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PROOF OF INSURANCE (2017 - 2018) CLOSED
Client#:1266412 305FLEMIENV ACORD,,., CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 0412412017 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. IMPOR r 'NT:If the certificato holder is an ADDITIONAL INSURED,time policy(les)must be endorse, rl.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 UndorSOInCIA(S), PRODUCER VVIE:�r:°w Allie Mosier NA aL:; BB&T Insurance Services PC?I- r N6;714 941-2900 I�A�c 877-297-7116 of Orange County E riRM1d(', amoslor@bbandt.com er'r>lal ss: C 2400 Katella Avenue Ste 1100 INSURERISj,AFFORDING COVERAGE NAICN Anaheim,CA 92806 INsuRERA:Homeland Insurance Company of N 34452 INS _. URED INSURER e URER :Redwood Fire and Casualty Ins 11673 Fleming Environmental Inc. INSURER C:Travelers Property Casualty Co 25674 1372 East Valencia Drive INSURER 0:West American Insurance Company 44393 Fullerton,CA 92831 INSURER E 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED 1EREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. 6.T TYPE OF INS ADDL BR' PO ICYEFF POLtCYkXP .. INSURANCE LIMITS uD POLICY IMrq o/Yd,,lh) (MMi".I—yY c.... X OCCUR PREMISES t e r:n uvrr»rom,, 11000'000 �� ? RENLE 7LAIMS-MADEGENERAL LIABILITY DAM GE TC )'Itl tV1I D Vk I .S3O,O,000 7930050560000 09/0112016 09101/2017 EACH OCCUR .e.Person1...... S10,0010 X Pollution Liab ..Meo..E.xP..(Any..o".. ... .. ............... Professional GATE LIMITLAPPnLIES PER; GENERAL AGGREGATE INJURY 1,$521000,000 PRO- RODUCTS--C.O.M.P�. .P..A......................wO,OO,000 S$2_ OC D AUTOMOBILE LIABILITY BAW57302315 09/0112016 09/0112017 'OlAHINPD i"NGcc'iiMlrcG S2' 500 X ANY AUTO BODILY O tW'a x ,d r,la 5.. 00,000 .......... .�. INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accldenl) $ AUTOS AUTOS X+ 'NON-OWNED PP '_.' HIRED AUTOS X ( tOPt R1Y LIAMAGE -- AUTOS I",oc»rr,»iiBorrl,4 IS A UMBRELLA LIAR OCCUR 7930050570000................................................991011201.6 09101/20171',1,. . OCCURRENCE .. -.............-----------,..0 EACH X EXCESS LIAO X CLAIMS-MADE AGGREGATE s5,000,000 0 DED I X I RETENTION$0 S B.. FLWC806706 05/01/2017 .. ( I AND EMVLOYFHS'ILIA8ILIYY Y� 05!0112018 X l5TATVTCrDEIr J.ERH $1,000,000 ANY PRP WORKERf�wSCOMPENSATION I i IMarnatN 1I y,¢dp�Il(') rG(: lNfpMYy'' ECUTIVE NIA E.L.DISE...�.AC. L EACW i yes,describe under ASE-EA EMPLOYEE $7,000,000 .1., ... ........ QESCRIPTION OF OPERATIONS below _- .""„ E.L.DISEASE-POLICY LIMIT -$7,000,000 C Rented/Leased QT6606686M19ATIL16 09101/2016 09101120171 $1,000 Deductible Equipment $160,000 Max Per Item A Transportation Po 7930050560000 �910112016 09101120171 $1,000,000/Ded$2,500 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Addltlonal Remarks Schedule,may be attached It more space Is required) THIS CERTIFICATE IS FOR THE WORKERS COMPENSATION RENEWAL ONLY.PLEASE RETAIN PREVIOUS CERTIFICATES AND ENDORESMENTS FOR ALL OTHER LINES OF COVERAGES. RE: Maintenance Agreement. The City of El Segundo,its officers,officials,employees,agents and volunteers are named as additional insured as respects general liability,this insurance is primary and noncontributory with any other (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS, 150 Illinois Street El Segundo,CA 90245 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) 1 of 2 The ACORD name and logo are registered marks of ACORD #S 180256371M 18025622 AC MOS DESCRIPTIONS (Continued from Page 1) Should any policy be cancelled before the expiration date,BUT Insurance Services will mall 30(thirty) days written notice to the certificate holders which require such action per written contract or agreement, 410 days notice of cancellation for non-payment of premium. I SAGITTA 25.3(2014101) 2 of 2 #S167252331M76725210 Fleming Environmental Inc. Policy Number: 793005056 0000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - FORM I This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II — WHO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (b) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain the same. OBENV GE 301 (02 11) Includes copyrighted material of Insurance Services Office,Inc. 1 of 1 Copyright,OneBeacon Insurance Group,2011 Fleming Environmental Inc. Policy Number: 793005056 0000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PRIMARY AND NOWCONTRNBUTORY ENDORSEMENT This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IV-CONDITIONS,8. Other Insurance, is amended by adding the following paragraph: This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement, that this insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same.,. OBENV GE 319(02 11) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright,OneBeacon Insurance Group,2011 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wVCW9041U0 (Ed.9-14) WAIVER OF OUR RIGHT T0RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS VVw have the right to recover our payments from anyone liable for an Injury covered by this pollcy.We will not enforce our right against the person or organization nomou/nthoSnhodu|n. (rh/meg,wem*mtmpp||maon|ytothwox(en\thotyou perform work under owritten oon{novt that requires you to obtain this agreement from om.) The additional premlum for this endorsement shall be 2%of the total manual premium oUhomNon due on such remuneration.The minimum premium for this endorsement |n*35O. This agreement shall not operate directly or Indirectly to benefit anyone not named in the Schedule, SCHEDULE BLANKET WAIVER Pomoon/mnmun|omuon Blanket Waiver—Any person o,organization for whom the Named Insured has agreed uv written contract to furnish this waiver. Job Description Waiver Premium All CAOperations This endorsement changes the policy to which It Is attached and Is effective on the date Issued unless otherMse stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation py the nol|c».) Endorsement Effective 05/01/2017 Policy No. pLmC806706 snuosomentwv. |nxvmo Premium* Insurance Company Redwood Fire and Casualty uo CwuntersIgmad»y nvo08V*1013