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PROOF OF INSURANCE (2016) CLOSED!D DATE (MWDDIYYW) CERTIFICATE OF LIABILITY INSURANCE 8/3/2016 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 PRODUCER . Danny Lopez Deal, Renton Associates PHONE 714 -427 -3484 P.O. Box 12675 E-MAIL Oakland CA 94604 -2675 JO,E. d�a1e(crnsdra.c INSURER A: Travelers Indemnity Co. of Connecti INSURED RISKMANAGI INSURERe:TravelersPro a Casual CoofA INSURER C:U.S Specialty Insurance Com an INSURER 0: Risk Management Professionals 300 Goddard, Suite 200 Irvine CA 92618 COVERAGES CERTIFICATE NUMBER: 1403497855 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. TR TYPE OF INSURANCE •• INSR IN WV „ POLICY NUMBER P •••••••• PPI00Y :'AF POPS Y EX..:. LIMITS A X COMMERCIALGENERALLIABILITY Y Y 68067071-691 12111/2015 12/1112016 EACH OCCURRENCE $2,000,000 CLAIMS -MADE [i] OCCUR ECM y,- 5p��py0y 51,000000 MED EXP (Any one person) $10.000 PERSONAL 8 ADV INJURY 52,000,000 GEN'LAGGRCGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY JERCOT- LE] 0 LOC PRODUCTS - COMP/OP AGG S4,000,000 OTHER: S B AUTOMOBILE LIABILITY Y Y BA67071_92A WN0 SINGLE 00 1 12/11/2015 12/1112016 fiaaccldont 51,000,000 ANY AUTO BODILY INJURY (Per person) 5 AUT8SNED AUTOS BODILY INJURY (Per accident) S ._.._... NON -OWNED X X TY 5 HIRED AUTOS AUTOS PeP Ifcca'def7�1 5 B X UMBRELLA LIAB X OCCUR CUP7491R818 12111/2015 12/11/2016 EACHOCCURRENCC 55,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE 55,000,000 DF.D 'x RFTENTION$0 $ B WORKERS COMPENSATION y UE17641Y390 11/12/2015 11112/2016 X PER -RH AND EMPLOYERS' LIABILITY Y❑ •••• ......... ANY PROPRIETOR/PARTNER/EXECUTIVE E L. EACH. ACCIDENT S1 ' 000 ' 00 OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE . FA EMPLOYEE $1,000,000 Ir yyes, das4'�Ibe under DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT S1,000,000 C Professional Liability USS1526330 12111/2015 12111/2016 $2,000,000 each claim $2,000,000 Aggregate Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached K more space Is required) CITY, its officials, and employees are additional insured as respects general liability for claims arising from the operations of the named insured as required per written contract or agreement. CERTIFICATE HOLDER CANCELLATION 30 Cacnellation /10 Non- Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of El Segundo — Public Works THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTE: Lifan Xu, P.E, Principal Civil Engineer ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St El Segundo CA 90245 -3813 AUTHORIZED REP ESENTATIVE ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD TRAVELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76(00) — 001 POLICY NUMBER: uB7641Y390 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 3.00 % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization ALL PERSONS OR ORGANIZATIONS THAT REQUIRES YOU TO OBTAIN EXECUTED THE CONTRACT BEFORE DATE OF ISSUE: 8 /3 /2016 017106 Schedule Job Description THAT ARE PARTIE TO A CONTRACT THIS AGREEMENT, PROVIDED YOU THE LOSS. ST ASSIGN: CA POLICY NUMBER: 6806707L691 COMMERICAL GENERAL LIABILITY ISSUE DATE: 8 /3/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED (ARCHITECTS, ENGINEERS A D SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): City of E1 Segundo - Public Works ATTE: Lifan Xu, P.E, Principal Civil Engineer 350 Main St E1 Segundo CA 90245 -3613 PROJECT /LOCATION OF COVERED OPERATIONS: CITY, its officials, and employees PROVISIONS A The following is added to WHO IS AN INSURED (Section II): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for bod- ily injury", '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 oper- ations; 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 person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render ing of or failure to render any "professional services ". e. 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 Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF 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, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 Page 1 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission COMMERICAL GENERAL LIABILITY Coverage 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 additional 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; after you have entered into that "contract or agreement requiring insurance" for such additional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when the additional insured is also an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the project, or at the location, shown in the Schedule above, performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal 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 under which you are required to include the person or organization shown in the Schedule as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury" 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. CG D3 82 09 07 Page 2 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission POLICY ##:BA6707L92A COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions ofthe Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. �_. mm........._ Endorsement Effective: s/3/2o16 Countersigned By: -------- .. .. - Named Insured: t� .. Risk Management Professionals Authorized Re resentative) SCHEDULE .......� . _...._ ...._...... w... .... ..... ._ .......... . Name of Person(s) or Organizations) CITY, its officials, and employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Paragraph 5. Transfer of Right Of Recovery Against Others To Us of the CONDITIONS section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" or "loss ", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. CA T3 40 08 08 ©2008 The Travelers Companies, Inc.