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PROOF OF INSURANCE (2018 - 2018) CLOSED DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/1912017 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Risk Stratgeggles Company NAME: Suite 270Qfon Avenue PHONE FAX (A//c Na); E-MMNew York, NY 10170 AppF'E,Ss,. INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Travelers Indemnity Company of CT 25682 INSURED Property Casualty Co of Amer 35674T ,help rou 1y IS200 INSURER c AXIS Insurance Compa 7273 o Vint A 0O094 INSURERD Great Divide Insurance Company 25224 INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: 38437418 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 TYPE OF INSURANCE AN UL'$Ur3Ft POLICY NUMBER .. ,.1MMIDDfYYYY) IMM D Y EXP ........ �.p pryYyyl LIMITS A V COMMERCIAL GENERAL LIABILITY 680-9612NO47 10/1/2017 10/1/2018 EACH OCCURRENCE $1,000,000 _ 0 CLAIMS-MADE OCCUR PRFERoccM S( occurrence) ✓ ROSS LIAB,INCLUDED MED EXP(Any one person) $5,000 7'' PRIMARY&NON-CONTRIBUTOFCY PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 ✓ POLICY D PRO• . " LJ LOC PRODUCTS s2,000,000 JECr 07H'ER $ ' ....... A AUTOMOBILECOMBINED SINGLE LHM'1"r �LIABILITY 680-9612N047 10/1/2017 10/1/2018 (Fo�NdP,d'R11 $1,,000,000 , „ ANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED BODILY INJURY AUTOS ONLY AUTOS Y aCcident) $ HIRED (PROPERTY IDAMAGE .... $ ✓ AUTOS ONLY ✓ NON-OWNED AUTOS ONLY Per ar.°'ud'e ll,11) 5 B UMBRELLA LIAB CUP-9614N213 10/1/2017 10/1/2018 OCCURRENCE $6,000,000 ✓ ✓ OCCUR EACI�101.,, EXCESS LIAB . CL GAr�„ $6,000,000 DED RETENTIONS' 'AIMS-MADE C+�LsGItE 5 WORKERS COMPENSATION SPER TATUTE ERH AND EMPLOYERS'LIABILITY YIN (FFIC R/MEMBE;EXC UDED?ECUTIVE """"""""'� NIA E L EACH ACCIDENT $ Mandato in NH E DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ D Misc.Rented Equipment �CNA2003859-16 10/1/2017 10/1/2018 Limit 750,000 C Ad Agency E&O Liability MCN000139851701 10/1/2017 10/1/2018 Limit 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of EI Segundo,its officials and employees are named Additional Insureds with respects to claims arising out of the negligence of the insured's services. CERTIFICATE HOLDER CANCELLATION t ltx Segundo Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C't Ot El THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3i Segundo ee 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r " Michael Chrlstian ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 35437418 1 9PHBL01 i C0I 17-18 1 Sandra Carey i 10/19/2017 2:57:08 PH (EDT) I Page 1 of 1 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 680-9612NO47-17-42 ISSUE DATE: 08/17/2017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-DESIIGNA ED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of person or organization: CITY OF EL SEGUNDO CITY, ITS OFFICIALS, AND EMPLOYEES 350 MAIN STREET EL SEGUNDO CA 90245 WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your acts or omissions. CG T4 91 11 88 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 '!67016 DATE(MMIDDIYYYY) �`'►" CERTIFICATE OF LIABILITY INSURANCE ,.. 31712017 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Jim Wi'.iCl,l'WiDT' Commercial Lines- i "3-5800 # SR) I248.948.5737 Fo N w} 855-272-2518 Wes Fargo Insurance Services USA,Inc. G Ataflrtr;s'� j R'n�.wrlllnor�!a�anarllsteirtyo e�wM 4000 Town Center,Suite 800 INSURERS AFFORDING COVERAGE NAIC N Southfield,MI 48075 INSURER A: XL Specialty Insurance Company 37885 INSURED INSURER 5; The Phelps Group INSURERC: 12121 Bluff Creek Drive,Suite 200 INSURER D: Playa Vista,CA 90094 INSURER E; INSURER F: COVERAGE'S CERTIFICATE NUMBER: 11541337 REVISION,NUMBER: See below 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. ..... Ut.1ti.�jNvn I POLICY NUMBER 'k Dd'CJ .. LI�.S 04SR ....,,._.--.. A, ... t,liR to TYPE OF INSURANCE �INSr,�� LT D.R'NYYF' NJtldFB'�C/DdYYN N). IT MITS COMMERCIAL GENERAL LIABILITY EACHN��OnCCry�.%U�R{R�wE�NCyE�w,' S II P"ib"E"M'C5'I't�COtO --- .,..„....,..4 CLAIMS-MADE I OCCUR „PREMISES(6)0;eull(Rigpy M,ED EF(Any one Pelson) 5 PERSONAL&ADV INJURY S GE N1 AR:,'C;1'41 GAIF L IMIT APPL.IIE SIP11 II'., R:1'E'9I;I'AI AUORL,GATE lu O pG.M I I P'r�41 LOC PRODUCTS71-1171 AGG w^ 1. L._ I JEC.T r,�C OMIrauNB:vtlNa'"nB ... . PP 3P I'R,,,Gr TR. 5 AUTOMOBILE LIABILITY G aPAI�a:r l+u71 T S ANY AUTO 60DILY INJURY(Pup pioson) S ...... AUTOS ONLY AUTO' BODILY OWNED " u INJURY(Per xc.culerli) AUTOS ONLY �AU Gdm 61A1'L AUTOS HIrdGO N06J-OWNED YIRC8tF4�Pt „ � ,pry i G UMBRELLA LIAR i o,Dt;R:0.6oO'REGATE $ _ „A EXCESS LIAR O C)F..r) � I RRI 1C NCY01 I -_ WORKERS LOMi ENSAVON Y P r1 � X CP rN A AND EMP OYER5l AIAA'BNLI�;MI''r R7rwAF` I___ RWC6200110 r.L EAcw�r� � �FE 1. y FFR 1,0!}l},O(HI NIA 01/01/17 01/01118 Ff.,..EACHACCIDEN'r ..... ....�.1-1.,.,. Imall otory in Nl r2 R':kCR,IJ'IrbI:I7'7 c tMandaRavv^y�in CW r4) E-EA FPt9P1..0YEE ....................I IT Y06,ide'm'dllo 10nlor M` ....�.,...��,,..�".,....1,000,00(7 nR'TRR„ralYaT40N�Or'OpF:R W'BC7 "M fiviow E I. r)1SrA$r•PP1Y.ICY R PMPT S DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Evidence of coverage CERTWICATE HOLDER CAN'CELLAT$ON City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. Clerk 350 Main Street,Room 5 EI Segundo,CA 90245-3813 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103)