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PROOF OF INSURANCE (2015) CLOSEDACS CERTIFICATE OF LIABILITY INSURANCE UATEIMMIDD III II F6/5/2015 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 Healey, Renton & Associates 3. O. Box 12675 )akland CA 94604 -2675 INSURED Risk Management Professionals 300 Goddard, Suite 200 Irvine CA 92618 RISKMANAG1 p �" F' ! 7 4- 427 -34 84 Ilo a insdr .. a.com INSURERISI AFFORDING COVERAGE .................. Travelers Indemnity Co. of Connecti Travelers Property Casualty Co of A U.S. SDecialty Insurance ComDanv rnAlroAr_'I rl -92Th CrA"T rdIIMIAFra- 1880338559 ra viginm rdtitldlpr -P• 4 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. .'N., ...... ............. .. ...... ................. ,,Au Y EXi? ,... ., .... Swyn ..,.. TYPE OF INSURANCE n POLICY NUMBER MIM 61DRY'Y' MIOM /D DBYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 68067071-691 12/11/2014 12/11/2015 EACH OCCURRENCE $2,000,000 II j CLAIMS X OCCUR DA,P Af'r1�",YPt�°_g".b— --- --- ------... -MADE PREMISES.( a o«sc„� .. A1200010.00 ,.,._ ............._ ......... ......... ........_ MED EXP (Any one person) ..,...... , ....... ...__.. $10,000 ._._._._.. ,,,,. --------- - ------- PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY PRO LOC x � PRODUCTS - COMP /OP AGG $4 000.000 OTHER B A U TOMOBILE LIABILITY Y Y BA6707L92A 12/11/2014 12/11/2015 !Ea acodism @',� I $ „� 00 0.000 ANY AUTO BODILY INJURY (Per person) $ ..m ALL WNED SCHEDULED AUTOS BODILY INJURY (Per . ..... accident) $ ....., X..._ NON- OWNED x iC]If "Wik iAAS $ HIRED AUTOS ..... AUTOS leap a¢.Cndsuh, �m v �, „ 4p $ B X UMBRELLA LIAB X , OCCUR CUP7491R818 1211112014 12/11/2015 EACH OCCURRENCE - -- s5,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE _s5.000.000 DED RETENTION $ $ B WORKERS COMPENSATION y UB7641Y390 11/12/2014 11/12/2015 X CTATI ITF I FR AND EMPLOYERS' LIABILITY YIN ''" -° ” "" ANY OFFICER /MEMBER EXCLUDED? ECUTIVE ❑NIA ( ry ) E L DISEASECEDA EMPLOYEE $1 000 0 0 If yes, describe under ._._ ,,.,.. _. _ . ..... ............... ...................... DESCRIPTION OF OPERATIONS below E L, DISEASE - POLICY LIMIT $1 000,000 C Professional Liability USS1425435 12/11/2014 12/11/2015 $2,000,000 each claim $2,000,000 Aggregate Claims Made '.. DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CITY, its officials, and employees are additional insured as respects general liability for claims arising from the operations of the named insured as required per written contractor agreement. TE HOLDER 30 Cacnellation /10 Non SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo — Public Works ACCORDANCE WITH THE POLICY PROVISIONS. ATTE: Lifan Xu, P.E, Principal Civil Engineer 350 Main St AUTHORIZED REPRESENTATIVE El Segundo CA 90245 -3813 4 © 1988 -2014 ACORD CORPORATION. All rights reserved, ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 6806707L691 COMMERICAL GENERAL LIABILITY ISSUE DATE: 6/5/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS EEI S A D SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION (S): City of E1 Segundo - Public Works ATTE: Lifan Xu, P.E, Principal Civil Engineer 350 Main St E1 Segundo CA 90245 -3813 PROJECT /LOCATION OF COVERED OPERATIONS: CITY, its officials, and employees 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 oper- ations; 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 person or organization has assumed liability in a contract 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 ". 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 Declarations 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. 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 Page 1 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission COMMERICAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available 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 additional 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 insured when the additional insured is also an additional 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 CONDITIONS (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 project, or at the location, shown in the Schedule above, performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" 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 under which you are required to include the person or organization shown in the Schedule as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury" is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. CG D3 82 09 07 Page 2 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission POLICY #: BA67071,92A COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions ofthe Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 6/5/2015 Countersigned By: ...... I (Authorized Representative) Named Insured: Risk Management Professionals SCHEDULE Name of Person(s) or Organization(s): CITY, its officials, and employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Ar TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76(00) — 001 POLICY NUMBER: UB7641Y390 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. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 3.00 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ALL PERSONS OR ORGANIZATIONS THAT REQUIRES YOU TO OBTAIN EXECUTED THE CONTRACT BEFORE DATE OF ISSUE: 6/5/2015 017106 Job Description THAT ARE PARTIE TO A CONTRACT THIS AGREEMENT, PROVIDED YOU THE LOSS. ST ASSIGN: CA COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHER TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident", provided that the "accident" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. CA T3 40 02 99