Loading...
PROOF OF INSURANCE (2016) CLOSEDAC"REP ° "0`�° 5" CERTIFICATE LIABILITY INS DCE 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 polley('les) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endornemenL A statement on this certificate does not confer rights to the certificate holder In lieu of such endDrsementfst. PRODUCER Brad Bell Insurance Agency 4869 Topange Canyon Blvd ., Suite #1 Woodland Hills. CA 91364 li631ri?? EeoTierra Consulting, Inc. 555 W. Fifth St-, 31st Floor Los Angeles, CA 90013 Brad Bell 8184883 -2996 A: Westchester Surplus Lines Insurance Company D: 818 -883 -2997 10172 arsuRER F : p COVERAGES' CERTIFICATE NUMBER: REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF IN JRANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMCD AROWE 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. TYPE of GENERAL LIABILRY VERCIAL GViE1VL LIABILITY CLADASmMADE 19 OCCUR LIMITS EACH OCCURRENCE._ ffi S 1.000 DDO PR>seses rFn �._�_� 50.D60 A ,... ,�, .,...... 624305298 004 08!04/2015 08!0412016 adR1 PERSONAL b ADV RY, INJURY Additional Primary Insured LLs _ GENERAL AGGREATE s- EIILACCRE GATE U A Pe.IESPER ,.. PRODUCTS - COMPIOPAGG S POLICY 7 5"10T LOC S AIROMORILEUABILITY M P p A ANY AUTO a � s ROCKY INJURY (Per 1 Ws G24305296 AUTOS 004 08/04/2015 08!04/2016 Y Mw i s OFD }C HIRED AUTOS hx —.1, AUTO$ r e�Io ...... ....., s s UMBRELLA LIAa OCCUR y F JeeH EXCESS LIAR . .. _.._ ....,.�...�,� s RETENTION 9 ..,.. s WORKERS COMPENSA110H AND I.... f MY� � �.... or LO ILOYERS' LIABILITY Y N . Vj ANY RAT IIERIiIdCL190rD� aIrypurNONWLAbI 'P'NEr "EIkEICDV4aE []NIA EACH S .�_.._...e..n .. J arod " VPTI E L DISEASE EA EMPLOYEE s CIS:PTI,..Oi OERATIOSIaBrr�a OF EL�SERE -... Y I My f A � Professional Liability; 2.000.000 G24305296 004 1 08/04/2015 , 08/0412016 I $2,000,000. (per inddent/per aggregate) TIONS I LOCATIONS I V'E141CLES I EXCLUS'1,04S Certificate Holder is Additional Insured for General Liability but only if required by written contract with the Named Insured prior to the occurrence and as per attached endorsement- Coverage is subject to an pDOW terms and conditions. 'Except 10 days notice of Cancellakm for non- payment of premium. For Professional Liability coverage, the aggregate limit Is the total Insurance available for an Covered claims reported within the policy period. City of El Segundo Attn: Idmberty Christensen, AICP, Planning Ma ar 350 Main Street El Segundo, CA 90245 SHOULD ANY OF THE ABOVE DE'SCRISED THE EXPUIIATIONI DAwTHEREw, THE issupio wsuRERwa.LEwvAvoRyo MAC 30 DAYS WRfrrEN NOTICE TO THE CERTMATEHOLDER NAMED TO THE LEFT. BUT FAWRE TO DO SO SHALL NPOSENO OBLIGAIM OR OF ANY UPON THE INSURER, n'SA061M OR REPRESENTATIVES, Named Insured Endorsement Number Ecotierra Consulting Inc Policy Symbol Polley Number Policy Period Effective Date of Endorsement ECP G24305296 004 08/04/2015 to 08/04/2016 08/04/2015 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the Information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations, (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that Insured, y B. With respect to the Insurance afforded to these additional insureds, the following exclusion is added; Exclusions This Insurance does not apply to bodily Injury or property damage occurring after. (1) 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 site of the covered operations has been completed; or (2) 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. ENV -3100 (08.04) Includes copyrighted material of Insurance Services Office, Inc. with Its permission Page 1 of 1 Named Insured Endorsement Number Ecotierra Consulting Inc Policy Symbol Polley Number Polley Period Effective Date of Endorsement ECP G24305296 004 08/04/2015 to 08/04/2016 08/04/2015 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number, The remainder of the Information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy,. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or oraanjxawi�� Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, Information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following; We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products- completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above, All other terms and conditions remain the same. ENV -3143 (03 -05) Includes copyrighted material of Insurance Services OfAce, Inc, with Its permission Page 1 of 1 C CERTIFICATE OF LIABILITY INSURANCE 08%12/2015) 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 pollcy(les) 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(a). PAYCHEX INSURANCE AGENCY INC 150 SAWGRASS DR ROCHESTER, NY 14820 (877) 3:82 -8785 INSURER(S) AFFORDING COVERAGE INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURED INSURER 0: ECOTIERRA CONSULTING INC 555 WEST 5TH STREET 31ST FLOOR INSURERc LOS ANGELES, CA 90013 INSURER D: INSURER 0: INSURER F; COVERAGES CERTIFICATE NUMBER: 022488907181422 REVISION NUMBER: NAIC M 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, INSR ADDL BURR POLICY EPP POLICY EXP L? TYPBOF INSURA ... ..._.. (NEo yyl/D - =___. POLICYNUMSER IMMIDDiWWI IMMIDDnWYI ..�. LIMITS COMMERCIALGIENERALLIASILITY EACH OCCURRENCE _ T . E CLAIMS -MADE OCCUR PREM1A A Ira nrrunanm% MED EXP (Any one oeraonl $ PERSONAL A ACV INJURY $ ®rNFRAL A[a ®R�[�A4F $ S3EN "L AGGREGATE LIMIT APPLIES PER POLICE C,. PE � LOC PRO ®ucrs c ®M ; ®P a ®® ............. OTHER; $ a NdenntBINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea BODILY INJURY (Per person) $ ANY AUTO ALL kE OWNED SC SWJLED AUTOS 7 BODILY INJURY (Per accident) III HIRED AUTOS NON -OWNED AUTOS PP Pgj.nDAMAGE Etr�d ��11 $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE aIEXCESI LIAR CLAIM$ MADE AGGREGATE $ urn RETENTION $ $ A COMPENSATION NIA %( U - 8937 708 -15 08/02/2015 08/02/2018 LITE T "° AND EMPLOYERS' L YIN ANY f)AOPRIETOR4PARTI�ERIEXECU'TIIVE H ACCIDENT $1,000,000 FE.L.DISEASE ° EA EMPLOYEE $ 1 ,000,000 FFICER1M MffREXCLLNDED"I Mandatory Ito H) t yos dasctlbe under DESGaRIPTION OF OPERATIONS belo�r EASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) AS RESPECTS TO WORKERS COMPENSATION COVERAGE, WC 99 03 78 (A) - WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA (BLANKET WAIVER) HAS BEEN ATTACHED TO THE POLICY, CERTIFICATE HOLDER THE CITY OF EL SEGUNDO ATTN KIMBERLY CHRISTENSEN, AICP PLANNING MANAGER 350 MAIN STREET EL SEGUNDO, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RSPRSSBNTATIVS 01988. 2014 ACORD CORPORATION, Allrights re...se erved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: (IJUB- 6937870 -6 -15) 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 2 % of the California workers' compensation pre- mium. Schedule Person or Organization K ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 Premlum insurance Company Countersigned by DATE OF ISSUE: 06 -18 -15 ST ASSIGN: Page 1 of 1