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PROOF OF INSURANCE (2018 - 2018) CLOSED DATE(MMIDD/YYYY) Ai+C6R'V CERTIFICATE OF LIABILITY INSURANCE 03/15/2017 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: it the certificate holder is an ADDITIONAL INSURED„ the policy('ie's) 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 NAME: Bill Siebe SL Insurance Associates 1A1 "q, Xt) (408)776-8600 LAI ,NpI.. (408)7 76 .. FA -8602 EPMDAnL bill sllnsure.com 275 Tennant Ave.#207 E-MA$L ll@slinsure.com ....................... Morgan Hill CA 95037 INSURERA: NATIONAL FIRE INS CO OF HARTFORD 20478 ........................................................-......,,.....,,,-,,,,,,, ......,,.... ,,, INSURED INSURERB: HARTFORD INS CO OF THE MIDWEST 37478 PACIFIC SERVICES,INC. INSURERC: dba:Pacific Datacom INSURER D: 927 Calle Negocio suite L INSURER E: San Clemente CA 92673 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 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. 'L TYPE OF INSURANCE IINSD wvn POLICY NUMBER IMMIDDII YYYI IMWOL182I �1 MP I, LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TC RFNTED.. a.... CLAIMS-MADE X OCCUR PREMISE$(Ea rcourrance) 300.000 MEDEXP,(... Y one eon) 5.1000 ..... A Y Y B 4031343323 01/20/2017 01/20/2018 PERSONAL&ADV INJURY s 2,000,000 G'EN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY _��,,,rrW. �.r"+,,, LOC PRODUCT$, COMP/OP AGG $ 4,000,000 G�Sd..�CSk,d�Bj�V „.................. O°r'HER; $ I q$dNGLE LIMIT' AUTOMOBILE LIABILITY COMBINED) $ 1,000,000 _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS Y Y B4031343323 01/20/2017 01/20/2018 BODILY INJURY(Per accident) $ _ �/ NON-OWNED FNtaOPE:Rf'9 I_AVAGE X HIRED AUTOS X AUTOS (Par iwdenO $ $ UMBRELLA LIAB 1�OCCUR EACH OCCURRENCE $ EXCESS S LIAB CLAIMS-MADE AGGREGATE $ DIED V V RETENTION$ �/ p $ WORKERS COMPENSATION /� STATUTE ERH AND EMPLOYERS'LIABILITY B OFFICERIMEMBEREXCLUDED?ECUTIVE YIN NIA Y 57WECES7871 01/09/2017 01/09/201$ E,L EACH ACCIDENT $ 1,000,000 (Mandatory In NH) �Y E DISEASE-EA EMPLOYEE' $ 1,000,000 If yyes,dawbe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) As it pertains to its California operations,and where required by contract for any and all locations for that contract,the following is named as additional insured interest. The City of El Segundo "30 Days notice of Cancellation* X10 day notice for Non-Pay CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 350 Main St El Segundo Ca 90245 ial4L u ®1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CNA S (Ed.06/11) Policy: B 4031343323 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH PRODUCTS COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM A. Paragraph C. WHO IS AN INSURED is amended to C. The insurance provided to the additional insured does include as an additional insured: not apply to "bodily Injury," "property damage," or 1. Any person or organization whom you are "personal and advertising injury"arising out of: required by written contract to add as an additional a. The rendering of, or the failure to render, any insured on the Businessowners Liability Coverage professional architectural, engineering, or Form. surveying services, including: B. The insurance provided to the additional insured is (1) The preparing approving, or failing to prepare limited as follows: or approve maps, shop drawings, opinions, 1. The person or organization is an additional reports, surveys, field orders, change orders insured only with respect to liability for "bodily or drawings and specifications; and injury," "property damage," or "personal and (2) Supervisory, inspection, architectural or advertising injury"caused in whole or in part by: engineering activities. a. Your acts or omissions;or b. 'Bodily Injury," "property damage," or "personal b. The acts or omissions of those acting on your and advertising injury" arising out of any premises or work for which the additional insured is behalf specifically listed as an additional insured on in the performance of your ongoing operations another endorsement attached to this Policy. specified in the written contract; or D. Section E. of the Businessowners General Liability c. "Your work" that is specified in the written Conditions is amended as follows: contract but only for"bodily injury"or"property The Duties in the Event of Occurrence, Offense, damage" included in the products completed Claim or Suit condition is amended to add the operations hazard,and only if: following additional conditions applicable to the (1) The written contract requires you to additional insured: provide the additional insured such An additional insured under this endorsement will as coverage;and soon as practicable: (2) This Coverage Form provides such a. Give us written notice of an 'occurrence" or an g coverage. offense which may result in a claim or"suit"under 2. We will not provide the additional insured any this insurance, and of any claim or"suit'that does broader coverage or any higher limit of insurance result; than the least that is: b. Tender the defense and indemnity of any claim or a. Required by the written contract; "suit' to any other insurer or self insurer whose policy or program applies to all loss we cover �.. b. Described in B.1.above; or under this Policy; c. Afforded to you under this policy. c. Except as provided in Paragraph B.3. of this an to make available agree 3. This insurance is excess of all other insurance endorsement, a g y other available to the additional insured, whether on a insurance the additional insured has for a loss we primary, excess, contingent or any other basis. cover under this Policy; and °— But if required by the written contract, this d. Send us copies of all legal papers received, and insurance will be primary and non-contributory otherwise cooperate with us in the investigation, relative to insurance on which the additional defense,or settlement of the claim or"suit." ° insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we SB-146935-C Page 1 of 3 (Ed.06/11) S 1- CAM (Ed. 06/151) receive from the additional insured written notice that person at any time which results as a of a claim or"suit." consequence of the bodily injury, sickness or disease. E. With respect only to the insurance provided by this J. Expanded Personals and Advertising Injury endorsement, the first sentence of Paragraph H.1. Definition Other Insurance Condition in the Businessowners A. The following is added to Section F. Liability and Common Policy Conditions, is deleted and replaced Medical Expenses Definitions, item 14. with the following: Personal and Advertising Injury, in the Other Insurance Businessowners General Liability Coverage 1. This insurance is primary and non-contributory Form: except when rendered excess by this h. Discrimination or humiliation that results in endorsement, or when Paragraph 2. below injury to the feelings or reputation of a natural applies. person, but only if such discrimination or F. The provisions of the written contract or written humiliation is: agreement do not in any way broaden or amend this 1. Not done intentionally by or at the Policy. direction of: G. Blanket Waiver of Subrogation a. The insured;or We waive any right of recovery we may have against: b. Any "executive officer," director, 1. Any person or organization with whom you have a stockholder, partner, member or written contract that requires such a waiver. manager (if you are a limited liability company)of the insured; and H. Broad Knowledge of Occurrence 2. Not directly or indirectly related to the The following items are added to E. Businessowners employment, prospective employment, General Liability Conditions in the Businessowners past employment or termination of Liability Coverage Form: employment of any person or person by e. Paragraphs a. and b. apply to you or to any any insured. additional insured only when such "occurrence," B. The following is added to Exclusions,Section B.: offense, claim or"suit"is known to: (15)Discrimination Relating to Room, Dwelling 1. You or any additional insured that is an or Premises individual; Caused by discrimination directly or indirectly (2) Any partner, if you or an additional related to the sale, rental, lease or sub-lease insured is a partnership; or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the (3) Any manager, if you or an additional direction of any insured. insured is a limited liability company; (16)Fines or Penalties (4) Any "executive officer" or insurance manager, if you or an additional insured is Fines or penalties levied or imposed by a a corporation; governmental entity because of discrimination. (5) Any trustee, if you or an additional insured is a trust;or C. This provision (Expanded Personal and Advertising Injury) does not apply if Personal (6) Any elected or appointed official, if you or and Advertising Injury Liability is excluded an additional insured is a political either by the provisions of the Policy or by subdivision or public entity. endorsement. This paragraph e. applies separately to you D. Personal and Advertising Injury Re-defined and any additional insured. Section F. Liability and Medical Expenses I. Bodily Injury Definitions, item 14, Personal Advertising Injury, Section F. Liability and Medical Expenses Paragraph c.is replaced by the following: Definitions, item 3. "Bodily Injury" is deleted and c. The wrongful eviction from, wrongful entry replaced with the following: into, or invasion of the right of private "Bodily injury" means bodily injury, sickness or occupancy of a room dwelling or premises disease sustained by a person, including death, that a person or organization occupies humiliation, shock, mental anguish or mental injury by SB-146935-C Page 2 of 3 (Ed.06/11) �w►�r SB-146935-C (Ed.06/11) committed by or on behalf of its owner, landlord or lessor. xv'9 ldi ^L S dub 'MMMM-IIMM r SB-146935-C Page 3 of 3 (Ed. 06/11) CIVA POLICY NUMBER: B 4031343323 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF' TRANSFER OF FIGHTS OF' RECOVERY AGAINST OTHERS TO IBS - I LANKET BASIS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work"done under a contract with that person or organization and included in the"products-completed operations hazard." This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Copyright, Insurance Services Office, Inc., 2008 Page 1 of 1 Policy : 57WECES7871 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA BLANKET BASIS 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 ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED INSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A.