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PROOF OF INSURANCE (2013) CLOSED0 DATE (MMIDDIYYYY) CERTIFICATE OF LIABILIW INSiRANCE/ /rta 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. IMPORTANT:: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 Dealey, Renton & Associates 199 S Los Robles Ave Ste 540 Pasadena, CA 91101 AFFORDING COVERAGE INSURED INSURER B _TMyRJ!�1n DSjjQ l Co', 1f COffneOtl ! 1100 Corporate le C Center Dr #201 INSURER p;g �grioan Insuran � � � KOA Corporation �rrsuR � � ^ n Automobile Ins. C� II m 323 - 260 -4703 ___________ _________________________.__... SURER : COVERAGES CERTIFICATE NUMBER: 1790774763 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. I R POLICY T TYPE OF INSURANCE POLICY NUMBER /ly YY POLICY r j LIMITS B GENERAL LIABILITY Y Y 020751_840 /13/2012 /13/2013 EACH OCCURRENCE $1,000,000 X EI E �X A �'T Ft $1,000,000 CLAIMS-MADE OCCUR MggEXP An one�Iperson) $10,000 PERSONAL & ADV INJURY $1,000,000 _ GENERAL AGGREGATE $2,000,000 _. ...... ..... �. GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 - -- ............... POLICY [L PRTJ- LOC $ ........... B AUTOMOBILE LIABILITY BA2A439568 /13/2012 /13/2013 OPSI lden $11A000,000 Ix ANYAUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS DE AUTOS BODILY INJURY (Peraccident) $ NON -OWNED PF4d",JPHIRED AUTOS AUTOS ..4P 111 -ps d +nt $ $ A X I UMBRELLA LIAB X OCCUR Y Y CUP6464YO33 /13/2012 /13/2013 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $4,000,000 DED X RETENTION$0 m_ $ C WORKERS COMPENSATION LW P81002950 /19/2012 /19/2013 X WC STATU- X UT AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR /PARTNER /EXECUTIVE ❑ N/A E LEACH ACCIDENT $1,000,000 OFFICER /MEMBER EXCLUDED? ( ) EA 000,000 Mandatory in NH E L_DISEASE _µEMPLOYE $1, If yes, describe under DFSrRIPTION OF OPIFRATIONS below I E.L. DISEASE - POLICY LIMIT $1,000,000 D Professional Liability 23631684007 /13/2012 /13/2013 $2,000,000 per claim $4,000,000 Annual Aggr DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) General Liability excludes claims arising out of the performance of professional services. Umbrella Policy is follow -form to underlying GL/AUTO /Employers Liability policies The City of El Segundo, its officials, and employees are named as additional insured as respects general liability for claims arising from the operations of the named insured. CERTIFICATE HOLDER CANCELLATION 30 daY /10 Dav foi Dion- Pavmnt of Preni SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo, City Eng Dept ACCORDANCE WITH THE POLICY PROVISIONS. 3i" St. El Segundo CA 90245 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680207SL840 COMMERICAL GENERAL LIABILITY ISSUE DATE: 8/22/2012 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIOAAL WISIRED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): City of E1 Segundo, City Eng Dept 350 Main Ct. E1 Segundo CA 90245 PROJECT /LOCATION OF COVERED OPERATIONS: The City of E1 Segundo, its officials, and employees -- Re: All Operations PROVISIONS A The following is added to WHO IS AN INSURED (Section II): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for bod- ily injury", `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 oper- ations; 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 person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render- ing of or failure to render any "professional services ". 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 Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF 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, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 Page t © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission COMMERICAL GENERAL LIABILITY Coverage 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 additional 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; after you have entered into that "contract or agreement requiring insurance" for such additional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when the additional insured is also an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the project, or at the location, shown in the Schedule above, performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal 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 under which you are required to include the person or organization shown in the Schedule as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury" 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. CG D3 82 09 07 Page 2 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office Inc., with its permission