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PROOF OF INSURANCE (2014) CLOSED 'X" DATE(MMIDDIYYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE 2/26/2014 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 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 PRODUCER G.NAME; Sandy Petefs p626 4-3070 m 99Dea1S LoseRobles Ave Ste nton& t540 PHONEMAIL tm,Ext); eters Insdla Cis �AAp ,N ),; 626 844-3074 ADDRESS, Pasadena, CA 91101 optl��s INSURER(S)AFFORDING O NAIC# IN :Travelers Property Casualty Co of A 25674 INSURED INSURER B Westcon Engineering, Inc. INSURER C: 6355 Topanga Canyon Blvd., Suite 411 -------- Woodland Hills, CA 91367 "NsuRR 818 226-0444 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1244947327 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. II ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDfYEYYY) POLICY EX LIMITS �����.�� MIODIYYYY) 'i A X COMMERCIAL GENERAL LIABILITY Y Y 68068111-445 12/5/2013 12/5/2014 EACH OCCURRENCE $1,000,000 CLAIMS-MADE � X„J ( X ) . X Contractual Liab MED EXP(An one person) $101,000 OCCUR PREMISES Ea acp„ A AG RENTED urrenca $1000000 X I XCU Included PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 II PR POLICY N X jd C, LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y BA67871_963 12/5/2013 112/5/2014 COMMNED SINGLE LIMIt $ (E,aarl„i<�tlnnt) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULEDUOS BODILY INJURY(Per accident) $ _ AUTOS ALL OWNED PAO,I eRTY^DAMAGE X HIRED AUTOS x AUTOS (Per act,doot,) $ $ UMBRELLA EXCESS LIABIAB OCCUR E�H CLAIMS-MADE .AGGREORE $ GATE ,NCE............................................................................................ DED I �RETENTION$ _ $ WORKERS COMPENSATIONPERI O TH- AND EMPLOYERS'LIABILITY YIN ...........L.��STATUTE.1............���..E,R ..................................................................... ANY OFFICE/M MBHREXCLUDED?ECUTIVE ❑ N/A .E.:L..,..DISEASE C�EA.EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) *General Liability excludes claims arising out of the performance of professional services* The City of EI Segundo,its officials,officers,agents and employees are named as additional insured as respects general and auto liability for claims arising from the operations of the named insured as required per contract or agreement. *NOTE: Insurance coverage includes primary and non-contributory wording and waiver of subrogation per the attached endorsements,see Sections B&C of the GL endorsement(Form #CG D3 82 09 07). CERTIFICATE HOLDER CANCELLATION 30 Day NOC/10 Day for NonPay of Prem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE J THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of EI Segundo'/ / ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street EI Segundo CA 9024`v'µ 1 Au R1EDREPRE NTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 6806811L445 COMMERICAL GENERAL LIABILITY ISSUE DATE:2/26/2014 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR"OGA 'IZATION(S): C:iLy ar Kl S gLlIA * 150 Ma 1 P SL rccf. PROJECT/LOCATIO ►F COV RED OPERATIONS: "The CiLy of Fl Segundo/ iLs od fi c i r-.O s, o F d i r r:sr agc-.nt..s and enir)loyee,s PROVISIONS A The following is added to WHO IS AN INSURED The insurance provided to such additional (Section II): insured is limited as follows: The person or organization shown in the Sched- ule above is an additional insured on this Cover- d. This insurance does not apply to the render- age Part, but only with respect to liability for bod- ing of or failure to render any "professional ily injury", 'property damage" or 'personal injury services". caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on e. The limits of insurance afforded to the addi- your behalf: tional insured shall be the limits which you agreed in that'contract or agreement requir- a. In the performance of your ongoing oper- ing insurance" to provide for that additional ations; insured, or the limits shown in the Declarations for this Coverage Part, b. In connection with premises owned by or whichever are less. This endorsement does rented to you;or not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III)for C. In connection with your work and included this Coverage Part. within the "products-completed operations hazard." B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL Such person or organization does not qualify as LIABILITY CONDITIONS(Section IV): an additional insured for "bodily injury", "property However, if you specifically agree in a contract or damage"or"personal injury'for which that person agreement requiring insurance that, for the addi- or organization has assumed liability in a contract tional insured shown in the Schedule, the insur- or agreement. ance provided to that additional insured under this CG D3 82 09 07 Page t ©2007 The Travelers Companies,Inc. Includes the copyrighted material of Insurance Services Office Inc.,with its permission COMMERICAL GENERAL LIABILITY Coverage Part must apply on a primary injury" arising out of"your work" on or for the basis, or a primary and non-contributory project, or at the location, shown in the basis, this insurance is primary to other Schedule above, performed by you, or on insurance that is available to such additional your behalf, under a "contract or agreement insured which covers such additional insured requiring insurance" with that additional as a named insured, and we will not share insured. We waive these rights only where with the other insurance, provided that: you have agreed to do so as part of the "contract or agreement requiring insurance" (1) The "bodily injury" or "property damage" with that additional insured entered into by for which coverage is sought occurs; you before, and in effect when, the "bodily and injury" or "property damage" occurs, or the "personal injury"offense is committed. (2) The "personal injury" for which coverage is sought arises out of an offense D. The following definition is added to committed; DEFINITIONS (Section V): after you have entered into that "contract or "Contract or agreement requiring insurance" agreement requiring insurance" for such means that part of any contract or additional insured. But this insurance still is agreement under which you are required to excess over valid and collectible other include the person or organization shown in insurance, whether primary, excess, the Schedule as an additional insured on contingent or on any other basis, that is this Coverage Part, provided that the "bodily available to the additional insured when the injury" and "property damage" occurs, and additional insured is also an additional the "personal injury" is caused by an offense insured under any other insurance. committed: C. The following is added to Paragraph 8. a. After you have entered into that contract Transfer Of Rights Of Recovery Against or agreement; Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): b. While that part of the contract or agreement is in effect; and We waive any rights of recovery we may have against the additional insured shown in c. Before the end of the policy period. the Schedule above because of payments we make for "bodily injury", "property damage" or"personal CG D3 82 09 07 Page 2 ©2007 The Travelers Companies,Inc. Includes the copyrighted material of Insurance Services Office Inc.,with its permission POLICY :BA67871,963 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions ofthe Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s)or organization(s)who are "insureds" under the Who Is An Insured Provi- sion 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. ........................................................ Endorsement Effective: 2/26/2014 Countersigned By: Named Insured: " Westcon Engineering, Inc. (Authorized Representative) SCHEDULE Name of Person(s)or Organization(s): *The City of El Segundo, its officials, officers, agents and employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured"for Liability Coverage, but only to the extent that person or organization qualifies as an"insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM W... GARAGE COVERAGE FORM , MOTOR CARRIER COVERAGE F TRUCKERS COVERAGE FORM With respect to coverage provided by this required of you by a written contract executed endorsement, the provisions of the Coverage Form prior to any"accident"or"loss", provided that apply unless modified by the endorsement. the "accident"or"loss"arises out of the Paragraph 5.Transfer of Right Of Recovery Against operations contemplated by such contract. Others To Us of the CONDITIONS section is replaced The waiver applies only to the person or by the following: organization designated in such contract. 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent CA T3 40 08 08 ©2008 The Travelers Companies, Inc. 1 OP ID:JMC DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/26/2014 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). CONTACT PRODUCER Phone:800-338-1391 NAME; °........ ................................................................................................................................................................................................................................................................................ ACEC/MARSH PHONE �FAX 701 Market St.,Ste.1100 Fax:888-621-3173 (AIC,No,Ext), (A/C,Na). ADDRESS:' ..., .., Jeff BuCoMOI6y 101 Pf�ocCR D 04 WR lir 0 WESTCON INSURER(S)AFFORDING COVERAGE NAIC# INSURED Westcon Engineering, Inc. INSURER A:Hartford Insurance Company X22357 6355 Topanga Canyon Blvd. INSURER B Woodland Hills,CA 91367 INSURER C INSURER D: 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 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, �5R............. TYPE OF INSURANCE ..ADbL 8066 POLICY EFF POLICY EXP ....... .. IN LIMITS TR 4NSR 4NVD POLICY NUMBER @pAM!'DD��PYYYYI�(MMIDDIVYYY) GENERAL LIABILITY EACH OCCURRENCE $ bAMAGL YO RENYED,,,,,, COMMERCIAL GENERAL LIABILITY PREMISES(Fa occurrence) CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY I II PRO• I, ry LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) ............. NON-OWNED AUTOS $ � UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU MOTH AND EMPLOYERS'LIABILITY TD.RY I IIMIT ., V FR A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 84WEGBQ5655 04/14/2013 04/14/2014 E L EACH ACCIDENT $ 1,000,000: OFFICER/MEMBER EXCLUDED? r7N/A (Mandatory in NH) E DISEASE-EA EMPLOYEE $ 1,000,0001: If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000Ij DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space to requirad) waiver of Subrogation is included in favor of the Citv of El Se undo. 30 days notice of cancellation will be given to the certificate holder. t Best Pla in on policy: AXV (WOSW9) 1 CERTIFICATE HOLD'E'R CANCELLATION CITYOF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of EI Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main St. EI Segundo,CA 90245-3813 AUTHORIZEDREPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 84WEGBQ5655 WORKERS COMPENSATION INSURED: Westcon Engineering, Inc. ADDITIONAL COVERAGES WHEN REQUIRED BY WRITTEN CONTRACT This is a summary of the C�oyerag, provided under the policy: Waiver of Subrogation We have the right to recoveiour payments from anyone liable for an injury covered by this policy, We will not enforce our right against any person or organization from whom you are required by written contract or agreement to obtain this waiver, but only with respect to bodily injury arising out of the operations where you are required by written contract or agreement to obtain this waiver of rights from us. Rev 5. 13 WESTENG-02 JUNE ACO R DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 2/27/2014 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 CONTACT KHT Insurance NAME: Ft Worth,IX X 761'04 u PHONE Ext) (817}336-2721 (AIC N ., (817}870-2520 200 W,Magwrarlia,Suite 201 ^i T .. loss INSURER(S)AFFORDING COVERAGE NAIC tt INSURER A:HISCOX Group Companies INSURED INSURER B: Westcon Engineering,Inc. INSURER C: Karig McCloskey 6355 Topanga Cyn.Blvd.#411 INSURER D. Woodland Hills,CA 91362 INSURER E k 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 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 'OLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE iADD`L'SYJ614:................................ 06LICY-Er'F PFOLIdY-1XP, r{�g.ylvra POLICY NUMBER (MMIDDIYYYY) IMMIDD7YYY'kl'' LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGETO RENTED X I CLAIMS-MADE OCCUR ANE112020712 12/05/2013 12/05/2014 PREMISES(Ea occurrence) $ X Professional Liab MED EXP(Aoey one peman) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY ECT LOC PRODUCTS-COMP/OP AGG $ 01 HER Per Claim $ 1,000,000 AUTOMOBILE LIABILITY COPAUINlEr-sn S kNGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ HIRED TSAUTOS AUTOS AOT OWNED QF"i x�AI,uB nk)aMAXGL $ UMBRELLA LIAB pII OCCUR EACH OCCURRENCE $ EXCESS LIAB II CLAIMS-MADE AGGREGATE $ DEQ I' I RETENTION$ $ WORKERS COMPENSATION f STATUTEPEEf J OTTH- AND EMPLOYERS'LIABILITY Y I N ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ACORD 25,Certificate of liability Insurance,is"issued as a matter of information only,and confers no rights upon the certificate holder. This certificate does not amend,extend,or alter the coverage afforded by policies". CERTIFICATE HOLDER CANCELLATION 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 EI Segundo AUTHORIZED REPRESENTATIVE Attn:Floriza Rivera,PW Dept yy,� 350 Main St. � u El Seaundo,CA 902453813 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks ofACORD