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PROOF OF INSURANCE (2017) CLOSED I DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 01/12/2017 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 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 w this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Aon Risk services Northeast, Inc. PHONE FAX L C/o Aon client services (A/C.No.Ext): C866) 283-7122 I (A/C.No.): (800) 363-0105 4 Overlook Point E-MAIL p Lincolnshire IL 60069 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: The Travelers Indemnity co of CT 25682 Cintas corporation and its subsidiaries INSURER B: Westchester Fire Insurance Company 10030 6800 Cintas Blvd PO Box 625737 INSURER C: Travelers Property Cas co of America 25674 Cincinnati OH 45262 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570065236246 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. Limits shown are as requested INSK AUUL SUBK PULICY EFF POLICY EXP LTR TYPE OF INSURANCE (NSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY HC2EGLSA4/2M4/31TCT16 01101120166110112011 EACH OCCURRENCE $2,000,000 UAMAGL IU KLNI LU CLAIMS-MADE X❑OCCUR I PREMISES(Ea occurrence) $1,000,000 X Contractual Liability I MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 v GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE $2,000,000 M CJ POLICY ❑PE ❑X LOC I PRODUCTS-COMP/OP AGG $1,000,000LID OTHER o AHc2E-CAP-472M4651-TCT-16 07/01/2016 07/01/2017 COMBINED SINGLE LIMIT N AOS AUTOMOBILE LIABILITY (Ea accident) $5,000,000 C X ANY AUTO I BODILY INJURY(Per person) z — OWNED SCHEDULED I BODILY INJURY(Per accident) N _ AUTOS ONLY AUTOS HIREDAUTOS NON-OWNED I PROPERTY DAMAGE R —ONLY AUTOS ONLY (Per accident) w X Comp/Coll$0 Ded B X UMBRELLA LAB OCCUR G22035277011 07/01/2016 0710112017IEACH OCCURRENCE $5,000,000 L) EXCESS LAB CLAIMS-MADE SIR applies per policy terns & condi-ions (AGGREGATE $5,000,000 DED I X IRETENTION C WORKERS COMPENSATION AND Hc23UB472M470616 07/01/2016 07101120171 X ISTATUTE I IORH EMPLOYERS'LIABILITY Y/N WC-AOS ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ IEL EACH ACCIDENT $1,000,000 EXCLUDED' OFFICER/MEMBER EXCLUDEDD' N N/A (Mandatory in NH) I E L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $1,000,000— DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of E1 Segundo is included as Additional Insured on the General Liabilitypolicy, but only with respect to work performed under contract between the certificate Holder and the Insured. On the Workers' Compensation Policy, a Waiverof Subrogation .;kl_.' exists in favor of the certificate Holder as required by written contract, but only on the condition that negligent acts of the aim certificate Holder are excluded. CERTIFICATE HOLDER CANCELLATION N_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE =� POLICY PROVISIONS. City of El Segundo AUTHORIZED REPRESENTATIVE Attn: Maria Cerritos 350 Main street El Segundo CA 9024 5-3 813 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY POLICY NUMBER: HC2E-GLSA-472M4731-TCT-16 ISSUE DATE: 06-13-16 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that: a. You agree in a written contract or agreement to include as an additional insured on this Coverage Part; and b. Has not been added as an additional insured for the same project by attachment of an endorsement under this Coverage Part which includes such person or organization in the endorsement's schedule; is an insured, but only if the written contract or agreement specifically requires you to provide additional insured coverage to that person or organization by the use of the provisions of ISO endorsement CG 20 37 07 04. Location And Description Of Completed Operations As required by the written contract or agreement that specifically requires you to provide additional insured cover- age to the person or organization that qualifies as an additional insured by the use of the provisions of ISO en- dorsement CG 20 37 07 04. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- location designated and described in the schedule of clude as an additional insured the person(s) or organ- this endorsement performed for that additional in- ization(s) shown in the Schedule, but only with sured and included in the "products-completed opera- respect to liability for "bodily injury" or "property dam- tions hazard". age" caused, in whole or in part, by"your work" at the CG T8 00 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-16 EFFECTIVE DATE: 07-01-16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person or organization that you have agreed in a "written contract requiring insurance" to include as an additional insured on your Commercial General Liability policy and that has not been added as an additional insured by attachment of an endorsement under this Coverage Part which includes such person or organization in the endorsement's schedule. However, such person or organization is only an additional insured with respect to liability for "bodily injury" or "property damage" (or for "personal injury" or"advertising injury" if coverage for such injury is required by the "written contract requiring insurance") that is in fact caused by your negligence or the negligence of those acting on your behalf in the performance of"your work" in connection with services provided to the additional insured to which the "written contract requiring insurance" applies. 2. The insurance provided to the additional insured by this endorsement is further limited as follows: a. In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits of liability required by a "written contract requiring insurance" for that additional insured, the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in SECTION III — LIMITS OF INSURANCE. b. The insurance provided to the additional insured does not apply to "bodily injury" or"property damage" (or "personal injury" or "advertising injury" if coverage for such injury is required by the "written contract requiring insurance") arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, or supervision of such services or activities. C. The insurance provided to the additional insured does not apply to "bodily injury" or"property damage" included in the "products-completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured. d. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization or with respect to "bodily injury" or "property damage" (or "personal injury" or "advertising injury" if coverage for such injury is required by the "written contract requiring insurance") caused by the negligence of such person or organization. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" for that additional insured specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that other insurance. But the insurance provided to the additional insured by this endorsement still is excess over any valid CG T8 01 Page 1 of 3 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-16 EFFECTIVE DATE: 07-01-16 and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under such other insurance. 4. If the "written contract requiring insurance" for that additional insured specifically requires that this insurance include a provision in which the insurer waives any right of recovery against that additional insured because of payments made under the insurance provided to the additional insured, then we will waive such right of recovery. 5. As a condition of coverage provided to the additional insured by this endorsement: a. The additional insured must give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (1) How, when and where the "occurrence"or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against the additional insured, the additional insured must: (1) Immediately record the specifics of the claim or"suit" and the date received; and (2) Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. C. The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. 6. As a condition of coverage provided to the additional insured by this endorsement, the additional insured must tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insurance provided to the additional insured by this endorsement is primary to other insurance available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 7. The following definition is added to SECTION V—DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional insured, provided that the "bodily injury" and "property damage" occurs (or the "personal injury" or "advertising injury", if coverage for such injury is required by the "written contract requiring insurance", is caused by an offense committed): CG T8 01 Page 2 of 3 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-16 EFFECTIVE DATE: 07-01-16 a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect, or as long as the written agreement specifically provides, whichever is later; and C. Before the end of the policy period. Copyright 2014 The Travelers Indemnity Company. All rights reserved. CG T8 01 Page 3 of 3 TRAVELERS!' WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00)- POLICY NUMBER: HC2JUB-472M470-6-16 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 DESIGNATED PERSON: DESIGNATED ORGANIZATION: Any person or organization for which the insured has agreed by written contract executed prior to loss to furnish this waiver. DATE OF ISSUE: 06-13-16 ST ASSIGN: POLICY NUMBER: HC2E-GLSA-472M4731-TCT-16 ISSUE DATE: 06-13-16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 PERSON OR ORGANIZATION: Any person or organization to whom you have agreed in a written contract that notice of cancellation of this policy will be given, but only if: 1. You send us a written request to provide such notice, including the name and address of such person or organization, after the first Named Insured receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this endorsement. ADDRESS: The address for that person or organization included in such written request from you to us. PROVISIONS: If we cancel this policy for any statutorily permitted above. We will mail such notice to the address shown reason other than nonpayment of premium, and a in the schedule above at least the number of days number of days is shown for cancellation in the shown for cancellation in the schedule above before schedule above, we will mail notice of cancellation to the effective date of cancellation. the person or organization shown in the schedule IL T4 05 03 11 ©2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 TRAVELERS JW WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: HC2JUB-472M470-6-16 NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX—CONDITIONS: Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organiza- tion before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation. SCHEDULE Number of Name and Address of Designated Persons or Organizations: Days Notice Any person or organization with whom you have agreed in a written 30 contract that notice of cancellation of this policy will be given, but only if: 1. You see to it that we receive a written request to provide such notice, including the name and address of such person or organization, after the first Named Insured receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this endorsement. Address: The address for that person or organization included in such written request from you to us. DATE OF ISSUE: 06-13-16 ST ASSIGN: Page 1 of ©2013 The Travelers Indemnity Company.All rights reserved. TRAVELERS JW WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: HC2JUB-472M470-6-16 Number of Name and Address of Designated Persons or Organizations: Days Notice DATE OF ISSUE: 06-13-16 ST ASSIGN: Page 2 of 3 ©2013 The Travelers Indemnity Company.All rights reserved. TRAVELERS JW WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: HC2JUB-472M470-6-16 Number of Name and Address of Designated Persons or Organizations: Days Notice All other terms and conditions of this policy remain unchanged. 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. Endorsement No. Insured Premium $ Insurance Company Countersigned by DATE OF ISSUE: 06-13-16 ST ASSIGN: Page 3 of 3 ©2013 The Travelers Indemnity Company.All rights reserved.