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PROOF OF INSURANCE (2018) CLOSED Client#: 2042 MOOREIACO ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)3/27/2018 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 I1older Is an ADDITIONAL INSURED,tho'pollcy(Ies)must be endorsed,If SUBRO'GA'TION 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 Alison Muller NAME: Dealey, Renton&Associates PHONE 510 465-3090 FAX , -2193ANo,.EM . (AICNo): 510 452 P.O. Box 12675 E-MAILDDREss. amull�er deIQyrenton.com Oakland,CA 94604-2675 ( AFFORDING COVERAGE NAIc# 510 465-3090 INSURER A:TravelersPrope FyCasualty � ............. 25674 INSURED Moore lacofano INSURER B:Atlantic Specialty Insurance Co 27154 00 Hearst Ave.Goltsman, Inc. �INSURER c pec'a,lty Berkeley,CA 94710 INSURER D i INSURER E: INSURER F: i 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, LTSR YPE OF INSURANCE NSR y/�/Q DID LSUBI POLICY NUMBER I@Ak01d13 ;LIC irvv) tua /PO ppavw'y(v)i,, Y LIMITS Y Y 6801 H899998 08/31/2017 08/31/2018 EACH OE TO RENTED ENCS $1,000,000 000,000 A �( COMMERCIAL GENERAL LIABILITY � �OfaQ CLAIMS-MADE I X OCCUR PREMISES(Ea occurrence) ,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN GTE LIMIT APPLIES PER: GENERAL AGGRELATE $2,000,000 V?C''P'PRO FLOC POLICY IX� EC PRODUCTS- J ........ —. COMP/DP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY Y Y BA213258325 08/31/2017 08131/201$'(Ea ace,den,t)wciE I�MIT $ 0 COMBINED 1,000 00 X ANY AUTO BODILY INJURY(Per person)ALL OWNED $ HIRED AUTOS .,�SCHEDULED X BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPr RTY DAMAGE X.".,, AUTOS {I•"&rY 1tCxi ion) ... $ A X OCCUR-MaDE CUPOH758762 08/31/2017 08/31/2018 EACH � t $10,000, EACI9��f,rBi�REN�E.. UMBRELLA LIAB ��� EXCESS LIAB 000 A WORK RS COMPENSATION X/� Y UB3J040141 04/01/2017 08/31/2019 X � $ RETENTION$ RS'LIABILITY STATUTE._4 �ORH- ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ti NIA (Mandatory in NHI E L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E;L DISEASE-POLICY LIMIT $1,,000,,000 B Professional DPL710217 08/31/2017 08/31/2018 $2,000,000 per Claim Liability $4,000,000 Annl Aggr, DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: Project#13408.00, EI Segundo Smoky Hollow Specific Plan Update City of Duarte and its officers, officials,employees,agents,and designated volunteers are named as additional insureds as respects general liability for claims arising from the operations of the named insured. CER'TIFICAT'E HOLDER CANCELLATION CI of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Planning&Bldg. Dept. ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Tina Gall 350 Main Street AUTHORIZED REPRESENTATIVE EI Segundo,CA 90245-3813 1 ©1988-2014 ACORD CORPORATION.All rights reserved,. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2285749/M2284631 BMA COMMERCIAL GENERAL LIABILITY Policy Number: 68011-1899998 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II - WHO IS its of insurance described in Section III - Lim- AN INSURED: its Of Insurance. Any person or organization that you agree in a h. This insurance does not apply to "bodily inju- "written contract requiring insurance"to include as ry" or "property damage" caused by "your an additional insured on this Coverage Part, but: work" and included in the "products- a. Only with respect to liability for"bodily injury", 11 completed operations hazard" unless the "property damage"or"personal injury"; and written contract requiring insurance specifi- cally requires you to provide such coverage b. If, and only to the extent that, the injury or for that additional insured, and then the insur- damage is caused by acts or omissions of ance provided to the additional insured ap- you or your subcontractor in the performance plies only to such "bodily injury" or "property of "your work" to which the "written contract damage"that occurs before the end of the pe- requiring insurance" applies, or in connection riod of time for which the "written contract re- with premises owned by or rented to you. quiring insurance" requires you to provide The person or organization does not qualify as an such coverage or the end of the policy period, additional insured: whichever is earlier. c. With respect to the independent acts or omis- 2. The following is added to Paragraph 4.a. of SEC- TION IV - COMMERCIAL GENERAL LIABILITY sions of such person or organization; or CONDITIONS: d. For"bodily injury", "property damage" or"per- The insurance provided to the additional insured sonal injury" for which such person or organi- is excess over any valid and collectible other in- zation has assumed liability in a contract or surance, whether primary, excess, contingent or agreement. on any other basis, that is available to the addi- The insurance provided to such additional insured tional insured for a loss we cover. However, if you is limited as follows: specifically agree in the"written contract requiring e. This insurance does not apply on any basis to insurance" that this insurance provided to the ad- any person or organization for which cover- ditional insured under this Coverage Part must age as an additional insured specifically is apply on a primary basis or a primary and non- added by another endorsement to this Cover- contributory basis, this insurance is primary to age Part. other insurance available to the additional insured If. This insurance does not apply to the render- which covers that person or organizations as a ing of or failure to render any "professional named insured for such loss, and we will not services". share with the other insurance, provided that: g. In the event that the Limits of Insurance of the (1) The "bodily injury" or "property damage" for Coverage Part shown in the Declarations ex- which coverage is sought occurs; and ceed the limits of liability required by the"writ- (2) The "personal injury" for which coverage is ten contract requiring insurance", the insur- sought arises out of an offense committed; ance provided to the additional insured shall after you have signed that"written contract requir- be limited to the limits of liability required by ing insurance". But this insurance provided to the that written contract requiring insurance". additional insured still is excess over valid and This endorsement does not increase the lim- CG D3 8109 15 ©2015 The Travelers indemnity Company.All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission COMMERCIAL GENERAL LIABILITY collectible other insurance, whether primary, ex- such person or organization signed by you be- cess, contingent or on any other basis, that is fore, and in effect when, the "bodily injury" or available to the additional insured when that per- "property damage" occurs, or the "personal injury" son or organization is an additional insured under offense is committed. any other insurance. 4. The following definition is added to the DEFINI- 3. The following is added to Paragraph 8., Transfer TIONS Section: Of Rights Of Recovery Against Others To Us, "Written contract requiring insurance" means that of SECTION IV - COMMERCIAL GENERAL LI- part of any written contract under which you are ABILITY CONDITIONS: required to include a person or organization as an We waive any right of recovery we may have additional insured on this Coverage Part, provid- against any person or organization because of ed that the "bodily injury" and "property damage" payments we make for "bodily injury", "property occurs and the "personal injury" is caused by an damage" or "personal injury" arising out of "your offense committed: work" performed by you, or on your behalf, done a. After you have signed that written contract; under a "written contract requiring insurance"with b. While that part of the written contract is in ef- that person or organization. We waive this right fect; and only where you have agreed to do so as part of the "written contract requiring insurance" with c. Before the end of the policy period. Page 2 of 2 ®2015 The Travelers Indemnity Company.All rights reserved. CG D3 8109 15 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission POLICY NUMBER: BA2G258325 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED UT LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s)who are "insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Moore lacofano Goltsman,Inc. Endorsement Effective Date: 08/31/2017 SCHEDULE Name Of Person(s)Or Organlzatlon(s): Name of additional insureds,cont'd:City of Duarte and its officers,officials,employees,agents,and designated volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph 13.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ®Insurance Services Office, Inc., 2011 Page 1 of 1 BA2G258325 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET" WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following replaces Paragraph A.S., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any "accident" or"loss", provided that the CONDITIONS Section: "accident" or 'loss" arises out of the operations 5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver ap- am To Us plies only to the person or organization desig- We waive any right of recovery we may have nated in such contract. against any person or organization to the extent CA T3 40 02 15 ®2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc,with its permission. Moore lacofano Goltsman, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76(00)-- POLICY NUMBER: UB3Jo40141 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. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be %of the California workers'compensation premium otherwise due on such remuneration, Schedule Person or Organization: Job Description: Name of person or organization cont'd:City of Duarte and its officers,officials, employees,agents,and designated volunteers City of EI Segundo Planning&Bldg.Dept. Attn:Tina Gall 350 Main Street DATE OF ISSUE: 04101/2017