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PROOF OF INSURANCE (2017) CLOSED ' 1 DATE(MMIDDIYYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 1/18/2017 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 Ken Noden NAME: Wigmore Insurance Agency Inc. PHONE (714)979-6543 FAX Nol:(714)549-2943 RAIC,No,Eet): l 2970 Harbor Blvd. #215 ADDRC E'SS.commercialtrigmoreins.com ADDRESS. License #0811959 ___ _INSURER(S)AFFORDING COVERAGE NAIC9 Costa Mesa CA 92626 INSURERA:Travelers Indemnity Co of Conn 25682 INSURED INSURERB:Ohio Security Insurance Co. 24082 RTI Consulting, Inc. MS'URE',RC:Travelers Pry Ca_s Co of Amer 25674 8325 McConnell Ave. INSURER D:Hous ton Casualty Company INSURER E: Los Angeles CA 90045 INSURFRF: COVERAGES CERTIFICATE NUMBER:2016-2017 ALL LINES 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. TYPE OF INSURANCE BRI POLICY EFF POLICY EXP LIMBS LTR ILTR Ifi=SU t POLICY NUMBER IMMMO(YYYYI fmMIDON YYY'I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 A CLAIMS-MADE X OCCUR PREMISES LEa occurrence) 5 X Y 6808946L14ATCT16 3/30/2016 3/30/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL 5 AGGREGATE ,000 2,000 X ICY PRO' LOG PRODUCTS-COMPiOP AGO 5 2,000,000 PRO. — - W'HER S AUTOMOBILE LIABILITY C'OM141NI'�t)SINGLE SINGLE LINCI S 1,000,000 IFffi arcs^IrInl) B X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BAS56703349 9/12/2016 911212017 BODILY INJURY(Per accidentl 5 AUTOS _AUTOS NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS _[Per accident) M,Modlr',all vayrne'Mll $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE S Itid0 R l"I N'I"IC:4 5 5 - WORKERS COMPENSATION X I'L k O f H ANY'r;Wil'1!q'Y(NIL'1'ONVI�rA4 I'14hR&XI YIN, EI.. "1�rHU1E _ER (Mandatory LACLULDED:' t'y 1X41 NIA EL EACH A_C_CIOENT S ____1,_000,000 C XJUB3714T60515 6/1/2016 6/1/2017 DISEASE-EA EMPLOYEE 5 1,000,000 S Cr t9'flC WPVI'aN C4P 01'9 RAT'C NS k Pjw F I. )IS,FASE MOCY LIMIT S S„Q01 000 D Errors and Omissions UCC162214 6/25/2016 6/25/2017 S1,000,000 PER CLAIM S2,000,000 AGGREGATE DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 107,Additional Remarks Schedule,may be attached if more space is required) C'ERTI'FICATE HOLDER IS INCLUDED AS ADDITIONAL INSU'R'ED PER BLANKET ADDITIONAL .INSURED (ARCHITECTS, ENGIN'EER'S AND SURVEYORS) 'FORM CG D3 81 09 07. THIS ENDORSEM'E'NT I'N'CUDES W'AI'VER OF 'RIGHTS OF RECOVERY LANGUAGE WHEN REQUIRED BY CONTRACT OR AGREEMENT. CERTIF'I'CATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C'AN'CELLED BEFORE THE CITY OF 'EL S'EGUNDO T'H'E 'EXP'IRATION (SATE THEREOF, NOTICE WILL BE DELIVERED IN 350 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. EL SEGUNDO, CA 90245 AUTHORIZED REPRESENTATIVE Timothy Fig Ore/K140 - 1988w2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) COMMERICAL 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 INSURED INSURANCE (Section III) for this Coverage (Section II): Part. Any person or organization that you agree in a B. The following is added to Paragraph a. of 4. "contract or agreement requiring insurance" to in- Other Insurance in COMMERCIAL GENERAL dude as an additional insured on this Coverage LIABILITY CONDITIONS(Section IV): Part, but only with respect to liability for"bodily in- However,if you specifically agree in a"contract or jury", "property damage" or "personal injury" agreement requiring insurance"that the insurance caused, in whole or in part, by your acts or omis- provided to an additional insured under this Cov- sions or the acts or omissions of those acting on erage Part must apply on a primary basis, or a your behalf: primary and non-contributory basis,this insurance a. In the performance of your ongoing opera- is primary to other insurance that is available to tions; such additional insured which covers such addi- b. In connection with premises owned by or tional insured as a named insured, and we will not rented to you;or share with the other insurance,provided that: c. In connection with "your work" and included (1) The "bodily injury" or "property damage" for within the "products-completed operations which coverage is sought occurs;and hazard". (2) The "personal injury" for which coverage is Such person or organization does not qualify as sought arises out of an offense committed; an additional insured for "bodily injury", "property after you have entered into that "contract or damage" or "personal injury" for which that per- agreement requiring insurance". But this insur- son or organization has assumed liability in a con- ance still is excess over valid and collectible other tract or agreement. insurance„whether primary,excess, contingent or The insurance provided to such additional insured on any other basis, that is available to the insured is limited as follows: when the insured is an additional insured under d. This insurance does not apply on any basis to any other insurance. any person or organization for which cover- C. The following is added to Paragraph 8. Transfer age as an additional insured specifically is Of Rights Of Recovery Against Others To Us added by another endorsement to this Cover- in COMMERCIAL GENERAL LIABILITY CON" age Part. DITIONS(Section IV): e. This insurance does not apply to the render- We waive any rights of recovery we may have ing of or failure to render any "professional against any person or organization because of services". payments we make for "bodily injuiry", 'property f. The limits of insurance afforded to the addi- damage" or"personal injury" arising out of "your tional insured shall be the limits which you work`" performed by you„ or on your behalf„ under agreed in that"contract or agreement requir- a"contract or agreement requiring insurance"with ing insurance" to provide for that additional that person or organization. We waive these insured, or the limits shown in the Declara- rights only where you have agreed to do so as tions for this Coverage Part, whichever are part of the"contract or agreement requiring insur® less. This endorsement does not increase the ance" with such person or organization, entered limits of insurance stated in the LIMITS OF into by you before,and in effect when,the"bodily CG 03 8109 07 G 2007 The'Trevelers Compames.Inc Page 1 of 2 indvaaes the ccpynghted mwlar4i of Insutaiace servAces orrice,tm vvitT As permssion, COMMERICAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- erage Part, provided that the "bodily injury" and sonal injury'offense is committed. "property damage" occurs, and the "personal in- D. The following definition is added to DEFINITIONS jury"is caused by an offense committed: (Section V): a. After you have entered into that contract or "Contract or agreement requiring insurance" agreement; means that part of any contract or agreement un- b. While that part of the contract or agreement is der which you are required to include a person or in effect;and organization as an additional insured on this Cov- c. Before the end of the policy period. Page 2 of 2 0 2007 The Travelers Companies.Inc. CG D3 8109 7 Vnc"ur es the copyrighled rnatenal of nwiance semces Offxe,Inc with its parmission COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 6809H276593 ISSUE DATE: 02-09.2017 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): The City of El Segundo 350 Main Street El Segundo,CA 90212 PROJECT/LOCATION OF COVERED OPERATIONS: Operations of name insured PROVISIONS A. The following is added to WHO IS AN INSURED The insurance provided to such additional insured (Section ll): is limited as follows: The person or organization shown in the Sched- d. This insurance does not apply to the render- ule above is an additional insured on this Cover- ing of or failure to render any "professional age Part, but only with respect to liability for"bod- services". Ily injury", "property damage" or"personal injury" e. The limits of insurance afforded to the addi- caused. in whole or in part, by your acts or orris- tional insured shall be the limits which you sions or the acts or omissions of those acting on agreed in that"contract or agreement requir- your behalf: ing insurance" to provide for that additional a. In the performance of your ongoing opera- insured, or the limits shown in the Declara- tions; tions for this Coverage Part. whichever are b. In connection with premises owned by or less. This endorsement does not increase the rented to you;or limits of insurance stated in the LIMITS OF INSURANCE (Section Itl) for this Coverage c. In connection with 'your work" and included 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 damage" or "personal injury" for which that per- However„ if you specifically agree in a"contract or son or organization has assumed liability in a con- agreement requiring insurance"that,for the addi- tract or agreement. t,Ional insured shown in the Schedute, the insur- ance provided to that additional insured under this CG D3 82 09 07 0 2007 The Travelers Companies.Inc- Page 1 of 2 Inctudes'tl a cepytr g rtes ntalen,40 0 ll'asw ante ServKas Office,Inc.wily,as ga4misstcn COMMERCIAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or injury"arising out of"your work"on or for the pro- a primary and non-contributory basis, this insur- ject, or at the location, shown in the Schedule ance is primary to other insurance that is avail- above, performed by you, or on your behalf, un- able to such additional insured which covers such der a "contract or agreement requiring insurance" additional insured as a named insured, and we with that additional insured. We waive these will not share with the other insurance, provided rights only where you have agreed to do so as that: part of the"contract or agreement requiring insur- (1) The "bodily injury" or "property damage" for ance" with that additional insured entered into by which coverage is sought occurs; and you before, and in effect when, the "bodily injury" or"property damage" occurs, or the "personal in- (2) The "personal injury" for which coverage is jury"offense is committed. sought arises out of an offense committed; D. The following definition is added to DEFINITIONS after you have entered into that "contract or (Section V): agreement requiring insurance" for such addi- tional insured. But this insurance still is excess "Contract or agreement requiring insurance" over valid and collectible other insurance, means that part of any contract or agreement un- whether primary, excess, contingent or on any der which you are required to include the person other basis, that is available to the additional in- or organization shown in the Schedule as an ad- sured when the additional insured is also an addi- ditional insured on this Coverage Part, provided tional insured under any other insurance. that the "bodily injury" and "property damage"oc- curs, and the"personal injury"is caused by an of- C. The following is added to Paragraph 8. Transfer fense committed: Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- a. After you have entered into that contract or DITIONS(Section IV): agreement; We waive any rights of recovery we may have b. While that part of the contract or agreement is against the additional insured shown in the in effect; and Schedule above because of payments we make c. Before the end of the policy period. for"bodily injury", "property damage" or"personal Page 2 of 2 0 2007 The'Travelers Cwnnpaarldes,unc. CG D3 82 09 07 wrado4es mlae mpyrtghted matorial of Nnsoraa oe Serkes Office.Inc.,wrritta Rs taea6ssio n � � � �Awak WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A)— 001 POLICY NUMBER: (XJUB-3714T60-5-16) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 5 .0 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE NAMED 'INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER 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. Endorsement No. Insured Premium Insurance Company Countersigned by�, DATE OF ISSUE: 02-23-17 ST ASSIGN: Page 1 of 1