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PROOF OF INSURANCE (2018) CLOSED A "R"� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �" _ 1 09/05/2017 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(los)must Illave ADDITIONAL INSURED pro0slons 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 ondorsomont(s), PRODUCER cON CI ROBERT B RICE,JR, '( SARG lAfC, a 9x(I... 1-2600 „019,yoi 818436 59f18 AR EANT INSURANCE AGENCY,LLC PHONE 818-561-2600 7740 Painter Ave Ste 210 F°r�tA�L °t.dGtAIV�E C�Nry AO()htrS'V I�OIBERT EANTINS — . -2477 INSURER A: LIBERTY MUTUAL/Ohio Security Insurance 24082 .Whittler CA 90602 ....... _ INSURED INSURER n;..A..M TRUST/TLCHNOLOGY INS....0... .R..A......N... GE CO ..- .....42376--- BARTEL ASSOCIATES,LLC INsu.ER c; INDIAN HARBOR ...... w..._.._., INSUI"�ANCE COMPANY 36940 411 BOREL AVE STE 101 INSURER.D.X..................................... .._...............................................----...__....., ... INSURER E: SAN MATED CA 94402-3525 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. ,COMMERCIAL 0 'S (y LmTYPE OFINSURANCE °-P-OLICY NUMBER = I �..il..slP:Sana((x.fl.�CoLIMITS COMMRGENERALLIABILITY EACH OCCURRENCE ,,$ ,...2..,.0.....0....0...,.0..00 -MADE ®OCCUR "IPAW,TOTNTTDCLAIMS 32000,000 . ...... 000 A _. X X BKS 18 57297374 09/01/2017 09/01/2018 MEDEXP(Anv DV NJURY $ 2,000,000- ( ) PE.R„soNA�a^ ...... ..,,, GLN �, OI ICY JEC �..., LOC ...PRODUCTSGCOMP OP.AGG....$.....'4�000,000 L A1W7CrEoA,rE LIMIT APPLIES PER: 4 P 000,000 ,�. .... 0'B H'�EI'$ �i $ AUTOMOBILE LIABILITY .............. - t,-(00LlTd'aL'"1.)—NNGLELIMIT ... .,........... ANY AUTO BODILY INJIURY(Per person) $-�'OOO,000 OWNED ISCHEDULED A HIRED NON-OWNED X X BAS 18 57297374 09/01/2017 09/01/2018 BODILY INJURY Pe AUTOSONLY AUTOS ( ) (Per $ AGE AUTOS ONLY „AUTOS ONLY I, $ ,,,,,,,,,, . II $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS IAB AGGREGATE GATE $ DED RETENTION$ $ WORKERS N PER 0AH_ EMPLOYERS TY ANY PROP IETOORIP BIER/EXECUTIVE IY`EL.EACH ACCIIDEN,T ...... .$u1,000,00,0....................... B OFFICER/MEMBER EXCLUDED? N/AI X TWC3655083 09/01/2017 09/01/2018 (Mandatory In NH) EL,DISEASE-EA 1,000,000 DESCR”T"ON OF OPERATIONS below E L.DISEASE-POLICY LIMIT E $ 1,000,000 If yes,dit r,1t�s under MISC.PROFESSIONAL LIABILITY Per Occurance $5,000"60-6-- C 5,000" l-0C MPPOO1715212 09/01/2017 09/01/2018 Annual-Aggregate $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF EL SEGUNDO,IT'S OFFICERS,DIRECTORS,EMPLOYEES,AGENTS AND VOLUNTEERS ARE HEREBY NAMED AS AN ADDITIONAL INSURED BY CONTRACT ON POLICY#BKS(18)57297374 and BAS(18)57297374 AS RESPECTS TO OPERATIONS OF THE NAMED INSURED ONLY,SEE CG2010.COVERAGE UNDER POLICY#BKS(18)57297374&BAS(18)57297374 IS PRIMARY AND NON-CONTRIBUTORY ABOVE ANY OTHER INSURANCE THE CERTIFICATE HOLDER(S)MAY CARRY.30 DAY NOTICE OF CANCELLATION. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF EL SEGUNDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. EL SEGUNDO CA 90245 ., AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD C PORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKS (18) 57 29 73 74 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL 1 SURE - OWNERS, LESSEES O CONTRACTORS - SCHEDULED PERSON O ORGANIZATION This endorsement modifies insurance provided under the following° COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Location(s)Of Covered Op erat'ions City of EL Segundo, it's officials, officers, employees and agents ALL LOCATIONS OF THE NAMED INSURED information required to complete this Schedule„ if not shown.above„ will be shown in the Declarations. Q A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organizations) shown in the Schedule„ but only exclusions apply: with respect to liability for"bodily injury"" "property This insurance does not apply to "bodily injury" or damage or personal and advertising injury '.property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 0413 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER Of OUR RIGHT To RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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.) 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 20/6 Of the California workers'compensation premium otherwise due on such remuneration. Schedule " Person or Organization Job Description Any person or organization as required by written contract. This endorsement changes the policy to which itis 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 91112017 Polley No. TWC3655083 Endorsement No. 0 Insured Bartel Associates,LLC Premium$ 7924 Insurance Company Technology Insurance Company,Inc. Countersigned by � 7 /7 WC 04 03 05 (Ed.04-84)