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PROOF OF INSURANCE (2018) CLOSED DATE(MM/DD/YYYY)
C" CERTIFICATE OF LIABILITY INSURANCE 03/09/2018
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(les)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
Marsh Risk&Insurance Services N'a,ME'
CA License(10437153 N Ne.EXtla,,, ((A� Nio)
777 South Figueroa Street E-MAIL.
Los Angeles,CA 90017 AE!Af10Ss,
INSURER(S)AFFORDING COVERAGE NAIC#
403265-STND.-GAWU-17-18 FileK GLALW INSURER A:Travelers Property Casually Co.of America 25674
INSURED SURER B:Travelers Indemnity Company of Connecticut 25682
File Keepers,LLC IN ...., .,
Raleigh Enterprises,LLC INSURERC.r .,.,
6277 East Slauson Avenue INSURER D:
Los Angeles,CA 90040
INSURER z
INSURER F:
COVERAGES CERTIFICATE NUMBER: LOS-002381132-01 REVISION NUMBER: 7
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTVNTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH 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 'AID CLAIMS
IPE OF INSURANCE ADDL,SUE POLICYEFFY POLICY EXP
LTR �vPOLICY NUMBER rMMMDONYYYMMIDDIYYYY1 LIMIT.S„
A X COMMERCIAL GENERAL LIABILITY 660-8105A95A-17 10/01/2017 10/01/2018 EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE I_X I OCCUR 100,000
L'YAMA1iE TO RE"NTLb
PREMISES(Ea opcurrencel $
MED EXP(ADV one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY I NCT LOC
J)?;C1'PF ( PRODUCTS;COMP/OP AGG $ 2,000,000
OI HILAR $
UTOMOBILE LIABILITY 810-8105A95A-17 10/01/2017 10/01/2018 COMi,3PNEDSIN(:A.IcWAT $ 1,000,000
B A (Fe-acojeCl).......... .,,,,,,,,,,
X ANY AUTO BODILY INJURY(Per person) $
O
AUTOS ONLY AUTOSWNED SCHEDULED BODILY INJURY(Per accident) $
HIRED NON-OWNED [Pel^e�:cGRCII EN; OAMAGItt
... ,, , $
AUTOS ONLY AUTOS ONLY �
Comp./Coll Ded $ 1,000/1,000
UMBRELLA LIAB
OCCUR
EXCESS LI cAB ury CLAIMS MADE AGGREEGATE OCCURRENCE $
DED M C RETENTION$ $
A WORKERS COMPENSATION 1'C2JUB4243El434-17 IO/OI/2017 10/01/2018 XPER OTH-
AND EMPLOYERS'LIABILITY YIN
Y _ _STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE N E L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N N I A
(Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
With the exception of Workers'Compensation&Employer's Liability,the City of EI Segundo,its officials,and employees are included as an additional insured,but only with respect to liability arising out of the
operations performed for them by the named insured as required by written contract The insurance afforded by these policies are primary and non contributory with any insurance maintained by the additional insured
as required by written contract.
/_0
"^
CERTIFICATE HOLDER CANCELLATION
City of EI Segundo Police Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attn:Mr,Vincent Martinez THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
348 Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
EI Segundo,CA 90245
AUTHORIZED REPRESENTATIVE
of Marsh Risk&Insurance Services
James L.Vogel
©1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANOES THE POLICY.PLEASE READ IT CAREFULLY,
OTHER ADDITIONAL INSUREDS
This endorsement modffW Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS 3. This Insurance Is excess over any valid and col-
i. WHO IS AN Il"SV (SECTION 11)Is amended iectible Insurance Unless You have agreed In a
to include as an Insured any person or organize. written contract for this Insurance to apply on a
tion (called hereafter "additional Insured") with primary or contrlWory basis.
whorn you have agreed In a written Coft1faCt, 4. This Insurance does not apply on any basis:
executed prior to lose,to name as an additional a. To any person or 01 rganizatlon for whom you
insured,but: have purchased an Owners and Contractors
a. Only with respect to liability because of Protective policy.
"bodtly Injury" or"property damagW arising b. To any person or organization who dia-
out of'your work,for that additional Insured tributes or sells"your products"in the regular
performed by you or for you;and course of Its business.
b, subjeot to any limitations In the written con- c. To any peraon or organization from whom
tract regarding the scope of the addklQnW you have acquired any products, or any in-
Insured status, gradient, part or container.entering Into,as
This Insurance does riot apply to"bodily injury" cornpanying or containing such products,
or ,property darnage" arising out of"your W106" d. To any manager or lessor of premises with
Included In the 'oproducts-completed operations respect to liablity arising out at the owner-
hazard"unless you are required to provide such ship. maintenance,or use of that pan of any
covarage by written contract and then only for pramlses leased to Yom
the parlod of time required by the 0ontract, but
In no event beyond the expiration date of the e. To any lessor of leased equipment,
policy, f. To any architect, engineer or surveyor for
2. The Limits of Insurance provided to such addl- injury or damage arising out of.
tIonal Insured shall be: (1) The preparing, approving or failing to
a. The limits which you have agreed to provide, prepare or approve maps, drawing%
or opinions, reports, surveys, ohairoa or-
b. The limits shown on the Declarations dens.designs or specificatlow and
(9) Supervisory, inspection or engineering
whichever is low services.
COMMERCIAL GENERAL LIABILITY
a. Rupture, bursting, or operation of pres- 5. The following replaces Paragraph 4.b.(1)(b)
sure relief devices; of SECTION IV—COMMERCIAL GENERAL
b. Rupture or bursting due to expansion or LIABILITY CONDITIONS:
swelling of the contents of any building or (b) That is insurance for premises rented to
structure, caused by or resulting from wa- you, or temporarily occupied by you with
ter, the permission of the owner;
c. Explosion of steam boilers, steam pipes, E. BLANKET WAIVER OF SUBROGATION
steam engines,or steam turbines. The following is added to Paragraph 8., Transfer
2. The following replaces Paragraph 6. of SEC- Of Rights Of Recovery Against Others To Us,
TION III—LIMITS OF INSURANCE: of SECTION IV— COMMERCIAL GENERAL LI-
ABILITY CONDITIONS:
Subject to 5. above, the Damage To Prem- We waive any right of recovery we may have
ises Rented To You Limit is the most we will against any person or organization because of
pay under Coverage A for damages because
of "property damage" to any one premises Payments we make for injury or damage arising
while rented to you, or temporarily occupied out of premises owned or occupied by or rented
by you with permission of the owner, caused or loaned to you; ongoing operations performed
by you or on your behalf, done under a contract
by fine; explosion; lightning; smoke resulting with that person or organization; "your work'; or
from such fire, explosion, or lightning; or wa- "your products". We waive this right where you
ter. The Damage To Premises Rented To have agreed to do so as part of a written contract,
You Limit will apply to all damage proximately executed by you prior to loss.
caused by the same "occurrence", whether F. BLANKET ADDITIONAL INSURED —OWNERS,
such damage results from fire; explosion; MANAGERS OR LESSORS OF PREMISES
lightning; smoke resulting from such fire, ex-
plosion, or lightning; water; or any combina- The following is added to SECTION II—WHO IS
tion of any of these. AN INSURED:
The Damage To Premises Rented To You Any person or organization that is a premises
Limit will be the higher of: owner, manager or lessor and that you have
.� agreed in a written contract or agreement to
a. $300,000;or name as an additional insured on this Coverage
_ b. The amount shown on the Declarations of Part is an insured, but only with respect to liability
this Coverage Part for Damage To Prem- for "bodily injury", "property damage", "personal
ises Rented To You Limit. Injury"or"advertising Injury"that:
4. The following replaces Paragraph a. of the a. Is"bodily injury"or"property damage"caused
definition of"insured contract" in the DEFINI- by an "occurrence" that takes place, or"per-
TIONS Section: sonal injury'or"advertising injury"caused by
an offense that is committed, after you have
a. A contract for a lease of premises. How signed and executed that contract or agree-
ever, that portion of the contract for a ment;and
lease of premises that Indemnifies any b. Arises out of the ownership, maintenance or
person or organization for damage to use of that part of any premises leased to
premises while rented to you, or tempo-
rarily occupied by you with permission of you,
the owner,caused by: The insurance provided to such premises owner,
manager or lessor Is subject to the following pro-
(1) Fire; visions:
Gc (2) Explosion; a. The limits of insurance provided to such
(3) Lightning; premises owner, manager or lessor will be
the limits which you agreed to provide in the
(4) Smoke resulting from such fire, ex- written contract or agreement, or the limits
.a plosion,or lightning;or shown on the Declarations of this Coverage
(5) Water. Part,whichever are less.
is not an'Insured contract"; b. The insurance provided to such premises
owner,manager or lessor does not apply to:
Page 4 of 9 ®2008 The Travelers Companies,Inc. CG D4 6712 08
011586
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fied by the endorsement.
GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only, Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights,duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS
OF USE—INCREASED LIMIT
B. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES—INCREASED LIMIT
C. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS
D. EMPLOYEES AS INSURED K. AIRBAGS
E. SUPPLEMENTARY PAYMENTS — INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT
LIMITS OR LOSS
F. HIRED AUTO — LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION
COVERAGE—INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS
PROVISIONS
A. BROAD FORM NAMED INSURED executed by you before the "bodily injury" or
The following is added to Paragraph A.1., Who Is "property damage" occurs and that is in effect
An Insured, of SECTION It — LIABILITY COV- during the policy period, to be named as an addi-
ERAGE: tional insured is an "insured" for Liability Cover-
age, but only for damages to which this insurance
Any organization you newly acquire or form dur- applies and only to the extent that person or or-
ing the policy period over which you maintain ganization qualifies as an "insured" under the
50% or more ownership Interest and that is not Who Is An Insured provision contained in Section
separately insured for Business Auto Coverage. II.
Coverage under this provision is afforded only un- C. EMPLOYEE HIRED AUTO
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which- 1. The following is added to Paragraph A.1.,
ever is earlier. Who Is An Insured, of SECTION II — LI-
B. BLANKET ADDITIONAL INSURED ABILITY COVERAGE:
The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while
Who Is An Insured, of SECTION II — LIABILITY operating an "auto" hired or rented under a
COVERAGE: contract or agreement in that "employee's"
name, with your permission, while performing
Any person or organization who is required under duties related to the conduct of your busi-
a written contract or agreement between you and ness.
that person or organization, that is signed and
CA T3 53 03 10 ©2010 The Travelers Indemnity Company. Page 1 of 4
Includes copyrighted material of Insurance Services Office,Inc.with its permission.
COMMERCIAL AUTO
2. The following replaces Paragraph b. in B.5., within such country or jurisdiction, for Liability
Other Insurance, of SECTION IV — BUSI- Coverage for any covered "auto" that you
NESS AUTO CONDITIONS: lease, hire, rent or borrow without a driver for
b. For Hired Auto Physical Damage Cover- a period of 30 days or less and that is not an
age, the following are deemed to be cov- "auto" you lease, hire, rent or borrow from
ered "autos"you own: any of your "employees", partners (if you are
a partnership), members (if you are a limited
(1) Any covered "auto" you lease, hire, liability company) or members of their house-
rent or borrow;and holds.
(2) Any covered "auto" hired or rented by (a) With respect to any claim made or "suit"
your "employee" under a contract in brought outside the United States of
that individual "employee's" name, America, the territories and possessions
with your permission, while perform- of the United States of America, Puerto
ing duties related to the conduct of Rico and Canada:
your business. (i) You must arrange to defend the "in-
However, any"auto" that is leased, hired, sured"against, and investigate or set-
rented or borrowed with a driver is not a tle any such claim or "suit" and keep
covered"auto". us advised of all proceedings and ac-
D. EMPLOYEES AS INSURED tions.
The following Is added to Paragraph A.1., Who Is (ii) Neither you nor any other involved
An Insured, of SECTION II — LIABILITY COV- "insured" will make any settlement
ERAGE: without our consent.
Any "employee" of yours is an "insured"while us- (iii)We may, at our discretion, participate
Ing a covered"auto"you don't own, hire or borrow in defending the "insured" against, or
in your business or your personal affairs. in the settlement of, any claim or
E. SUPPLEMENTARY PAYMENTS — INCREASED "suit".
LIMITS (iv)We will reimburse the "insured" for
1. The following replaces Paragraph A.2.a.(2), sums that the "insured" legally must
of SECTION II—LIABILITY COVERAGE: pay as damages because of "bodily
injury" or"property damage" to which
(2) Up to $3,000 for cost of bail bonds (in- this insurance applies, that the "in-
cluding bonds for related traffic law viola- sured" pays with our consent, but
tions) required because of an "accident" only up to the limit described in Para-
we cover, We do not have to furnish graph C., Limit Of Insurance, of SEC-
these bonds. TION II—LIABILITY COVERAGE.
2. The following replaces Paragraph A.2.a.(4), (v) We will reimburse the "insured" for
of SECTION II—LIABILITY COVERAGE: the reasonable expenses incurred
(4) All reasonable expenses Incurred by the with our consent for your investiga-
"insured" at our request, including actual tion of such claims and your defense
loss of earnings up to $500 a day be- of the "insured" against any such
cause of time off from work. "suit", but only up to and included
F. HIRED AUTO — LIMITED WORLDWIDE COV- within the limit described in Para-
ERAGE—INDEMNITY BASIS graph C., Limit Of Insurance, of
SECTION II — LIABILITY COVER-
The following replaces Subparagraph (5) in Para- AGE, and not in addition to such limit.
graph B.7., Policy Period, Coverage Territory, Our duty to make such payments
of SECTION IV — BUSINESS AUTO CONDI- ends when we have used up the ap-
TIONS: plicable limit of insurance in
pay-
(5) Anywhere in the world, except any country or ments for damages, settlements or
jurisdiction while any trade sanction, em- defense expenses.
bargo, or similar regulation imposed by the (b) This insurance is excess over any valid
United States of America applies to and pro- and collectible other insurance available
hibits the transaction of business with or
Page 2 Of 4 ©2010 The Travelers Indemnity Company. CA T3 53 03 10
Includes copyrighted material of Insurance Services Office,Inc.with its permission.
COMMERCIAL AUTO
to the "insured" whether primary, excess J. PERSONAL EFFECTS
contingent or on any other basis. The following is added to Paragraph AA., Cover-
(c) This insurance is not a substitute for re- age Extensions, of SECTION III — PHYSICAL
quired or compulsory insurance in any DAMAGE COVERAGE:
country outside the United States, its ter- Personal Effects
ritories and possessions, Puerto Rico and
Canada. We will pay up to $400 for "loss" to wearing ap-
You agree to maintain all required or
parel and other personal effects which are:
compulsory insurance in any such coun- (1) Owned by an"insured"; and
try up to the minimum limits required by (2) In or on your covered"auto".
local law. Your failure to comply with This coverage applies only in the event of a total
compulsory insurance requirements will theft of your covered"auto".
not invalidate the coverage afforded by
this policy, but we will only be liable to the No deductibles apply to this Personal Effects
same extent we would have been liable coverage.
had you complied with the compulsory in- K. AIRBAGS
surance requirements. The following is added to Paragraph B.3., Exclu-
(d) It is understood that we are not an admit- sions, of SECTION III — PHYSICAL DAMAGE
ted or authorized Insurer outside the COVERAGE:
United States of America, its territories Exclusion 3.a. does not apply to "loss" to one or
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the more airbags in a covered"auto"you own that in-
furnishing of certificates o insurance, or flate due to a cause other than a cause of"loss"
for compliance in any way with the laws set forth in Paragraphs A.1.b. and A.1.c., but
of other countries relating to insurance. only:
G. WAIVER OF DEDUCTIBLE—GLASS a. If that"auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE b. The airbags are not covered under any war-
COVERAGE: ranty; and
No deductible for a covered "auto" will apply to c. The airbags were not intentionally inflated.
glass damage if the glass is repaired rather than We will pay up to a maximum of $1,000 for any
replaced. one"loss".
H. HIRED AUTO PHYSICAL DAMAGE—LOSS OF L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
USE—INCREASED LIMIT LOSS
The following replaces the last sentence of Para- The following is added to Paragraph A.2.a., of
graph AA.b., Loss Of Use Expenses, of SEC- SECTION IV—BUSINESS AUTO CONDITIONS:
TION III—PHYSICAL DAMAGE COVERAGE: Your duty to give us or our authorized representa-
However, the most we will pay for any expenses tive prompt notice of the "accident" or "loss" ap-
for loss of use is $65 per day, to a maximum of plies only when the "accident" or"loss" is known
$750 for any one"accident". to:
1. PHYSICAL DAMAGE — TRANSPORTATION (a) You (if you are an individual);
EXPENSES—INCREASED LIMIT (b) A partner(if you are a partnership);
The following replaces the first sentence in Para- (c) A member (if you are a limited liability com-
graph A.4.a., Transportation Expenses, of pany);
SECTION III — PHYSICAL DAMAGE COVER- (d) An executive officer, director or insurance
AGE:
We will a u to $50 per da to a maximum of manager(if you are a corporation or other or-
We P P Y ganization); or
$1,500 for temporary transportation expense in- (e) Any"employee" authorized by you to give no-
curred by you because of the total theft of a cov- tice of the"accident"or"loss".
ered"auto"of the private passenger type.
CA T3 53 03 10 u 2010 The Travelers Indemnity Company, Page 3 of 4
Includes copyrighted material of Insurance Services Office,Inc.with its permission.
COMMERCIAL AUTO
M. BLANKET WAIVER OF SUBROGATION such contract. The waiver applies only to the
The following replaces Paragraph A.S., Transfer person or organization designated in such
Of Rights Of Recovery Against Others To Us, contract.
of SECTION IV — BUSINESS AUTO CONDI- N. UNINTENTIONAL ERRORS OR OMISSIONS
TIONS: The following is added to Paragraph B.2., Con-
5. Transfer Of Rights Of Recovery Against cealment, Misrepresentation, Or Fraud, of
Others To Us SECTION IV—BUSINESS AUTO CONDITIONS:
We waive any right of recovery we may have The unintentional omission of, or unintentional
against any person or organization to the ex- error in, any information given by you shall not
tent required of you by a written contract prejudice your rights under this insurance. How-
signed and executed prior to any "accident" ever this provision does not affect our right to col-
or"loss", provided that the"accident"or"loss" lect additional premium or exercise our right of
arises out of operations contemplated by cancellation or non-renewal.
Page 4 of 4 O 2010 The Travelers Indemnity Company. CA T3 53 03 10
Includes copyrighted material of insurance Services Office,Inc.with its permission.
'T WORKERS
COMPENSATION
TRAVELEMS AND
ONE TOM SQUAM EMPLOYERS LIABILITY
WTFORD, CT 06183
ENDORSEMENT WC 99 37 )— 001.
POUCYNUMBER: ( 2 -4243 43-4-1.6)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT- CALIFORNIA
(BLANKET WAIVER)
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.
The additional premium for this endorsement shall be 0, % of the California work compensation e-
iu ,
Schedule
Person r Organization Job Description
ANY PERSON OR ORGMIZATION FOR
WHICH THE INSUREDRORKED
BY WRITTEN CONTRACT EXECUTED
PRIOR. TO LOSS Ta FURNISH
THIS WAIVER
This endorsement changes the policy to which it is attached and is effective on the date Issued unless otherwise
stated.
Information bet Is required ly when this endorsement Is Issued subsequent to pireparation o
the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured Premium
Insurance Company CountersIgned by
DATE r ISSUE: 10-20-16 ST ASSIGN: Page 1 of 1