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PROOF OF INSURANCE (2017) CLOSED'a DATE (MMIDONYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 10/10/2016 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 pollcy(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 endorsomengs), PRODUCER CONTACT NAMFi Cheri McClain Alliant Insurance Services, Inc. PHONE 1301 Dove Street, Suite 200 _(WC_Nn.J2xq'*._. - — E-MAIL C Q Newport Beach CA 92660-2436 ADDRESS- c Cla n _alliant,corn ................ LN S..AfFqf�T!n COVERAGE NAIC # �M� ­.­ - --- — - ----------------- - — ----- INSURER A:American Guarantee and LiabilitV In 26247 INSURED INSURER B:ZUriCh American Insurance Company 16535 ......... . ............. The Rados Companies Travelers Property Casual Co ofA 25674 dba: Steve P. Rados, Inc. . ... ................................ �2002 E McFadden "INSURER R": ........ . . : :Santa Ana CA 92705 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 923159936 REVISION NNE _MBER- 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. -fok � - 1, SUOR . . . . . . . . . . ....................... _Pd1_i6fEF_F _0_WdY ­EXP I LTR TYPE OF INSURANCE IN SO WVP I POLICY NUMBER ,. lmmmgnyyj lywann-yyys LIMITS B X COMMERCIAL ENERALUABILrTY GLO 0113180-01 4/1/2016 4/1/2017 EACH OCCURRENCE 52.000,000 CLAIMS-MADE FRIOCCUR — ----- -ER_EmLP9§.1Ea.Qc_—mn_c_P S302,00.9 .......... MED EXP (Any one person} _LS-10.000 PERSONAL AOV INJURY Y 52.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: JECT GENERAL AGGREGATE 54.000.0.00 —1 POLICY F LOC PRODUCTS - COMPIOPAGG S4.000,000 OTHER: S B AUTOMOBILE LIABILITY BAP 0113179 -01 4/1/2016 41112017 COMBDIED SINGLE LIMIT _& —acel-111111) 51.000.000 FX_] ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED J AUTOS AUTOS BODILY INJURY (�...id.M S HIREDAUTOS X NON-OWNED AUTOS or ac W S Medical Payment S5,000 A X UMBRELLAUIIAB X OCCUR AUC011318301 4/1/2016 4/1//20117 EACH OCCURRENCE S25 000 C X -1. EXCESS LIAB CLAIMS-MADE' ZUP-12T79030-16-NF 4!1/2016 4/12017 AGGREGATE . . . .. s25.00O.00O O I—FRETENTION S Each Occur/ A 510.000.0110 B WORKERS COMPENSATION WC 0113182-01 4/1/2016 4/1/2017 x R Ty AND EMPLOYERS' UABILITY h _ , T_' L"o, YIN _J;.TA ANY PROPRIETORIPARTNER/EXECUTIVE NIA E.L. EACH ACCIDENT _I S1.000.00q_ OrFJCERftAEM,0ER EXCLUDED? Li E.L DISEASE (Mandstory In NH) $1.000.000 - POUCY UIM­ff1_ ;I-SCIVIPTION OFOPfRATIONS below. E.L. DISEASE Si'000,000 . .... .. ...................... L DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space Is required) Re: Project #PW16-07, Pump Station #1 & #7 Modification City, its officials and employees are named as Additional Insured per attached endorsements on Primary and Non-Contributory basis. Waiver of Subrogation applies per attached endorsements. CERTIFICATE HOLDER CANCELLATION 30 Days, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cl Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 114 Attn: Litan Xu ACCORDANCE VATH THE POLICY PROVISIONS. The City The Contractor Pubfic WOIRS 350 Main Street El Segundo CA 90245 AUTHOROM REPRESElffATIVIE ®1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 0 Additional Insured —Automatic — Owners, Lessees Or ZURICH Contractors Policy No. Eff. Date of Pol, Exp. Date !!d� Date of End. Producer No. AddT Prem �!n GLO 0113180 -01 4/1/2016 4/1/2017 /2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: The Rados Companies. dba: Steven P. Rados, Inc. Address (including ZIP Code): 2002 E McFadden Santa Ana CA 92705 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused. in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products- completed operations hazard ", which is the subject of the written contract or written agreement. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury ", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily injury" or "property damage ", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. U -GL- 1175 -F M (04,13) Page i or 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission, C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV - Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an 'occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non - contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV - Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV- Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same 'occurrence ", offense, claim or "suit'. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement. the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U -GL- 1175 -F CW (04/13) Page 2 or 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission.. POLICY NUMBER: GLO 0113180 -01 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): V, HERE REQUIRED BY WRITTEN; CONTRACT, Information reauired to complete this Schedule. if not shown above. will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by 'occur- damages or under Coverage C for medical rences" under Section I — Coverage A, and for all expenses shall reduce the Designated Con - medical expenses caused by accidents under struction Project General Aggregate Limit for Section I — Coverage C, which can be attributed that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule gregate Limit shown in the Declarations nor above: shall they reduce any other Designated Con - 1. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above, equal to the amount of the General Aggregate 4. The limits shown in the Declarations for Each Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli- "property damage" included in the "products- cable Designated Construction Project Gen - completed operations hazard ", and for medi- eral Aggregate Limit. cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits ". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 Walters Kluwer Financial Services I Uniform ForrnsT"' B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which cannot be at- tributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products - completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Construction Project General Aggre- gate Limit. C. When coverage for liability arising out of the "products- completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard" will reduce the Products - completed Operations Ag- gregate Limit, and not reduce the General Ag- gregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed; or abandoned and then restarted, or if the authorized contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction pro- ject. E. The provisions of Section III — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated_ Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 26 03 05 09 0 Waiver Of Subrogation (Blanket) Endorsement ZURICH Policy 'Nu. En: Date of Pol. Exp. Date of Pol Eff. Dade of End Producer MCI. Preen Return Preen. GLO 0113180 -01 4/1/2016 1 4/1/2017 4/1/2016 s THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Lis Condition: If you are required by a written contract or agreement. which is executed before a loss. to waive your rights of recovery froin others. we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. ti -GL -925 -B CW (13r01) Page l of l POLICY NUMBER: BAP 0113179 -01 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: The Rados Companies, dba: Steven P. Rados, Inc. Endorsement Effective Date: 4/1/2016 SCHEDULE Name Of Person(s) Or Organization(s): R-HERE. REQUIRED BY WRITTEN COVTRACT. Information required to complete this Schedule. if not shown above. will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 O Insurance Services Office, Inc., 2011 Page 1 of 1 Wolters Kluwer Financial Services I Uniform Formsim POLICY NUMBER: BAP 0113179 -01 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below_ Named Insured: The Rados Companies, dba: Steven P. Rados, Inc. Endorsement Effective Date: 4/1/2016 Name(s) Of Person(s) Or Organization(s): WHERE REQUIRED BY WRITTEN CO \TRACT. n reouired to complete this Schedule. if not shown above. will be shown in the Declarations The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 4410 13 O Insurance Services Office, Inc., 2011 Page 1 of 1 Wolters Kluwer Financial Services I Uniform FormsTM WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule WHERE RE-QL-IRED BY WRITTEN CONTRACT, /r, This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. WC 0113182 -01 Endorsement No. Insured The Rados Companies, dba: Steven Y. Rados, Inc. Premium $ Insurance Company Zurich American Insurance Company Countersigned by WC124 (4-84) Page 1 of 1 WC 00 03 13 Copyright 1983 National Council on Compensation Insurance, Inc. Uniform Forms -""