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PROOF OF INSURANCE (2013) CLOSEDClient#: 1266412 305FLEMIENV DATE (MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1 8131/2012 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. _.......m . _..._ ._ ------- _ ­ IMPORTANT: _.. _ ..._ .... r_. _. _....... _......,.,,,_ IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 certificate holder in lieu of such endorsement(s), PRODUCER NAME: Vanessa Maldonado BB&T Insurance Services PHONE FAX of Orange Count MAIL n ° i 714 578 7256 I c, Nnh 877 297 -1116 _.._ 9 Y nta�+Ia�E�s vmaidonado@bbondt.com o xt 680 Langsdorf Drive Suite 100 INSURER A : ChrtIS $pe.ER(Sl i) AFFORDING COVERAGE NAIC # Fullerton, CA 92831 a s R Specialty Insurance Co 26883 1372 East Valencia eDr vent Granite State INSURED INSURER B General Insurance Company 24732 R c e Insurance Company 23809 INSURER D Travelers Property Casualty Co 25674 Fullerton, CA 92831 ..... - - -- ....... . INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.: 1NSR ..-- ..,mm..0 ... - ......�IND SUER . ... .. (FUM Y FFF P�pL Y E7tr� ... ..............------- LTR ......... .. TYPE OF INSURANCE IN$R WMQ POLICY NUMBER YYYY IMMdl1 YYYYI LIMITS A GENERAL LIABILITY PROP2018813 9/01/2012 09101/201 EACH OCCURRENCE $1 000,000 Mai _ .... COMMERCIAL GENERAL IABILITY G� �e*� ��r,���rr�anse $300,000 OCCUR MED EXP (Any one person) $ 25,000 X Pollution Lability _ __ PERSONAL &ADV INJURY $1 UOO,OO,O ...._..._ ------ - ......... .............. X Professional Liab GENERAL AGGREGATE mmm mm $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: P_ ^' RODUCTS- COMP /OPAGG $2,000,000 I" .... .l'. av, aecvdemikl._ $ .. B ..... POLICY. (ABILITY I ... 24�'.C.2 .............. .... ...--- . �I. , AUTOMOBILE �L � O L„ ............... 857813 09/01/2012 09/01/201 cO"eBINOS "NGLE LIMIT _ __... ........... ..... ........... X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ .,,. AUTOS .. AUTS NON-OWNED A 9 OPERT'9" OANiAfs $ .. HIRED AUTOS X AUTOS (Pere accident,).. A UMBRELLA LIAB X OCCUR PROU2019429 9/01/2012 09/01/201 EACHOCCURRENCE $5,000,000 " X EXCESS LIAB -� —� CLAIMS -MADE AGGREGATE $5,000,000 RETENTI DIED X WORKERSCOMPENSATION - --------- ------ - -- - ---------- ---.....-- --- -- - -- ........WCSTATU.........��OTH .. r' AND EMPLOYERS' LIABILITY WC65256167 05/01/2012 05/01/2 I»,III- ANY PROPRIETOR/PARTNER/EXECUTIVE I O Y / N E.L. EACH ACCIDENT (Mandatory OFFICER/MEMBER n Ni EXCLUDED? N / A ..E,L,..DISEASE.-..EA.EMPLOYEE ...$.1..000 OOO ............................ If DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $� -t.� $1,000,0 D Rented /Leased QT6606686M19ATIL12 9/01/2012 09/01/201 Limit: $160,000 Equipment Deductible: $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Maintenance Agreement The City of El Segundo, its officers, officials, employees, agents and volunteers are named additional insured as respects general liability, and this insurance is primary and noncontributory with any other insurance of the additional insured, as required by written contract, per endorsement attached. Should any policy be cancelled before the expiration date, BB$T Insurance Services will mail 30 (thirty) (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo �, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ain Yvette Simoneau ACCORDANCE WITH THE POLICY PROVISIONS. Department of Public Works 150 Illinois Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 s� L4.Jc/ie� ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S9177743/M9174247 KAVON SAGITTA 25.3 (2010/05) 2 of 2 #S9177743/M9174247 ENDORSEMENT NO. 13 This endorsement, effective 1201 AM, 9/1/12 Forms a part of Policy No: PROP 2018813 Issued to: FLEMING ENVIRONMENTAL INC By: CHARTIS SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY_ ADDITIONAL INSURED /PRIMARY COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICY In consideration of an additional premium of $INCLUDED it- is hereby agreed that the following is included as an Additional Insured as respects Coverage A and B but only as respects liability arising out of your work for the Additional Insured by or for you. Additional Insured: BLANKET WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMEN This does not apply to bodily injury or property damage arising out of the sole negligence or willful misconduct of, or for defects in design furnished by, the Additional Insured. As respects the coverage afforded the Additional Insured, this insurance is primary and non - contributory, and our obligations are not affected by any other insurance carried by such Additional Insured whether primary, excess, contingent, or on any other basis. This endorsement does not increase the Company's limits of liability as specified in the Declarations of this policy. All other terms, conditions, and exclusions shall remain the same. AUTHORIZED ..... _...� ' REPRESENTATIVE or countersignature (in states where applicable) 90667 (04/06) C12791 PAGE 1 OF 1 BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS EINDORS15MEN'T This endorsement changes the policy to which It is attached effective on the Inception date of the policy unfess a different date is indicated below. (The fofloWng "attaching clause° need be comp6eW only when this endorsement Is issued subsequerd lo preparation or the policy). This endorsement, effective 92:01 AM 5/1/12 forms a part of Policy No. WC65256167 issued to Fleming Environmental, Inc. By GRAN I Tlr STATE INSURANCE CDNPANY We have a right to recover our payments from anyone liable for an injury covered by this policy. We mall not enforce our right against arty person or organization With whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be for this policy. WC 111.4 03 61 (Ed. 11190) 2 !a of the total estimarted workers compensation premium