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PROOF OF INSURANCE (2017) CLOSED
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 10/25/2016 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: 0 the corti'fic'ato holder is an ADDITIONAL INSURED, the policy(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 endorsoment(s). PRODUCER CONTACT Diana Chau _NAME: SelectSolutions Insurance Services PHONEr xt). (866)500-6359 �FAX,N ]:(925)951-0077 IM0N 1350 Carlback Avenue ADDRESS„dianac @ppibselect.com Suite 100 INSURERIS)AFFORDING COVERAGE NAIC# NaWalnut Creek CA 94596 025674 .... -- IINSURERB:Cr Property Casualty INSURER B Cont nental Casualty Compan 20443 _ INSURED Denn Engineers INSURER C: 3914 Del Amo Boulevard INSURER D: Suite 920 INSURER E Torrance CA 90503 I INSURER F COVERAGES CERTIFICATE NUMBER:16/17 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 ILTR TYPE OF INSURANCE IX�WVD POLICY NUMBER .(POLICY DIYYYY) (MM DD[YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 IJAI&OE 1'0 A _ __—_CLAIMS-MADE 5W OCCUR PRPMj3ES(F(acccurrenue) „„$ 1,000,000 X 6801H8819461647 9/1/2016 9/1/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[-_I P, �p LOG PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER, $ AUTOMOBILE LIABILITY N/A COMBINEr`U S INGLE l "LIMIY $ __. S . ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED j ROF EEC"I'Y I AMAGE $ HIRED AUTOS Far,gc. dtm" UMBRELLA LIAB O N/A OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I A RETENTION$ $ WORKERS COMPENSATION N/A ;"iTr'F')"U'T'E 111H- AND ND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN I E ,EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) I E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ B PROFESSIONAL LIABILITY AEH113984368 11/7/2016 11/7/2017 PER CLAIM $1,000,000 AGGREGATE $1,000,000 I b DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: As Per Contract or Agreement on File with the Insured. City of E1 Segundo, its officials, and employees are named as additional insured on General Liability policy if required by written contract per the attached endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of E1 Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Floriza Rivera 350 Main St. AUTHORIZED REPRESENTATIVE E1 Segundo, CA 90245 L Trevino/CHADII ..,,Ylrf:::a i".. d,, b;i ,.p� r.•� .,f"...,, ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025/?m4ni) POLICY NO.: 6801H8819461647 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN B. The following is added to Paragraph a. of 4. INSURED(Section II): Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section Any person or organization that you agree in a IV): "contract or agreement requiring insurance" to include as an additional insured on this However, if you specifically agree in a"contract Coverage Part, but only with respect to liability or agreement requiring insurance" that the for "bodily injury', "property damage" or insurance provided to an additional insured "personal injury" caused, in whole or in part, by under this Coverage Part must apply on a your acts or omissions or the acts or omissions primary basis, or a primary and non- of those acting on your behalf: contributory basis, this insurance is primary to other insurance that is available to such a. In the performance of your ongoing additional insured which covers such additional operations; insured as a named insured, and we will not b. In connection with premises owned by or share with the other insurance, provided that: rented to you;or c. In connection with "your work" and (1) The "bodily injury" or "property damage" included within the "products-completed for which coverage is sought occurs;and operations hazard". (2) The "personal injury' for which coverage Such person or organization does not qualify is sought arises out of an offense as an additional insured for "bodily injury", committed; "property damage" or "personal injury" for which that person or organization has after you have entered into that "contract or assumed liability in a contract or agreement. agreement requiring insurance". But this insurance still is excess over valid and The insurance provided to such additional collectible other insurance, whether primary, insured is limited as follows: excess, contingent or on any other basis, that is available to the insured when the insured is d. This insurance does not apply on any an additional insured under any other basis to any person or organization for insurance. which coverage as an additional insured specifically is added by another C. The following is added to Paragraph 8. endorsement to this Coverage Part. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL e. This insurance does not apply to the LIABILITY CONDITIONS(Section IV): rendering of or failure to render any "professional services". We waive any rights of recovery we may have against any person or organization because of f.. The limits of insurance afforded to the payments we make for "bodily injury", additional insured shall be the limits which "property damage" or "personal injury" arising you agreed in that"contract or agreement out of"your work"performed by you, or on your requiring insurance" to provide for that behalf, under a "contract or agreement additional insured, or the limits shown in requiring insurance" with that person or the Declarations for this Coverage Part, organization. We waive these rights only whichever are less. This endorsement where you have agreed to do so as part of the does not increase the limits of insurance "contract or agreement requiring insurance" stated in the LIMITS OF INSURANCE with such person or organization entered into (Section III)for this Coverage Part. by you before, and in effect when, the "bodily CG D3 81 09 07 ©2007 The Travelers Companies, Inc. Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission, injury" or "property damage" occurs, or the "personal injury" is caused by an offense "personal injury"offense is committed. committed: D. The following definition is added to a. After you have entered into that contract or DEFINITIONS(Section V): agreement; "Contract or agreement requiring insurance" b. While that part of the contract or means that part of any contract or agreement agreement is in effect;and under which you are required to include a person or organization as an additional insured c. Before the end of the policy period. on this Coverage Part, provided that the"bodily injury" and "property damage" occurs, and the CG D3 81 09 07 ©2007 The Travelers Companies, Inc. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. N C E 4. / ► DATE,MM/DDIYYYY) INSURANCE 1/11/2017 THIS CERTIFICATE IS ISSUED AS A MAATTE� I R OF INFORMATION MATTION ONLLY�A'D 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 ollc, Ios must be. p y( � 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 u of such ondorsement(s). PRODUCER ate holdor in I'I„e CONTACT'Blanca De La Hoz Danmar Insurance Services Inc. L (951)509-0509 �; No) (951)509-0515 O.GICk➢,.. License # OD36873 ADDRESS,, RERI i#4F C7 Gfi0dlGC 1dERAGE NAIC0 9899 Indiana Avenue Ste INSta„ CA 92503 INSPiRERA:Hart 'or, Apci.dent TmC1t,�_ n psR't�1i�'y. o Riverside .... . . INSURED rINSURERB:TechnOlocry ,Insurance .C,Ompany 42376 Dann 39 4 DallAmor Blvdc INSURER C:Ste 921 INS �... _ U RER D INSURER E:_ Torrance CA 90503 INSURER F COVERAGES CERTIFICATE NUMBER.CL2711105282 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 ppPOLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I INSURANCE p r POLICY NUMBER IMMIDOY FF R POLICY'EX" PC�LI��CY EFI'. NtMIOONYEXY I'LTI� LIMITS I TYPE OF �0 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE _.w. OCCUR PR�SE$( srrccxa�rpn ,),„ ,.., 0 . $ MED EXP(My cne person) $ PERSONAL 8 ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S PRO.ET �LOC PRODUCTS- OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE P LIMIT 1,000,000 O NJURY( person) S A X ANY AUTO ALL OWNED AUTOS SCHEDULED O BODILY INJURY „ (Per 72UECKC2774 7/17/2016 7/17/2017 BODILY INJURY accident) HIRED SAUTOS AUTOS X 4._sr0-kienl)„....,. _ NON-OWNED ._,N.. ...$ Underinsured motorist S 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS ,.(CESS LIAR �� AGGREGATE S OED]7 RETENTIONS pp $ - WORXERSCOMPENSATIONI ANY C ROPH IMBER EXCLUDED?AEIVE ECUTIVE YIN NIA E 1_� T CI D... 1 HRH_ e__ s o _ AND EMPLOYERS LIABILITY Ip B (Mae ato In.NH) ”' TWC3605817 2/1/2017 2/1/2018 EL.DISEASE-.. 1 AEM LIMIT $ 1,000x000 (Mandatory If yye dasor be under DES CRIPTION OF OPERATIONS Wk- --...,.. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101 ., ( ,Additional Remarks Schedule,may be attached H more space Is required) The City, its officers, elected and appointed officials, employees and volunteers are to be covered as insureds with respect to liability arising out of automobiles owned, leased, hired or borrowed by or on behalf of the Consultant per attached RA9916 0312 endorsment. Waiver of Subrogation Endorsement in favor of the Workers Compensation Policy Included Endorsement WC040306 to follow CERTIFICATE HOLDER CANCELLATION' frivera @elsegundo.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of E1 Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. Floriza Rivera 350 Main Street AUTHORIZED REPRESENTATIVE E1 Segundo, CA 90245 fyr B De La Hoz/BLANCA �— 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 pouo1) COMMERCIAL AUTOMOBILE HA 9916 0312 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE, BROAD ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form,the provisions of this endorsement apply. 1. BROAD FORM INSURED d. Any "employee" of yours while using a A. Subsidiaries and Newly Acquired or covered "auto" you don't own, hire or Formed Organizations borrow in your business or your The Named Insured shown in the personal affairs. Declarations is amended to include: C. Lessors as Insureds (1) Any legal business entity other than a Paragraph A.1. -WHO IS AN INSURED -of partnership or joint venture,formed as a Section II - Liability Coverage is amended to subsidiary in which you have an add: ownership interest of more than 50%on e. The lessor of a covered "auto"while the the effective date of the Coverage Form. "auto" is leased to you under a written However, the Named Insured does not agreement if: include any subsidiary that is an (1) The agreement requires you to "insured" under any other automobile policy or would be an "insured" under provide direct primary insurance for the lessor and such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) The "auto"is leased without a driver. (2) Any organization that is acquired or Such a leased "auto" will be considered a formed by you and over which you covered "auto" you own and not a covered maintain majority ownership. However, "auto"you hire. the Named Insured does not include any D. Additional Insured if Required by Contract newly formed or acquired organization: (1) Paragraph A.I. -WHO IS AN INSURED (a) That is a partnership or joint - of Section It - Liability Coverage is venture, amended to add: (b) That is an "insured" under any other f. When you have agreed, in a written policy, contract or written agreement,that a (c) That has exhausted its Limit of person or organization be added as Insurance under any other policy,or an additional insured on your (d) 180 days or more after its business auto policy, such person or acquisition or formation by you, organization is an"insured",but only unless you have given us notice of to the extent such person or the acquisition or formation. organization is liable for "bodily Coverage does not apply to "bodily injury" or "property damage" caused injury" or "property damage"that results by the conduct of an"insured"under from an "accident" that occurred before paragraphs a. or b. of Who Is An you formed or acquired the organization. Insured with regard to the B. Employees as Insureds ownership, maintenance or use of a Paragraph A.1. -WHO IS AN INSURED -of covered auto. SECTION II - LIABILITY COVERAGE is amended to add: O 2011,The Hartford(Includes copyrighted material Form HA 99 16 0312 of ISO Properties, Inc.,with its permission.) Page 1 of 5 The insurance afforded to any such E. Primary and Non-Contributory if additional insured applies only if the Required by Contract "bodily injury" or "property damage" Only with respect to insurance provided to occurs: an additional insured in 1.D. - Additional (1) During the policy period,and Insured If Required by Contract, the (2) Subsequent to the execution of such following provisions apply: written contract,and (3) Primary Insurance When Required By (3) Prior to the expiration of the period Contract of time that the written contract This insurance is primary if you have requires such insurance be provided agreed in a written contract or written to the additional insured. agreement that this insurance be (2) How Limits Apply primary. If other insurance is also If you have agreed in a written contract primary, we will share with all that other Y 9 insurance by the method described in or written agreement that another Other Insurance 5.d. person or organization be added as an additional insured on your policy, the (4) Primary And Non-Contributory To Other most we will pay on behalf of such Insurance When Required By Contract additional insured is the lesser of: If you have agreed in a written contract (a) The limits of insurance specified in or written agreement that this insurance the written contract or written is primary and non-contributory with the agreement;or additional insured's own insurance, this b The Limits of Insurance shown in insurance is primary and we will not ( ) seek contribution from that other the Declarations. insurance. Such amount shall be a part of and not Paragraphs (3) and (4) do not apply to other in addition to Limits of Insurance shown insurance to which the additional insured in the Declarations and described in this has been added as an additional insured. Section. (3) Additional Insureds Other Insurance When this insurance is excess, we will have no duty to defend the insured against any suit if If we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit". If no other insurer by other insurance available to an defends, we will undertake to do so, but we will additional insured, such additional be entitled to the insured's rights against all Insured must submit such claim or"suit" those other insurers. to the other insurer for defense and When this insurance is excess over other indemnity. insurance, we will pay only our share of the However, this provision does not apply amount of the loss, if any, that exceeds the sum to the extent that you have agreed in a of: written contract or written agreement (1) The total amount that all such other that this insurance is primary and non- insurance would pay for the loss in the contributory with the additional insured's absence of this insurance;and own insurance. (2) The total of all deductible and self-insured (4) Duties in The Event Of Accident, Claim, Suitor Loss amounts under all that other insurance. If you have agreed in a written contract We will share the remaining loss, if any, by the or written agreement that another method described in Other Insurance 5.d. person or organization be added as an 2. AUTOS RENTED BY EMPLOYEES additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an"auto"you hire. CONDITIONS 2. - DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT, CLAIM , SUIT by adding the following: OR LOSS — OF SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. ©2011,The Hartford (Includes copyrighted material Form HA 9916 0312 of ISO Properties, Inc.,with its permission.) Page 2 of 5 If an "employee's" personal Insurance also 5. PHYSICAL DAMAGE - ADDITIONAL applies on an excess basis to a covered "auto" TEMPORARY TRANSPORTATION EXPENSE hired or rented by your "employee" on your COVERAGE behalf and at your direction, this insurance will Paragraph AA.a. of SECTION III - PHYSICAL be primary to the "employee's" personal DAMAGE COVERAGE is amended to provide a insurance. limit of $50 per day and a maximum limit of 3. AMENDED FELLOW EMPLOYEE EXCLUSION $1,000. EXCLUSION 5. - FELLOW EMPLOYEE - of 6. LOAN/LEASE GAP COVERAGE SECTION II - LIABILITY COVERAGE does not Under SECTION III - PHYSICAL DAMAGE apply if you have workers' compensation COVERAGE, in the event of a total "loss" to a insurance in-force covering all of your covered "auto", we will pay your additional legal "employees". obligation for any difference between the actual Coverage is excess over any other collectible cash value of the "auto" at the time of the"loss" insurance. and the"outstanding balance"of the loan/lease. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE "Outstanding balance" means the amount you If hired "autos" are covered "autos" for Liability owe on the loan/lease at the time of"loss" less Coverage and if Comprehensive, Specified any amounts representing taxes; overdue Causes of Loss, or Collision coverages are payments; penalties, interest or charges provided under this Coverage Form for any resulting from overdue payments; additional „auto you own, then the Physical Damage mileage charges; excess wear and tear charges; Coverages provided are extended to"autos"you lease termination fees; security deposits not hire or borrow, subject to the following limit. returned by the lessor; costs for extended The most we will pay for "loss" to any hired warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or "auto"is: lease; and carry-over balances from previous (1) $100,000; loans or leases. (2) The actual cash value of the damaged or 7. AIRBAG COVERAGE stolen property at the time of the"loss';or Under Paragraph B. EXCLUSIONS - of (3) The cost of repairing or replacing the SECTION III - PHYSICAL DAMAGE damaged or stolen property, COVERAGE, the following is added: whichever is smallest, minus a deductible. The The exclusion relating to mechanical breakdown deductible will be equal to the largest deductible does not apply to the accidental discharge of an applicable to any owned "auto" for that airbag. coverage.No deductible applies to"loss"caused g, ELECTRONIC EQUIPMENT - BROADENED by fire or lightning. Hired Auto Physical Damage COVERAGE coverage is excess over any other collectible insurance. Subject to the above limit, deductible a. The exceptions to Paragraphs B.4 - and excess provisions, we will provide coverage EXCLUSIONS - of SECTION III - PHYSICAL equal to the broadest coverage applicable to any DAMAGE COVERAGE are replaced by the covered"auto"you own. following: We will also cover loss of use of the hired"auto" Exclusions 4.c. and 4.d. do not apply to if it results from an "accident", you are legally equipment designed to be operated solely liable and the lessor Incurs an actual financial by use of the power from the "auto's" loss, subject to a maximum of $1000 per electrical system that, at the time of"loss", "accident". is: This extension of coverage does not apply to (1) Permanently installed in or upon any "auto" you hire or borrow from any of your the covered"auto"; "employees", partners (if you are a partnership), (2) Removable from a housing unit members (if you are a limited liability company), which is permanently installed in or members of their households. or upon the covered"auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs(1)and (2)above;or ©2011,The Hartford(includes copyrighted material Form HA 9916 0312 of ISO Properties, Inc.,with its permission.) Page 3 of 5 (4) Necessary for the normal If another Hartford Financial Services Group, operation of the covered"auto"or Inc. company policy or coverage form that is not the monitoring of the covered an automobile policy or coverage form applies to "auto's"operating system. the same"accident",the following applies: b.Section III — Version CA 00 01 03 10 of the (1) If the deductible under this Business Auto Business Auto Coverage Form, Physical Coverage Form is the smaller (or smallest) Damage Coverage, Limit of - Insurance, deductible, it will be waived; Paragraph C.2 and Version CA 00 01 10 01 of (2) If the deductible under this Business Auto the Business Auto Coverage Form, Physical Coverage Form is i not the smaller (or Damage Coverage, Limit of Insurance, smallest) deductible,, it will be reduced by Paragraph C are each amended to add the the amount of the' ,smaller (or smallest) following: deductible. $1,500 is the most we will pay for"loss" in 12. AMENDED DUTIES IN THE EVENT OF any one "accident" to all electronic ACCIDENT, CLAIM, SUIT OR LOSS equipment(other than equipment designed The requirement in LOSS CONDITIONS 2.a. - solely for the reproduction of sound, and a DUTIES IN THE EVENT OF ACCIDENT,CLAIM, accessories used with such equipment) SUIT OR LOSS - of SECTION IV - BUSINESS that reproduces, receives or transmits AUTO CONDITIONS that you must notify us of audio, visual or data signals which, at the time of"loss", is: an "accident" applies only when the"accident"is known to: (1) Permanently installed in or upon the covered "auto" in a housing, (1) You,if you are an individual; opening or other location that is not (2) A partner,if you are a partnership; normally used by the "auto" (3) A member, if you are a limited liability manufacturer for the installation of company;or such equipment; (4) An executive officer or insurance manager,if (2) Removable from a permanently you are a corporation. installed housing unit as described 13. UNINTENTIONAL FAILURE TO DISCLOSE in Paragraph 2.a. above or is an HAZARDS integral part of that equipment;or (3)An integral part of such equipment. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we c.For each covered "auto", should loss be limited will not deny coverage under this Coverage to electronic equipment only, our obligation to Form because of such failure. pay for, repair, return or replace damaged or 14. HIRED AUTO-COVERAGE TERRITORY stolen electronic equipment will be reduced by the applicable deductible shown in the Paragraph e. of GENERAL CONDITIONS 7. - Declarations, or $250, whichever deductible is POLICY PERIOD, COVERAGE TERRITORY - less. of SECTION IV - BUSINESS AUTO 9. EXTRA EXPENSE - BROADENED CONDITIONS is replaced by the following: COVERAGE e. For short-term hired "autos", the coverage Under Paragraph A. -COVERAGE-of SECTION territory with respect to Liability Coverage is III - PHYSICAL DAMAGE COVERAGE, we will anywhere in the world provided that if the pay for the expense of returning a stolen covered "insured's" responsibility to pay damages for "bodily injury" or "property damage" is "auto"to you. determined in a"suit,"the"suit"is brought in 10. GLASS REPAIR-WAIVER OF DEDUCTIBLE the United States of America, the territories Under Paragraph D.-DEDUCTIBLE-of SECTION and possessions of the United States of III - PHYSICAL DAMAGE COVERAGE, the America, Puerto Rico or Canada or in a following is added: settlement we agree to. No deductible applies to glass damage if the 15. WAIVER OF SUBROGATION glass is repaired rather than replaced. TRANSFER OF RIGHTS OF RECOVERY 11. TWO OR MORE DEDUCTIBLES AGAINST OTHERS TO iUS - of SECTION IV - Under Paragraph D.-DEDUCTIBLE-of SECTION BUSINESS AUTO CONDITIONS is amended by III - PHYSICAL DAMAGE COVERAGE, the adding the following: following is added: ©2011,The Hartford(Includes copyrighted material Form HA 9916 0312 of ISO Properties, Inc.,with its permission.) Page 4 of 5 i We waive any right of recovery we may have c.Regardless of the number of autos deemed a against any person or organization with whom total loss, the most we will pay under this you have a written contract that requires such Hybrid, Electric, or Natural Gas Vehicle waiver because of payments we make for Payment Coverage provision for any one damages under this Coverage Form. "loss"is$10,000. 16. RESULTANT MENTAL ANGUISH COVERAGE For the purposes of the coverage provision, The definition of "bodily injury" in SECTION V- a.A "non-hybrid" auto is defined as an auto that DEFINITIONS is replaced by the following: uses only an internal combustion engine to "Bodily injury" means bodily injury, sickness or move the auto but does not include autos disease sustained by any person, including powered solely by electricity or natural gas. mental anguish or death resulting from any of b.A "hybrid" auto is defined as an auto with an these. internal combustion engine and one or more 17. EXTENDED CANCELLATION CONDITION electric motors; and that uses the internal Paragraph 2. of the COMMON POLICY combustion engine and one or more electric g p motors to move the auto, or the internal CONDITIONS - CANCELLATION - applies combustion engine to charge one or more except as follows: electric motors,which move the auto. If we cancel for any reason other than 19. VEHICLE WRAP COVERAGE nonpayment of premium, we will mail or deliver to the first Named Insured written notice of In the event of a total loss to an "auto"for which cancellation at least 60 days before the effective Comprehensive, Specified Causes of Loss, or date of cancellation. Collision coverages are provided under this 18. HYBRID, ELECTRIC, OR NATURAL GAS Coverage Form, then such Physical Damage VEHICLE PAYMENT COVERAGE Coverages are amended Ito add the following: In the event of a total loss to a "non-hybrid" auto In addition to the actual cash value of the "auto", for which Comprehensive, Specified Causes of we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the Loss, or Collision coverages are provided under time of total loss. Regardless of the number of this Coverage Form, then such Physical autos deemed a total loss, the most we will pay Damage Coverages are amended as follows: under this Vehicle Wrap Coverage provision for a.If the auto is replaced with a "hybrid" auto or any one "loss" is $5,000. For purposes of this an auto powered solely by electricity or natural coverage provision, signs or other graphics gas, we will pay an additional 10%, to a painted or magnetically affixed to the vehicle are maximum of$2,500, of the "non-hybrid"auto's not considered vehicle wraps. actual cash value or replacement cost, whichever is less, b.The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of"loss," ©2011,The Hartford(Includes copyrighted material Form HA 9916 03 12 of ISO Properties, Inc.,with its permission.) Page 5 of 5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.01-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA We have the right to recover our payments from anyone liable(or an Injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged In the work described in the Schedule. The additional premium for this endorsement shall be 0%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description City of El Segundo Segundo,CA 90245 All CA Operations This endorsement changes the policy to which it is attached and Is effective on the date issued unless otherwise stated, (The Information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 2/1/2017 Policy No. TWC3605817 Endorsement No. 1 Insured Donn Engineers,Inc. Premium$ 4431 Insurance Company Technology Insurance Company,Inc. Countersigned by WC 04 03 06 (Ed.01-84)