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PROOF OF INSURANCE (2017) CLOSED DATE(MMIDDIYYYY)
ACCM0 CERTIFICATE OF LIABILITY INSURANCE 11/23/2016
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(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 NAME: Laura Barth
Altus Partners, Inc PHONE (610)526-9130 FAX NC):(610)526-2021
919 Conestoga Road A"DDRIRss lbarth @altuspartners.com
Building , Suite 311 INSURER(S)AFFORDING COVERAGE NAIC q
g INS,
Rosemont PA 19010 INSURERAACE American Insurance Co. 22667
INSURED INSURER B ACE Property and Casualty Insurance 20699
Aerotek, Inc. INSURERC:
7301 Parkway Drive INSURER D:
INSURER E:
Hanover MD 21076 INSURER F:
COVERAGES CERTIFICATE NUMBER:Standard + All 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 T INSURANCE INSD�SWVD POLICY NUMBER (MM DDY.E
TYPE OF INSURANCE FF POLICY EXP ( LIMITS
IYYYYI IM MIDD/XYYX)a
• COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE 1'0 RENIE0
A I CLAIMS-MADE I X OCCUR PREMISES(Ea occurrence) $ 1,000,000
X XSL G2785929A 11/30/2016 11/30/2017 MED EXP(Any one person) $ 10,000
• $1,000,000 (SIR) PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
F'170.
X
POLICY JE'CT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
I OTHER: Employee Benefits $
AUTOMOBILE LIABILITY COMHUgED SuN'Gki' LIMIT $ 1,000,000
(Ea»cxjdept),
A ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
X AUTOS AUTOS H09051570(H&NO)/H09051582 11/30/2016 11/30/2017 BODILY INJURY(Per accident) $
X X NON-OWNED PROPERTY DAMAGE
HIRED AUTOS AUTOS .tPo'f.7 edenlp $
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
B EXCESS LIAB ION$I
DPD X �RETENT CLA100,0A 0E) G27926691 11/30/2016'11/30/2017 AGGREGATE $ 5,000,000
,
COMPENSATION'S 049105149 (AOS) Y
AND EMPLOYERS'LIABILITY YIN l STATUTE ERH-
VPORKER
A OrTICE MI under+CL)OLD7'ECC)'CIVE Y N I'N/A 049105137 (CA, MA) EL DaSEASECIEAEMPLOYEE $ 1,000,00,0,
Iyyandalo hi NH y C49105150 (WI) 11/30/2016 11/30/2017
DESCRRTION OF OPE::RA"'PIONS below C49105162 (TN) E L DISEASE-POLICY LIMIT $ 11000,000
DESCRIPTION OF OPERATIONS,LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
Certificate issued as evidence of insurance per policy terms,conditions and exclusions. Certificate
holder is an additional insured on the general liability insurance policy per the written agreement. A
waiver of subrogation in favor of certificate holder applies to the workers compensation insurance policy
per the written agreement.
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
350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
E1 Segundo, CA 90245
AUTHORIZED REPRESENTATIVE
Krista Dean/KMD •
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025 r9manrn
ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT
Named Insured Endorsement Number
Allegis Group Inc 6 12
Policy Symbol Policy Number Policy Penod Eftemve Date of Endorsement
XSL G2785929A 11/3012016 to 11/30/2017
Issued By(Name of Insurance company)
ACE American Insurance Company
Insert the policy number.The remadndoi Wine Intormallon is ID be completed only when(bls endorsement Is issumd subsequent to the preparation of the polcy,
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
EXCESS COMMERCIAL GENERAL LIABILITY POLICY
The following is added to Section 11.2—Who Is An Insured:
e. Any person or organization that you are required to include as an additional insured under this policy
because of a written contract that:
1) Is in effect during this policy period;and
2) Was executed prior to the"occurrence"of the"bodily injury"or"property damage";and
3) Qualifies as an"insured contract"as defined in this policy.
Any such person or organization is an additional insured only for "bodily injury" and "property
damage"resulting from:
a. "your work"that you do for that additional insured pursuant to such contract;or
b. "your product"distributed or sold to that additional insured pursuant to such contract;and
such person is only an additional insured for"occurrences"taking place during the period of time
required by such contract or until the end of the policy period,whichever is sooner.
However:
i)The insurance afforded to such additional insured only applies to the extent permitted by law;and
ii)If coverage provided to the additional insured is required by a contract or agreement,the insurance
afforded to such additional insured will not be broader than that which you are required by the
contract or agreement to provide for such additional insured.
In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance
required by the written contract:
x. The insurance provided by this endorsement shall be limited to the Limits of Insurance
required by the written contract;and
y. This endorsement shall not increase the Limits of Insurance stated in the Declarations
under Item 3.Limits of Insurance pertaining to the coverage provided herein.
Any coverage provided by this endorsement to an additional insured shall be excess over any other
valid and collectible insurance available to the additional insured whether primary, excess, contingent
or on any other basis unless the written contract specifically requires that this insurance apply on a
primary or non-contributory basis.
XS-21234b(08/13) Includes copyrighted material of Insurance Services Office, Inc.,with Its permission. Page 1 of 2
In accordance with the to and conditions of the policy and as more fully explained In the policy,as
soon as Practicable, each additional insured must give us prompt notice of any"occurrence" which
may result in a claim, forward all legal papers to us, cooperate in the defense of any actions, and
otherwise comply with all of the policy's to and conditions.
..............
Authorized Representative
XS-21234b(08/13) Includes copyrighted material of Insurance Services Office,Inc.,with its peffnission. Page 2 of 2
Workers'Compensation and Emplpyer 'Llablilty Policy
Named Insured Endorsement Number
ALLEGIS GROUP INC
7301 PARKWAY DRIVE Policy Number
HANOVER MD 21076 Symbol: WLR Number C49105149
Policy Period Effective Date of Endorsement
11-30-2016 TO 11-30-2017 11-30-2016
Issued By(N mo of InsuranceCompany)
INDEMNITY MS,CO.OF NORTH AMERICA
Insert iheibe ail numbex.The rei;a nder gat Ilia tnfomialJon N to be completed oniy when this endramement is Issued subsequent to tho rarepasratlon of the jLcy
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
ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR
RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS
EXECUTED PRIOR TO THE DATE OF LOSS.
For the states of CA, UT,TX, refer to state specific endorsements.
This endorsement is not applicable in KY, NH,and NJ.
The endorsement does not apply to policies in Missouri where the employer is in the construction group of code
classifications.According to Section 287.150(6)of the Missouri statutes,a contractual provision purporting to waive
subrogation rights against public policy and void where one party to the contract is an employer in the construction
group of code classifications.
For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A..
16-1801 through 16-1807 and any amendments thereto)and the Kansas Faimess in Public Construction Contract
Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract
for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by
liability or workers compensation insurance shall be against public policy and shall be void and unenforceable
except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a
consolidated or wrap-up insurance program.
Authorized Repivsentallve
WC 66-03 1 3 ,1105—f Ptd.U.S.A... .... .........t.. .8.-2-----. M.........................-o-i.........................................................ns.i...-_��, ..,.„.,
atonal Council®n pen lion