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PROOF OF INSURANCE (2016) CLOSEDClient #: 9198 TRANSENER DATE (MMIDD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 11/04/2015 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the olic ies must " "be endorsed. If SUBIROGATION IS WAIVED subject t P Y(� ) , stns e t 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 NAME: Dealey, Renton & Associates PHONE FAQ 510 465 -3090 510 452 -2193 fAIC. No. Extl,: .._.. _ ...I�c,.�!.�!L..... ..... .. P. O. Box 12675 Attn: RBC EMAIL " nbarrett @dealeyrenton.com Oakland, CA 94604 -2675 ADDRESS, 510 465- 3090 _ _ _ E NAIC a Travelers Indemnity Co. of Conn INSURER A : Y 256$2 INSURED ....... ........ �. ....._ INSURER B: Travelers Property Casualty Co 25674 Transportation and Energy Solutions Inc - °° 5475 Brentwood Place wsuReR c : Casualty &Surety Co. 31194 Travelers C ..... Yorba Linda, CA 92887 ER D INSUR.. ......... ----- ERE: 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. ............... ................... ILNSR TYPE OF INSURANCE — ADDL SUBR POLICY EFF P- OLICY EXP LIMITS _ ,., �.,. (MMIDD/YYYY) I MIDD/YYYY) 7R ucan NUMBER .....- .....____ - ,_,___.._,_..,.., .,_._._.m.,,_.. A �( COMMERCIALGENERALLIABILITY 6806103LO72 11/14/2015 09/261201 EACH OCCURRENCE $1.000.000 DAMAGE TO RENTED __....... J CLAIMS -MADE � XI OCCUR PREMI$ESlEaoccurrenrpl $1.000.000 X Contractual Liab. MED EXP (Anv one person) $10.000 _.._._. - ........ .,..,. ,.. ........_ , ...,- ............. Included PERSONAL &ADVINJURY $1.000.000 ................. GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52.000.000 POLICY [X JECT LOG PRODUCTS - COMP /OP AGG, s2,000,600 .. PRO - OTHER: $ geaemrcfaseml. L $1,000,0 B AUTOMOBILE LIABILITY BA6104L265 11114/2015 091261201 MIT 00 C4'7MBINED SVNGLr ........... ANY AUTO BODILY INJURY (Per person) $ "�- ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS $ .X, m NON -OWNED F�RdJPI"8'�"9i" DANIA�',�E .... ..... HIRED AUTOS X AUTOS (Peer aK rSidenh $ ...... �,...... ._._ _ ....... ,$ .. .. ................... _.. �. „ - ..,...._._ .................. .......................... ....�„ _._. ....,......_ UMBRELLA LIAB OCCUR CUP7685Y13A 11/14/2015 09/26/201 EACH OCCURRENCE s4.000.000 B X X EXCESS LIAR CLAIMS -MADE AGGREGATE s4.000.000 »! .... .... .. .................. - -- ----- - ------- _ ,..,..,.... , ... .. mA.m. 5 AND EMPLOYERS' LIABILITY T WORKERS COMPENSATION Ni OTH B DFn RPrBIOTY CUTIVEY'� -N UB7138Y004 9/26/2015091261201 XL EAC��I�TF `.. -_ ANY PROPRIETOR/PARTNER/EXE H ACCIDENT $1.000.000 OFFICER/MEMBER EXCLUDED? NIA - - - - -- - - - - - -- -•••• (Mandatory in NH) E.L. DISEASE EA EMPLOYEE 51.000.000 If DESCRIPTION OF OPERATIONS $1.,0 ��. 00, below E.L. DISEASE - POLICY LIMIT $ 000 C Professional 106120752 06/18/2015 061181201.... $2,000,000 0,000 per claim Liability $5,000,000 annl aggr. DESCRIPTION OF OPERATIONS I 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90245 11 1I 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 #S1518228/M1518222 NMB SAGITTA 25.3 (2014/01) 2 of 2 #S1518228/M1518222 Transportation and Energy Solutions Inc 6806103LO72 lifirfElmu COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) 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 81 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the coovriohted 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 4 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: 09/26/2015