WC 00 03 01 (Ed. 4184) Address BENCHMARK: WC 049901198 -NV WC 049901199 -IL WC 049901201 -CA State of Special or Temporary Employment PROTIVITI GOVERNMENT SERVICES: WC 049901202 -AOS WC 049901203- IL,NH, UT WC 049901204 -PA WC 049901205 -GA, VA WC 049901206 -CA WC 049901207 -MA, NJ WC 027527603 -FL 1'/ Countersigned by- .._....,.,- ..._...__ -... ........- .m.__.__... ...- -._.. Authorized Representative 2014 -2015 RHI Workers Compensation Policy Numbers Policy States Pgljgv Entity Eff. Date Exg. Qqje Isguing Corn an RHI/PROTIVITI AOS- CO,DC,DE,IA,MD,MN, NM, 049901202 AOS:AL,AR,CO,CT,DC,DE,HI,IA,I D,IN,KS,LA,MD,MI,MN,MO,MT,NE, Prot. Govt. Svs. 6/112014 6/1/2015 Ins. Co. of the State of Penn 049901203 NM,NV,NY,OK,OR,RI,SC,TN,TX 049901191 IL,NH, UT Prot. Govt. Svs. 6/1/2014 6/1/2015 Ins. Co. of the State of Penn _ RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co. of the State of Penn 049901192 PA Prot. Govt. Svs, 61112014 6/1/20151 Ins. Co. of the State of Penn 049901205 IL KY NC,NH,UT RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co. of the State of Penn 949901193 GA, VA Prot. Govt. Sus, 611/2014 6/1/2015 Ins. Co. of the State of Penn 049901206 NJ, PA RHI/ Protiviti 6/112014 6/1/2015 Ins. Co. of the State of Penn 049901194 CA Prot. Govt. Svs. 6/1/2014 611/2015 Ins. Co, of the State of Penn 049901207 AZ, GA, VA RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co. of the State of Penn 049901195 MA, NJ jProt. Govt. Svs. 6/1/2014 6/1/2015 Ins. Co. of the State of Penn 027527603 CA RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co. of the State of Penn i 049901196 FL RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co, of the State of Penn 049901197 MA, WI RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co. of the State of Penn 027527602 IME RHI/ Protiviti 6/1/2014 6/1/2015 Ins. Co. of the State of Penn BENCHMARK PROTIVITI GOV. SERVICES AOS- CO,DC,DE,IA,MD,MN, NM, 049901202 NY,OK,SC,TX Prot. Govt. Svs. 6/112014 6/1/2015 Ins. Co. of the State of Penn 049901203 .'..949901204 IL,NH, UT Prot. Govt. Svs. 6/1/2014 6/1/2015 Ins. Co. of the State of Penn I PA Prot. Govt. Svs, 61112014 6/1/20151 Ins. Co. of the State of Penn 049901205 GA, VA Prot. Govt. Sus, 611/2014 6/1/2015 Ins. Co. of the State of Penn 049901206 CA Prot. Govt. Svs. 6/1/2014 611/2015 Ins. Co, of the State of Penn 049901207 MA, NJ jProt. Govt. Svs. 6/1/2014 6/1/2015 Ins. Co. of the State of Penn 027527603 JFL jProt. Govt. Svs. 6/1/2014 6/1,120151 Ins. Co. of the State of Penn DATE SUPPLEMENT TO CERTIFICATE OF INSURANCE 02/12/2015 OF INSURED: Robert Half International Inc. including Accountemps Additional Descd124on of 0 rafion&fflpmnrkq frnm Pq,r - ': Additional Information: Shilling, Mona From: Garcia, Angelina Sent: Tuesday, February 17, 2015 12:05 PM To: 'Halstead, Misty (HQP)' Cc: Tran, Van (03080); DeZiel, Julie; King, David; Shilling, Mona Subject: RE: ES - Office Team - temporary contract Yes. Thank you.. Angelina Garcia - - - -- Original Message---- - From: Halstead, Misty (HQP) [mailto :misty.halstead @ roberthalf.com] Sent: Thursday, February 12, 2015 3:55 PM To: Garcia, Angelina Cc: Tran, Van (03080); DeZiel, Julie; King, David; Shilling, Mona Subject: RE: ES - Office Team - temporary contract Angelina, Is the attached version of the Certificate of Insurance acceptable? Thanks, Misty Halstead Client Contracts Department 925.913.2148 Shortel (x82148) Connect with us: Linkedln I Twitter I YouTube Robert Half 12613 Camino Ramon I San Ramon I CA 94583 1 misty.halstead @roberthalf.com Brand New Look, Same Great Service. Learn more about Robert Half's new visual identity! This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to which they are addressed. If you have received this email in error please notify the sender and destroy all electronic or hard copies of the transmitted email and attachments. - - - -- Original Message---- - From: Garcia, Angelina [mailto:AGarcia @elsegundo.org] Sent: Thursday, February 12, 2015 10:20 AM To: Halstead, Misty (HQP) Cc: Tran, Van (03080); DeZiel, Julie; King, David; Shilling, Mona Subject: Re: ES - Office Team - temporary contract Thank you Ms. Halstead,