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PROOF OF INSURANCE (2015 - 2016) CLOSEDC" CERTIFICATE OF LIABILITY INSURANCE °ATE`MM' ° °"YY"'
1/6/2015
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.
IIMPORTANT: 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 ICCONITTACT Mary Healy
The Liberty Company Insurance Brokers, Inc. PHONE_ (888) 918 -3960 F�`X N, , (eee)ssa -3ies
CA License No. OD79653 • ARII_� AP!2R.E$S..mheal-y@libertycompany.com
21820 Burbank Blvd Ste #330 INSURER(S) AFFORDING COVERAGE NAIC #
Woodland Hills CA 91367 INSURER a:Ohio Security Insurance COmDanV 4082
INSURED INSURER B.-American Fire & Casualty 24066
General Lighting and Electric INSURER C'
DBA: Strom Lighting Services INSURER D;
mW�_v
8132 Firestone Blvd #814 -INSURER E:
Downev CA 90241 INSURER F:
___
COVERAGES CERTIFICATE NUMBER:15 -16 MASTER REVISION NUMBER:
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.
INSR
TYPE OF INSURANCE
lNSR
unrn
POLICY NUMBER,
P� f.I1DNWY
IIO�q,ILll} ply 'y ..
LIMITS
GENERAL LIABILITY
�EEACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
RFM CFR (Fa nrriirLce),
$ 100,000
A
CLAIMS -MADE � OCCUR
X
KS56314241
1/15/2015
/15/2016
MED EXP (Anv one person)
$ 5, 000
'.. PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2, 000, 000
PRODUCTS - COMP /OP AGG
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
'X POLICY PItC7- LOC
$
AUTOMOBILE
LIABILITY
c
Ea cciwJoP n
1.000.000
_.
X
B
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED SCHEDULED
SAA56314241
1/15/2015
1/15/2016
BODILY INJURY (Per accident)
$
AUTOS AUTOS
X
X NON -OWNED
PROPERT Y DAMAGE
$
HIRED AUTOS AUTOS
(Per-ar..ni,tentl
Medical oavments
$ 51000
X
UMBRELLA LIAB X OCCUR
EACH OCCURRENCE
$ 1,000,00_2
B
2DED
XCESS LIAB CLAIMS -MADE
AGGREGATE
$ 1,000,000
$
I X RETENTION$ 0
SA56314241
1/15/2015
/15/2016
WORKERS COMPENSATION
I OTH-
AND EMPLOYERS' LIABILITY Y / N
T(1RV I IMITR FR
E.L,. EACH ACCIDENT
$
ANY PROPRIETOR /PARTNER /EXECUTIVE
OFFICER /MEMBER EXCLUDED?
NIA
E .i L DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Project: Various.
City of E1 Segundo, Its Officials and Employees are named as Additional Insured, including Completed
Operations /Ongoing Operations per the attached Liberty Mutual Endorsements.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of E1 Segundo, ACCORDANCE WITH THE POLICY PROVISIONS.
Its Officials and Employeec Attn: Arianne Bola AUTHORIZED REPRESENTATIVE
350 Main St
E1 Segundo, CA 90245
Mary Healy /RSP2
ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved.
INS021; t,)nlnns1ni Tha a(`non nnma nnel Inn^ era ranieforarl mnrka of Annizi 1
COMMERCIAL GENERAL LIABILITY
CG 88 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX
SUBJECT
PAGE
NON -OWNED AIRCRAFT
2
NON -OWNED WATERCRAFT
2
PROPERTY DAMAGE LIABILITY — ELEVATORS
2
EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)
2
MEDICAL PAYMENTS EXTENSION
3
EXTENSION OF SUPPLEMENTARY PAYMENTS — COVERAGES A AND B
3
ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT
3
PRIMARY AND NON - CONTRIBUTORY — ADDITIONAL INSURED EXTENSION
5
ADDITIONAL INSUREDS — EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"
6
WHO IS AN INSURED — INCIDENTAL MEDICAL ERRORS /MALPRACTICE AND WHO IS AN INSURED —
6
FELLOW EMPLOYEE EXTENSION — MANAGEMENT EMPLOYEES
NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES
7
FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
7
KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
7
LIBERALIZATION CLAUSE
7
BODILY INJURY REDEFINED
7
EXTENDED PROPERTY DAMAGE
8
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US —
8
WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 1 of 8
With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the
endorsement.
A. NON -OWNED AIRCRAFT
Under Paragraph 2. Exclusions of Section I — Coverage A - Bodily Injury And Property Damage Liability,
exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided:
It is not owned by any insured;
2. It is hired, chartered or loaned with a trained paid crew;
3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the
United States of America or Canada, designating her or him a commercial or airline pilot; and
4. It is not being used to carry persons or property for a charge.
However, the insurance afforded by this provision does not apply if there is available to the insured other valid and
collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this
policy), contingent or on any other basis, that would also apply to the loss covered under this provision.
B. NON -OWNED WATERCRAFT
Under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability,
Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following:
This exclusion does not apply to:
(2) A watercraft you do not own that is:
(a) Less than 52 feet long; and
(b) Not being used to carry persons or property for a charge.
C. PROPERTY DAMAGE LIABILITY — ELEVATORS
1. Under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage
Liability, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such
"property damage" results from the use of elevators. For the purpose of this provision, elevators do not
include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations.
2. The following is added to Section IV — Commercial General Liability Conditions, Condition 4. Other
Insurance, Paragraph b. Excess Insurance:
The insurance afforded by this provision of this endorsement is excess over any property insurance,
whether primary, excess, contingent or on any other basis.
D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)
If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part:
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage
Liability:
a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the
following:
Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than
damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system)
to:
(i) Premises rented to you for a period of 7 or fewer consecutive days; or
(ii) Contents that you rent or lease as part of a premises rental or lease agreement for a
period of more than 7 days.
Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to 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 III — Limits of
Insurance.
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8
b. The last paragraph of subsection 2. Exclusions is replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage
from automatic fire protection systems to premises while rented to you or temporarily occupied by
you with permission of the owner. A separate limit of insurance applies to Damage To Premises
Rented To You as described in Section III — Limits Of Insurance.
2. Paragraph 6. under Section III — Limits Of Insurance is replaced by the following:
6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will
pay under Coverage A for damages because of "property damage" to:
Any one premise:
(1) While rented to you; or
(2) While rented to you or temporarily occupied by you with permission of the owner
for damage by fire, lightning, explosion, smoke or leakage from automatic
protection systems; or
b. Contents that you rent or lease as part of a premises rental or lease agreement.
3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO
YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following:
9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises
that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or
leakage from automatic fire protection systems to premises while rented to you or temporarily
occupied by you with the permission of the owner, or for damage to contents of such premises
that are included in your premises rental or lease agreement, is not an "insured contract ".
E. MEDICAL PAYMENTS EXTENSION
If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are
amended as follows:
Under Paragraph 1. Insuring Agreement of Section I — Coverage C — Medical Payments,
Subparagraph (b) of Paragraph a. is replaced by the following:
(b) The expenses are incurred and reported within three years of the date of the accident; and
F. EXTENSION OF SUPPLEMENTARY PAYMENTS — COVERAGES A AND B
Under Supplementary Payments — Coverages A and B, Paragraph 1.b. is replaced by the following:
b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising
out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have
to furnish these bonds.
2. Paragraph 1.d. is replaced by the following:
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or
defense of the claim or "suit ", including actual loss of earnings up to $500 a day because of time
off from work.
G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT
1. Paragraph 2. under Section II — Who Is An Insured is amended to include as an insured any person or
organization whom you have agreed to add as an additional insured in a written contract, written
agreement or permit. Such person or organization is an additional insured but only with respect to liability
for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by:
a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the
performance of your on going operations for the additional insured that are the subject of the
written contract or written agreement provided that the "bodily injury" or "property damage" occurs,
or the "personal and advertising injury" is committed, subsequent to the signing of such written
contract or written agreement; or
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8
b. Premises or facilities rented by you or used by you; or
C. The maintenance, operation or use by you of equipment rented or leased to you by such person
or organization; or
d. Operations performed by you or on your behalf for which the state or political subdivision has
issued a permit subject to the following additional provisions:
(1) This insurance does not apply to "bodily injury", "property damage ", or "personal and
advertising injury" arising out of the operations performed for the state or political
subdivision;
(2) This insurance does not apply to "bodily injury" or "property damage" included within the
"completed operations hazard ".
(3) Insurance applies to premises you own, rent, or control but only with respect to the
following hazards:
a) The existence, maintenance, repair, construction, erection, or removal of
advertising signs, awnings, canopies, cellar entrances, coal holes, driveways,
manholes, marquees, hoist away openings, sidewalk vaults, street banners, or
decorations and similar exposures; or
(b) The construction, erection, or removal of elevators; or
(c) The ownership, maintenance, or use of any elevators covered by this insurance.
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.
With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this
endorsement ends when:
(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.
With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this
endorsement ends when their written contract or written agreement with you for such premises or facilities ends.
With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after
the equipment rental or lease agreement has expired or you have returned such equipment to the lessor.
The insurance provided by this endorsement applies only if the written contract or written agreement is signed
prior to the "bodily injury" or "property damage ".
We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit"
by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence,
Offense, Claim Or Suit under Section IV — Commercial General Liability Conditions.
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8
2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2.
Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability:
This insurance does not apply to:
a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured.
b. "Bodily injury' or "property damage" that occurs prior to you commencing operations at the
location where such "bodily injury' or "property damage" occurs.
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering
of, or the failure to render, any professional architectural, engineering or surveying services,
including:
(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders, change orders or drawings and specifications; or
(2) Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which
caused the "bodily injury" or "property damage ", or the offense which caused the "personal and advertising
injury', involved the rendering of, or the failure to render, any professional architectural, engineering or
surveying services.
d. "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.
e. Any person or organization specifically designated as an additional insured for ongoing operations
by a separate ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS
endorsement issued by us and made a part of this policy.
3. With respect to the insurance afforded to these additional insureds, the following is added to Section III —
Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay
on behalf of the additional insured is the amount of insurance:
a. Required by the contract or agreement; or
b. Available under the applicable Limits of Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
H. PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED EXTENSION
This provision applies to any person or organization who qualifies as an additional insured under any form or
endorsement under this policy.
Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is
amended as follows:
a. The following is added to Paragraph a. Primary Insurance:
If an additional insured's policy has an Other Insurance provision making its policy excess, and
you have agreed in a written contract or written agreement to provide the additional insured
coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek
contribution from the additional insured's policy for damages we cover.
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 5 of 8
b. The following is added to Paragraph b. Excess Insurance:
When a written contract or written agreement, other than a premises lease, facilities rental
contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a
state or political subdivision between you and an additional insured does not require this insurance
to be primary or primary and non - contributory, this insurance is excess over any other insurance
for which the additional insured is designated as a Named Insured.
Regardless of the written agreement between you and an additional insured, this insurance is
excess over any other insurance whether primary, excess, contingent or on any other basis for
which the additional insured has been added as an additional insured on other policies.
I. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"
This provision applies to any person or organization who qualifies as an additional insured under any form or
endorsement under this policy.
The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit:
An additional insured under this endorsement will as soon as practicable:
a. Give written notice of an 'occurrence" or an offense that may result in a claim or "suit' under this
insurance to us;
b. Tender the defense and indemnity of any claim or "suit' to all insurers whom also have insurance
available to the additional insured; and
C. Agree to make available any other insurance which the additional insured has for a loss we cover
under this Coverage Part.
d. We have no duty to defend or indemnify an additional insured under this endorsement until we
receive written notice of a "suit" by the additional insured.
2. The limits of insurance applicable to the additional insured are those specified in a written contract or
written agreement or the limits of insurance as stated in the Declarations of this policy and defined in
Section III — Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not
in addition to the limits of insurance available under this policy.
J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE
WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES
Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following:
(1) "Bodily injury" or "personal and advertising injury":
(a) To you, to your partners or members (if you are a partnership or joint venture), to your members
(if you are a limited liability company), to a co-"employee" while in the course of his or her
employment or performing duties related to the conduct of your business, or to your other
"volunteer workers" while performing duties related to the conduct of your business;
(b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a
consequence of Paragraph (1) (a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay
damages because of the injury described in Paragraphs (1) (a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services. However,
if you are not in the business of providing professional health care services or providing
professional health care personnel to others, or if coverage for providing professional health care
services is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does
not apply.
© 2013 Liberty Mutual Insurance
CG 88 10 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8
Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an
"employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the
"employee's" job responsibilities assigned by you, includes the direct supervision of other "employees" of yours.
However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury' arising out
of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and
advertising injury", or caused in whole or in part by their intoxication by liquor or controlled substances.
The coverage provided by provision J. is excess over any other valid and collectable insurance available to your
"employee ".
K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES
Paragraph 3. of Section II - Who Is An Insured is replaced by the following:
3. Any organization you newly acquire or form and over which you maintain ownership or majority interest,
will qualify as a Named Insured if there is no other similar insurance available to that organization.
However:
a. Coverage under this provision is afforded only until the expiration of the policy period in which the
entity was acquired or formed by you;
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you
acquired or formed the organization; and
C. Coverage B does not apply to "personal and advertising injury" arising out of an offense
committed before you acquired or formed the organization.
d. Records and descriptions of operations must be maintained by the first Named Insured.
No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture
or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured
under this provision.
L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
Under Section IV — Commercial General Liability Conditions, the following is added to Condition 6.
Representations:
Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy
shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or
prior "occurrences" is not intentional.
M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section IV — Commercial General Liability Conditions, the following is added to Condition 2. Duties In
The Event of Occurrence, Offense, Claim Or Suit:
Knowledge of an "occurrence ", offense, claim or "suit" by an agent, servant or "employee" of any insured
shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of
Section II — Who Is An Insured or a person who has been designated by them to receive reports of
"occurrences ", offenses, claims or "suits" shall have received such notice from the agent, servant or
"employee ".
N. LIBERALIZATION CLAUSE
If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional
premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your
state.
O. BODILY INJURY REDEFINED
Under Section V — Definitions, Definition 3. is replaced by the following:
"Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental
anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease.
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8
P. EXTENDED PROPERTY DAMAGE
Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the
following:
Expected Or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This
exclusion does not apply to "bodily injury" or "property damage" resulting from the use of
reasonable force to protect persons or property.
Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US — WHEN REQUIRED IN A
CONTRACT OR AGREEMENT WITH YOU
Under Section IV — Commercial General Liability Conditions, the following is added to Condition 8. Transfer
Of Rights Of Recovery Against Others To Us:
We waive any right of recovery we may have against a person or organization 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" provided:
You and that person or organization have agreed in writing in a contract or agreement that you waive such
rights against that person or organization; and
2. The injury or damage occurs subsequent to the execution of the written contract or written agreement.
© 2013 Liberty Mutual Insurance
CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8
� =V CERTIFICATE OF LIABILITY INSU ICS DA 06/2620114 I
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 holdor Is an ADDITMAI, MOW, D, the po lcy les) must ba endorse . I SUBROGATION IS WAIVED, sub)oct 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 andorsomont(s),
PRODUCER
COVERAGES CERTIFICATE NUMBER: 244025 REVISION NUMBER:
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.
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PERSONAL & ADV INJURY
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GENERALAGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER;
PRODUCTS - COMP /OP AGG
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$
AUTOMOBILE LIABILITY
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$ ^ ^
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ALL OWNED SCHEDULED
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AUTOS AUTOS ,.'
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EXCESS LIA9 CLAIMS -MADE
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ORD RETENTION $
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WIORXERS COMP9NSAT'ION
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more #pace In required)
-
Job Reference: City of El Segundo
CERTIFICATE HOLDER CANCELLATION
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,
Attn: Julie Hegvold
350 Main Street r° AUTHORIZED REPRESENTATIVE
El Segundo, CA 90245
ACORD 25 (2010105) Th 0 1988 -2010 ACORD CORPORATION. All rights reserved.
e`AtORD name and logo are registered marks of ACORD