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PROOF OF INSURANCE (2016) CLOSED DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 11/05/2015 -HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ERTIFICATE 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. O Q 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 endorsement(s). CONTACT d NAM PRODUCER 15146WE."Ext,�,....,,..,"(866).283-7122 ,.,...�.. ����.k�tlo Y.-(0) 363_.................... Aon RilsLos ggk Insurance Services West, Inc. 0105 d 707 Wilshire l shi reeles CBouul Boulevard ADDRESS: LOS p......._80............ _.............................." ...........,.,. v 0 x LOS Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE NAIC# wslldan Energv Solutions INSURER B: The,continentalnInsurancce company 305 478 ' 289 DBA Intergy Corporation 2401 East Katella Avenue, Suite 300 INSURER C: Lexington Insurance Company 19437 Anaheim CA 92806 USA INSURER D: Valley Forge insurance Co 20508 .............._-----_____--1....... INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570060055011 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 INSR ADDL SUBR POLICY En hh POLICY EA LTR TYPE OF INSURANCE INSO, WV'O POLICY NUMBER IMl11 DWYYYYp RMM,r WyyYYI LIMITS l B X COMMERCIAL GENERAL LIABILITY 5088210281 11/t79/2G15 1l/09/2016 EACHOCCURRENCE $1,000,0001, CLAIMS-MADE OCCUR PREMISES fEaocau renael.......:............... ......$1,000,OOO, MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATED IMO0 IT APPLIES PER: GENERAL AGGREGATE $2,„0 O Ln POLICY X LOC PRODUCTS-COMP/OP AGG WW"" $2,OOO�OO o 00 O O PRO- cop OTHER: 0 AUTOMOBILE LIABILITY 6020541619 11/09/2015 11/09/2016 COMBINED SINGLE LIMIT X ANY AUTO BODILY INJURY(Per person) Z — ALL OWNED SCHEDULED BODILY INJURY(Per accident) N _ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE U AUTOS „(Per accident) '— D UMBRELLA LI IIX OCCUR MADE 6020541586 11/09/2015 11/09/2016 EACH OCCURRENCE $2,000,000 L) VVV AGGREGATE $2,000,000 UMBRELLA LIAB X " DED RETENTION B WORKERS COMPENSATION AND Yd 6022647422 11/09/201511/09/2016 XVSTATUTF. �ORTH- B �Y_N_„ workers compensation AOS EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $1,000,000 OFF ICER/MEMBER EXCLUDED? I NIA 6020541572 11/09/2015111/09/2016 ,,,,,, (Mandatory in NH) Workers Compensation CA EL DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E DISEASE-POLICY LIMIT $1,000,000�... C Contractor Prof 028174912 11/09/2015 11/09/2016 Per Claim $1,000,000 Professional Liability Aggregate $2,000,000 SIR $250,000„,.. DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) lat`mlac rvic:,es for the implementation of the city's energy efficiency strategic plan. General Liability cye,a excludes claims am°'i� ` out�c'af the performances c'r'd Professional services. Independent Contractors are included as .n ems�aects to�.aGeneralhl_iabf,a1'iyorE- atkdisiab alittyofVer-age 9,Xcludes Professional Liability. City of El Segundo, its officials and I�r? sar'pr7�,r C�crora�'u L'rtla y p y s, aa,c)ent's, and employees are included as additional insureds as respects y y am) N6;-Crani:Pibut7i ng coverage, Cross Liability coverage, Waiver of Subrogation applies to General w f Aertca L a rh i tl i t `rs i omppimsGa'4:W on; and Pri matry tread' Non-Contributing coverage app/i es to Auto Liability, all in 1:o C;carmem°'kr and' b n l i.t: and 4�a}r'el'.s t::om h 4.=9.,yAL tiaua(l wC"sellicy provisions. (WES hriONROV'TA). CERTIFICATE HOLDER CANCELLATION bi 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 Stephanie Katsouleas Public works Director Dep ✓ndu nem Dept of Public Works 350 Main Street E1 Segundo CA 90245 USA ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Policy Number: 5088210281 CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this coverage part, including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. unless paragraph B. below applies, 1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the acts or omissions by or on behalf of the Named Insured and in the performance of such Named Insured's ongoing operations as specified in such written contract; or 2. bodily injury or property damage caused in whole or in part by your work and included in the products- completed operations hazard, and only if a. the written contract requires the Named Insured to provide the additional insured such coverage; and b. this coverage part provides such coverage. B. bodily injury, property damage, or personal and advertising injury arising out of your work described in such written contract, but only if: 1. this coverage part provides coverage for bodily injury or property damage included within the products completed operations hazard; and 2. the written contract specifically requires the Named Insured to provide additional insured coverage under the 11-85 or 10-01 edition of CG2010 or the 10-01 edition of CG2037. II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide Kv such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written Policy Number: 5088210281 CN CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph (4) does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. �wr CN(Ed. 04/12) Policy Number: 6020541619 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED COVERAGE ENDORSEMENT - BUSINESS AUTO PLUS - This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE name, with your permission, while performing A. Who Is An Insured duties related to the conduct of your business. "Policy," as used in this provision A. Who Is An The following is added to Section II, Paragraph Insured, includes those policies that were in force A.1.,Who Is An Insured: on the inception date of this Coverage Form but: 1. a. Any incorporated entity of which the 1. Which are no longer in force; or Named Insured owns a majority of the voting stock on the date of inception of 2. Whose limits have been exhausted. this Coverage Form; provided that, B. Bail Bonds and Loss of Earnings b. The insurance afforded by this provision Section II, Paragraphs A.2. (2) and A.2. (4) are A.1. does not apply to any such entity revised as follows: that is an "insured" under any other liability"policy"providing "auto"coverage. 1. In a.(2), the limit for the cost of bail bonds is 2. Any organization you newly acquire or form, changed from $2,000 to$5,000; and other than a limited liability company, 2. In a.(4), the limit for the loss of earnings is partnership or joint venture, and over which changed from $250 to$500 a day. you maintain majority ownership interest. C. Fellow Employee The insurance afforded by this provision A.2.: Section II, Paragraph B.5 does not apply. a. Is effective on the acquisition or formation Such coverage as is afforded by this provision C. date, and is afforded only until the end of is excess over any other collectible insurance. the policy period of this Coverage Form, or the next anniversary of its inception II. PHYSICAL DAMAGE COVERAGE date, whichever is earlier. A. Glass Breakage — Hitting A Bird Or Animal — b. Does not apply to: Failing Objects Or Missiles m (1) "Bodily injury" or "property damage" The following is added to Section III, Paragraph caused by an "accident" that A.3.: occurred before you acquired or With respect to any covered "auto," any deductible formed the organization; or shown in the Declarations will not apply to glass r (2) Any such organization that is an breakage if such glass is repaired, in a manner "insured" under any other liability acceptable to us, rather than replaced. "policy"providing "auto" coverage. B. Transportation Expenses 3. Any person or organization that you are Section III, Paragraph A.4.a. is revised, with required by a written contract to name as an additional insured is an "insured" but only with respect to transportation expense incurred by you, respect to their legal liability for acts or to provide: omissions of a person, who qualifies as an a. $60 per day, in lieu of$20; subject to "insured" under Section II — Who Is An Insured and for whom Liability Coverage is b. $1,800 maximum, in lieu of$600. afforded under this policy. If required by C. Loss of Use Expenses written contract, this insurance will be primary and non-contributory to insurance on which Section III, Paragraph AA.b. is revised, with the additional insured is a Named Insured. respect to loss of use expenses incurred by you, to provide: 4. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a a. $1,000 maximum, in lieu of$600. contract or agreement in that "employee's" CNA63359XX Copyright,CNA Corporation,2000. Page 1 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission. C NA63359XX Policy Number: 6020541619 (Ed. 04/12) D. Hired "Autos" d. A $100 per occurrence deductible applies to The following is added to Section Ill. Paragraph the coverage provided by this provision. A.: G. Diminution In Value 5. Hired "Autos" The following is added to Section III, Paragraph If Physical Damage coverage is provided under B.6.. this policy, and such coverage does not extend to Subject to the following, the "diminution in value" Hired Autos, then Physical Damage coverage is exclusion does not apply to: extended to: a. Any covered "auto" of the private a. Any covered "auto" you lease, hire, rent passenger type you lease, hire, rent or or borrow without a driver; and borrow, without a driver for a period of 30 b. Any covered "auto" hired or rented by days or less, while performing duties your "employee" without a driver, under a related to the conduct of your business; contract in that individual "employee's" and name, with your permission, while b. Any covered "auto" of the private performing duties related to the conduct passenger type hired or rented by your of your business. "employee"without a driver for a period of c. The most we will pay for any one 30 days or less, under a contract in that "accident" or "loss" is the actual cash individual employees name, with your value, cost of repair, cost of replacement permission, while performing duties or $75,000, whichever is less, minus a related to the conduct of your business. $500 deductible for each covered auto. c. Such coverage as is provided by this No deductible applies to "loss" caused by provision is limited to a "diminution in fire or lightning. value" loss arising directly out of d. The physical damage coverage as is accidental damage and not as a result of provided by this provision is equal to the the failure to make repairs; faulty or physical damage coverage(s) provided on incomplete maintenance or repairs; or the your owned "autos." installation of substandard parts. e. Such physical damage coverage for hired d. The most we will pay for "loss" to a "autos"will: covered "auto" in any one accident is the lesser of: (1) Include loss of use, provided it is the consequence of an "accident" for (1) $5,000; or which the Named Insured is legally (2) 20% of the "auto's" actual cash value liable, and as a result of which a (ACV). monetary loss is sustained by the III Drive Other Car Coverage—Executive Officers leasing or rental concern. (2) Such coverage as is provided by this The following is added to Sections II and Ill: provision will be subject to a limit of 1. Any "auto" you don't own, hire or borrow is a $750 per"accident." covered "auto" for Liability Coverage while being E. Airbag Coverage used by, and for Physical Damage Coverage while in the care, custody or control of, any of your The following is added to Section Ill, Paragraph "executive officers,"except: B.3.. a. An "auto" owned by that "executive officer" or The accidental discharge of an airbag shall not be a member of that person's household; or considered mechanical breakdown. b. An "auto" used by that "executive officer" F. Electronic Equipment while working in a business of selling, Section Ill, Paragraphs B.4.c and B.4.d. are servicing, repairing or parking "autos." deleted and replaced by the following: Such Liability and/or Physical Damage Coverage c. Physical Damage Coverage on a covered as is afforded by this provision. "auto" also applies to "loss" to any (1) Equal to the greatest of those coverages permanently installed electronic equipment afforded any covered "auto"; and including its antennas and other accessories. CNA63359XX Copyright,CNA Corporation,2000 Page 2 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission Policy Number: 6020541619 CNA63359XX (Ed. 04/12) (2) Excess over any other collectible damage, against any person or organization for insurance. whom or which you are required by written 2. For purposes of this provision, "executive officer" contract or agreement to obtain this waiver from means a person holding any of the officer us. positions created by your charter, constitution, by- This injury or damage must arise out of your laws or any other similar governing document, activities under a contract with that person or and, while a resident of the same household, organization. includes that person's spouse. You must agree to that requirement prior to an Such "executive officers" are "insureds" while "accident"or"loss." using a covered "auto"described in this provision. C. Concealment, Misrepresentation or Fraud IV. BUSINESS AUTO CONDITIONS The following is added to Section IV, Paragraph A. Duties In The Event Of Accident, Claim, Suit Or B.2.: Loss Your failure to disclose all hazards existing on the date The following is added to Section IV, Paragraph of inception of this Coverage Form shall not prejudice A.2.a.: you with respect to the coverage afforded provided (4) Your "employees" may know of an such failure or omission is not intentional. "accident" or "loss." This will not mean D. Other Insurance that you have such knowledge, unless The following is added to Section IV, Paragraph such "accident" or "loss" is known to you B.5.: or if you are not an individual, to any of your executive officers or partners or your Regardless of the provisions of Paragraphs 5.a. insurance manager. and 5.d. above, the coverage provided by this The following is added to Section IV, Paragraph policy shall be on a primary non-contributory A.2.b.: basis. This provision is applicable only when required by a written contract. That written (6) Your "employees" may know of contract must have been entered into prior to documents received concerning a claim "Accident" or"Loss." or"suit."This will not mean that you have E. Policy Period, Coverage Territory such knowledge, unless receipt of such documents is known to you or if you are Section IV, Paragraph B. 7.(5).(a). is revised to not an individual, to any of your executive provide: officers or partners or your insurance manager. a. 45 days of coverage in lieu of 30 days. B. Transfer Of Rights Of Recovery Against Others V. DEFINITIONS To Us Section V. Paragraph C. is deleted and replaced by The following is added to Section IV, Paragraph the following: A.5. Transfer Of Rights Of Recovery Against "Bodily injury" means bodily injury, sickness or disease Others To Us: sustained by a person, including mental anguish, We waive any right of recovery we may have, mental injury or death resulting from any of these. because of payments we make for injury or CNA63359XX Copyright,CNA Corporation,2000, Page 3 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission G-1 9160-B NA (Ed. 11/97) Policy Number: 6022647422 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One Workers' Compensation Insurance G. Recovery From Others and Part Two Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE - The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is r Nw IS ,.s G-19160-B Page 1 of 1 (Ed. 11/97) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) 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 anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION ON WHOSE BEHALF YOU ARE REQUIRED TO OBTAIN THIS WAITER OF OUR RIGHT TO RECOVER FROM UNDER A WRITTEN CONTRACT OR AGREEMENT. r• 19 fCY 0 0.� ?Y Vry 4V K3 in 4L� f! RM 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 11/09/2015 Policy No. 6020541572 Endorsement No. N/A Insured Wllldan Group, Inc. Premium$ N/A Insurance company The Continental Insurance Company Countersigned by WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance.