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PROOF OF INSURANCE (2012) CLOSED
Client #: 1266412 305FLEMIENV DATE (MMIDDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 04/26/2012 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 'EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ORTANT If the certificate holder is an ADDITIONAL~ INSURED, the ollcy(le) , � Ia s) must be endorsed. If SUBROGATION IS WAIVED, subject to ,e 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" Gloria Gabriel or Mary Faber BB &T Insurance Services PHONE °° rAx W9040-11, ..714 578 - 7000.. I vC N / -..... of Orange County E-MAIL _ ADDRESS: 680 Langsdorf Drive Suite 100 - . ", "., ( # Fullerton, CA 92831 INSURER A: Chartis Spec alty Insurance CoGE 268830 _ ..... -- ......... — ......... .......... INSURED INSURER B: General Insurance Co of America 24732 Fleming Environmental Inc. INSURER c : Granite 5 ............................-...._....•••._._....._____....__.......____.-__._._._._._._._._._..............-.....- ravelers Property Casualty Company 23809 1372 East Valencia Drive wsuRER.. D.. ��... � .................................... 1, -... w .............. --.. W ......... ...... �.,..._..... ...--- .....-------------- - - - - -- tate Casualty Co 25674 FullertonCA 92831 ..................................................................................................................................................................... ............................... INSURER E: 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, LTR H. ° ° ° ° °.. LLa _ ___ POLICYNUMBER_ E'+IMdG7fiFYYY MMI IDYL..µ LIMITS INSR TYPE OF INSURANCE........ "IP( ADDIL R ...I POLICY Err (....�..,� ... ... .. ....... ,.-------------------------- . _ -_- Y OCCURRENCE $,1000,000 A GENERAL LIABILITY PROP2018813 9/0112011 09/01/2012 EACH OCC DAMAGE X CO GENERAL TORENTED ) 30%gOO � CLAIMS MADE OCCUR MED E �XP (Any one person) $25 UDU I, .X POIIUtion Liabilit�/°,,,,,,,,,,,,,,,,°, PERSONAL &ADVINJURY_ $_1,000,000 _X, Professional Llab. GENERAL AGGREGATE 62,000,000 __ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG s2,000,000 .� ... ......... ..... FOMBIPNEDSINCLE'..UM�d ..,°� -. .. LOC PROEA JF AUTOMOBILE LIABILITY 24CC285781�2 9101/2011 09/01/201 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ - ALL OWNED ° SCHEDULED AUTOS AUT03 BODILY INJURY (Per accident) $ .,. ,� - -_- c Y DAMAGE X HIRED AUTOS X AUUTOSWNED . ( e�grRi„ eAI .... ..... $. .. $ X OCCUR PROU2019429 9/01/2011 09/01/201 EACH RRENCE A UMBRELLA AB $5 000 O - 15,000J000111-1. , �( EXCESS LIAB RETENTION $0 ......... .... ............m.......... _...---- $ a A....�D .. C WORKERS COMPENSATION WC65256167 05/01/2012105/01/201 X wcsTAru- IorH- ND EMPLOYERS' LIABILITY Y -ALT'S — 'F"'R - -- YIN ANY PROPHIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICCRJMEMBER EXCLUDED? F N/A (Mandwory In NH) EL DISEASE -,EA EMPLOYEE! $1,000,000 If yes, describe under m. ._._ - -.. ....�......... DISEASE 1,000,000 DESCRIPTION OF OPERATIONS below E..L. DISE -POLICY LIMIT $ D Equipment QT6606686M19ATIL11 9101/2011 09/01/2012 $160,000 Max Per Item Rented /Leased $1,000 Deductible 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 City f El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y o g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Yvette Simoneau ACCORDANCE WITH THE POLICY PROVISIONS. Department of Public Works 150 Illinois Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S85377621M8537744 KAVON DESCRIPTIONS (Continued from Page 1) days written notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non - payment of premium. SAGITTA 25.3 (2010/05) 2 of 2 #S8537762/M8537744 ENDORSEMENT NO. 13 This endorsement, effective 1201 AM, September 1, 2011 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 ENDORS'EIy1ENT 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 AGREEMENT 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. 41. *0144_ -_ AUTHORIZED � REPRESENT p or coup ers g atu a ((in states where apiic`a� bie) )0667 (04/06) 012791 PAGE 1 OF 1