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PROOF OF INSURANCE (2015) CLOSED' C0 ATE ERTIFICATE OF LIABILITY INSURANCE D 09 /23IDDIY 09/23/2014 4 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 1EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed!, If SUBROGATION IS WAIVED, subject to -,le terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1- 800 - 326 -6203 CONTACT PESTSURE CERTIFICATES Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX wr m. F„n. 1- 800 - 326 -6203 972- 663 -6258 Two Lincoln Centre 5420 LBJ Fwy. Suite 400 Dallas, TX 75240 INSURED DEWEY SERVICES, INC. BRANCH NO. 7 DBA DEWEY PEST CONTROL 939 EAST UNION STREET PASADENA, CA 91106 -7214 COVERAGES CERTIFICATE NUMBER: 41550745 F: PESTSURECERTS @AJG.COM OLD REPUBLIC INS CO XL INS AMER INC REVISION NUMBER: 24147 24554 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. ILTR TYPE OF INSURANCE AD DL 'bUBFv POLICY NUMBER MMLi EX F MMOid�f icy /YYYY ! LIMITS ImTR A GENERAL LIABILITY I X X IMWZY 302468 1 10/01/1 10/01/151 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY —1 CLAIMS -MADE rxII OCCUR A WORKERS COMPENSATION X M 300292 00 AND EMPLOYERS' LIABILITY Y i N ANY PROPRIETOR/PARTNER/EXECUTIVE p OFFICER/MEMBER EXCLUDED? a' N / A (Mandatory in NH) bAMAGC i'O HENTED. $. 1 ... 000 PRFMI'5F $ 5,000 Y person) ..........................._. .. - - --- ------ ......... PERSONAL &ADVINJURY .$2.000,000 .11111 GENERAL AGGREGATE $ 4,000,000 PRODUCT. . ... . S- COMP /O 4 000 000 0 COMP/OP $ I$ �_• - _ _, _ 2, 00'000 -- BODILY INJURY (Per person) $ .......... .............................................................................. ---------.,...... ......--------------- ----...... BODILY INJURY (Per accident) $ PROPERTY DAMAGE _ $ ^^ (PPr arridenl, 10/01/1 10/01/15 EACHOCCURRENCE $ 1,000,000 AGGREGATE — $ 1,000,000 ------ -------- 01/01/14 01 /01 /15 E.L, EACH ACCIDENT $ 1, 000, 000 E1, DISEASE -EA EMPLOYEE $ 1,000,000 E DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) All Locations and Operations. Additional Insured coverage is provided by form #CG 2010 (04 -13), See Attached.. THE CITY OF EL SEGUNDO IS NAMED AS ADDITIONAL INSURED. COMPLETED OPERATIONS IS INCLUDED ON THE GENERAL LIABILITY POLICY. A WAIVER OF SUBROGATION IS PROVIDED IN FAVOR OF THE CITY OF EL SEGUNDO. 30 DAYS NOTICE OF CANCELLATION WILL BE PROVIDED TO CERTIFICATE HOLDER (10 DAYS FOR NON - PAYMENT OF PREMIUM.) CERTIFICATE HOLDER CANCELLATION CITY OF EL SEGUNDO PUBLIC WORKS DEPARTMENT _ -NERAL SERVICES DIVISION ILLINOIS STREET SEGUNDO, CA 90245 ACORD 25 (2010/05) maximal 41550745 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GEML AGGREGATE LIMIT APPLIES PER: X I F POLICY LOC AUTOMOBILE LIABILITY X X' MWTB 302499 X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED Nx HIRED AUTOS AUTOS B X UMBRELLA LIAB X OCCUR US0006587OL114A EXCESS LIAB CLAIMS -MADE A WORKERS COMPENSATION X M 300292 00 AND EMPLOYERS' LIABILITY Y i N ANY PROPRIETOR/PARTNER/EXECUTIVE p OFFICER/MEMBER EXCLUDED? a' N / A (Mandatory in NH) bAMAGC i'O HENTED. $. 1 ... 000 PRFMI'5F $ 5,000 Y person) ..........................._. .. - - --- ------ ......... PERSONAL &ADVINJURY .$2.000,000 .11111 GENERAL AGGREGATE $ 4,000,000 PRODUCT. . ... . S- COMP /O 4 000 000 0 COMP/OP $ I$ �_• - _ _, _ 2, 00'000 -- BODILY INJURY (Per person) $ .......... .............................................................................. ---------.,...... ......--------------- ----...... BODILY INJURY (Per accident) $ PROPERTY DAMAGE _ $ ^^ (PPr arridenl, 10/01/1 10/01/15 EACHOCCURRENCE $ 1,000,000 AGGREGATE — $ 1,000,000 ------ -------- 01/01/14 01 /01 /15 E.L, EACH ACCIDENT $ 1, 000, 000 E1, DISEASE -EA EMPLOYEE $ 1,000,000 E DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) All Locations and Operations. Additional Insured coverage is provided by form #CG 2010 (04 -13), See Attached.. THE CITY OF EL SEGUNDO IS NAMED AS ADDITIONAL INSURED. COMPLETED OPERATIONS IS INCLUDED ON THE GENERAL LIABILITY POLICY. A WAIVER OF SUBROGATION IS PROVIDED IN FAVOR OF THE CITY OF EL SEGUNDO. 30 DAYS NOTICE OF CANCELLATION WILL BE PROVIDED TO CERTIFICATE HOLDER (10 DAYS FOR NON - PAYMENT OF PREMIUM.) CERTIFICATE HOLDER CANCELLATION CITY OF EL SEGUNDO PUBLIC WORKS DEPARTMENT _ -NERAL SERVICES DIVISION ILLINOIS STREET SEGUNDO, CA 90245 ACORD 25 (2010/05) maximal 41550745 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: NWZY 302468 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations All persons or organizations when required by Contract or Agreement. All locations. 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury ", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" .'property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 POLICY NUMBER: Mwzx 302468 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED D - OWNERS, LESSEES OIL CONTRACTORS - COMPLETED TED O E ATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anizaton s s r All persons or organizations when required by contract or agreement. All completed operations.. 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or "property If coverage provided to the additional insured is damage" caused, in whole or in part, by "your required by a contract or agreement, the most we work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products- completed operations 1. Required by the contract or agreement; or hazard ". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: MWZY 302468 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVED OF TRANSFER OF 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 Person Or Organization: All persons or organizations as required by contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, 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. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 11 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 12:01 AM 01/01/14 forms a part of Policy No. MWc 300292 00 Issued to: DEWEY SERVICES, INC. BRANCH NO. 7 DBA DEWEY PEST CONTROL By: OLD REPUBLIC INS CO Premium: INCL 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 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization CITY OF EL SEGUNDO PUBLIC WORKS DEPARTMENT GENERAL SERVICES DIVISION 150 ILLINOIS STREET EL SEGUNDO, CA 90245 Job Description All persons or organizations as required by contract or agreement. The sentence in parenthesis above does not apply. WC 04 03 06 Countersigned by (Ed. 4 -84) Authorized Representative Shillin , Mona From: certificates @ebix.com nt: Tuesday, September 23, 2014 12:40 PM Shilling, Mona Subject: Delivery by CertificatesNow Attachments: 0641550745.pdf This insurance document was sent to you from Maria Maldonado ( mailto:Maria_maldonado @ajg.com ) (Phone: 1 -800- 326 -6203) via CertificatesNow. CERTIFICATE OF INSURANCE FOR PEST CONTROL OPERATOR LISTED AS THE INSURED. This document was brought to you by CertificatesNow and Arthur J. Gallagher Risk Management Services, Inc. in Dallas, TX. Any documents forwarded with the certificate request were reviewed for the sole purpose of completing the certificate,. If you have questions regarding the content of this document, please contact the Producer /Agent listed on the certificate of insurance. The data included in this notice and in the attached document is confidential to Ebix and Arthur J. Gallagher Risk Management Services, Inc. cc The attachment is an Adobe Acrobat PDF file. To open the PDF file, you need Adobe Acrobat Reader, which can be easily downloaded by going to http: / /www. adobe. com /prodindex /acrobat /readstep.html. After completing Adobe's simple 3- step process, just double -click on the file to open it. The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information.