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PROOF OF INSURANCE (2009) CLOSED�il�iii�: ���� raw��►w.�cprrxiMc RD,. CERTIFICATE OF °IYY' LIABILITY INSURANCE C 03DATE /17/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 199 S Los Robles Ave Ste 540 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena, CA 91101 626 844 -3070. INSURERS AFFORDING COVERAGE ----------- -- -- - - - - -- INSURED ...... INSURER A Travelers Property Casualty CO of Am KOA Corporation R ....... n ,..m. ... . - -- INSURER B: American Automobile Ins. Co. 1055 Corporate Center Dr #300 ---------- _— ------ -------------- INS .. — pa ny Monterey Park, CA 91754 INSURER Travelers Indemnity Co. of CT » »� ... ».. ».. —. INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ,,..»,,,,,,,,,,,,,,, POLICY NUMBER .. SR 4�TR .... _ w LIMITS POLICY MMIDDIYYE POLICY EXPIRATION TS DATE dOD YY DATE MM /DD/YY A GENERAL LIABILITY 68020751-840 06/15/08 06/15/09 EACH OCCURRENCE $1a000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $1,000 000 CLAIMS MADE X OCCUR MED EXP (Any one person) $5,000 PERSONAL 8 ADV INJURY $1000,000 _ _ GENERAL AGGREGATE $2a000�000 GEN'L AGGREGATE LIM ITAPPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY PFtf?. LOC D AUTOMOBILE LIABILITY BA20721_002 06/15/08 06/15109 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 . ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) _ . ..... PROPERTY DAMAGE $ (Per accident) ,.... _ GA q GARAGE LIABILITY NLY EA ACCIDENT $ AUTO 0 » " » »IT .. j C ANY AU 1'0 OTHER THAN EA ACC $ LL— AUTO ONLY: qGG $ A EXCESS LIABILITY CUP6464YO33 06/15/08 06/15/09 EACH OCCURRENCE $4,000,000 X OCCUR CLAIMS MADE P_...._.__ AGGREGATE ........ $4 000 000 a „�. i DEDUCTIBLE X RETENTION $O $ B WORKERS COMPENSATION AND W P8096634'6 09/19/08 09/19/09 X WC STATT OTH- 'T.4?I%XT.)MLT_..- - EMPLOYERS' LIABILITY - -- - --'''` E L EACH ACCIDENT _ $1,000,000 ......_ . m. E L DISEASE EA EMPLOYEE $100,0,0010 .... —_ w w.. E L q USEA. E ^POLICY LIMIT $1,000. 9000 C OTHER Professional G23631684004 03/13/09 03/13/10 $2,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS 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 ADDIT NALINSURED;INSURERLETTER CANCELLATION SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of El Segundo DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30DAYSWRITTEN Attn: Dan Garcia, Assistant City Engineer NOTICETOTHE CERTIFICATE HOLDER NAMED TOTH E LEFT, BUTFAILURE TODOSOSHALL 350 Main St. IMPOSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR El Segundo, CA 90245 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE / /ZAiW ACORD 25-S (7/97)1 of 1 #M250112 MGS © ACORD CORPORATION 1988 POLICY NUMBER: 6802075L840 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 03/17/09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL AL. INS RED (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 Attn: Dan Garcia, Assistant City Engineer 350 Main St. E1 Segundo, CA 90245 PROJECT /LOCATION OF COVERED OPERATIONS: All Operations of the Named Insured 1. WHO IS AN INSURED (Section II) is amended to include the person or organization shown in the Schedule above as an additional insured on this Coverage Part, but: This endorsement does not increase the lim- its of insurance stated in the LIMITS OF IN- SURANCE (Section III) for the Coverage Part. a. Only with respect to liability for "bodily injury", 3. The following is added to Paragraph a. of 4. "property damage" or "personal injury"; and Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): b. If the injury or damage arises out of the per- formance by you or your subcontractor, of "your work" on or for the project, or at the lo- cation, shown in the Schedule above. Such person or organization does not qualify as an additional insured with respect to their inde- pendent acts or for "bodily injury", "property damage" or "personal injury" for which that person or organization has assumed liability in a contract or agreement 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the render- ing of or failure to render any "professional services ". b. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed to provide in a "contract or agreement requiring insurance" for that additional in- sured, or the limits shown in the Declarations for this Coverage Part, whichever are less However, if you specifically agree in a "contract or agreement requiring insurance" that, for addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this Coverage Part must apply on a primary basis, or a primary and non - contributory basis, this insur- ance is primary to other insurance that is avail- able 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 addi- tional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any CG D3 82 09 06 2006, The St. Paul Travelers Insurance Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY other basis, that is available to the additional in- sured when the additional insured is also an addi- tional insured under any other insurance. 4. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (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 pro- ject, or at the location, shown in the Schedule above, performed by you, or on your behalf, un- der 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 insur- ance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal in- jury" offense is committed. 5. As respects the insurance provided to the addi- tional insured by this endorsement, the following definition is added to DEFINITIONS (Section V): "contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include the person or organization shown in the Schedule as an ad- ditional insured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs, and the "personal injury" is caused by an of- fense 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. All other terms of your policy remain the same. The City of E1 Segundo, its officials, and employees are named as additional insured as respects general liability for claims arising from the operations of the named insured. Page 2 of 2 2006, The St. Paul Travelers Insurance Companies, Inc. CG D3 82 09 06