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PROOF OF INSURANCE (2018 - 2019) CLOSED (2)
Client#:25326 KPFFINCO ACORD_ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYW) 3/26/2018 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:lithe certlificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provis)orts 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 any rights to the certificate holder in lieu of such endorsement'('s)., .. . EI;770.5PRODUCER NAME: Katie Kresner 3780 Mansell Road,Suite 370 AILNip,866.550.4082 CONTACT Greyling Inss.Brokersg a/EPIC (HdNEAIC,No, 52 4225 (a Alpharetta,GA 30022 ADDRESS, Katie.Kresner@greyl,ing.com INSURER(S)AFFORDING COVERAGE N A1C# INSURER A:Nall...I Union Firs Ins.co. 19445 INSURED INSURER B:The continental In.—o.company 35289 KPFF Inc. - INSURER C Lloyds of London ' : y 1607 5th Ave ..INSURER D...................................................................................................................................................................................... Suite 1600 INSURER E: Seattle,WA 98101 INSURER P COVERAGES CERTIFICATE NUMBER: 18-19 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, pp EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED W PAID CLAIMS. i.TR TYPE OF INSURANCE IH(SFt 3 IJCV NUM .I POLI"/ EY ) 1BOP LIMITS COMMERCIAL GENERAL LIABILITY I rA CH MTYY BER M fD65 "N' 14tl„ A X GL5268 36 D4/01 2018 04/0112 1 EACH $1,000,000 CLAIMS-MADE rX OCCUR Nq'$ A�P'. E(ie4�naeg�, $500,000 MED EXP(Any one powis) s25,000 PERSONAL&ADV INJURY $1,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 62,000,000 PR - POLICY�JECT [_]LOC PRODUCTS-COMP/OP AGG 52,000,,000 OTHER: $ A AUTOMOBILE LIABILITY CA9775930 04/01/2018 04/0112019(y ^�" E„(y�""OGLE L"M"I $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ..,........"OWNED .............SCHEDULED ...BODILY INJURY accident)..$............................................................... AUTOS ONLY AUTOS m' HIRED NON-OWNED i...w...�....-..W'.�.....,. AC .. ........ AUTOS ONLY ___... AUTOS ONLY � KTPEfi��niS AM,.,...................................$. ........... UMBRELLA LIAB �( CLAIMS-MADE R 6050399824 10110/2017 04/01/2019 EACH OCCURRENCE $7Orppp,ppp .._ C B X 000 000 . EXCESS LIAB I S-MADE AGGREGA �, .. ,.. A D EMPLOYERS'COMPENSATIONBY$p Y/N WCO22298245(AOS) 04/0112018 04/0112019 X SER �, ETH- $ u f CSPnEERs PARTNT-PJr-,XECUTIVE WCO22298244 CA 04/01/2018 04/01/2011_E.L �H C ER WORKERS Y r ET1T ���' DNa,1pA1 �PTATIJ OFF/E RMLMBER LXCLUrDLD'I' N N/A ( ) .EAC ,ACCIDENT $7,000,000 L ('Mandatory In NII) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under II ........,•,•„pESGRIPTION I?F..Q._...._____,.....r.._...._. _ ............................................................................................................. .. .., -POLICY LIMIT U 0001000 ...... PERATIONS below _ .._� ...................................�..'E.�..DISEASE...... $7 r_...............,.�,,.m._.........._. C Professional/ B0146LDUSA1704384 10/10/2017 10/10/2018 Per Claim$10,000,000 Pollution Liab. Aggregate$10,000,000 SIR$250,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Re:KPFF Job#115277-EI Segundo Fire Station No.1 Seismic Evaluation&Retrofit.The City of EI Segundo is named as an Additional Insured with respects to General&Automobile Liability where required by written contract.Waiver of Subrogation is applicable where required by written contract&allowed by law.Umbrella Follows Form with respects to General,Automobile&Employers Liability Policies.Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof,30 days'written notice(except 10 days for nonpayment of premium)will be provided to the Certificate Holder. a CERTIF'ICA'TE 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 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo,CA 90245-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S10253511M1022304 KKRE1 POLICY NUMBER:GL5268336 COMMERCIAL GENERAL LIABILITY GL 526-83-36 CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oranization(s) _ Location(s) Of Covered Operations Any person or organization whom you become Per the contract or agreement. obligated to include as an additional insured as a result of any contract or agreement you have entered into. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to or "property damage" occurring after: include as an additional insured the person(s) or 1. All work, including materials, parts or organization(s) shown in the Schedule, but only equipment furnished in connection with such with respect to liability for "bodily injury", work, on the project (other than service, "property damage" or "personal and advertising maintenance or repairs) to be performed by injury" caused, in whole or in part, by: or on behalf of the additional insured(s) at 1. Your acts or omissions; or the location of the covered operations has been completed; or 2. The acts or omissions of those acting on your behalf; 2. That portion of "your work" out of which the injury or damage arises has been put to in the performance of your ongoing operations its intended use by any person or for the additional insured(s) at the location(s) organization other than another contractor or designated above. subcontractor engaged in performing However: operations for a principal as a part of the 1. The insurance afforded to such additional same project. insured only applies to the extent permitted C. With respect to the insurance afforded to these by law; and additional insureds, the following is added to 2. If coverage provided to the additional Section III - Limits Of Insurance: insured is required by a contract or If coverage provided to the additional insured is agreement, the insurance afforded to such required by a contract or agreement, the most additional insured will not be broader than we will pay on behalf of the additional insured that which you are required by the contract is the amount of insurance: or agreement to provide for such additional 1. Required by the contract or agreement; or insured. 2. Available under the applicable Limits of B. With respect to the insurance afforded to these Insurance shown in the Declarations; additional insureds, the following additional whichever is less. exclusions apply: This insurance does not apply to "bodily injury" This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 This page has been left blank intentionally. POLICY NUMBER:GL5268336 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization whom you Per the contract or agreement. become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown in the Schedule, but only insurance afforded to such additional insured will with respect to liability for "bodily injury" or not be broader than that which you are required "property damage"caused, in whole or in part, by by the contract or agreement to provide for such "your work" at the location designated and additional insured. described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: anan 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 1= CG 20 37 0413 0 Insurance Services Office, Inc.,2012 Page 1 of 2 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement;or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 ISO Properties, Inc.,2004 CG 20 37 0413 O ENDORSEMENT This endorsement, effective 12:01 A.M.04/0112018 forms a part of Policy No.CA9775930 issued to KPFF, Inc. by National Union Fire Insurance Company of Pittsburgh, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A COVERED AUTO. I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. AUTHORIZED REPRESENTATIVE ON am EM an 1= 87950 (9/14) This page has been left blank intentionally, ENDORSEMENT BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement,effective 12:01 AM 04/01/2018 forms a part of Policy No.WC 022-29-8244 Issued to KPFF, Inc. By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA 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 any person or organization with whom you have a written contract that requires you to obtain this agreement from us,as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2%of the total estimated workers compensation premium for this policy. WC 04 03 61 (11/90) Countersigned by____________ ____ Authorized Representative This page has been left blank intentionally.