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PROOF OF INSURANCE (2015) CLOSEDDATE (MM /DD/YYYY) AC"` CERTIFICATE OF LIABILITY INSURANCE 8,1if2014 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 -PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IRTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to rms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the icate holder in lieu of such endorsement . PRODUCER NAME. )eale , Renton & Associates PHONE FAx . O. ox 10550 E.M 3 rata Ana CA 92711 -0550 ADDRESS! AFFORDING COVERAGE NAIC # INSURED INSURER B :Traye; ..5 In AC MARTIN PARTNERS INSURER c ;Catl.i� prance Comp,y, In( ci 444 South Flower Street, #1200 INSURER D: Los Angeles CA 90071.._.... .............._. ...._.......................... ''... INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 2115781759 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. NUMBER.......- _.......�.._.. -._ ......... m. ,....,,.._.._ .. .. ... ....... . .. ...... ....... ....LIMIT ........... ....... .... INSR A L POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD. POLICY MM /DD/YYYY MMIDRIY`YYY S B' X GENERAL LIABILITY 8031521-208 /19/2014 3/19/2015 EACH OCCURRENCE $1,000,000 A Ai, -' 11F — COMMERCIAL GENERAL LIABILITY P $1,000,000 m. CLAIMS -MADE �X OCCUR MED EXP (Any one person) $10,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Sam Lee, Director 350 Main St., AUTHORIZED REPRESENTATIVE El Segundo CA 90245 k�� U yy� ale ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD X Contractual X BFPD,XCU GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL& ADV INJURY $1.000.000 GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Sam Lee, Director 350 Main St., AUTHORIZED REPRESENTATIVE El Segundo CA 90245 k�� U yy� ale ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 'X POLICY PRO LOC _ $ TOMOBILE LIABILITY BA6568R700 /19/2014 /19/2015 '- t a aocVcie�nl 1.000.000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED i $ HIRED AUTOS ! AUTOS (P�r nc�id, „nI s.?_) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGtaREaATE $ DEL) RETENTION $ $ A WORKERS COMPENSATION UB3543T351 /19/2014 /19/2015 X '/VCS "1 "'A'TU - uTH- AND EMPLOYERS' LIABILITY YIN "" . _TDfiY t,lC>FitT'S..' " " "uu' -- 1 OFFICER/MEMBER EXCLUDED? [-q NIA $1 000.000 000,0 ( Mandatory in NH) E L D SEASE_CEOA EMPLOYEE° $_1,000,000 If mmE.L. DESCRIPTION OF OPERATIONS below DISEASE - POLICY LIMIT $1,000,000 C Professional Liability AED6773090815 /19/2014 /19/2015 per claim $2,000,000 Claims Made annl aggr. $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) General Liability policy excludes claims arising out of the performance of professional services. Independent Contractors Included as respects to General Liability. 30 Day Notice of Cancellation /10 Day notice for Non - Payment of Prem Re: Tenant Improvements City of El Segundo, its officials and employees are additional insured as respects to General and Auto Liability as required by written contract. Primary and Non - Contributing coverage applies to GL as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Sam Lee, Director 350 Main St., AUTHORIZED REPRESENTATIVE El Segundo CA 90245 k�� U yy� ale ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY #: BA6568R700 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. Endorsement Effective: 8/18/2014 Countersigned By: ...... Named Insured: � AC MARTIN PARTNERS (Authorized Representative SCHEDULE ....(s) �9 �s ) City of E1 Segundo, its officials and employees ns or Organ Name of Person(s) (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 COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS A I 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 copyrighted material of Insurance Services Office, Inc., with its permission. COMMERICAL 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 copyrighted material of Insurance Services Office, Inc., with its permission,