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PROOF OF INSURANCE (2019) CLOSED
ACCOR"® CERTIFICATE OF LIABILITY INSURANCE I DATE6/15/2018 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(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). CONTACT PRODUCER Risk Strategies Company NAME: Risk Strategies Company 2040 Main Street, Suite 450PHONE FAX Irvine, CA 92614 I(A/C,No.Ext): 949-242-9240 (A/C,No): E-MAIL ADDRESS: syoung(cD_rlsk-strategles.com INSURER(S)AFFORDING COVERAGE NAIC# www.risk-strategies.com CA DOI License No.OF06675 INSURERA: Travelers Property Casualty Co of America 25674 INSURED INSURER B: Travelers Indemnity Company of CT 25682 MINIS En Cgineers, Inc. 201 N. alle Cesar Chavez, Suite 300 I INsuRERc: Travelers Indemnity Company 25658 Santa Barbara CA 93103 I INSURER D: AXIS Insurance Company 37273 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 42571001 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A / COMMERCIAL GENERAL LIABILITY ✓ 6802JO51458 6/14/2018 6/14/2019 EACH OCCURRENCE $$1,000,000 DAMAGE RENTE CLAIMS-MADE 1✓ OCCUR PREMSESO(Ea occurence) $$1,000,000 MED EXP(Any one person) $$10,000 PERSONAL&ADV INJURY $$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $$2,000,000 POLICY Z JE� E] LOC PRODUCTS-COMP/OPAGG $$2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BA2220L967 6/14/2018 6/14/2019 CO aBINEDtSINGLE LIMIT(Ea $$1,000,000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY (Per accident) A / UMBRELLALIAB ,/ OCCUR CUP8E545094 6/14/2018 6/14/2019 EACH OCCURRENCE $$5,000,000 EXCESS LAB H CLAIMS-MADE AGGREGATE $$5,000,000 DED I ✓ I RETENTION$0 $ C WORKERS COMPENSATION ✓ UB6K139301 6/14/2018 6/14/2019 �/ SPER TATUTE OERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y❑ E.L.EACH ACCIDENT $$1,000,000 OFFICE R/M EMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $$1.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $$1,000,000 D Professional Liability DP002553022018 6/14/2018 6/14/2019 Per Claim:$5,000,000 Aggregate:$5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Projects as on file with the insured. City of EI Segundo, its officials and employees are named as additional insureds and primary/non-contributory clause applies to the general liability policy and a waiver of subrogation applies to the work comp policy-see attached endorsements. CERTIFICATE HOLDER CANCELLATION CIt of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Pu lun ic Works ACCORDANCE WITH THE POLICY PROVISIONS. Attn: John Gilmour 350 Main St. EI Segundo CA 90245 AUTHORIZED REPRESENTATIVE Michael Christian ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 42571001 118-19 GL-AL-UMB-WC-PL Sherry Young 16;15;2018 2:52:13 PM (PDT) I Page 1 of 4 Insured: MNS Engineers, Inc. Policy No. : 6802JO51458 COMMERCIAL GENERAL LIABILITY Effective Date:6/14/2018 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 h. This insurance does not apply to "bodily AN INSURED: injury" or "property damage" caused by "your Any person or organization that you agree in a work" and included in the "products- „written contract requiring insurance"to include as completed operations hazard" unless the an additional insured on this Coverage Part, but: "written contract requiring insurance'", specifically requires you to provide such a. Only with respect to liability for"bodily injury" coverage for that additional insured, and them "property damage" or"personal injury"; and the insurance provided to the additional b. If, and only to the extent that, the injury or insured applies only to such "bodily injury" or damage is caused by acts or omissions of "property damage" that occurs before the end you or your subcontractor in the performance of the period of time for which the "written of "your work" to which the "written contract contract requiring insurance" requires you to, requiring insurance" applies, or in connection provide such coverage or the end of the with premises owned by or rented to you. policy period, whichever is earlier. The person or organization does not qualify as an 2. The following is added to Paragraph 4.a. of additional insured: SECTION IV — COMMERCIAL GENERAL c. With respect to the independent acts or LIABILITY CONDITIONS: omissions of such person or organization; or The insurance provided to the additional insured) d. For "bodily injury" "property damage" or is excess over any valid and collectible other "personal injury" for which such person or insurance, whether primary, excess, contingent or organization has assumed liability in a on any other basis, that is available to the additional insured for a loss we cover. However, if contract or agreement. you specifically agree in the "written contract The insurance provided to such additional insured requiring insurance" that this insurance provided) is limited as follows: to the additional insured under this Coverage Parc e. This insurance does not apply on any basis to must apply on a primary basis or a primary and any person or organization for which non-contributory basis, this insurance is primary coverage as an additional insured specifically to other insurance available to the additional is added by another endorsement to this Insured which covers that person or organizations Coverage Part. as a named insured for such loss, and we will not share with the other insurance, provided that: f. This insurance does not apply to the The "bodily injury" or "property dame e for rendering of or failure to render any y j ry,f g # "professional services" which coverage is sought occurs; and g. In the event that the Limits of Insurance of the (2) The "personal injury" for which coverage is Coverage Part shown in the Declarations sought arises out of an offense committed; exceed the limits of liability required by the after you have signed that "written contract "written contract requiring insurance", the requiring insurance". But this insurance provided) insurance provided to the additional insured to the additional insured still is excess over valid shall be limited to the limits of liability required and collectible other insurance, whether primary, by that "written contract requiring insurance". excess, contingent or on any other basis, that is This endorsement does not increase the available to the additional insured when that limits of insurance described in Section III — person or organization is an additional insured) Limits Of Insurance. under any other insurance. CG D3 81 09 '15 (D 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission 42571001 18-19 GL-AL-UMB-WC-PL I Sherry Young 16;15;2018 2:52:13 PM (PDT) I Page 2 of 4 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8, Transfer 4. The following definition is added to the Of Rights Of Recovery Against Others To Us. DEFINITIONS Section: of SECTION |\/ — COMMERCIAL GENERAL 'Written contract requiring innunmnce" means that LIABILITY CONDITIONS:� pnrt nfany written contract under which you are We waive any hOh1 of recovery we may have required 10include aperson ororganization as an against any person or organization because of additional insured on this Coverage Pmrt, payments we make for "bodily injury'. "property provided that the "bodily injury' and "properly demeg*/' or "personal injury" arising out of ''your dema8*" 000una and the "personal injory'^ is work!' performed by you, or on your behalf, done caused by an offense committed: under a"written contract requiring insurance" with that person or organization. We waive this right m. After you have signed that written cnntnoot� only where you have agreed 1odono as part of b. While that part of the written contract is in the ''vvrU1*n oon1nao1 requiring insurance" with effect; and such person or organization akQnnd by you o. Before the end ofthe 9o|ieypehod� bnfnn*, and in effect when, the "bodily injury" or "property damage" occurs, nrthe "personal injury' offense kscommitted. Page 2of2 (D 2v1nThe Travelers Indemnity Company. All rights reserved. CG D3 81 O915 Includes the copyrighted material n,Insurance Services Office, mn_ with its permission WORKERS COMPENSATION TRAVELERS AND EMPLOYERS LIABILITY ENDORSEMENT WC 99 03 76(00) Insured: MNS Engineers, Inc. Policy No.: U1361<139301 Effective Date: 6/14/2018 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 5.000% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION WITH WHOM YOU AGREE IN WRITING TO WAIVE YOUR RIGHT TO RECOVER AGAINST THEM. YOU MUST AGREE TO THIS WAIVER PRIOR TO THE DATE OF LOSS Job Description: Projects as on file with the insured. Authorized Representative 42571001 18-19 GL-AL-UMB-WC-PL I Sherry Young 16;15;2018 2:52:13 PM (PDT) I Page 4 of 4