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PROOF OF INSURANCE (2015) CLOSEDClient #: 9198 TRANSENER
=TEDDIYYYY)
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 15
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 INSURERS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
__ .... ___________________________ If' holder i n ADDITIONAL INSURED the olic ies must be endorsed. If SUBROGATION WAIVED, to
IMPORTANT- --the certificate olde s a p y( )
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
NAME:
Dealey, Renton & Associates PHONE
(A/O. No, Extl: 510 465-3090 A(c No) 510 452 -2193
P. O. Box 12675 Attn: RBC E-MAIL
Oakland, CA 94604 -2675 611DRESS. INS FORDING NAlca
510 465 -3090
INSURER(S) AF COVERAGE
wsURERA: Travelers Indemnity Co. of Conn '25682
-- - ..._ ..................................... . ..................... m .... ....
INSURED INSURER B: .. p__ ...,.�.,m.,.,.,..,..,..........._.,....- ----...... —'
Travelers Property Casualty Co 25674
Transportationand Energy Solutions Inc ............................................................................................................................... ............................... ........................................ ...............................
p gy INSURER C: Travelers Casualty & Surety Co. 31194
5475 Brentwood Place ............... a .............._.... ...
Yorba Linda, CA 92887 INSURER D
INSURER E:
INSURER F
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 CONTRACTOR 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.... ADDL SUBR... ... ... ..._ ---- POLICY EFF POLICY EXP
LTR ...N URANCE NSR wvo POLICY NUMBER__ IMM /DD/YYYYI IMMIDD/YYYYI LIMITS
A X COMMERCIAL GEN ERAL ....................... s.,T. r r8 _ 6806
TYPE OF IN
LIABILITY 103LO72 11/14/2014 11/14/201 EACH OCCURRENCE $1.000,000
DAMAGE TO RENTED
..I CLAIMS -MADE X1 OCCUR PREMISES (Fa occurrence) $1.000$000
X Contractual Liab. MED EXP (Anv one person) $10.000
.. Included .PERSONAL &ADVINJ ...�. ,.,.,.,.. .....,..... ...................
JURY $1.000.000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2.000.000
JPRO- LOC PRODUCTS - ODUCTS- COMP /OPAGG $2.000.000 POLICY [X ECT
OTHER:
B AUTOMOBILE LIABILITY BA6104L265 11/14/2014 11/14/2015 OC?MBINEDIh(d�LLLIM °� R1,000,000�
- ,..�... m(E
ANY AUTO BODILY INJURY (Per person)
............. ALL OWNED ........ SCHEDULED
AUTOS BODILY ... INJURY .(Per accident) .....$..................................... ...............................
. ...... .... .... AUTOS .. ...
NON -OWNED PROPERTY DAMAGE $
X HIRED AUTOS X AUTOS lPPrnccid Pnt)
OCCUR CUP7685Y13A 11/14/2014 11/14/201 EACHOC URRENCE
EXCESS. ............... ...,..
c s4.000.000
X
AGGREGATE $4,000;000
B X LA LIAR
LIAB
f1Fr1 RFTFNTInN R $
B AND N EMLPPLIOYEOR /PARBINER/EXECUTIVE UB7138YOO4 W
WORKERS
COMPENSATION
PER OTH
9/26/2014 09/26/201 X -I ITF OT
OFFICER)MEMBER EXCLUDED? � N/A
E L. EACH ACCIDENT $11.000.000,
(Mandatory In NH) E L, DISEASE EA EMPLOYEE $1,000,000 ,
_ .............. _.... , _..
1 000 000
C
If
onal under 106120752 6/18/2015 06/18/201 $2,000,000 per claim
DESCRIPTION OF OPERATIONS below E..L DISEASE POLICY
eeee
Liability $5,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
General Liability policy excludes claims arising out of the performance of professional services.
RE: TES Contract
GENERAL LIABILITY ADDITIONAL INSUREDS, as required by written contract: City of El Segundo, its officials,
officers, agents and employees
(See Attached Descriptions)
City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
a, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Public Works Dept. ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street 9
El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE
©1988 -2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) 1 of 2 The ACORD name and logo are registered marks of ACORD
#S1453570/M1449817 N M B
SAGITTA 25.3 (2014/01) 2 of 2
#S1453570/M1449817
Transportation and Energy Solutions Inc
6806103LO72
ifiYJUAIT01
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED �
(ARCHITECTS, ENGINEERS AND SURVEYOR
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. The following is added to WHO IS AN INSURED
(Section II):
Any person or organization that you agree in a
"contract or agreement requiring insurance" to in-
clude as an additional insured on this Coverage
Part, but only with respect to liability for "bodily in-
jury", "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.
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 the insurance
provided to an additional insured under this Cov-
erage 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 addi-
tional 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;
The insurance provided to such additional insured
is limited as follows:
d. This insurance does not apply on any basis to
any person or organization for which cover- C
age as an additional insured specifically is
added by another endorsement to this Cover-
age Part.
e. This insurance does not apply to the render-
ing of or failure to render any "professional
services ".
f. 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
after you have entered into that "contract or
agreement requiring insurance ". But this insur-
ance still is excess over valid and collectible other
insurance, whether primary, excess, contingent or
on any other basis, that is available to the insured
when the insured is an additional insured under
any other insurance.
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 any person or organization because of
payments we make for "bodily injury", "property
damage" or "personal injury" arising out of "your
work" performed by you, or on your behalf, under
a "contract or agreement requiring insurance" with
that person or organization. We waive these
rights only where you have agreed to do so as
part of the "contract or agreement requiring insur-
ance" with such person or organization entered
into by you before, and in effect when, the "bodily
CG D3 8109 07 © 2007 The Travelers Companies, Inc. Page 1 of 2
Includes the copvriahted material of Insurance Services Office. Inc.. with its permission
COMMERCIAL GENERAL LIABILITY
injury" or "property damage" occurs, or the "per-
sonal 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 un-
der which you are required to include a person or
organization as an additional insured on this Cov-
erage Part, provided that the "bodily injury" and
"property damage" occurs, and the "personal in-
jury" 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.
Page 2 of 2 © 2007 The Travelers Companies, Inc. CG D3 81 09 07
Includes the coovriahted material of Insurance Services Office. Inc.. with its permission
Transportation and Energy Solutions Inc
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 99 03 76 (00) --
POLICY NUMBER: UB7138YO04 r ;
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 % of the California workers' compensation premium
otherwise due on such remuneration.
Schedule
Person or Organization: Job Description:
City of El Segundo, its officials, officers, agents and employees
City of El Segundo
Public Works Dept.
350 Main Street
El Segundo, CA 90245
DATE OF ISSUE: 09/26/2014