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PROOF OF INSURANCE (2016) CLOSED0 A CERTIFICATE OF LIABILITY INSURANCE DATE (MMlooIYYYY) 1 /zl /zo16 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 Meg Rasmussen, CISR Walter Mortensen Insurance / INSURICA PP P.F ri (661) 834 -6222 NpI. 16e11 2e1 -4992 CA License #OD94424 f4AIL mrasmu.ssen @INSURICA.com AOORLyS,$ ...... _.....,_..m.,........,.,. 8500 Stockdale Hwy., #200 INSURERIS) AFFORDING COVERAGE NAIC If Bakersfield CA 93311 INSURER A Travelers Property Casualtv Cc of 25674 INSURED INSURERB.State Comoensation Ins. Fund of CA 35076 Sierra School Equipment Co., Inc, INSURER C' P. O. Box 80667 INSURER E Bakersfield CA 93380 -0667 INSURER F• COVERAGES CERTIFICATE NUMBER:15 /16 General CA 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. LTR TYPE OF INSURANCE wcn wvn; POLICY NUMBER JMMQDrYYYYI IMMODNMt I LIMITS }[ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1 , 000 , 000 �( X- iSAmwd"I I"b"ffi=N1"E"ii S� ... WWW _ _ _ ..10..... A JI CLAIMS -MADE OCCUR PRFMI.RF.9 IF. oN��ia _1 Y6309197R385TIL15 j 10/1/2015 10/1/2016 MED EXP (Any one person) S 10,000 PERSONAL 8 ADV INJURY S 1,000,000 GE. N "L..MG'GREGATE. LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 _ POLICY ° PRO- T LOC PRODUCTS COMPIOPAGG S 2 000,000 0 g p' tl :I'HER S AUTOMOBILE LIABILITY OOM 13'N ED 51 NGLE LIMIT iFtir acc�Jk"11L ..._ ... .� S__.....— 1,000,000 X. ANY AUTO BODILY INJURY (Per person) S A ,,_, ALL OWNED AUTOS AUTOS BA9197R385TIL15 10/1/2015 10/1/2016 BODILY INJURY (Peracciden l) S X,. .... NON -OWNED X ""f''£"'I''°tj{�,Ivl" -_,...m HIREDAUTOS ....,,_.. AUTOS SOT. �arCI` aost_. Medical payments S 5,000 $ UMBRELLA LIAR X .00CUR EACH OCCURRENCE S 4 .000. 000 EXCESS LIAB...... A CLAIMS -MADE 4,000,000 nFn IRETENTION� CUP9197R385TIL15 10/1/2015 10/1/2016 ......AGGREGATE .. WORKERS I TH. Up AND EMPLO E A I RSEL BILIITY YIN ANY PROPRMETORIPARTNER /EXECUTIVE -}{ ^ ,^ , T E.L, EACH ACCIDENT S ..mm. 1.000 000 ' OFFICFWM'EMBEREXCLUDED? a N/A ., B IMandatory in NHI .. 9142586 -2015 10/1/2015 10/1/2016 E.L, DISEASE - EA EMPLOYE 5 1 . 000.000 If yes, describe under -. -.• - ..•••. ..•.•.. _ • w..... ........:.:...�.,. DESCRIPTION OF OPERATIONS below E L,. DISEASE- POLICY LIMIT S 11000;000 A Installation Floater Y6309197R38STILI5 10/1/2015 10/1/2016 Limillany one site $300,000 Transportation Y6309197R385TIL15 10/1/2015 10/1/2016 ''..Limit $80,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: City of E1 Segundo, PW15 -29A Furbish seating for City Council Chambers: When required by written contract, The City of E1 Segundo is added as additional insured on the general liability policy per the attached form #CGD2460805 and primary per the attached form #CGDO370405 subject to the terms, conditions and exclusions of the policy. Cancellation provisions are provided per the attached form #ILT9280912. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of E1 Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. E1 Segundo, CA 90245 -3813 4^ AUTHORIZED REPRESENTATIVE Ron Burcham /MRASMU f� ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) j 4 COMMERCIAL GENERAL LIABILITY Sierra School Equipment Co. Inc Policy #Y6309197R.85TII115 Effective 10 -4-2015 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 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 ", "properly 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 (he 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: 1. 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 IL Supervisory, ,inspection, architectural or engineering activities. 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 (hen 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 fnsu�ed for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires (hat 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: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" oi�- 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; f(. The names and addresses of any injured persons and witnesses; and lit. The nature and location of any Injury or damage arising out of (lie "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: I. 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 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 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE OCTOBER 1, 2015 AT 12.01 A.M. AND EXPIRING OCTOBER 1, 2016 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME f�b SIERRA SCHOOL EQUIPMENT COMPANY,] 1911 MINERAL CT BAKERSFIELD, CA 93308 9192586 -15 RENEWAL NE 1-- 27- 02--02 PAGE 1 OF 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. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE DIN ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: SEPTEMBER 30, 22015 Y;1/ AUTHORIZED REPRESENT IIVE PRESIDENT AND CEO 1 2572