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PROOF OF INSURANCE (2016) CLOSED,. DATE (MMIDDWWI CERTIFICATE OF LIABILITY INSURANCE 1/27i2016 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(sk PRODUCER %' a�a;.v�w NCI~, Stacie Evans Edgewood Partners Ins. Center PHONE 916-576-1603 FAX 916 560 5393 License Number- OB29370 PO Box 13847 � d - la�C�t,lp): -M .,,.,....,:,...... E o�Qa stacie.evans@_epicbrokers.com Sacramento CA 95853 INSURE !NS) AFFORDING COVERAGE NALCO R 'y N_NUMBER* INSURER:A :Travelers Pro p2qy Casualty C,o of 25674 INSURED CPSHU -2 ..... - INSURERB:Llovds of London 85202 Cooperative Personnel Services u1SURERC:. dba: CPS HR Consulting_ " "' " " " " "" 241 Lathrop Way INSURER D Sacramento CA 95815 INSURER E COVERAGES CE'R IFIC TE NUMBga., 548049408 R 'y N_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. aNSR LTY1 _' TYPE OF INSURANCE Ate' luen unm ._- Pr1LICY NIIMRFR P4'LICYE MVoyr YYY P01DONY4l"I MMdOD9YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 6307704A197 7/112015 7/1/2016 EACH OCCURRENCE $1;000;000 ............ CLAIMS -MADE � OCCUR a,m, .... '�f Y4fAiS£ "'rIC"Y "iTF I�"I`FI�"""" -""" PRFMIRFS IF. nn­"neg_1 SSOO.ODO X Deductible NIL MED EXP (Any one Derson) 510,000 PERSONAL & ADV INJURY 5'1,000.000 GEN"L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S2000,000 POLICY 0 PRO - LOC PRODUCTS - COMP /OP AGG 5S 2,000.000 OTHER: AUTOMOBILE LIABILITY BA7704A197 7/112015 7/112016 Eaodenl $1,000.000 ANY AUTO BODILY INJURY (Per person) !S ALL OWNED SCHEDULED BODILY INJURY (Per accident) 15 X X .... `rC_A GE_ " o ,� S HIREDAUTOS AUTOS ra S A X UMBRELLA LIAR X OCCUR CUP7704A197 7/1/2015 7/1!2016 EACH OCCURRENCE 55,000,000 EXCESS LIAB CLAIMS -MADE ..... A�REGAT'E $5.000,000 ...... -. nFn X RETENTIOSNIL 5 A QfCEM S COMPENSATION U61176A220 7!1/2015 71112016 PER OTH- X CTATI ITF X ER Stop Gap' PLOYERS' LIABILITY YIN Ar1Y PROP'RdETO"ARTNErVEXECt1T'1VE OFFICER/ME WER EXCL.UOEO'/ NIA E.L. EACH ACCIDENT 51.000,000 ---.�. IMan4latory In Nb!) E, L, DISEASE - EA EMPLOYEd $1,000,000 Iy 1'y SCRIPTIONO O DESCRIhTION OF OPERATIONS tastowv I , -:,. , ., ,,,�.J . ".Ua:., -r� . >- �� :::,, � E.L. DISEASE - POLICY LIMIT .. 51,,000,000 Prof Liab - Claims Made 11Gw51501 1 s 71112075 7l1 2016 Per ClalmlA $5,000,000 Retro Date - 10/13/1989 'Stop Gap- only NO, OH, WA, WY f' >w ,mP bpI-1,4., .i. w, �3- rg.d.,.- Ded Per Claim $75,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) Re: Agreement #4665. City of El Segundo, its officials and employees are Additional Insured with respects to General Liability per the attached endorsement General Liability is Primary and Non- Contributory per the attached endorsement. 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 g I ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Martha Di kstra 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 s ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 6307704A197 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a 'written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury', "property damage" or 'personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance ", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by 'your work" and included in the "products - completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance ", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non - contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: fl. Supervisory, Inspection, architectural or a "` engineering activities.'°, a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; III. The names and addresses of any injured persons and witnesses; and Ill. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: L Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the 'suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance' which would cover the additional insured for a loss we cover under this endorsement However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part,_ provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; 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 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 Policy No. 6307704A197 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this 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 that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs; and b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1