Loading...
PROOF OF INSURANCE (2015) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE 08 /0M /2014 Y) ""�`���� 08/05/2014 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 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 Hector M. Diaz -Colon M4NIEs _ DCI Insurance and Risk Services PHONE F ,,. 888.457.4426 ;,^,C No,. 323.576.4552 (AM, M9A9L ... 2079 S. Atlantic Blvd., Ste I contaot dci insurance com IT ITmm Monterey Park, CA 91754 INSURER(S) AFFORDING COVERAGE NAIL# INSURER mA: Maxum Indemnitv ComDanv INSURED Norman A. Traub Associates INSURER B : INSURER C : I 5409 Via Fonte '' INSURER E Yorba Linda CA 92886 INSURER F. ....................................................... ...........................�._. E__1 COVFRAnFS CF BTIIFIrATE NIIMI FR., 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,. I_._ _ _ _. _._.. ... n NSR TYPE OF INSURANCE uc unm POLICY NUMBER (MM olonYF) (eeMIDD /If v, LIMITS AUTHORIZED REPRESENTATIVE X COMMERCIAL GENERAL LIABILITY A BDG 3005244 -01 4/7/2014 4/7/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE �X X OCCUR �,......... A ''. PRFMISFC IF. nrriirranral -. $ 100,000 ....... ............_.."........�..�... ........_. MED EXP (Anv one Derson) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY � JECT PRO. F LOC PRODUCTS - COMP /OP AGG ', $ 2,000,000 Errors & Omissions $ Included OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMY (F .,.. D $ ANY AUTO BODILY INJURY (Per person) ..... . . .... .. ....... $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) .$_._. ....... ...... �PROPItT'Y DAMAGE , (Per accident) $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER H- STATI„ITF FR IT ANY EACH $ BEPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED NIA MandaR/ME (Mandatory ) E,L.. EASECIDA EMPLOYEE ?, $ If yes, describe under"" DESCRIPTION OF OPERATIONS below " " " " " " """ " "" E.L, DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) REGARDING THE ABOVE REFERENCED GENERAL LIABILITY INSURANCE POLICY, THE CERTIFICATE HOLDER IS INCLUDED AS AN ADDITIONAL INSURED, BUT ONLY WITH RESPECT TO THE NEGLIGENT ACTS, ERRORS OR OMISSIONS OF THE NAMED INSURED. CFRTIFICOTF N-IOI r)FR rANCF'I I ATION City of El Segundo Human Resources Director SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn:Martha Dljkstra ACCORDANCE WITH THE POLICY PROVISIONS. 350 S. Main Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES O CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "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: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. 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. CG 20 33 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 2. 'Bodily injury" or "property damage" occurring after: a. 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 b. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 33 0413 VEHICLE OR EQUIPMENTCERTIFICATEOF INSURANCE I .,� � � b Y# �' f '+. 4.. UL WY ... I k imermnm xrvmtvummoe ��,wrosu auuwwanwwm wwwww T �A 4 w� rr4M vtooftwx '4M mWW-7m n t ti N 0W=4 tei ACY Lj ADM= a .._ .�.�. A 430 tl4*64M -?lA Arra�rs® �'JOp m. 13 PE 0 FFATW AIM Law I