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PROOF OF INSURANCE (2017) CLOSEDAC CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 5/12/2016 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. `ORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the - rtificate holder in lieu of such endorsernent(s). CONTACT PRODUCER NAME. CSIS Insurance Services C Insurance Services llf, PHONE F�}� (888) 501 2747 la Net. B05) 446-4881 INSURER E Rancho Santa CA 92685 INSURERF: COVERAGES CERTIFICATE NUMBER:Master as of 5/18/16 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. YFF POLICY EXP �LTR TYPEOFINSURANCE AOOL R..- _...._ POLIGYNUMeE.. MdUf _,P, -_ . _01dY. -_— .._ ... .. -- __ ....,...,.. LIMITS ITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 5XI -ffAMKGE_TO RENiLO 100,000 A CLAIMS -MADE OCCUR PREN(JSS (Ea occurrance $ 0100038622 -0 5/18/2016 5/18/2017 MED EXP (Any one person) .... $ Excluded PERSONAL & AD V INJURY _-_ 1,000,000' $ , 00 , 0 0 GENT AGGREGATE LIMI ����P�� IT APPLIES PER GENERAL AGGREGATE , $ 2,000,000 X POLICY PRO- LOC JECT PRODUOTS., COMP/OP ............. $ „ Yn 2 , 000 , 000 OTI IEW Property damage - single limit $ UTOMOBILE LIABILITY COMBINED N L I $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per acciden t) $ AUTOS AUTOS NON-OWNED f)JAMAGF $_ HIRED AUTOS �PROPERTY Per r�c;fd�n6 X UMBRELLA LIAB X OCCUR EACH OCCURRE NCE $ 1,000f000 A CLAIMS -MADE EXCESS LIAB ............... ^ AGGR GATE E. .n,.,. -__ -- - $ 1_!_9.09'090 QED RETENTION $ 0100038622 -0 5/18/2016 5/18/2017 RETE $ WORKERS COMPENSATION H- X S ER Y/ N PROM E L EA CH ACCIDENT $ 1 r 000 000 MB ER/ EXCLUDED? NIA OFFOICERPMOEMBER• EXCLUDED? OFF B (Mandatory in NH) - 720150136 6/30/2015 6/30/2016 E1 DISEASE - EA EMPLOYE $ _____11000 0 Ify�es, describe umfea DE'SCRIPI ION, OF OPERATIONS tbek)w E DISEASE - POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The City of E1 Segundo, its officers, officials, employees, agents, and volunteers are named additional insured as respects general liability and this insurance is primary and noncontributory with any other insurance of the additional insured; and waiver of subrogation applies as respects workers compensation as required by written contract. CERTIFICATE HOLDER CAN'CELLA'TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of E1 Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. E1 Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ACORD 25 (2014101) INS025 (201401) Tamara Epping /TE ,.. I ..tez -_ P,, r&,m .._? ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD