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PROOF OF INSURANCE (2015) CLOSED'C" >R" CERTIFICATE OF LIABILITY INSURA C DATE(MMJ /2014 Pa+e 1 of 2 03/27/2014 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. ORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to arms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the _Ificate holder in lieu of such endorsement(s). Willis of New York, Inc. c/o 26 Century Blvd. P. O. Box 305191 s Nahville, TN 37230 -5191 Atkins North America, Inc. 2001 NW 107th Avenue Miami, FL 33172 -2507 877 - 945 -7378 888- 467 -237 COVERAGES CERTIFICATE NUMBER: 21333479 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. UFR_I TYPEOFINSURANCE WRIJ MFD POLICY NUMBER ' --'-' - ' - -' -' W LIMITS A GENERAL LIABILITY Y Y CGG740901603 4/1/2014 4/1/2015 EACH OCCURRENCE $ 1a 000900 COMMERCIAL GENERAL LIABILITY . AMAGETORENTELt [PREMISES (Eaoc.. -, curr�nca) 3 0 - $ .... CLAIMS - MADE' ]{ � OCCUR MED EXP (An Dose ersovm ) _- . - - -- -- $ X Cm�rn,metak...lrslaa,it...._ PERSONAL&ADVINJURY GENERAL AGGREGATE $ 2L QOO1MO ,,, E L PER: PRODUCTS- COMP /OPAGG $___2_j 000,000 -_ -, OLICY.�„IMITAPPLIE u�"" T IE $ TOMOBILELIABILITY - Y CAR740901703 4/1/2014 4/1/2015 M ED sTNGLE LIMIT Ea acc'dent $ 2,000,000 X ANYAUTO BODILY INJURY(Per person) $ X ALLOWNED (SCHEDULED AUTOS AUTOS __........ raccident) BODILY INJURY(Pe '.$ X _ HIREDAUTOS X NON -OWNED AUTOS PAb'FEAT7bA M A' JP ar accident ... ,,,,,,,,, .. $ .._-- $ B X AB X OLAIMS AUC924234902 4/1/2014 4/1/2015 OCCURRENCE 000,000 EXCESS LAB -MADE AGGREGATE .�_ __5,t0001000 DED RETENTION $ $ A WORKERS COMPENSATION Y CWG74O901503 4/1/2014 4/1/2015 X H YIN /E ECUTIVE X pp N N/A E.L.EACHACCID,ENT $ 1,000,000 OFFICER /MEMBOEREXCLNER (Mandatory in NH) EL DISEASE EA EMPLOYEE $ 1,000,000 f yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional B080111209P14 4/1/2014 4/1/2015 $2,000,000 Each Claim & Liability - Claims Made $2,000,000 Annual Aggregate 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acerd'101, Additvon,al Remarks Schedule, If more space Is roquired) Greenwich Insurance Companies Best Rating A XV American Guarantee and Liability Insurance Company Best Rating A+ XV Underwriters at Lloyd's London AM Best Rating: A XV. Professional Liability policy written on claims -made basis. There are no Deductibles or Self- Insured Retentions on the General Liability, Automobile Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of E1 Segundo AUTHORIZED REPRESENTATIVE Attn: Kimberly Christensen, AICP, Planning Manager t 350 Main Street E1 Segundo, CA 90245 Coll:4373372 Tpl:1788034 Cert:21333479 © 1988- 2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: .33004588 _ LOC # : ............... .............................. ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Atkins North America, Inc. T is of New York, Inc. 2001 NW 107th Avenue (UMBER . ��_ n.... �,_ ........_..._..,............___ �...__. — . -- -- Miami, FL 33172-2507 See First Page ... CARRIER ..........................................,......................................,, m... w..............,.,.........._....,,,,.,.,....,,....... m........_,............,.. .,.,..n....��._...,,,.,.�...... .. ...., �...,.,.,....,......._.. NAIC CODE See First Page EFFECnvEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ................FORM NUMBE R. 25 FORM TITLE. CERTIFICATE OF LIABILITY INSURANCE City of E1 Segundo, its officials, and employees are included as Additional Insureds as respects to General Liability and Auto Liability. General Liability policy shall be Primary and Non - Contributory with any other insurance in force for or which may be purchased by the Additional Insureds. Waiver of Subrogation applies in favor of the Additional Insureds as respects to General Liability and Workers' Compensation, as permitted by law. ACORD 101 (2008/01) Coll:4373372 Tp1:1788034 Cert: 21333479 © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CGG740901603 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • • fAV • • • r A • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization s : Locations Of Covered Operations ANY PERSON OR ORGANIZATION W ITH WHOM YOU VARIOUS AS REQUIRED PER WRITTEN HAVE AGREED, THROUGH WRITTEN CONTRACT, CONTRACT. AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 location 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER:CGG740901603 COMMERCIAL GENERAL LIABILITY CG 2037 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization (s): Location And Description, Of Completed Operations ANY PERSON OR ORGANIZATION WITH WHOM VARIOUS AS REQUIRED PER WRITTEN YOU HAVE AGREED, THROUGH WRITTEN CONTRACT. CONTRACT, AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sche- dule of this endorsement performed for that addi- tional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 D WAIVER OF TRANSFER RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following;. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Persons or Organization: Any person or organization with whom you have agreed in writing to waive any right of recovery prior to a loss. I Information required to complete this Schedule, if not shown in the Declarations. II The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others To Us of Section IV — Conditions: 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. This endorsement is executed by the Greenwich Insurance Company Premium $ Effective Date 4/1/2014 Expiration Date 4/1/2015 For attachment to Policy No. CGG740901603 Issued To Atkins North America, Inc. Issued Countersigned by Authorized Representative Sales Office and No. Rnd. Serial No. 17 CG 24 04 05 09 ©ISO Properties, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4 -84) WAIVER OF OUR RIGHT To RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit: any one not named in the Schedule. Schedule As required by written contract This endorsement changes the policy to which it is attached effective on the date issued unless otherwise stated. (The information below is required onfy when this endorsement is issued subsequent to preparation of the policy) Endorsement Effective Policy No. CWG740901503 Endorsement No. Insured Atkins North America, Inc. Premium Insurance Company Greenwich Insurance Company WC000313 {Ed. 4/84) 1983 National Council on Compensation Insurance POLICY NUMBER: CGG740901603 COMMERCIAL GENERAL LIABILITY CG 02 2410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 90 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. S'Aa� CG022410 93 Copyright, Insurance Services Office, Inc., 1992 POLICY NUMBER: CAH740901703 XIC4051007 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CANCELLATION BY US This endorsement modifies insurance provided u.nder the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Changes In Conditions The number of days required for notice of cancellation by us for any reason other than nonpayment of premium, as provided in either paragraph 2. of the CANCELLATION Common Policy condition or as amended by an applicable state cancellation endorsement, is extended to the number of days shown in the Schedule below: SCHEDULE Number of Days' Notice: 90 0- : . All other terms and conditions of this policy remain unchanged. (Authorized Representative) XIC 405 1007 © 2007, XL America, Inc. Page 1 of 1 Includes copyrighted material of Insurance Office, Inc., with its pennission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY THIS ENDORSEMENT CHANGES THE POLICy_ PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY Number of Days Notice:90 we 99 olio BEd. 1 /08) (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in PART SIX "" CONDITIONS, D. Cancelation of the Workers' Compensation and Employers' Liability Insurance Policy or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. All other terms and conditions remain the same. 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 April 1, 2014 Policy No.CWG740901503 Endorsement No. Insured ATKINS US HOLDINGS INC. Insurance CompanyGreenwich Insurance CompsdKtersignedby we 99 oleo Ed. 1/08 0 2007 XI, America, Inc. Willis Limited FINER Global CONTRACTENDORSEMENT INSURED: WS Atkins Plc and as more fully defined in the contract PERIOD: 1 April2014 to 31 March 2015 TYPE: Insurance of UK PI Generic Primary UNIQUE MARKET REFERENCE: B080111209P14 ENDORSEMENT REFERENCE: 0002 EFFECTIVE DATE: 1 Apri12014 local standard time at the address of the Insured. It is hereby noted and agreed that with effect from the effective date above the following General Condition is added to the policy: " If INSURERS cancel this policy prior to its expiry date by notice to the INSURED for any reason, INSURERS will send written notice of cancellation to the persons or organizations listed in the schedule to be created and maintained by the INSURED (the "Cancellation Notice Schedule ") at least 30 days prior to the cancellation date applicable to the policy. This notice will be in addition to any notice to the INSURED. The INSURED will provide an updated copy of the Cancellation Notice Schedule to Insurers on a monthly basis. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Cancellation Notice Schedule in the event of a pending cancellation of coverage. INSURERS have no legal obligation of any kind to any such person(s) or organization(s). Any failure to provide advance notice of cancellation to the person(s) or organization(s) named in the Cancellation Notice Schedule will impose no obligation or liability of any kind upon INSURERS, will not extend any policy cancellation date and will not negate any cancellation of the policy. INSURERS are not responsible for verifying any information in any Cancellation Notice Schedule, nor are INSURERS responsible for any incorrect information that the INSURED may use." All other terms and conditions remain unaltered. Willis Limited 1 WUv1081!1 Willis Internal Rei 0002 •