PROOF OF INSURANCE (2011) CLOSEDClientM 974 AICMCONSUL
ACORD_n CERTIFICATE OF
LIABILITY INSURANCE DATE Dm)
09/09/10
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associates
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. O. Box 12675
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Oakland, CA 94604 -2675
510 465 -3090
INSURERS AFFORDING COVERAGE
INSURED
INSURED
wSURERA Hartford Casualt Insuran Ce CO
bN %<
INSURER B American Automobile Ins . ... ......__ ._._ . .
. CO.
553 Wald Street
wsu ...... ..... ... ......... ......... . .........__....�...............
RER c. Travelers Casualty & Surety Co. Amer
Irvine, CA 92618
_..m_. ._._........
INSURER
..........................................................................."""'..........................." ............. ..............------- ......................................................------... ............................__„
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUREMENT, 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.
L R ._......_
INSR TYPE OF INSURANCE POLICY NUMBER
_.. _
... ....-..
POLICY rf' IOWY F POLICY MM/DP/YY) LIMITS
_.'O IC EFFEC YY AT EXPIRATIO N
....
• ,GENERAL LIABILITY 57SBALU8719
09/20/10 09/20/11 EACH OCCURRENCE $,2,000,000 ,
X COMMERCIAL GENERAL LiAB ILITY
FIRE DAMAGE (Any one fire) $300.000
CLAIMS MADE X OCCUR
1.
_An person) $10 000 .. _..
MED EXP (' Y one a .
PERSONAL 8 ADV INJURY $2000,000
_
GENERAL AGGREGATE $4 OOO O
r. U . 0
GEN'L AGGREGATE LIM ITAP PLIES PER:
PRODUCTS - COMP /OPAGG $4,000,000
O. LOC
POLICY X P Jg
,,,, ..w... ......................... ____.,
•
AUTOMOBILE LIABILITY
57SBALU8719
09/20/10 09/20111
COMBINED SINGLE LIMIT
ANY AUTO
(Ea accident)
$2,000,000
ALL OWNED AUTOS
BODILY INJURY
$
''.. SCHEDULED AUTOS
(Per person)
...........
. X HIRED AUTOS
BODILY INJURY
$.
''. X ''. NON - OWNEDAUTOS
I
(Per accident)
. ......___________ - --..
PROPERTY DAMAGE
F]
(Per accident)
''. GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
'. ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS LIABILITY
57SBALU8719
09/20110 09120111
EACH OCCURRENCE
$1,000,000
X OCCUR CLAIMS MADE
AGGREGATE
$1 000,000
DEDUCTIBLE
..$........
$ _
'.. RETENTION S
B
WORKERS COMPENSATION AND
WZP80986801
09/20/10 09/20/11
WC S
(NJ TS.. OTH
X TQRYA M
^
EMPLOYERS' LIABILITY
E L EACH CCIDEN T
^EL
".
$11000 000
WSEASE -EA 0M 13I.0YEE..$1,000,000
L„ DISEASE -POLICY LIMIT
$1,000,000
C
!OTHER Professional
105344511
09/20/10 09/20/11
..._.�.....__ ...
$1,000,000 per Claim
!ability
$2,000,000 Annl Aggr.
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY
ENDORSEMENTISPECIAL PROVISIONS
General Liability Policy excludes claims arising out of the
performance of professional
services.
Ref: El Segundo Sanitary Sewer Rehabilitation Project.
(See Attached Descriptions)
CERTI'FICAT'E HOLDER ADD rrION AL INSURED; INSURER LETTEM _ CANCELLATION &CMIUM
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of El Segundo
DATE THEREOF, THE ISSUING INSURER WlMXWI=Xn TOMAIL30 DAYSWRITTEN
Attn: Maryam Jonas
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHELEFT,x K
350 Main Streettoenlctgklrt
A
El Segundo, CA 90245 -3895
X*WXI 5=KkVaoc
AUTHORIZED REPRESENTATIVE
s
ACORD 25-S (7/97)1 of 2 #M273888
NMF 0 ACORD CORPORATION 1988
DESCRIPTIONS (Continued from Page 1)
BUSINESS LIABILITY, NON -OWNED and HIRED AUTOMOBILE LIABILITY ADDITIONAL
INSURED: The Certificate Holder" and any other person named in the written
contract between the Named Insured and the Certificate Holder. The
coverage afforded is pursuant to Section C., Who Is An Insured, Sub
Section 6., Additional Insureds When Required By Written Contract, Written
Agreement Or Permit, Subsection f. Any Other Party of the Business
Liability Coverage Form, Form No. SS 00 08.
"ADDITIONAL INSURED PER POLICY FORM WORDING: City of El Segundo, its
officers, officials, employees and volunteers.
Insurance is primary per policy form.
AMS 25.3 (07197) 2 of 2 #M273888
Insurer: Hartford Casualty Insurance Co.
Insured: AKM Consulting Engineers, Inc
Policy Number: 57SBALU8719
Policy Period: 09/20/10-09/20/11
ADDITIONAL INSURED: City of El Segundo, its officers, officials, employees and volunteers.
EXCERPTS FROM: Hartford Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
C. WHO IS AN INSURED
6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit
The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when
you have agreed, in a written contract, written agreement or because of a permit issued by a state or
political subdivision, that such person or organization be added as an additional insured on your policy,
provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the
issuance of the permit. A person or organization is an additional insured under this provision only for that
period of time required by the contract, agreement or permit.
f. Any Other Party
(1) Any other person or organization who is not an insured under Paragraphs a. through e. above, but only
with respect to liability for "bodily injury, "property damage" or "personal and advertising injury' caused, in
whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:
(a) In the performance of your ongoing operations;
(b) In connection with your premises owned by or rented to you; or
(c) In connection with 'your work" and included within the "products- completed operations hazard, but
only if
(i) The written contract or written agreement requires you to provide such coverage to such
additional insured; and
(ii) This Coverage Part provides coverage for "bodily injury or "property damage" included within the
"products- completed operations hazard.
(2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to:
"Bodily injury, "property damage" or "personal and advertising injury" arising out of the rendering of, or the
failure to render, any professional architectural, engineering or surveying services, including: inspection, or
engineering
E.5. Separation of Insureds
Except with respect to the Limits of Insurance, and any rights or duties specifically assigned
in this policy to the first Named Insured, this insurance applies:
a. As if each Named Insured were the only Named Insured; and
b. Separately to each insured against whom a claim is made or "suit" is brought.
E.7.b.(7).(b) Primary And Non - Contributory To Other Insurance When Required By Contract
If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-
contributory with the additional insured's own insurance, this insurance is primary and we will not seek
contribution from that other insurance.
E.8.b. Waiver Of Rights Of Recovery (Waiver Of Subrogation)
If the insured has waived any rights of recovery against any person or organization for all or part of any
payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that
right, provided the insured waived their rights of recovery against such person or organization in a contract,
agreement or permit that was executed prior to the injury or damage.
EXCERPT FROM Hartford Form SS 04 38 06 01
HIRED AUTO AND NON -OWNED AUTO
B. With respect to the operation of a "non -owned auto ", WHO IS AN INSURED is replaced by the following:
The following are "insureds ":
d. Anyone liability for the conduct of an "insured ", but only to the extent of that liability.