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PROOF OF INSURANCE (2019 - 2019) CLOSED DATE(MM/DDIYYYY) . c "'IRR CERTIFICATE OF LIABILITY INSURANCE 6/28/2018 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 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 I NAME: Wigmore Insurance Wigmore Insurance Agency Inc. PHONE H NE (714)979-6543 WPo). t , ,(714)549-2943 p . .......... .... 880 W. 19th St. A¢tOFESI�PDRFS�commercial@wigmoreins.com License #0811959 INSURER(S)AFFORDING COVERAGE NAIO# Costa Mesa CA 92627 INSURERA:Travelers Prop Cas Co of Amer 25674 INSURED I INSURERB:Ohio Security Insurance Co. 2„4,0,82, RTI Consulting, Inc, INSURER C:Hous ton Casualty Company 42734 8325 McConnell Ave. INSURER D: INSURER E: Los Angeles CA 90045 INSURER F: u COVERAGES CERTIFICATE NUMBER:2018 UPDATED 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. INTR !Ab6L'SUSR SMarD POLICY NUMBER IMMIDDIYYYYI IMM UOIYY P.. POLICY EFF LIMITS TYPE OF INSURANCE yYp X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAM+1AGP="16P :t+I'1`E0 - - �r S(E,$r;iriz,yaa;rnn?s)...... $ 00 A CLAIMS-MADE X OCCUR g�}��I"'MISE 1,00,0,,0 X Y 680-9H276593-18-47 3/30/2018 3/30/2019 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY ... ,$.... ......1 000,, .., 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY LOC PRODUCTS COMP/OP AG PR')_ 2,000,000 'OTN° IL .0 OM'BaIs�en,Et,�r,D INGL.E...LIMII��...... ���$ AUTOMOBILE LIABILITY $ 1,000,000 $ B X ALL OWNED SCHEDULED BAS56703349 9/12/2017 9/12/2018 BODILY INJURY�Perpers ANY AUTO BODILY INJURY N on AUTOS %AUTOS Per accident) $ NON-OWNED IDROPERTY DAMAGE $ HIRED AUTOS AUTOS tPe'l a:Gmioe,n,t)................,. ., .... ...... UMBRELLA LIAR .,.. EACH OCCUR- $ ...,, EXCESS LIAB 'IgyN' CLAIMSMADE AGGREGATE $..OCCURRENCE.... PED I ( RETENTION$ I $ W . ORKERS COMPENSATION X u P,ER LITE.,�.l„�,�,�,�,LOT ANY PROPRIETOR/PARTNER/EXECUTIVE H....... AND EMPLOYERS'LIABILITY YIN * (Mandatory in NH) N/A E.L.EACH ACCIDENT 11 Y UB-5K37391A-18-47-G 6/1/2018 6/1/2019 E.L.DISEASE-EA EMPLOYEE $ 11000,000 00 OFFICER/MEMBER EXCLUDED? describe under DIf ESCRIPTION OF OPERATIONS below E,L,DISEASE-POLICY LIMIT $ 1,000,000,,,,, C Professional Liability HCC1822602 6/25/2018 6/25/2019 $1,000,000 Each Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ;CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER SCHEDULED ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) FORM CG D3 82 09 15. THIS ENDORSEMENT INCUDES WAIVER OF RIGHTS OF RECOVERY LANGUAGE WHEN REQUIRED BY CONTRACT OR AGREEMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 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 �,„.... ....., ._. ,,mss.M+ ,;��,,,,•”"-" Timothy Wi9more/G128 �,•, ".._, ,..,. ,,�,. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) COMMERICAL GENERAL LIABILITY 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 A. The following is added to WHO IS AN INSURED INSURANCE (Section 111) for this Coverage (Section 11): Part. Any person or organization that you agree in a B. The following is added to Paragraph a. of 4. "contract or agreement requiring insurance"to in- Other Insurance In COMMERCIAL GENERAL ctude as an additional insured on IhIs Coverage LIABILITY CONDITIONS(Section IV): Part, but only with respect to liability for"bodily in- However,if you specifically agree in a'contract or jury", "property damage" or "personal injury" agreement requiring insurance' that the insurance caused, in whole or in part, by your acts or ornis• provided to an additional insured under this Cov- sions or the acts or omissions of those acting on erage Part must apply on a primary basis, or a your behalf: primary and non-contributory basis,this insurance a, In the performance of your ongoing opera- is primary to other insurance, that Is available to tions; such additional insured which covers such addi- lb. In connection with premises owned by or tional insured as a named insured,and we will not rented to you;or share with the other insurance,provided that: c. In connection with "your work" and included (1) The "bodily injury" or "property damage' for within the "products-completed operations which coverage iksou gfit occurs;and hazard*. (2) The "personal injury" for which coverage is Such person, or organization does not quality as sought arises out of an offense committed; an additional insured lot 4bodily injury", "'property after you have entered into that "contract or damage" or "personal Injury" for which that per- agreement requiring insurance'. But this Insur- son or organization has assumed liability in a con. ante still is excess over valid and collectible other tract or agreement insurance,whether primary,excess,contingent or The insurance provided to such additional insured on any other basis,that is available to the insured Is limited as follows: when the Insured is an additional insured under d. This insurance does not apply on any basis to any other insurance. any person or organization for which cover- C. The following is added to Paragraph 8, Transfer age as an additional insured specifically is Of Rights Of Recovery Against 00iers, To Us added by another endorsement to this Cover- in COMMERCIAL GENERAL LIABILITY CON. age Part. DITIONS(Section IV): a, This Insurance does not apply to the render We waive any rights of recovery we may have Ing of or failure to render any "professional against any person or organization because of services"- payments we make for "bodily Injury", *property f. The limits of insurance afforded to the addi- damage" or"personal injury" arising out of "your Itonal Insured shall be the limits which you work"performed by you,or on your behalf, under agreed In that "contract or agreement requIr. a'Contract or agreement requiring insurance"with Ing insuranceto provide for that additional that person or organization. We waive these insured, or the limits shown in the Declara- rights only where you have agreed to do so as tions for this Coverage Part, whichever are part of the"contract or agreement requiring insur- less, This endorsement does not increase the ante" with such person or organization entered limits of insurance stated in the LIMITS OF into by you before, and in effect when,the"bodily CG ID3 8109 OT 0 2007 The Travelers Companies,Inc. Page 1 of 2 Incluoss the copyrighteo material of Insurance services Office,Inc,with Its permission, COMMERICAL GENERAL LIABILITY injury"or"property damago" occurs, or the*Per- erage Part, provided that the "bodily injury" and sonal lr4ury"offonso is committed. "property damage" occurs, and the 'personal In- D. The following definition is added to DEFINITIONS jury"is caused by an offense committed! (Section V): a. After you have entered into that contract or "Contract or agreement requiring insurance' agreement; means that part of any contract or agreement un- b. While that part of the contract or agreement is der which you are requirod to Include a person or in effect;and organization as an additionai Insured on this Cov- c. Before the end of the policy period. Page 2 of 2 0 2007 The Travelers Companies,Inc. CG D3 8109 07 includes the copyrighted material of insurance services office,Inc..vAth its permission. COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 680-9x276593-18-47 ISSUE DATE: 01/29/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULED ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSONS OR ORGANIZATIONS: THE CITY OF EL SEGUNDO 350 MAIN STREET EL SEGUNDO CA 90245 PROJECT/LOCATION OF COVERED OPERATIONS: OPERATIONS OF NAMED INSURED PROVISIONS 1. The following is added to SECTION II — WHO IS e. This insurance does not apply to the AN INSURED: rendering of or failure to render any The person or organization shown in the "professional services". Schedule above is an additional insured on this f. In the event that the Limits of Insurance of the Coverage Part, but: Coverage Part shown in the Declarations a. Onlywith respect to liability for "bodily exceed the limits of liability required by the p y y injury , written contract requiring insurance", the "property damage"or"personal injury"; and insurance provided to the additional insured b. If, and only to the extent that, the injury or shall be limited to the limits of liability required damage is caused by acts or omissions of by that "written contract requiring insurance". you or your subcontractor in the performance This endorsement does not increase the of "your work" to which the "written contract limits of insurance described in Section III — requiring insurance" applies, or in connection Limits Of Insurance. with premises owned by or rented to you. g. This insurance does not apply to "bodily The person or organization does not qualify as an injury" or "property damage" caused by "your additional insured: work" and included in the "products- completed operations hazard" unless the c. With respect to the independent acts or "written contract requiring insurance" omissions of such person or organization; or specifically requires you to provide such d. For "bodily injury", "property damage" or coverage for that additional insured, and then "personal injury" for which such person or the insurance provided to that additional organization has assumed liability in a insured applies only to such "bodily injury" or contract or agreement. "property damage"that occurs before the end of the period of time for which the "written The insurance provided to such additional insured contract requiring insurance" requires you to is limited as follows: provide such coverage or the end of the policy period, whichever is earlier. CG D3 82 09 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission COMMERCIAL GENERAL LIABILITY 2. The following is added to Paragraph 4.a. of 3. The following is added to Paragraph 8., Transfer SECTION IV — COMMERCIAL GENERAL Of Rights Of Recovery Against Others To Us, LIABILITY CONDITIONS: of SECTION IV — COMMERCIAL GENERAL The insurance provided to the additional insured LIABILITY CONDITIONS: shown in the Schedule above is excess over any We waive any right of recovery we may have valid and collectible other insurance, whether against the additional insured shown in the primary, excess, contingent or on any other basis, Schedule above because of payments we make that is available to the additional insured for a loss for"bodily injury", "property damage" or "personal we cover. However, if you specifically agree in the injury" arising out of "your work" on or for the "written contract requiring insurance" that this project, or at the location, shown in the Schedule insurance provided to the additional insured above, performed by you or on your behalf, done under this Coverage Part must apply on a primary under a "written contract requiring insurance" with basis or a primary and non-contributory basis, this that person or organization. We waive this right insurance is primary to other insurance available only where you have agreed to do so as part ofthe "written contract requiring insurance" with to the additional insured which covers that person such person or organization signed by you or organization as a named insured for such loss, before, and in effect when, the "bodily injury" or and we will not share with the other insurance, "property damage" occurs, or the"personal injury" provided that: offense is committed. (1) The "bodily injury" or "property damage" for 4. The following definition is added to the which coverage is sought occurs; and DEFINITIONS Section: (2) The "personal injury" for which coverage is "Written contract requiring insurance" means that sought arises out of an offense committed; part of any written contract with the person or after you have signed that "written contract organizations shown in the Schedule above, under which you are required to include that requiring insurance". But this insurance provided person or organization as an additional insured to the additional insured still is excess over valid on this Coverage Part, provided that the "bodily and collectible other insurance, whether primary, injury" and "property damage" occurs and the excess, contingent or on any other basis, that is "personal injury" is caused by an offense available to the additional insured when that committed: person or organization is an additional insured a. After you have signed that written contract; under any other insurance. b. While that part of the written contract is in effect; and c. Before the end of the policy period. Page 2 of 2 ©2015 The Travelers Indemnity Company.All rights reserved, CG D3 82 09 15 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission i011k WORKERS COMPENSATION TRAVELERS J AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-5K37391A-18-47-G 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR ENGINEERS WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. INCLUDING: 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. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 04-09-18 ST ASSIGN: Page 1 of i