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PROOF OF INSURANCE (2016) CLOSEDA CERTIFICATE OF LIABILITY INSURANCE UATE(MMI °DIYYYY) 10/28/2015 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. the IMPORTANT: If n certificate holder ise ADDITIONAL INSURED, endorsement. lc ( endorsed. certificate SUBROGATION c°)t to the terms and conditions of the poiY, C�P oI ci sma require A statement on this dos not onferrights to the certificate holder in lieu of such endorsement(s), PRODUCER Garrett /Mosier /Griffith /Sistrunk CONTACT NAME 44slynn Rowe Risk Management & Insurance Services PHONE FAX 12 Truman E-MAIL AI�. � Extl 949-559-3700 (Arc, N� : 949559 8703 �Mt ,.. � Irvine, CA 92620 E A $ � aslyrtnra gm, s,com fNSURE'R(SI AFFORDING COVERAGE �I� NAIC # www.gmgs.com OBB4519 INSURER Great Divide Insurance ................... _,_ -... INSURED INSURER B: Peerless Insurance Co EEC Environmental - - - - -- dba. Envirornental Engineering Contracting Inc., INSURERC. One City Boulevard West, Suite 1 S00 INSURER D utu Nautilus us Insurance Cor Orange 92868 INSURER E: COVERAGES CERTIFICATE NUMBER: 27097701 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. INSii TAWL'SUSA... ...,... ,,,... _........ POLICY EFF,,,, POLICY EX{"'..,.. L TR TYPE OF INSURANCE I INCn wvn POLICY NUMBER IMMnOrnvn MMrDDV'M'YYY LIMITS A COMMERCIAL LIABILITY GLP2008942 -13 10/31/2015 10/3112016 EACH OCCURRENCE $ 5 000 OO CLAIMS is CLAIMS-MADE ✓. OCCUR $ 000; 0 ..., e .� PRLM sE� ocrrla u� ca,) . ,100 MED EXP (Anv one person) S 5,000 ,,.....� ,,,,,, .... -- .......- _,.... PERSONAL & ADV INJURY $ ......5,000,000. T GENI 'LAGGREGA LIMIT APPLIES PER: GEN E E_ L,AGGREGATE $ 5,00 0 00 POLICY �_ JECT LOC PRODUCT S- COMP /O P AGG $ 5,000,000 OTHER; $ B AUroMOBILE uaeluTY CBP8977390 10/3112015 10/31/2016 a O FJtND iNG E UMIT $ 1X000 000 '- ANY AUTO BODILY INJURY (Per person) $ ED -.. ��. ---- - SCHEDULED BODILY INJURY (Per accident) $ AUTOS .. _ NON -OWNED ��(5AG,° iff0'h' bAMAC'f---- _ ✓ $ m HIRED AUTOS ✓,. AUTOS 4 144 UMBRELLA LIAB OCCUR ,I EACH OCCURRENCE ''.. $ EXCESS LIAR _....... , ADE.. AGGREGATE $... RETENTION DED $ A WORKERS COMPENSATION WCA2006615 -12 5/24/2015 5/24/2016 ✓ C FRH AND EMPLOYERS' LIABILITY Y I N ...E STATI ITF Y PRP PRIIE'rORJ ECUTIV'E L EACH ACCIDENT $.,,, R'rN RE 1 OOO OOO Y.,71 : j7 NIA __ -000 EA EMPLOYEE $ 1 000,000 If under e.. DESCRIPTION LiPE.RA1 IONS below EL DISEASE SE POLICY LIMIT S 1,000.000 D Pollution Liability CCP26069 11 -13 10/31/2015 10131/2016 Each Poll Occurrence $5,000,000 Professional Liability Each Prof Liab Claim $5,000,000 General Aggregate: $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Sewer S stem Tanaggemerit Pisn As' general Liability coveraggaa Cit of El Segundo„ its officials and emplo ees are added as Additional Insureds and th6s insurance is primary per EN 06 aflachedi. As respects Automobile Coverage, Business Auto Coverage Form CA 00 01 10 01 applles. AS respects Worker$ Co pensallon coverage„ a Waiver of Subrogalion Is hereby Included per WC040306 attached, As respects General Liability coverage„ 30 dray written notice of cancellation (10 days for non - payment of premium) applies per IL00171198 attached. CERTIFICATE HOLDER CANCELLATION CItYY of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PUDIIC Works THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo CA 90245 - AUTHORIZED REPRESENTATIVE Grill Grlfflth ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 27097701 1 15 -16 G /A /UMB /P0LL /E &0 /WC I Jaelynn Rowe 1 30/28/2015 4:33:36 PM (PDT) I Page 1 of 4 GLP2006942 -13 EEC Environmental ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED - BLANKET - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Who is An Insured (Section II) is amended to include as an insured any person(s) or organizations, for whom you are performing operations under a written contract or agreement, which is in effect prior to the performance of your work which is the subject of such written contract or agreement, that such person(s) or organization(s) be added as an additional insured on your policy, but 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 the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured; or 2. Your work performed for such person(s) or organizations(s) and included in the products - completed operations hazard, only when required by the written contract or written agreement. With respect to damages caused by your work, as described above, the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above, but only when required by written contract or agreement. ® 2006 by Berkley Specialty Underwriting Managers LLC, an affiliate of Nautilus Insurance Company and Great Divide Insurance Company. All rights reserved. ® 1985.2006 by Insurance Services Office, Inc,, material used by permission. ENV 2154 A 09 06 Page 1 of 1 27097701 1 15 -16 0 /A /VMB /P0LL /E &0 /WC I Jaalynn Rowe 1 10/28/2015 4:33:36 PM (PDT) I Page 2 of 4 EEC Environmental GLP2006942 -13 dba Enviromental Engineering Contracting Inc., COMMON POLICY CONDITIONS All Coverage Parts Included in this policy are subject to the following conditions. A Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or dellver- Ing to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel - lation If we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation If we ca noel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last. mailing address known to US. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy Is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than {pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 5. If notice Is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown In the Declarations Is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended) or waived only by endorsement Issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and re- oords as they relate to this policy at any time dur- Ing the policy period and up to three years after- ward. D. Inspections And Surveys 1. We have the right to; a. Make inspections and surveys at any time; IL 00 17 11 98 IL 00 17 11 98 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any Inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surabllky and the premiums to be charged. We do not make safety Inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this oondition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes In- suranoe Inspections, surveys, reports or rec- ommendations. 4. Paragraph 2. of this condition does not apply to any Inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premlums; and 2. Will be the payee for any return premiums we pay- F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive. Until your legal representative Is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright, Insurance Services Office, Inc., 1899 27097701 1 15 -16 0 /A /VME /POLL /E &O /WC I Jaelynn Rowe 1 10/28/2015 4:33:36 PM (PDT) I Page 3 of 4 Page 1 of 1 0 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 04 84 A a� A' 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.) 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 0.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization As required by written contract 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 5/24/2015 Insured EEC Environmental Insurance Company: Great Divide Insurance Company Policy No. WCA2008815 -12 Countersigned by Endorsement No. WC 04 03 06 04 84 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual 2001. 27097701 1 15.16 O /A /VMB /POLL /B &O /WC I Jaelynn Rowe 1 10/78/2015 4:33:36 PM (PDT) I Page 4 of 4 Premium Page 1 of 1