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PROOF OF INSURANCE (2017) CLOSED AC CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDD/YYYY) 1 6/2312016 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). CONTACT PRODUCER Adamson & McGoldrick Insurance Solutions NAME: Gloria Gabriel Brea, CA 92821 Rd., Ste 225 E-MAIL Xt1, ttUe'br A� oaio$oorlri 1�AAic,ftn1,. 714-257-9833 INSURE,R(S)AFFORDING COVERAGE NAIC# www.snains,com INSURER A: Travelers Property Casualty Co of America 25674 INSURED SUR B: Travelers Indemnity Company Of CT 25682 Morrow-Meadows Corporation INSURER 231 Benton Court RE City of Industry CA 91789 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 30546961 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, iLTR. ..TYPE OF INSURANCE 'AbbL aU R POLICY EFF POLICY EXP LIMITS lN$,D wVD POLICY NUMBER lMMIDD/YYXKI t�MMlDOJYYY'Y'9' A ,w/ COMMERCIAL GENERAL LIABILITY ✓ VTC2J-CO-9322B094-16 7/1/2016 7/1/2017 EACH OCCURRENCE $ 1,000,0001 CLAIMS-MADE .DAMAGE TO REN I'EO OCCUR OC&P&XCU INCLUDE P 7(Eaorcuorence) $ 300,000; V Blanket Cont.L MED EXP(Any one person) $ 5,0001 V BFPD,Cross Li „ a PERSONAL&ADV INJURY 1,000,000" GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000i1 RO�. PPOLICY ✓ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 U IRO, ✓ OTHER' $50.000 Dedu'cflble $ B AUTOMOBILE LIABILITY VTECAP9322B12516 1 7/1/2016 7/1/2017 �EOMMI���t,ny�INGL�E"LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PRO PE R1 Y DAMA6E. $ ✓ AUTOS ONLY V/ AUTOS ONLY (Pw aE6oenq UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB V CLAIMS-MADE AGGREGATE $ DED ( RETENTION$ $ A WORKERS COMPENSATION ,/ VTC2JUB9494A622-16 7/1/2016 7/1/2017 ��STATUTE ORH- AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE �YIN EL EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? •- ! NIA (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS t VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Job#215507,El Segundo Instrumentation&SCADA Services,350 Main Street,El Segundo,CA 90245-3813.City of El Segundo,its officials and employees are additional insured to General Liability policy per the attached endorsement.Primary wording applies to General Liability policy per the attached endorsement. *10 days notice of cancellation for non-payment of premium CERTIFICATE HOLDER CANCELLATION 215507 City Of El Segundo/Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y 9 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Lifan Xu ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90245-3813 AUTHORIZED REPRESENTATIVE Ted Adamson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 30546961 I MORRO-1 1 16/17 GL AU WC UMB $5M *Master Template* I Edith Maganda 1 6/23/2016 3:45:59 PM (PDT) I Page 1 of 4 VTC2J-CO-9322BO94-16 COMMERCIAL GENERAL LIABILi T Y THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you "property damage" or"personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that b) The insurance provided to the additional in- "other insurance". But the insurance provided to the additional insured by this endorsement still is sured does not apply to 'bodily injury", prop- excess over any valid and collectible "other in- of t damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- i. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- ii. Supervisory, inspection, architectural or rence" or an offense which may result in a claim. To the extent possible, such notice engineering activities. should include: CG D2 46 08 05 O 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 30546961 MORRO-1 16/17 GL AU WC UME $5M *Master Template* I Edith Maganda 6/23/2016 3:45:59 PM (PUT) i Page 2 of 4 COMMERCIAL GENERAL LIABILITY I. How, when and where the 'occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by ill. The nature and location of any injury or this endorsement is primary to 'other insur- damage arising out of the"occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. I. Immediately record the specifics of the —DEFINITIONS: claim or"suit' and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement The additional insured must see to it that we under which you are required to include a person or organization as an additional in- receive written notice of the claim or suit as sured on this Coverage Part, provided that soon as practicable. the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or "suit', cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit', and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or "suit' to c. Before the end of the policy period. Page 2 of 2 ©2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 30546961 MORRO-1 16/17 GL AU WC UMH $5M *Master Template- I Edith Maganda 6/23/2016 3:45:59 PM (PDT) I Page 3 of 4 TRAVELERS WORKERS COMPENSATION AND ONE TONER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 00 03 13(00)-oi POLICY NUMBER: VTC2JUB9494A622-16 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 any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: Person or Organization: City of El Segundo Attn: PW Dept 350 Main St El Segundo, CA 90245 Job Descri tiow City of El Segundo, its officials, officers, agents and employees re: En ineenng Plan Check Svcs, City of EI Segundo 247004/ 1 DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. i V MORRO 1 11 A6/11 o'l. Fill tot: M'm $aim i or T, ,,pI h)) I Rd 11,11 1 6/2^ /2016 5::C, 44 front I wll- 1 ua. 1 IS DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE �~ 111942017 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 Adamson & McGoldrick Insurance Solutions NAME: Gloria Gabriel 1800 E. Lambert Rd., Ste 225 !mac No.Eut)� 714-257-9644 (A"/ ,No), 714-257-9833 Brea, CA 92821 ADORESS: ggabriel@snains,com INSURER(S)AFFORDING COVERAGE I NAIL# www.snains.com INSURERA: Greenwich Insurance Company 22322 INSURED INSURER B: Morrow-Meadows Corporation 231 Benton Court INSURER C: City of Industry CA 91789 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 33844252 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, INSR TYPE OF INSURANCE IAIOL SUE11 POLICY EFF POLICY EXP LTR INS WVD POLICY NUMBER IMM/DD/'YY'YYt IMMfDDNYYYYi LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE TO RENTED s,,,, PREMISES(Ea occurrence) MED EXP(Any one person) S PERSONAL&ADV INJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY Jrl 0 LOG PRODUCTS-COMWOP AGG ,S, .... 0'TI'IEl'4 $ AUTOMOBILE LIABILITY COMBINED SMGLE 1,564117" $ (Eta acc�danI) ANY AUTO BODILY INJURY(Per person) $ AUTOS ONLY AUTOS I (Per $ OWNED SCHEDULED BODILY INJURY Per HIRED NON-OWNED (Per AUTOS ONLY AUTOS ONLY P $ $ UMBRELLALIAB fj I OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED ( RETENTIONS $ WORKERS COMPENSATION NEffit O'TH- AND EMPLOYERS'LIABILITY Y/N STATUTE FR ANYPROPRIETOR/PARTNER/EXECUTIVE F E L EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) EL DISEASE-EA EMPLOYEE: $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE•P()I.K Y I.,lMIT' $ A Professional Llabilily CPL742045503 1/21/2017 ' 1/21/2018 $5,000,000 Per Claim $10,000,000 Aggregate Retention$150,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Job#215507,El Segundo Instrumentation&SCADA Services,350 Main Street,El Segundo,CA 90245-3813. CERTIFICATE HOLDER CANCELLATION 215507 City of El Segundo/Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City: f El eg THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Street ACCORDANCE WITH THE POLICY PROVISIONS. 350 El Segundo, CA 90245-3813 AUTHORIZED REPRESENTATIVE ,r I Ted Adamson ©1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 33844252 1 MORRO-1 1 17/18 PROF $10M I Edith Maganda 1 1/19/2017 3:39:52 PM (PDT) I Page 1 of 1 DATE(MMIDDIYYYY) C"'R " CERTIFICATE OF LIABILITY INSURANCE lir�" 1 612312016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Adamson & McGoldrick Insurance Solutions NAME: Gloria Gabriel Brea, CA 92821 Rd., Ste 225 E PHONE ADDRESS: tl, gzJalar z�8 s il7s.c ar'r� �'6("i „Noy: 7'84-257.9633 INSURER(S)AFFORDING COVERAGE NAIC# .. www.snains.com INSURER A: Travelers Property Casualty Co of America 25674 INSURED INSURER B: Morrow-Meadows Corporation 231 Benton Court INSURERC: City of Industry CA 91789 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 30546959 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY 'ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH DOLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, NSR' TYPE OF INSURANCE . AbC7L'$UE3Ft i PMIDDY EFF PMIDDf EYdP LTR YN§,D SMAID.I POLICY NUMBER �IMMIDDIYYYKI(fMMd'DOM'1"NYI Y LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREM'YSF.S(Ea or,.�:n 0AMYACE TO yaEN'r urr'onc+r) $ MED EXP(Any one person) $ PERSONAL BADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY[ , JELT LOC PRODUCTS-COMP/OP AGG $ 01 HER � $ AUTOMOBILE LIABILITY COMBINED$gNGLE LIMIT 5 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY 1AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY ,,,(Per accident) p $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIA 11 B „ .. ' . CLAIMS-MADE AGGREGATE � DED RE7ENT�ON$ ,.. A WORKERS COMPENSATION VTC2JUB9494A622-16 7/1/2016 7/1/2017 PER ( 01H- YIN STATUTE ANYP R MEMBERP PARTNER/E ECUTIVE N/A E L(EACH ACCIDENT ER $ 1,000,000 If yes,describe Nunnder EL RISE $ 1 000,000 4 DESCRIPTION OF OPERATIONS below EL DISEASE POLICPL LIMIT $ Y LIMIT 0,000, DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) All operations *10 days notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION All Operations Clt Of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C'eyt. Of Bld'9 & Safety ACCORDANCEIW THDTHE POLICY PROVISIONS.NOTICE WILL BE DELIVERED IN 350 Main 'Street El Segundo CA 90245 AUTHORIZED REPRESENTATIVE Ted Adamson " ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 30546959 1 MORRO-1 1 16/17 GL AU WC UMB $5M *Master Template* I Edith Maganda 6/23/2016 3:45:59 PM (PDT) I Page 1 of 1 Adamson&McGoldrick Insurance Solutions 1800 E.Lambert Rd.,Ste 225 Brea,CA 92621 MAIL UU010VOIENT Certificate of Insurance Delivery by ecertsonlineTm City of El Segundo nd6t'lii Edith Maganda Dept. of Bldg. & Safety P1tom 714-257-9644 350 Main Street El Segundo CA 90245 SUbjC t:, Cert No.30546959 INt µ 6/23/2016 No of Pages, 2 www.snains.com Certificate of Insurance attached, per your request. THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED,CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW,IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT,OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT,YOU ARE HEREBYNOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED.IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR,PLEASE NOTIFY US IMEDIATELY BYTELEPHONE,AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonlineTA° Insurance Visions,Inc.All rights reserved.