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PROOF OF INSURANCE (2015) CLOSEDACORP. CERTIFICATE OF LIABILITY INSURANCE 450 N Brand Blvd 6th Floor Glenicale , CA 912D3 INSURED 17331 Ventura Blvd,U215 Encmo CA 91316 o^TE(MmmmYYYY) 'THIS CERTIFICATE ONLY AND CONFERS NO RIGHTS UPON THE CERT(FICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY I"HE POLICIES BELOW INSURERS AFFORDING COVERAGE wmo# /wSUaen^ COLONY INSURANCE COMPANY |/xomspo UNITED FINANCIAL CASUALTY /m``mo,r GRANITE STATE INS. CO /w�nxn | I'IF,°oLIGRIoc*muux*wcLuaneomsLmvnAvFeeew ISSUED rorxe INSURED NAMED ^oovsponTmp POI. ICY PERIOD INDICATED mmWxoar^wo/w: / xmvnpoumswewT /snwoxcowonmwop ANY CONTRACT onums:000uwsw/wxrw*saPsc/ Towomx/maos*nocxrc MAY ap ISSUED mP w^rpe+rx/w /n� INS owx*csx~�onneoav THE rnuo:seoeaox/oeu HEREIN maua�sorrom�rxsrenMs sxou/mmwa AND oowomowsu�»ou� pu�wHu^s�mccArsom/rmu*o�wmx, HAVE BEEN nenvc�oa, PAID CLAIMS � POLICY 'NUMBER ___-__ ocwco^To^amn s2,0W0.Q88 A � ./`°wmovuncwrn^/Lm`u"` ��u^u '9��TI,r) 100.Q08 IV I .w/wxHwo/ IARm^w`wr""==* $|0.#U0 GL4112228 09M8/2014 09Y18/3815 -4'�cnw°w�-ummwmm, s2V)O, 008 a�ms"m�mnn*mc x1000000 w,uw�^^nmx u^RAGEmABII-ir, ,xuFoum*o",Iwu^emn Iju,`^uJI I,t x,mw o WORK mn�MJ` FIV, A TION AN IT C Vwm LAAmv,, ^wmun°'u^r^ n��max/wr ^ .''mm wum/xc.vmm ,°nwrwvvmm: �o OTHER F. LIMIT " 1,500.000 08/24/2014 08124/2015 /fODILYKWORY mA(.�c ^noxvw^v � � �� e*n"w*wao, S1,000,000 00 1831708 UQY3O�014 OS/302O15 ' s/ nms m c^c��mo �1.00O.00O L1fAICV(A3Tr 11 upocmmuonmpr RATIONS /LOCATIONS 'vcxICLCo' EXCLUSIONS ADDED o,swoop,%EvrNT'aP6CI^ PROVISIONS THE CITY, |TS OFFICERS, OFF|C|AL8, EMPLOYEE8, AGENT8 AND VOLUNTEERS ARE NAMED A8ADDITIONAL INSURED, Pnojeo\� Group 84RS114-21 '10 clays k`rnonpay. 30 days for all other- -f HIS INSURANCE IS PRIMARY AND NON-CONTRIBUTORY CERTIFICATE HOLDER CANCELLATION qHOU1,11ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FXPIRATION CITY FRK DAIE YHV,,RFOF, THE ISSUING INSURER WILL FNQQ&*Q44O MAIL '3(j DAYS WRII[TET) 350 MAIN STREET EL SEGUNDO, CA 90245 ACOnoo(mU1Nn) 0 ACOmoCORp0RAnON49oa ACR DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/26/2015 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 CONTACT Shilo Losino Contractors Best Insurance Services Inc. �L��* ) 348 4900 rAX (8669 9237 Woodland Hills CA 91364 (818 c Nat )_30 E-MAIL Shilo@contractorsbestins.com 20335 Ventura Blvd., Suite 426A nnneoss 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 SR ......., .... DL SUBR " " }PO POLICY E)P NTQ TYPE OF INSURANCE }uu}nniwvv} LIMITS c^ A X COMMERCIAL GENERAL LIABILITY X CT20150291 2/26/2015 2126/2016 EACH OCCURRENCE a 1,000, 000 ...............w _X ,., , „ DAMAGEC RENTED 50,000 CLAIMS -MADE OCCUR ---_ MED EXP lAnv one Dersonl __.;,�.. _ $ 5,000 _ .. ... ..,.,.�.._ _....... PERSONAL &ADVINJURY ­1111111 - $ 1,000,000 ­­ .. . ��............ GEN 0 .... .. AGGREGATI. LIMIT APPLIES PER: CFNFRAI AC(',RFG�— ATE_ S 2 000,000 ..— .._. X 0 � 2,000,000 .m.,._., POLICY JCS LOC PRODUCTS COMP/OP $ �.... $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IFe erriAcn }1 $ ANY AUTO BODILY INJURY lorso (Per col $ ^ . . . ............... ... ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS°rEt....n.n._,____ $ LIAB OCCUR F_.ACH OCCURRENCE_ $ LMBRESLLA S LIAB CI AIMC -MADE ''. AGGREGATE $ RFTENTI, N A ,,.. , $ ATION WORKERS COMPENSATION PER OTH- CTATIITF FR AND EMPLOYERS' LIABILITY YIN ' ...... •.- ..- .. �• -.. ... .......... ......— ANY PROPRIETOR/PARTNER /EXECUTIVE E,L, EACH ACCIDENT $ FFICERIMEMBER EXCLUDED? NIA in NH (Mandatory ) , DIS EASE, FA FMPI HYPE $ If des rib under yes, SGSIP F,. _L DIISEARF- POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Addiffonal Remarks Schedule, gran be attached If more space Is raquired) The City of El Segundo, its officers, officials, eleCtre¢I, employees &volunteers are a d`Itional insured per attached endorsement. CERTIFICATE HOLDER CANUIZL-LA I ION ^' " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The CI Of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City 9 ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo y " P CA 90245- AUTHORIZED REPRESENTATIVE �� ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CT20150291 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oraanization(s) Location(s) Of Covered Operations The City of El Segundo, its officers, offi a elected, The City of El Segundo employees and volunteers 350 Main Street El Segundo, CA 90245 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 POLICY NUMBER: CT20150291 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OIL CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) The City of El Segundo, its of " ers, officials, elected, employees and voluntee Location And Description Of Completed Operations The City of El Segundo 350 Main Street El Segundo, CA 90245 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products- completed operations 1. Required by the contract or agreement; or hazard ". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 24 0410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHT'S OF RECOVERY AGAINST" O' HE S TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of El Segundo, officers, officials, elected, employees and volunteers The City of El Segun Ik 350 Main Street El Segundo, CA 90245 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMER- CIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: 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 0410 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 0 ALBERT STIPAIN 450 N BRAND 111 61'fl 1`1 GILIENDALF, CA 91203 CITY OFF( SEGUNfX) 350 MAIN STREET Fl, c0UNDO, CA 90245 Additional insured endorsement Policy nottliber, 02358067-1 Underwritten by: United Hnancilal Casualty ISDITIP811Y insured:0RABUILD DEVELOPMENT, IN July 1, 2014 Policy Period: Aug 24, 2014 - Aug 24, 2015 rMoing Address United Firiandal Ca.sualtyCmparry Po BDx 94739 Cleveland, Oil 44101 11.800-4411444B? For customer service, 24 hours a day, 7 days a week CITY 0[ Fl- SEGUNDO 350 MAIN STREET H SFUNDC), (A 90245 The person at organization named a bove is an insured with respect to such 11abiIny coverage as is afforded by the policy, but this Insurance applies toe said insured only as a pNson (liable for tie conduct of ,1nolhe, insured a11A thini: only to the exlent ifthat liobilktY We �Ilso aqreewlth you that insurance provided by this enclorsernent Will be ptinjary for any powr!r un4 sper.ifia Ily cfe%flbed on the Declarations Page. Limit Of USIbliltY Bodily Injury Not applicable Property Damage Not applicable Combined Liability $1,500,000 each accident All otber terms, limits and provisions Of this Policy r0m8i" unchanged. This pflijorsement applies to I'Dilcy Number: 02358067-1 issued to (Name of Insured): KARAF11 III r, Df.-Vr. I.OPMENT, IN Policy PxpiraflOn date: 08/24/2015 f:ffective , da%° of endorsement: 08/24 /2014 FMI I 19H (!j I N�) BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes, the policy to which it is attached effective on the inception date of the policy unless a different (late is indicated below, (Thn, following ",ittarhilIC clause" need be completed only when this endorsement is issued subsequent to preparation of the policy), This endorsement, effective 12:01 AM 09/30/2014 forms a part of Policy No, WC 001-63-1708 Issued to KARABU I LD DEVELOPMENT INC We have a right to recover our payments from anyone liable for an injury covered by this pollcy. We will not enforce our right against any person or organization with whom you have a written contract that raquires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy, WC 04 03 61 Countersigned by (Ed. 11190) Authorized Representative