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PROOF OF INSURANCE (2018 - 2018) CLOSED Client#: 1266412 305FLEMIENV YYYY) ATE(M ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 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 endorsement(s). PRODUCER CON'TACT Allie Mosier NAME; BB&T Insurance Services PHONE IAX JAIL.No,Ems):714 r_..1 �4A�c,Nt»r� 877-297-1116 of Orange County EMAIL 714 941-29 ggJ,ESs: andt com 2400 E Katella Ave.Suite 1100 INsuRER(s)AFFORDIN Anaheim, CA 92806 HomelandlnsuranURER( n AFFORDING GCOVERAGE 34 NAIC# INSURER A: ray 452 INSURED INSURER B:Redwood Fire and Casualty Ins 11673 Fleming Environmental Inc. INSURER C:Travelers Property casualty Co 25674 1372 East Valencia Drive INSURER D:Atlantic Specialty Insurance Co 27154 Fullerton,CA 92831 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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, "NSR OX ADSU-SR POLICY EFF POLICY EXP LIMITS LTIf1 TYPE OF INSURANCE p_NS'R VWD POLICY NUMBER (MM/DCdYYYY) (MM,,/„D,D/YYYY),I A X COMMERCIAL GENERAL LIABILITY 7930050560001 09/01/2017 09101/2018 EACH OCCURRENCE $1,,000,,000 DAIv4l F �O RENTED CLAIMS-MADE X OCCUR PR'„:ttHd (n'� (,frm oCCl.urrcrste;pl $300,000 X Pollution Liab MED EXP(Any one.p,eTq�y...... 0.9.1QUU X Professional Liab PERSONAL&ADV INJURY $1,000,000 GEITL AGGREGATE LIMIT APPLIES PER: '0 GENERAL AGGREGATE s2,000,000 PRO''. POLICY' X JECT LOC PRODUCTS-COMP/OP AGO $2,000 OO --- OTHER: .... .........................................................................„,,,,.,,,,,,,,,, ._.,.... .,,,..,...................$..............................................,,,,, D AUTOMOBILE LIABILITY 7930068410000 09/01/2017 09101/2018 ciw(Ea ffr:4,t,,,,ry,t 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED I'ROPE RTY DAMAGE X HIRED AUTOS X AUTOS „4Pei apcgdonl) $ A ...UMBRELLA LIAB...........X....�..OCCUR....................................................79..........................,,..,,,,, AAGRE ATERRENCE $5 .......� .............. ,000,000 2017 09/01/2018L...................°..�............. $5,000,000 SSLIAB .. . ..E DFC7E. CLAIMS-MADE MADE G $ B AN.. COMPENSATION FLWC806706 05/01/2017 05/01/2018 XPEAR orH- WOD EMPLOYERS'X RETENTION$ LIABILITY Y/N 7.TLlTF FR ANY PROPRIETOR/PARTNER/EXECUTIVE° E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ( NJ N I A (Mandatory In NH) E L DISEASE-EA EMPLOYEE $,1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE LIMIT $1,000,000 C Rented/Leased QT6606686M19ATIL17 09101/2017 09/01/2018 $160,000 Limit Equipment $1,000 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Maintenance Agreement No.5331 The City of EI Segundo, its officers,officials,employees,agents and volunteers are named as additional insured as respects general liability,this insurance is primary and noncontributory with any other insurance of the additional insured; and waiver of subrogation applies as respects workers compensation as required by written contract, per endorsements attached. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLA'T'ION Ci of EI Se SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 150 Illinois Street EI Segundo,CA 90245 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved, ACORD 25(2014/01) 1 of 2 The ACORD name and logo are registered marks of ACORD #S19483132/M19092280 ACMOS DESCRIPTIONS (Continued from Page 1) - - _ . ................ Should any policy be cancelled before the expiration date, BB&T Insurance Services will mail 30(thirty) days written notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non-payment of premium. SAGITTA 25.3(2014101) 2 of 2 #S194831321M19092280 PoUnyNmnber 793-00-50-56-000I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ O[CAREFULLY. ��8�8o�� U�� LESSEES o�� unu��m�� mm��~�� n�m�u�°�» m��~�� o� CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION ~ ORM U This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the Named Insured has agreed to provide insurance prior to loos as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this emdoraementw|0 be shown in the Declarations aoapplicable tothis endorsement.) A. SECTION || -VVHO IS AN INSURED is amended to include as on insured the person or organization shown in the SCHEDULE abovo, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds,the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (o) All wnrk, including matoria|o, parts orequipment furnished in connection with such wmrk, on the project (other than oomioo, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (b) That portion ofyour work out of which the injury or damage ah000 has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a port of the same project. All other terms and conditions remain the same. oosmvmsxo1 <ou11> Includes copyrighted material mInsurance Services Office,Inc 1cv1 Copyright oV11.nnooeucunInsurance Group LLC E'/wsunso Fleming Environmental Inc. Policy Number: 793005056 0001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IV-CONDITIONS, 8. Other Insurance, is amended by adding the following paragraph: This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement, that this insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same. OBENV GE 319(02 11) Includes copyrighted material of Insurance Services Office,Inc. 1 of 1 Copyright,OneBeacon Insurance Group,2011 Policy Number: 793-00-50-56-0001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations: 11 , rtl,'i p ,r':.;.>r', <:r :rur,r;'i . t'I u,",t, I r.. W,.,;Pt'i ':it Ihu ': �'x.rr'✓ Y,,,.:,.,k. u.>r, .,�' ,: 't ,, I N „l:." i ,.,l. u,.>t,y },,tin p ili,'.o.Vs .n^' ' : ,.Ar.;. ,! I ,., k,'i LV', • Po,arri ,l 1rr.. or . Y. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the SCHEDULE above, but only with respect to liability for bodily injury, property damage or environmental damage caused, in whole or in part, by your work at the location designated and described in the SCHEDULE above performed for that additional insured and included in the products- completed operations hazard. All other terms and conditions remain the same, OBENV GE 304(02 11) Includes copyrighted material of Insurance Services Office,Inc. 1 of 1 Copyright 2011,OneBeacon Insurance Group LLC E-INSURED WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10B (Ed.9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration.The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver—Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Descriptlon Waiver Premium All CA Operations This endorsement changes the policy to which It is attached and Is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 05/01/2017 Policy No. FLWC806706 Endorsement No. Insured Premium$ Insurance Company Redwood Fire and Casualty Co Countersigned by WC 99 04108 (Ed.9-14)