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PROOF OF INSURANCE (2017 - 2017) CLOSED Client#:2042 MOOREIACO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 09/1412016 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 CONTACT Jo Lusk NAME; Dealey, Renton&Associates PHONE FAX 2-2193 [Alq�IL Eztllusk' deal's rento (n/c,No) P.O. Box 12675 E-MAIL 510 465-3090 n.com 510 45 Oakland,CA 94604-2675 ADDt1�SS. j „� . y INSURER(S)AFFORDING COVERAGE NAIC 510 465-3090 INSU RER A:Travelers Property Ca sualty H Co 25674 INSURED 00 Hearst Av nue ltsman, Inc„ INSURERC:Twin City Fire Insurance Cony 29459 INSURER B: Berkeley,CA 94710 INSURER D:ACE American Insurance Company 22667 INSURER E: INSURER F: 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 CONTRACTOR 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, .IN .INSURANCE.... .......____ .... ....... Td NSRL WWD POLICY NUMBER IMMMIDD YYYYI 1MMIDDIYYEYYY) TYPE OF LIMITS COMMERCIAL GENERAL LIABILITY OCCURRENCE $1,000,000 A EACH R B _�CLAIMS-MADE � X)OCCUR 6801H845960 "08131/2016 0813112017 o RED r l.accCD RE I L'11NI Earl .) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL& DV INJURY $1 900,000 1 GEN'L AGGREGATE LIMIT APPLIES PER: ._. 1• ...GENERAL . RE AGGREGATE ,$,21000100,,,, 0 P.( POLICY X JI Cf LOC PRODUCTS COMPIOPAGG s2?000,000 OTHER: A ,AUTOMOBILE LIABILITY BA2G258325 08/3112016 0813112017 cO El"'")SINcal�.t:LIMI'u COMII'3t t�L nt, $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per ac odent) 5 X OCCUR MAD CUPOH758762 08/3112 UMBRELLA LIAR 016 08/31/2017 AGGREGATE $19,000,000 $10 000 00 EXCESS LIAB .. ........ . . 000 C 57WEDD85 c $ g YIN.. OFFICER/MEMBERIEXCLUER/E PROPRIETOR/PARTNER/EXECUTIVE 25 04101/2016 04101/2017„EL�EACH A9CIDENT IERH $1,000,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY N11NIA (Mandatory in NH) E DISEASE-EA EMPLOYEE $1,,000,000 „DESCIf OF OPERATIONS below E L DISEASE-POLICY LIMIT $ , , RIPTIO,,.�N 1000000., ...., ... D Professional G21656434013 07101/2016 08/31/2017 $2,000,000 per Claim Liability $3,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability Policy excludes claims arising out of the performance of professional services. 30 Days Notice of Cancellation(10 Days for Non-Payment of Premium). Re: Project#13408.00, El Segundo Smoky Hollow Specific Plan Update City of Duarte and its officers, officials,employees,agents,and designated volunteers are named as additional insureds as respects general liability for claims arising from the operations of the named insured. CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Planning&Bldg. Dept. ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Kimberly Christensen 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo,CA 90245-3813 ©1988-2014 ACORD CORPORATION.All rights reserved, ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1815281/M1815152 AZM POLICY NUMBER: 6801H899998 COMMERICAL GENERAL LIABILITY ISSUE DATE: 08/31/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (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 El Segundo Planning&Bldg.Dept. Attn:Kimberly Christensen 350 Main Street PROJECT/LOCATION OF COVERED OPERATIONS: Name of additional insureds,cont'd:City of Duarte and its officers,officials,employees,agents,and designated volunteers PROVISIONS A The following is added to WHO IS AN INSURED The insurance provided to such additional (Section ll): insured is limited as follows: The person or organization shown in the Sched- ule above is an additional insured on this Cover- d. This insurance does not apply to the render- age Part, but only with respect to liability for bod- ing of or failure to render any "professional ily injury", 'property damage" or 'personal injury services". caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on e The limits of insurance afforded to the addi- your behalf: tional insured shall be the limits which you agreed in that'contract or agreement requir- a, In the performance of your ongoing oper- ing insurance" to provide for that additional ations; insured, or the limits shown in the Declarations for this Coverage Part, b. In connection with premises owned by or whichever are less. This endorsement does rented to you; or not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III)for C. In connection with your work and included this Coverage Part. within the "products-completed operations hazard." B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL Such person or organization does not qualify as LIABILITY CONDITIONS(Section IV): an additional insured for "bodily injury", "property However, if you specifically agree in a contract or damage"or"personal injury'for which that person agreement requiring insurance that, for the addi- or organization has assumed liability in a contract tional insured shown in the Schedule, the insur- or agreement ance provided to that additional insured under this CG D3 82 09 07 Page 1 ©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 injury" arising out of"your work" on or for the basis, or a primary and non-contributory project, or at the location, shown in the basis, this insurance is primary to other Schedule above, performed by you, or on insurance that is available to such additional your behalf, under a "contract or agreement insured which covers such additional insured requiring insurance" with that additional as a named insured, and we will not share insured. We waive these rights only where with the other insurance, provided that: you have agreed to do so as part of the "contract or agreement requiring insurance" (1) The "bodily injury" or "property damage" with that additional insured entered into by for which coverage is sought occurs; you before, and in effect when, the "bodily and injury" or "property damage" occurs, or the "personal injury" offense is committed. (2) The "personal injury" for which coverage is sought arises out of an offense D. The following definition is added to committed; DEFINITIONS (Section V): after you have entered into that 'contract or "Contract or agreement requiring insurance" agreement requiring insurance" for such means that part of any contract or additional insured. But this insurance still is agreement under which you are required to excess over valid and collectible other include the person or organization shown in insurance, whether primary, excess, the Schedule as an additional insured on contingent or on any other basis, that is this Coverage Part, provided that the "bodily available to the additional insured when the injury" and "property damage" occurs, and additional insured is also an additional the "personal injury" is caused by an offense insured under any other insurance. committed: C. The following is added to Paragraph 8. a. After you have entered into that contract Transfer Of Rights Of Recovery Against or agreement; Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): b. While that part of the contract or agreement is in effect; and We waive any rights of recovery we may have against the additional insured shown in c. Before the end of the policy period. the Schedule above because of payments we make for "bodily injury", "property damage" or "personal CG D3 82 09 07 Page 2 ©2007 The Travelers Companies,Inc. Includes the copyrighted material of Insurance Services Office Inc.,with its permission Insured: Moore lacofano Goltsman, Inc. Policy Number: 57WEDD8525 Effective Date: 04/01/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Name of person or organization cont'd:City of Duarte and its officers,officials,employees,agents, City of El Segundo and designated volunteers Planning&Bldg.Dept. Attn:Kimberly Christensen 350 Main Street Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: Policy Expiration Date: