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PROOF OF INSURANCE (2015) CLOSEDr JLEEENG -01 YUENG A;��1r�Mw DATE (MM/DDJYYYY) CERTIFICATE OF LIABILITY INSURANCE 8126/2014 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 cortificalls holder Is an ADDITIONAL INSURED, the polh y(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 License # OES7768 Na ra. (31al Yuen Services-SF IOA Insurance y and Road Suits 240 '3875 Ho (925) 416 -7862 � No),. (925) 416 -7868 Pleasan on, CA 94568 1 a I - Y u enft Ioauaa.Ccrn INBURER(S) AFFORDING COVERAGE NAIC 0 INSURER A: Travelers Property Casualty Company of America 25674 INSURED INSURERS: Argonaut Insurance Company 19801 JLee Engineering, Inc. INSURER C: 430 S. Garfield Avenue, #301 INSURER 0: Alhambra, CA 91801 INSURER E: COVERAGES CERTIFICATE NUMBER: 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. ffW LTR TYPE OF INSURANCE wvn Po,ucY wuuaEn I LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE B 2,000,00 CLAIMS -MADE a OCCUR 6808855N594 09101/2014 09/01/2015 B 1,000,00 MED EX P (Any one person) S 10,00 PERSONAL 8 ADV INJURY B 2,000,00 ..�._� GEN"LPOLICY GGEt ATE LIMIT APPLIES PER: GENERAL AGGREGATE B 4,000,00 PRO - JECT LOC PRODUCTS - COMP /OP AGO B 4,000,00 OTHER, n: s AUTOMOBILE LIABILITY (Ese:xrdaral) !3 2,000,00.. A I ANY AUTO 8808855N594 0910112014 09/01/2015 BODILY INJURY (Per person) B _...m. ALL OWNED SCHEDULED Per accident AUTOS AUTOS ( ) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS Pe( a m S UMBRELLA LIAR OCCUR EACH OCCURRENCE S j EXCESS LIAB AGGREGATE S CLAIMS-MADE pED RETENTION; V S WORKER8COMPENSATION A pPROPRIETOWPA INERIEXECUTIVE Y/N UB329OT632 09101/2014 09/01/2015 E L EACHII,TF FR OFFICER/MEMSER EXCLUOEO7 EI N / A ACCIDENT i 1,000,00 IMandelory In NH) E.L. DISEASE - EA EMPLOYE..... S 1,000,00 If O S� I%IPT und F ipERATIONS beldre E.L. DISEASE - POLICY LIMIT ,�.._.......... $ 1.000,00 B 'Professional Liab. IAE1262601 11/0212013 11/0212014 Per Claim 1,000,00 B Professional Liab. IAE1262601 11102/2013 11/02/2014 Aggregate 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addldonal Remarks Schedule, may be attached If more space Is requlrsd) All Operations of the Named Insured. ;General Liability only: City of El Segundo, its officers, offlCle* employees, and authorbsd Volunteers Is named Be Additional Insured trot only as respects liability arising out of the Named Insured "s operations In Professional Services Agreement; such coverage Is, primary and Non - Contributory as respect$ any Insurance carried by the Additional Insured with respect to work performed by the Named Insured, Also, note that the aforstnsntloned General Liability Includes coverage for Hired 6 Non -Owned Auto Liability. Above policies Include Waiver of Subrogation In favor of the eformentioned Additional Insured. CERTIFICATE FOLDER CANCELLATION Xv j 7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 ACCORDANCE WITH THE POLICY PROVISIONS. ll t AUTHORIZED REPRESENTATIVE City of El Segundo rN 360 Main Street 1 IEI 3aatlndo_ CA 1111M ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680- 8855N594- TIL -13 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 07 -17 -13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL '" UR (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART NAME OF PERSON(S) OR ORGANIZATION(S): PER SCHEDULE ON FILE SCHEDULE PROJECT&OCATION OF COVERED OPERATIONS: PROVISIONS A. The following is added to WHO IS AN INSURED (Section II): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for "bod- ily injury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products - completed operations hazard ". Such person or organization does not qualify as an additional Insured for "bodily injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render- ing of or failure to render any "professional services ". e. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. B. The following Is added to Paragraph a, of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 ® 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission COMMERCIAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or a primary and non - contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance" for such addi- tional Insured. But this Insurance still Is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional in- sured when the additional insured is also an addi- tional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal Injury" arising out of "your work" on or for the pro- ject, or at the location, shown in the Schedule above, performed by you, or on your behalf, un- der a "contract or agreement requiring insurance" with that addltional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with that additional Insured entered Into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal in- jury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include the person or organization shown in the Schedule as an ad- ditional insured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs, and the "personal injury" is caused by an of- fense committed: a. After you have entered into that contract or agreement; b. While that part of the contractor agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 ® 2007 The Travelers Companies, Inc. CG D3 82 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission TRAVI� AND ELERS WORKERS COMPENSATION ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: (XJUH- 3290T63 -2 -13) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 03.00 % of the California workers' compensation pre- mium. Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Schedule Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 07 -16 -13 ST ASSIGN: Page 1 of 1 - - - -- Original Message---- - From: Garcia, Angelina Sent: Tuesday, September 09, 2014 11:34 AM To: Stack, Rebecca Cc: Lee, Sam Subject: RE: Emailing: 2014 SEVENTH Amendment to J Lee Contract #3790, INSURANCE This looks good.Approved. Angelina Garcia - - - -- Original Message---- - From: Stack, Rebecca Sent: Tuesday, September 09, 2014 11:27 AM To: Garcia, Angelina Cc: Lee, Sam Subject: Emailing: 2014 SEVENTH Amendment to J Lee Contract #3790, INSURANCE Angie If this looks ok I will send to consultant for signature and forward to Clerk. Thanks The message is ready to be sent with the following file or link attachments: 2014 SEVENTH Amendment to J Lee Contract #3790 INSURANCE Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled.