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PROOF OF INSURANCE (2017 - 2017) CLOSEDOP ID: SC ACORO° CERTIFICATE OF LIABILITY INSURAI CE DATE,M 10127/207120 6 16 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 endomement(s). u NAME: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD John Buttine, Inc. 0 Lexington Ste 2700 PHONE fAX EIS 212r697 1e Om ...mm. — i....t � Np).. 1..... 11......1.. N 10170 (�c�i�° ttin ADDFttE SC@buttine.com � �+ Li'dYtip LIMITS John M. ButtineRuurR �......m. ST !6ELRIR_! 9PHEL01 _ ......... EACH OCCURRENCE $ 1,000,000 FOR G NAIL q —INSURED-- The fps rou of CT � Travelers Indemnity Co of CT � 82 256 12121 Bluff Creek Drive S200 INSURER a ro�erty Casual Co 25674 Playa Vista, CA 0094 AXIS Insurance INSURER C . A 37273�� $ INSURER D COMBINED SINGLE LIMIT $ 1,000,000 INSURER E,. ANYAUTO 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 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' 7 DY Sit, � �+ Li'dYtip LIMITS TYPE OF INSURANCE wvD POLICY NUMBER MMIDDA*YYY IODIYYYY' GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 680- 9612NO47 IB;�iGE "q'0 PA "If�TF PREMISES 1111.... .,� 10/01/2016 10/01/2017 IFaoccg__gp $ 1,000,00 ) ... CLAIMS -MADE [K OCCUR MED EXP (Any one person) $ 5,00 � ... ._ X CROSS LIAB. INCLU ........... PERSONAL & ADV INJURY $ 1,000,00 X PRIMARY & N ON -CON _ .EA 2,000,000 GENERAL AGGREGATE $ - G�ENL AGGREGATE ELIMITAPPLIESPER: PRODUCTS - COMP/OP AGG $ 2,01)0�00 �....... -. —. PRO. F LOC X POLICY $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANYAUTO .... ......................._......_ — � -........................ ............................,, BODILY INJURY (Per person) $ ALL OWNED AUTOS .................... .................... ............................... BODILY INJURY (Per accident) $ SCHEDULED AUTOS �.....____. D ( ......... ......................AM..... AGE $ X 6809612N047 A HIRED AUTOS 10/01/2016 10 /01/ 2017 ER ACC DE NT) � P ..... ..................�............ ..�. X NON -OWNED AUTOS 6809612NO47 10101/2016 10/0112017 _ ................ 1111 $ ...m.....�.......... X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 6,000,000 EXCESS LIAB CLAIMS -MADE CUP- 9614N213 10/01/2016 10/01/2017 AGGREGATE. E 6,000AO DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION I WC STATU- P.TH- IJ�I AND YIN ANY PROPRIETORIPARTNER/EXECUTIVE H ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA Msndato In NH (Mandatory ) _ �.L.!EAC E - EA E.... MPLOYEE $ DISEAS,... ........ ....................... �.. .. If yes, descr be under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ A (Property (All -Risk 680- 9612NO47 10101/2016 10/0112017 BPP & EDP 3,400,00 C Ad Agency E &O Llab MCN000139851601 10/0112016 10/01/2017 Limit 5,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2009109) AUTHORIZED REPRESENTATIVE ®1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680- 9612NO47 -16 -42 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 11/11/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of person or organization: CITY OF EL SEGUNDO(CITY) ITS OFFICIALS, AND EMPLOYEES 350 MAIN STREET EL SEGUNDO CA 90245 WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your acts or omissions. CG T4 91 11 88 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 POLICY NUMBER: 680- 9612MO47 -16 -42 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 11/11/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of person or organization: CITY OF EL SEGUNDO(CITY) ITS OFFICIALS, AND EMPLOYEES 350 MAIN STREET EL SEGUNDO CA 90245 WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your acts or omissions. CG T4 91 11 88 Copyright, Insurance Services Office, Inc., 1984 Pagel of 1 157016 DATE(MMIDD /YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/28/2016 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 policy(ies) must have ADDITIONAL INSURED provisions or 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 COOT CT Jim Wagner Commercial Lines - (248) 353 -5800 PHONE � FA' (ACC. Nur' Cmt}., .,.m„ ���, �,�, tNc NcdJ 5- 272 -2518 248 948 5737 85 Wells Fargo Insurance Services USA, Inc. EMAIL im,wa nerrawellstar o:f fn ADDRESS: 1 g @ 9 4000 Town Center, Suite 800 INSURER S) AFFORDING COVERAGE NAIC # Southfield, MI 48075 INSURERA: XL Specialty Insurance Company 37885 INSURED INSURER B; The Phelps Group INSURER C 12121 Bluff Creek Drive, Suite 200 INSURER D: Playa Vista, CA 90094 INSURER E: COVERAGES CERTIFICATE NUMBER: 11047345 REVISION NUMBER: See below 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. _ �, 9NSR 1Ab[SL $WVD POLICY PWRDI EXP „ _.. TYPE OF INSURANCE NUMBER MMIDWYYY L "GR YY MMdt7D /YYYY LIMITS V COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ RENT �Y CLAIMS -MADE OCCUR PRE SES (Ea ouuurrgnPe) S ..,....,,,, ,,,,,,,,,,, MED EXP [Any one person} S PERSONAL & ADV INJURY $ GENLL AGGREGATE LI TAPPLIESPER: ( GENERAL S, .........,.,. u J L SCOMP /OP ACG S .... R OTHER S ,,,® AUTOMOBILE LIABILITY I MIT 1NULE L.... (F �BI�Y�f�Dt� '.. ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED OWNS BODILY INJURY (Per accident) S ONLY AUTOS �W HIRED NON -OWNED PROPERf"YDAMAr3E S AUTOS ONLY AUTOS ONLY Per accident) $ UMBRELLA LIAB I OCCUR CUR CH OCCURRENCE EXCESS LIAR -- ..., ....... CLAIMS-MADE w AGGREGATE ?.. � .. ........... DED RETENTION$ S A WORKERS COMPENSATION RWC6200110 01/01/16 01/01/17 X ER TATUT YIN S 1,000.0 00 ANYP OPROEMBE F I 'EA�"li,A[,CIUENT OFFICERlMEMBEREXCLUDED� NIA EXCLUDED? ❑ -� 1000,000 (Mandatory in NH ( ry ) E L DISEASE - EA EM L S — -- ��� If yes, describe under below E DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS . DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Coverage CERTIFICATE HOLDER CANCELLATIOfN The Phelps Group 12121 Bluff Creek Drive Suite 200 Playa Vista CA 90094 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9e -4/�- The ACORD name and logo are registered marks of ACORD © 1988 -2015 ACORD CORPORATION. All rights reserved.