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PROOF OF INSURANCE (2018) CLOSED Client#: 25361 GEOSCONS ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 8/18/2017 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: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 endorsoment(S), PRODUCER ACT NAME: Carly Underwood Greyling Ins. Brokerage/EPIC PHONE 770.552.4225 PAX 866 550 (AIC,No,,Ext): IA/C,Nu)�;,„ 3780 Mansell Road,Suite 370 E-MAIL 4082 ADDkESS: carly.underwood@greyl'iing.com Alpharetta,GA 30022 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A National Union Fire Ins.Co. 19445 INSURED INSURER B:New Hampshire Ins.Co. 23841 Geosyntec Consultants,Inc. INSURER c;Allianz Underwriters Insurance 36420 900 Broken Sound Parkway NW,Suite 200 INSURER D Boca Raton, FL 33487 INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: 17-18 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 HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. F INSUNCE A X COMMERCIALOGENERAL LIABILITY MtlSR �WVD 5268179 POLICY NUMBER '04/01/2017 04/0112018 EACH OCCURRENCE LIMITS$1,000',000 INSRR TYPE .,DREM13E8 �"�E .p.El?)...... CLAIMS-MADE X�OCCUR P.....,MA.........., $500,000 MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: s2,000,000 PRO- POLICY X,I GENERAL ,$2,,000,000 LOC PRODUCTS-COMP/OPAGG $ OTHER: $ ( ) &,;L.,SAIpY;p3Ip7)......................L...........�........... $1,000,000 A AUTOMOBILE LIABILITY 4489673 AOS 04/01/2017 04101/2018,'���I°+1R�NFC�S °N?�LE'LIMr� A X ANY AUTO 4489674(MA) 04/01/2017 04/01/2018,BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ _.I NON-OWNED PROP�ERTYOAMAGE $ HIRED AUTOS AUTOS UMBRIELLA LIAB OCCURRENCE $ EXCESS LIAB OLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION A OFFIC�PtPI[�:B'MBEREXR NEFIE ECUTIVE N/A 015893709(AO) •04/01 'A AND EMPLOYERS'LIABILITYY/N 015893710(CAI ) /2017 04/01/201 _^—LEACHIAcciDEI T EB_ $1,000,000 B IfyS,describe ON OF OPERATIONS below ancialory In NH) 015893711 (ME) E L.DISEASE:POLICY LO ITE $1,000,000 I,00',.0.0.0............................. C Professional Liab EIL2008657 04/01/2017 04/01/2018 Per Claim$2,000,000 /Contractors Aggregate$2,000,000 Pollution Liab DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Re: Municipal Stormwater Permit Assistance 2017-18. The City of EI Segundo, its officials,and employees are named as Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary&non contributory where required by written contract. CERTIFICATE HOLDER CANCELLATION City of EI Segundo-Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo,CA 90245 AUTHORIZED REPRESENTATIVE ©1988»201 ORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S8436391M810194 KKRE1 This page has been left blank intentionally, POLICY NUMBER: 5268179 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to a. The preparing, approving, or failing to include as an additional insured any person or prepare or approve, maps, shop organization for whom you are performing drawings, opinions, reports, surveys, operations when you and such person or field orders, change orders or drawings organization have agreed in writing in a contract and specifications; or or agreement that such person or organization b. Supervisory, inspection, architectural or be added as an additional insured on your engineering activities. policy. Such person or organization is an addi- tional insured only with respect to liability for This exclusion applies even if the claims against "bodily injury", "property damage" or "personal any insured allege negligence or other wrong- and advertising injury" caused, in whole or in doing in the supervision, hiring, employment, part, by: training or monitoring of others by that insured, if the "occurrence" which caused the "bodily in- 1. Your acts or omissions; or jury" or "property damage", or the offense 2. The acts or omissions of those acting on which caused the "personal and advertising your behalf; injury", involved the rendering of or the failure in the performance of your ongoing operations to render any professional architectural, for the additional insured. engineering or surveying services. However, the insurance afforded to such 2. "Bodily injury" or "property damage" additional insured: occurring after: 1. Only applies to the extent permitted by law; a. All work, including materials, parts or and equipment furnished in connection with such work, on the project (other than 2. Will not be broader than that which you are service, maintenance or repairs) to be required by the contract or agreement to performed by or on behalf of the provide for such additional insured. additional insured(s) at the location of the A person's or organization's status as an addi- covered operations has been completed; tional insured under this endorsement ends or when your operations for that additional insured b. That portion of "your work" out of which are completed. the injury or damage arises has been put B. With respect to the insurance afforded to these to its intended use by any person or additional insureds, the following additional ex- organization other than another clusions apply: contractor or subcontractor engaged in This insurance does not apply to: performing operations for a principal as a part of the same project. 1. "Bodily injury", "property damage" or C. With respect to the insurance afforded to these "personal and advertising injury" arising out of the rendering of, or the failure to render, additional insureds, the following is added to any professional architectural,engineering or Section III - Limits Of Insurance: surveying services, including: The most we will pay on behalf of the additional insured is the amount of insurance: CG 20 33 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 0 1. Required by the contract or agreement you Insurance shown in the Declarations; have entered into with the additional whichever is less. insured; or This endorsement shall not increase the 2. Available under the applicable Limits of applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CQ 20 33 04 13 13 POLICY NUMBER: 5268179 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of A d_..ional Ins. ured Person(s) Location And Description.Of Completed ompleted OperationsOr Organization(s) .._ ANY PERSON OR ORGANIZATION WHOM PER THE CONTRACT OR AGREEMENT YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to completeSchedule, if not _ ..this Sched shown above, will be shown ' m n the Declarations. A. Section II - Who Is An Insured is amended to which you are required by the contract or include as an additional insured the person(s) or agreement to provide for such additional organization(s) shown in the Schedule, but only insured. with respect to liability for "bodily injury" or B. With respect to the insurance afforded to these "property damage" caused, in whole or in part, additional insureds, the following is added to by "your work" at the location designated and Section III - Limits Of Insurance: described in the Schedule of this endorsement If coverage provided to the additional insured is performed for that additional insured and required by a contract or agreement, the most included in the "products-completed operations we will pay on behalf of the additional insured hazard". is the amount of insurance: However: 1. Required by the contract or agreement; or 1. The insurance afforded to such additional 2. Available under the applicable Limits of Insu- insured only applies to the extent permitted by law; and rance shown in the Declarations; whichever is less. 2. If coverage provided to the additional insured is required by a contract or agree- This endorsement shall not increase the appli- ment, the insurance afforded to such addi- cable Limits of Insurance shown in the Decla- tional insured will not be broader than that rations. CG 20 37 04 13 * insurance Services Office, Inc., 2012 Page 1 of 1 0 This page has been left blank intentionally, BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation or the policy), This endorsement, effective 12:01 AM 4/1/2017 forms a part of Policy No. 15893710 Issued to GEOSYNTEC CONSULTANTS, INC. By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy. d WC 04 03 61 Countersigned by (Ed. 11190) Authorized Representative