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PROOF OF INSURANCE (2017) CLOSED DATE(MMIDD/YYYY) A1f4:<?RE)) CERTIFICATE OF LIABILITY INSURANCE 10/28/2016 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: If the certificate holder is an ADDITIONAL INSURED,the policy(les) 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 g PHONE#« Xt) 949 dy Brewster Risk Manasementff&t Insurance Services PHONE A4hk55s 3377 q c„rya) 949-559-6703 , 12 Truman Irvine, CA 92620 APPREsS.. INSURERS)AFFORDING COVERAGE NAIC# www.gmgs.com 5 wsuReR A: Great reat Divide Insurance Company 25224 ...... INSURED Company 24198 EEC Environmental Engineering INSURERS: Peerless Insurance Orange CA Boulevard West, Suite 1800 INSURER Inc., INSURERC One City g .on?pany... ...... ... _Nautilus Insurance C ur:ER D Na ...17370 g INSURER E ........... ...... ... ..... .... .... .... .... .............. INSURER F: COVERAGES CERTIFICATE NUMBER: 32610711 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 'ARID[.50eR POLICY EFF POLICY EXP .. ...."......................................... LTR TYPE OF INSURANCE INap WVD POLICY NUMBER (MM/DDIYYYYI (MM/DD/YYYY) LIMITS A COMMERCIAL GENERAL LIABILITY GLP2006942-14 10/31/2016 10/31/2017 EACH OCCURRENCE $ 5,000,909' . ......... . tAMA.G T6_RE r�,...:........ 1.. .00,000 CLAIMS-MADE OCCUR PREMSE . . lr? d $ ... MED EXP(Any one person) $ 5,000 $ ............................... ..................................._.,...................................................5..000..«000 PERSONAL 8 ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 POLICY�,✓,,,,,�.NECT LOC 5,000,000 B AUTOMOBILE LIABILITY CBP8977390 10/31/2016 10/31/2017 COMBINED I�.!�!.�°,L�-.!LIMIT ................$.....................................l.,,01pp..Q,pP ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PRf,JPERTY DAMAGE $ AUTOS ONLY ._�.. AUTOS ONLY _(PPA axro_aadytr'ikY - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB ` {CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WCA2008815-13 5/24/2016 5/24/2017 PER OH AND EMPLOYERS'LIABILITY Y❑ ✓, 4TAH UTF F (MaOFFICER/MEMBER datory in NH)EXCLUDED?ECUTIVE N/A E.L.DISEASE CEAEEMPLOYEEI $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L,DISEASE POLICY LIMIT $ 1,000,000 D Pollution Liability CCP2006941-14 10/31/2016 10/31/2017 Each Poll Occurrence$5,000,000 Professional Liability Each Prof Liab Claim$5,000,000 General Aggregate:$5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Sewer System Management Plan As respects General Liability coverage, City of El Segundo,its officials and employees are added as Additional Insureds and this insurance is primary per ENV2154AO906 attached.As respects Automobile Coverage,Business Auto Coverage Form CA 00 01 10 01 applies. As respects Workers'Compensation coverage,a Waiver of Subrogation is hereby included per WC040306 attached. As respects General Liability coverage,30-day written notice of cancellation(10 days for non-payment of premium)applies per IL00171198 attached, CERTIFICATE HOLDER CANCELLATION Sewer System Management Plan City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo CA 90245 AUTHORIZED REPRESENTATIVE Griff Griffith ©1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 32610711 1 16-17 G/A/UMB/POLL/E&O/WC I Ashley Brewster 1 10/29/2016 3:19:03 PM (PDT) I Page 1 of 4 GLP2006942-14 EEC Environmental ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED - BLANKET- OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART Who is An Insured (Section II) is amended to include as an insured any person(s) or organizations,for whom you are performing operations under a written contract or agreement, which is in effect prior to the performance of your work which is the subject of such written contract or agreement, that such person(s) or organization(s) be added as an additional insured on your policy, but Only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by: 1. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured; or 2. Your work performed for such person(s) or organizations(s) and included in the products-completed operations hazard, only when required by the written contract or written agreement. With respect to damages caused by your work, as described above,the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above, but only when required by written contract or agreement. ©2006 by Berkley Specialty Underwriting Managers LLC,an affiliate of Nautilus Insurance Company and Great Divide Insurance Company.All rights reserved. ©1985-2006 by Insurance Services Office,Inc.,material used by permission. ENV 2154 A 09 06 Page 1 of 1 32610711 1 16-17 G/A/UMB/POLL/E&O/WC I Ashley Brewster 1 10/26/2016 3:19:03 PM (PDT) I Page 2 of 4 EEC Environmental dba Enviromental Engineering Contracting Inc., IL 00 17 11 08 COMMON POLICY CONDITIONS All Coverage Parts Included in this policy are subject to the following conditions. A. Cancellation b. Give you reports on the conditions we find; 1. The first Named Insured shown in the Declara- and tions may cancel this policy by mailing or deliv- c. Recommend changes. eying to us advance written notice of cancella- 2. We are not obligated to make any Inspections, tion. surveys, reports or recommendations and any 2. We may cancel this policy by mailing or deliver- such actions we do undertake relate only to fin- ing to the first Named Insured written notice of sura(bllity and the premiums to be charged.We cancellation at least: do not make safety Inspections. We do not un- a. 10 days before the effective date of cancel- dertake to perform the duty of any person or lation if we cancel for nonpayment of pre- organization to provide for the health or safety mium;or of workers or the public. And we do not warrant b. 30 days before the effective date of cancel- that conditions: lation if we cancel for any other reason. s. Are safe or healthful;or 3. We will mail or deliver our notice to the first b. Comply with laws, regulations, codes or Named Insureds last.mailing address known to standards. US. S. Paragraphs 1.and 2.of this condition apply not 4. Notice of cancellation will state the effective only to us, but also to any rating, advisory, rate date of cancellation. The policy period will end service or similar organization which makes an- on that date surance Inspections, surveys, reports or rec- ommendations. If this policy Is cancelled, we will send the first agraph2.o Named Insured any premium refund due. If we 4. Paragraph 2.of this condition does not apply to cancel, the refund will be pro rata. If the first any ationstibe sways, reports or recom- Named Insured cancels, the refund may be tion, under state may make relative to certiord- less than pro rata. The canceilation will be ef- lion, under state or municipal statutes, ves- f'ective even if we have not made or offered a nances le regulations,of boilers, pressure ves- refund. eels or elevators. 6. If notice Is mailed, proof of malling will be sufb- E. Premlums clent prof of notice. The first Named Insured shown In the Declara- B. Changes twns: This policy contains all the agreements been 1. Is responsitile for the payment of ail premiums; you and us concerning the Insurance afforded. and The first Named Insured shown In the Declarations 2. Will be the payee for any return premiums we Is authorized to make changes in the terms of this pay. policy with our consent. This policy's terms can be F. Transfer Of Your Rights And Duties Under This amended or waived only by endorsement Issued Policy by us and made a part of this policy. C. Examination Of Your Books And Records Your sand duties under this policy may not be transferred without our written consent except In We may examine and audit your books and re- the case of death of an Individual named insured. cords as they relate to this policy at any time dur- it you dle,your rights and duties will be transferred Ing the policy period and up to three years after- to your legal representative but only while acting ward. whhln the scope of duties as your legal represents- D. Inspections And Surveys live, until your legal representative Is appointed, 1. We have the right to: anyone having proper temporary, custody of your property will have your rights and duties but only a. Make inspections and surveys at any time; with respect to that property. IL 00 17 11 08 Copyright,Insurance Services Oflloe,Inc., 1888 Page 1 of 1 D 32161071 4 16-1'/ U/N/UM8/P0L.L/9&0/WC ( AGIi Ley erew,ter 1 10/28/2016 1:1.9:01 PIN (PDT) I Page 4 cat n WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 04 84 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 0.00%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization As required by written contract 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. WCA2008815-13 Endorsement No. 5/24/2016 Insured Premium EEC Environmental Insurance Company: Countersigned by Great Divide Insurance Company WC 04 03 06 04 84 1998 by the Workers'Compensation Insurance Rating Bureau of California. Page 1 of 1 All rights reserved. From the WCIRB's California Workers'Compensation Insurance Forms Manual 2001. 32610711 1 16-17 G/A/UMB/POLL/2&O/WC I Ashley Brewster 1 10/28/2016 3:19:03 PM (PDT) I Page 3 of 4