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PROOF OF INSURANCE (2018 - 2019) CLOSED DATE(MM/DDIYYYY) A�Rf> CERTIFICATE OF LIABILITY INSURANCE lul 5r22/201 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 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 949-559-3377 STrS Risk Management& Insurance Services NAME: Lit), Ashley Brewster FAX Nit 949-559-16703 Irvine, CA 92620 EMAIL ADDREss., ashleyb@gmgs.corr) INSURER(S)AFFORDING COVERAGE NAIC# www. m s.com OB84519 INSURERA: Great Divide Insurance Company 25224 g g INSURED INSURER B: Peerless Insurance Company 24198 EEC Environmental tIral nte10cting Inc.,On ba CiBoulevardV s ,Engineering 80 . Nautilus Insurance Cop any 17370 Orange CA 92868 INSURERS INSURER F: COVERAGES CERTIFICATE NUMBER: 42036750 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 ILTR TYPE OF INSURANCE II1NSD�WVD POLICY NUMBER (MM DDYIYYYYI (MM POLICY EXP EFF /YYyYI LIMITS A COMMERCIAL GENERAL ENE ADE ✓Ll LIABILITY OCCUGLP2006942-15 10/31/2017 10/31/2018 EACHPRFMOCC5FS RRENCE $5,000,000 DAMAGE OR' N1'Eb Es occurrence) $300M0 MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY s 5.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 5,000,000 POLICY(,,,,,✓,,, JECT LOC PRODUCTS-COMP/OPAGG $5„000,000 B AUTOMOBILE LIABILITY CBP8977390 10/31/2017 10/31/2018 COMBINED LIMIT $1,000,000 ,r ANY AUTO BODILY INJURY(Per person) $ OWNED ! SCHEDULED BODILY INJURY(Per accident) AUTOS ONLY AUTOS HIRED NON-OWNED' AUTOS ONLY ✓ AUTOS ONLY (POP crI11 G�dlkgAfaE $ UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ EXCESSLIABCLAIMS , ”ITL- AGGREL $ DED RETENTION$ $ A WORKERS COMPENSATION WCA2008815-15 5/24/2018 5/24/2019 �/ STATUTE I 01 ERH AND EMPLOYERS'LIABILITY Y I N r- A ACCIDENT $x,000,000 (OFFICER/MEMBER ddn NH) EXCLUDEDoECUTIVE I�1 NIA E L DISEASE.EA MIDLOYEE $ ,000,000 DESCRIPTION OF OPERATIONS below E (Mandatory 1 Rr,'Y LIMar $1,000,000 If es,describe under D Pollution Liability CCP2006941-15 10/31/2017 10/31/2018 Each Poll Occurrence$5,000,000 Professional Liability Each Prof Liab Claim$5,000,000 General Aggregate:$5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Sewer System Management Plan As respects Genera'I Liabl)Ily coverage, City of EI Segundo,its officials and employees are added as Additional Insureds per CG2010041'3 and CG20100413 and'CG2037&13 attached,and this insurance is primary per CG20 10413 attached.As respects Automobile Coverage,Business Auto Coverage Form CA00011001 applies.As respects Workers'Compensation coverage,a Waiver of Subrogation is herebyy Included per W0040306 attached. As respects General Liability coverage,30-day written notice of cancellation(10 days for nonpayment opipremium)app per IL00171198 attached. CERTIFICATE HOLDER CANCELLATION Sewer System Management Plan Yy of EN Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CIt PUDIIC VIII S THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo CA 90245 _ AUTHORIZED REPRESENTATIVE I Grill Griffith ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 42036750 117-18 G/A/UMB/P0LL/E&0 18-19 WC I Ashley Brewster 5/22/2018 3:04:03 PM (PDT) I Page 1 of 7 POLICY NUMBER: GLP2006942-15 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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 Organization(s) Location(s)Of Covered Operations Any person, organization, or project with whom the named insured executes a written contract prior to the start of the project and is shown on a certificate of insurance issued by our authorized representative prior to the start date of the project. 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) 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 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 42036750 17-18 O/A/UMB/POLL/E60 18-19 WC I Ashley Brewster 1 5/22/2018 3:04:03 PM (PDT) I Page 2 of 7 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 ©Insurance Services Office, Inc., 2012 CG 20 10 0413 42036750 1 17-18 O/A/U14B/P0LL/B&0 18-19 WC I Ashley Brewster 1 5/22/2018 3:04:03 PM (PDT) I Page 3 of 7 POLICY NUMBER: GLP2006942-15 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS S - 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, organization, or project with whom the named insured executes a written contract prior to the start of the project and is shown on a certificate of insurance issued by our authorized representative prior to the start date of the project. 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III —Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is property damage"caused, in whole or in part, by required by a contract or agreement, the most we your work at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is 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 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 42036750 i 17-18 0/A/UMB/P0LL/B&0 18-19 WC i Ashley Brewster 1 5/22/7018 3:04:03 PM (PDT) i Page 4 of 7 GLP2006942-15 EEC Environmental COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NIONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 ©insurance Services Office, Inc., 2012 Page 1 of 1 47036750 17-18 0/A/UMB/P0LL/&&0 18-19 WC I Ashley Brewster 1 5/77/7018 3:04:03 PM (PDT) I Page 5 of 7 EEC Environmental dba Enviromental Engineering Contracting Inc., IL 00 17 1198 COMMON I POLICY CONDITIONS All Coverage Parts Included in this policy are subject to the following conditions, A. Cancellation b. Give you reports on the conditions we find; 1. The first Named Insured shown in the Declara- and tions may cancel this policy by mailing or deliv- c. Recommend changes. ering to us advance written notice of cancella- 2. We are not obligated to make any Inspections, tion. surveys, reports or recommendations and any 2. We may cancel this policy by mailing or deliver- such actions we do undertake relate only to fin- ing to the first Named Insured written notice of surabliity and the premiums to be charged.We cancellation at least: do not make safety inspections. We do not un- a. 10 days before the effective date of cancel- dertake to perform the duty of any person or lation If we cancel for nonpayment of pre- organization to provide for the heakh or safety mium;or of workers or the public. And we do not warrant b. 30 days before the effective date of cancel- that conditions: lation if we cancel for any other reason, a. Are safe or healthful;or 3. We will mail or deliver our notice to the first b. Comply with laws, regulations, codes or Named Insured's last.mailing address known to standards. US. 3. Paragraphs 1.and 2.of this condition apply not 4. Notice of cancellation will state the effective only to us, but also to any rating, advisory, rate date of cancellation. The policy period will end service or similar organization which makes !n- on that date. suranoe Inspections, surveys, reports or neo- 5. If this policy is cancelled, we will send the first ommendations. Named Insured any premium refund due. If we 4. Paragraph 2.of this condition does not apply to cancel, the refund will be pro rata. If the first any Inspections, surveys, reports or reoom- Named Insured cancels, the refund may be mendations we may make relative to certifica- less than {pro rata. The cancellation will be of- tion, under state or municipal statutes, ordi- fective even if we have not made or offered a nanoes or regulations, of boilers, pressure ves- refund. sels or elevators. 6. If notice Is mailed, proof of mailing will be suffi- E. Premiums cient prof of notice. The first Named Insured shown in the Declara- B. Changes tions: This policy contains all the agreements between 1. Is responsible for the payment of all premiums; You and us concerning the Insurance afforded. and Tho first Named Insured shown In the Declarations 2. Will be the payee for any return premiums we Is authorized to make changes in the terms of this pay- policy with our consent. This poll'cy's terms cern be F. Transfer Of Your Rights And Duties Under This amended or waived only by endorsement Issued Policy by is and made a part of this policy. C. Examination Of Your Books And Records Your rights and duties under this policy may not be transferred without our written consent except In We may examine and audit your books and re- the case of death of an individual named insured. cords as they relate to this policy at any time dur- If you die, .your rights and duties will be transferred Ing the policy period and up to three years after- to your legal representative but only while acting ward. within the soope of duties as your legal representa D. Inspections And Surveys tive. until your legal representative Is appointed, 1. We have the right tm anyone having proper temporary custody of your a. Make ins actions and surveys at an time; property will have your rights and duties. but only P ys y with respect to that property. IL 00 17 1198 Copyright,Insurance Servioes Offioe, Inc., 1998 Page 1 of 1 D 42036750 117®16 Q/A/UMB/P0LL/B&0 18-19 WC I Ashley Brewster 15laa/2018 3:0x.03 Pre (PDT) I Page 6 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC o4 03 00 04 N WAIVER F OUR II " HTI ' 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 0,00%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization As required by written contract This endorsement changes the policy to which it is 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 Policy No, WCA2008815-15 Endorsement No, 5/24/2018 Insured Premium EEC Environmental Insurance Company: Countersigned by Great Divide Insurance Company WC 04 03 08 04 84 1998 by the Workers'Compensation Insurance Rating Bureau of California. Page 1 of 1 All rights reserved. From the WCIRB's California Workers'Compensation Insurance Forms Manual 2001. 42036750 1 17-19 a/A/OMB/F0LL/E&0 1e-19 we I Ashley Brewster 1 5/22/2018 3:04;03 $M (PDT) I Page 7 of 7 AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDn'YYY) 5/22/2018 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). CONTACT PRODUCER (A G,No,E><tt' 949-559-3377 tef GMGS Risk Management& Insurance Services NAME: Ashley Irvine, CA 92620 (HONE AJC,NOI 949-559.6703 12 Truman -MADDRESS: sable b m s.00m y 9 9 INSURER(S)AFFORDING COVERAGE NAIC# www.gmgs.com OB84519 INSURERA: Great Divide Insurance Company 25224 I INSURED INSURERB: EEC Environmental dba rINER c: C e CityBoulevalydn�JContracting Inc., est, Suite 800INSURE ER D Orange CA '92868 INSUR R E: INSURER F: COVERAGES CERTIFICATE NUMBER: 42036905 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 'AID CLAIMS, lisisk .. .IANSD wVD POLICY NUMBER .... 'POLICY EFF POLICY EXP LTR TYPE OF INSURANCE MM/D2/YYYYL_fMMIDn1YYYYi LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAC E"7'O tEN Y L U CLAIMS-MADE OCCUR PREMISES,(Ea occurrence) $ MED EXP(Any one person) $ „ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICYLOC — „p, ,aEC'I" RODUCTS-COMP/OPAGG $ AUT'OTHER $ " AUTOMOBILE LIABILITY COMBINED LIIMI'T $ (Ea,aucudent) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NCI@9•tiT4'WNUd:7 PROPERTY DAMAGI::� $ AUTOS ONLY AUTOS ONLY (E'er ac.rdenl) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LII RETENTION$ � 11 CLAIMS MADE AGGREGATE $ _ $ A WORKERS AND EMPLOYERS'L COMPENSATION YIN WCA2008815-15 5/24/2018 5/24/2019 STATUTEPER I OTH- ER ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $1,000000 OFFICER/MEMBER EXCLUDED? NIAr (Mandato If DESCRIPTION EMPLOYEE: 1, ON OF OPERATIONS below E L DISEASE-POLICY LIMIT $,,,,,Q001QO 000 1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE.:Sewer Syystem Management Plan As respects WDrkers'Compensation coverage,a Waiver of Subrogation is hereby included per WC040306 attached. CERTIFICATE HOLDER CANCELLATION Sewer System Management Plan CItY ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Citg oof EI lic Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo CA 90245 AUTHORIZED REPRESENTATIVE Griff Griffith ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 42036905 1 18-19 we i Ashley Brewster i 5/22/2018 3:05:07 PM (PDT) Page 1 of 2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 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 0.00%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization As required by written contract This endorsement changes the policy to which it is 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 Policy No. WCA2008815-15 Endorsement No. 5/24/2018 Insured Premium EEC Environmental Insurance Company: Countersigned by Great Divide Insurance Company - WC 04 03 06 04 84 1998 by the Workers'Compensation Insurance Rating Bureau of California. Page 1 of 1 All rights reserved. From the WCIRB's Califomis Workers'Compensation Insurance Forms Manual 2001. 42036905 1 16-19 WC I Ashley Brewster 1 5/22/2018 3:05:07 PM (PDT) I Page 2 of 2