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PROOF OF INSURANCE (2018) CLOSED ACCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �'. 7126Q017 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 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 I this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).CONTACT Strategies PRODUCER Irvinep � � �Company 2040 Main Street,Company50 PHONE j .� Ax 92 �tX49 2224t " r?�� ADDRESS: syo f g a@rlSk,strategles,.com W„N,StJ;RER[SI(AFFORDING COVERAGE NAIC# gies com CA DOI License No.OF06675 Travelers Property Casualty Cc of Amer 25674 www.risk-strate .. wsuRERA: . INSUREDU n Company 37273 MNS Engineers, Inc. INsuRERc 201 N. Calle Cesar Chavez, Suite 300 INSURER B AXIS Insurance Santa Barbara CA 93103 INSURER D: INSURER E: .....,, INSURER F: COVERAGES CERTIFICATE NUMBER: 36865044 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 'AID CLAIMS. (LTR TYPE OF INSURANCE ANBD mn POLICY NUMBER 1MMADD(YYYIR Y) (MM DDmYV1 1 LIMITS COMMERCIAL GENERAL LIABILITY 6802J051458 6/14/2017 6/14/2018 -�ennlsss tE OCCURRENCE $ $1,000,000' CLAIMS-MADE OCCUR DAMA6F_TO REWEb L✓� $1,000,000 I MED EXP(Any oneP $.............. .,,.„„„$10,000 .. .. ......................................... , ...a.............rson)................. ............. .................................... PERSONAL&ADV INJURY $ $1,000,000 ...G..... �__I PEAGGREGATE O- F—] LOC PRODUCTS-C.....MP/OPA $2,000,000, E� POLICY GENERALAGGORE.....A..............G,G......$........,,,,.,,,,,, A AUTOMOBILE LIABILITY BA2220L967 6/14/2017 6/14/2018 I..0° M,'aINED INGa c LUMI't. ...$........................ ...000„000 ANY AUTO BODILY INJURY(Per person) $ OWNED P SCHEDULEDBODILY INJURY(Per accident) $ AUTOS ONLY AUTOSHIRED NON-OWNED -- --..._..AUTOS ONLY AUTOS ONLY (PAA aaEcRTen)AMAGE $ $ _ ELLA LIAB OCCUR AGGREGATE EACH OCCURRENCLAIMSMADE CUPBE545094 6/14/2017 6/14/2018 CE $ $5,000,000 ACESS LIAR ED 1 ✓I RETE [y/ .. .. ..................... .. ,:000,OOO D NTION$� A WORKERS COMPENSATION �- UB3240T745 6/14/2017 6/14/2018 PER DTH- AND EMPLOYERS'LIABILITY Y/N ✓ ,,,,,STATUTE I --....LER ANyyYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ $1 000,0,001 OFF"CEFDas,as, nbe 7F OI'E6 ATtlI NS below ❑ NIA E.L.DISEASE-EA EMPLOYEE(( 0 Mandato In NH If SCRIPoTIONOFrsY SE-POLICY LIMIT ($ $1,000,000, B Professional Liability DP002553012017 6/14/2017 6/14/2018 $2,000,000 Per Claim $2,000,000 Aggregate b DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Projects as on file with the insured including but not limited to On-Call Land Surveying Services,PW 17-28. City of EI Segundo,its officials and employees are named as additional insureds and priniaryinon-contributory clause applies to the general liability policy and a waiver of subrogation applies to the work comp policy--see attached endorsements. CERTIFICATE HOLDER CANCELLATION City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y 9 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Orlando Rodriguez, Sr. Civil Engineer ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St. EI Segundo CA 90245 AUTHORIZED REPRESENTATIVE Michael Christian ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 36065044 1 17-18 GL-AL-UMB-WC-PL I Sherry Young 17/26/2017 12:22:34 PM (PDT) I Page 1 of 4 Insured:MNS Engineers, Inc. Policy No. : 6802JO51458 COMMERCIAL GENERAL LIABILITY Effective Date:6/14/2017 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 1. The following is added to SECTION II — WHO IS h. This insurance does not apply to "bodily AN INSURED: injury" or "property damage" caused by "your Any person or organization that you agree in a work" and included in the "products- ,.written contract requiring insurance"to include as completed operations hazard" unless the an additional insured on this Coverage Part, but: "written contract requiring insurance" specifically requires you to provide such a. Only with respect to liability for"bodily injury", coverage for that additional insured, and then "property damage" or"personal injury"; and the insurance provided to the additional b. If, and only to the extent that, the injury or insured applies only to such "bodily injury" or damage is caused by acts or omissions of "property damage" that occurs before the end you or your subcontractor in the performance of the period of time for which the "written of "your work" to which the "written contract contract requiring insurance" requires you to requiring insurance" applies, or in connection provide such coverage or the end of the with premises owned by or rented to you. policy period, whichever is earlier. The person or organization does not qualify as an 2. The following is added to Paragraph 4.a. of additional insured: SECTION IV — COMMERCIAL GENERAL c. With respect to the independent acts or LIABILITY CONDITIONS: omissions of such person or organization; or The insurance provided to the additional insured d. For "bodily injury", "property damage" or is excess over any valid and collectible other "personal injury" for which such person or insurance, whether primary, excess, contingent or organization has assumed liability in a on any other basis, that is available to the additional insured for a loss we cover. However, if contract or agreement. you specifically agree in the "written contract The insurance provided to such additional insured requiring insurance" that this insurance provided is limited as follows: to the additional insured underthis Coverage Part e. This insurance does not apply on any basis to must apply on a primary basis or a primary and any person or organization for which non-contributory basis, this insurance is primary coverage as an additional insured specifically to other insurance available to the additional is added by another endorsement to this insured which covers that person or organizations Coverage Part. as a named insured for such loss, and we will not share with the other insurance, provided that: f. This insurance does not apply to the rendering of or failure to render any � The "bodily injury"ryor "property damage" for "professional services". which coverage is sought occurs; and g. In the event that the Limits of Insurance of the (2) The "personal injury" for which coverage is Coverage Part shown in the Declarations sought arises out of an offense committed; exceed the limits of liability required by the after you have signed that "written contract "written contract requiring insurance", the requiring insurance". But this insurance provided insurance provided to the additional insured to the additional insured still is excess over valid shall be limited to the limits of liability required and collectible other insurance, whether primary, by that "written contract requiring insurance". excess, contingent or on any other basis, that is This endorsement does not increase the available to the additional insured when that limits of insurance described in Section III — person or organization is an additional insured Limits Of Insurance. under any other insurance. CG D3 81 0915 m 2015 The Travelers Indemnity Company.All rights reserved. Pagel of 2 Includes the copyrighted material of Insurance Services Office, Inc.,with its permission 36865044 117-10 GL-AL-UMS-WC-PL I Sherry Young 1 7/26/2017 12:22:34 PM (PDT) I Page 2 of 4 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer 4. The following definition is added to the Of Rights Of Recovery Against Others To Us, DEFINITIONS Section: of SECTION IV — COMMERCIAL GENERAL "Written contract requiring insurance" means that LIABILITY CONDITIONS: part of any written contract under which you are We waive any right of recovery we may have required to include a person or organization as an against any person or organization because of additional insured on this Coverage Part, payments we make for "bodily injury", "property provided that the "bodily injury" and "property damage" or "personal injury" arising out of "your damage" occurs and the "personal injury" is work" performed by you, or on your behalf, done caused by an offense committed: under a'written contract requiring insurance with that person or organization. We waive this right a. After you have signed that written contract; only where you have agreed to do so as part of b. While that part of the written contract is in the "written contract requiring insurance" with effect; and such person or organization signed by you before, and in effect when, the "bodily injury" or c. Before the end of the policy period. "property damage" occurs, or the "personal injury" offense is committed. Page 2 of 2 0 2015 The Travelers Indemnity Company.All rights reserved. CG D3 81 09 15 Includes the copyrighted material or Insurance Services Office, Inc.,with its permission 36865044 117-18 GL-AL-UM®-WC-PL I Sherry Young 1 7/25/2017 12;22:34 PM (PUT) I Page 3 of 4 WORKERS COMPENSATION TRAVELER CO AND EMPLOYERS LIABILITY ENDORSEMENT WC 99 03 76 (00) Insured: MNS Engineers, Inc. Policy No.: UB3240T745 Effective Date: 6/14/2017 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. 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 5.000% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION WITH WHOM YOU AGREE IN WRITING TO WAIVE YOUR RIGHT TO RECOVER AGAINST THEM. YOU MUST AGREE TO THIS WAIVER PRIOR TO THE DATE OF LOSS Job Description: Projects as on file with the insured. Authorized Representative 36065044 17-18 GL-AL-UMB-WC-PL I Sherry Young 1 7/26/2017 12:22:34 PM (PDT) I Page 4 of 4