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PROOF OF INSURANCE (2018 - 2019) CLOSED CERTIFICATE OF LIABILITY INSURANCE DATE6/2120 8YYY) 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 ADDG';fii IONAL INSURED provisions or be ondorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this w certificate does not confer rights to the certificate holder in lieu of such ender'sement(s), c PRODUCER CONTACT' 0) Aon Risk services Northeast, Inc., NAME` — ........................ . Aon Risk Services Northeast, Inc. (AIC.No.Ext): 866-283-7122 FAX (800) 363-0105 y CAet:.No.); ................ww.-. NY NY Office E-MAIL 199 water Street ADDRESS: _ New York NY 10038-3551 USA """ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Hartford Fire Insurance Co, 19682 EMG INSURER ............... .. Inrance Company 3010461 104 IT. w_ tford underwriters S w..0 Owings MMills ill uMDC21117 USA INSURER 1100 INSURER a Allianz Global Risks us insurance Co. 35 INSURERD................ ....._............. ......_........._.......... . M................ .,.,.,.,.,.,.,.,.,.www �....,.,.,.,.,. INSURER E: SURER F: COVERAGES CERTIFICATE NUMBER: 570071892395 REVISION NUMBER: THIS IS TO CERT"'IFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDNAMED ABO'VC 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- Limits shown are as requested dNS1Y A'SEL S'UB�'{ �Pi'mDrLICY Ey POLICY Y:XP EACH OCCURRENCE LCR COMMERCIAL GENERAL LIABILITY INSLN U MYDDdY'YYY 1/01/2019 S TYPE OF INSURANCE LCaL2OYOy/�ICY,NUMBER 3/Ol/LU1�G�/Ul/2019 LIMIT $2,000,000 .,... CLAIMS-MADE II X I OCCUR ..l)AWAGE"10 RENT hL;—­­ . .....— ;...................-....................— !! u_M PREMISES,,,,,,occurence) $1,000,000 _.....-,.,...... .ES-(Ee.............................. .,................. MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $2,000,000 m G ENL LLrDGATL LIMITAPPLIES S PER GENERALAGGREGATE mm............ $2,000,000 POLICYPRO- m EJECT X.]LOC PRODUCTS-COMP/OPAGG $2,000,000 m OTHER r 0 0 r` A AUTOMOBILE LIABILITY 10 AB 541202 03/01/2018 01/01/2019 COMBINED SINGLE LIMIT $2�QOO,000 � AOS _!Fa accident) B X ANYAUTO 10 AB 541203 03/01/2018 01/01/2019 BO 0 BODILY INJURY(Per person) OWNED 'SCHEDULED HI BODILY INJURY(Per accident)denl) d AUTOS ONLY ",",",",_I;AUTOS ,. .,,,,,,_,,,,,,,,, r tD HIRED AUTOS NON-OWNED PROPERTY DAMAGE V ..— ONLY ,,,,, AUTOS ONLY (Per accident) C X UMBRELLALIAB X OCCUR ULA2011067 03/01/2018 01/01/2019U EACH OCCURRENCE $1,000,00011 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000" .,.,..,..,. .._........_....._..., ............W Www_ (DED X RETENTION$10,000 WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS'LIABILITY Y P N _ FR, ANY PROPRIETOR/PARTNER/EXECUTIVE �"""' E.L.EACH ACCIDENT OFFICE JMEMBER EXCLUDED? II II NIA 4 U (Mandatory in NH) -- E .DISEASE-EA EMPLOYEE If as,denclibe under ._...,�....,_ OnCRI'PTION OF OPERATIONS toi4cwn E L DISEASE-POLICY LIMIT C Archit&Eng Prof PPL2011144 03/01/2018(01/01/2019 Each claim $1,00'0,00'0 SIR applies per policy terns & condit(ions Aggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedufa,may be attached if more space is required) The Architects & Engineers policy includes coverage for Professional Liability and Contractors Pollution Liability. city of El Segundo, its officials and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of El Segundo -AUTHORIZED REPRESENTATIVE Ken Berkman 350 Main Street El Segundo CA 90245 USA Q 6 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CGL 2010971 COMMERCIAL GENERAL LIABILITY 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 Organization(s) Location s)Of Covered Operations Any owner, lessee or contractor for whom Locations that are listed in the written you are performing operations when you contracts or agreements stated on the left and such owner, lessee or contractor have side of this SCHEDULE. agreed in writing in a contract or agreement that such owner, lessee or contractor should be added as an additional insured on your policy. 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 with respect to liability for "bodily injury", "property will not be broader than that which you are damage" or "personal and advertising injury" required by the contract or agreement to caused, in whole or in part, by: provide for such additional insured. 1. Your acts or omissions;or 2. The acts or omissions of those acting on your B. With respect to the insurance afforded to these behalf; additional insureds, the following additional in the performance of your ongoing operations for exclusions apply: the additional insured(s) at the location(s) This insurance does not apply to "bodily injury" or designated above. "property damage"occurring after: However: 1. All work, including materials, parts or 1. The insurance afforded to such additional equipment furnished in connection with such insured only applies to the extent permitted by work, on the project (other than service, law; and maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 10 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 2. That portion of "your work" out of which the 2. Available under the applicable Limits of injury or damage arises has been put to its Insurance shown in the Declarations; intended use by any person or organization other than another contractor or subcontractor whichever is less. engaged in performing operations for a This endorsement shall not increase the principal as a part of the same project. applicable Limits of Insurance shown in the Declarations. C. 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 Page 2 of 2 ©Insurance Services Office, Inc.,2012 CG 20 10 04 13 POLICY NUMBER: CGL 2010971 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 �p SCHEDULE Name Of Additional Insured Person(s) _w Or Organization(s) Location And Description Of Completed Operations Any owner, lessee or contractor for whom you are Locations that are listed in the written contracts or performing operations when you and such owner, agreements stated on the left side of this SCHEDULE, lessee or contractor have agreed in writing in a contract or agreement that such owner, lessee or contractor should be added as an additional insured on your 221LICY. 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: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and CG 20 37 04 13 ©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 ©ISO Properties, Inc.,2004 CG 20 37 07 04 ❑ CERTIFICATE OF LIABILITY INSURANCE 1M/DD 06/2s/2o16/YYYY) o6/z 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't 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 1-617-391-0245 CONTACT _ -- - -- -- Green Insurance Exchange, LLC PH)ON�EE "'.. ............... .... ......,........................__ .. FAX JAIC,Nol: 15 Broad Street E-MAIL Suite 200 A„q„D,, ESS; ................. ..... ............... ........................... Boston , MA 02109 ,,,,,,,,,,, INS RE AFFORDING COVERAGE NAIC# INSURER A: GREAT DIVIDE INS CO 25224 IN......... m ........,, _ SURED . EMG INSU B INSURER C: ..................... ............................... .......,,, 10461 Mill Run Circle INSURERD: Suite 1100 Owings Mills, MD 21117 INSURENE: INSURER F COVERAGES CERTIFICATE NUMBER: 53164091 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. INSI2 %arimD POLICY NUMBER I'MMPOWYYYY'6 1'INMM11 FF 0DrYYYY'1 LIMITS..........., LTR TYPE OF INSURANCE �' UP GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL L_IABILITY MEFMISES Fa ncr .,un-e c—, „$ _ CLAIMS 0 MADE OCCUR o PERSONAL&ADV NJURY...........$... �, -... GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ ^1 POLICY'p. ..�I�"O. I LOC .... ... ..,.$.... - - AUTOMOBILE LIABILITY COMBINED SINGLE LIMITffapcci ' ANY AUTO BODILY dIINJIURY(Per person) $... ....................... . - —... IN......... ................................................. -- ALL OWNED SCHEDULED AUTOS AUTOS BODILY JURY(Per accident) $ NON-OWNED HkOPf...,1aa. �AM;A� _ ., c.,n+T dq' ... ......,.., HIRED AUTOS AUTOS --._..�^,�,-.� $ $ UMBRELLA LIAB EACH ...........URRENCE $ EXCESS LIAB JOCCURAIM -MADE EEACH OCCCLS ^....AGGREGATE $ DEDENTION$pp RET ---........................ $. .................................. ---- I' A WORKERS COMPENSATION WCA2012615-14 - AZ 09/03/1; 09/03/18 X� WCSTATU- I �OTH YIN A OFFICER/MEMBER EXCLUDED? u... i N/A 09/03/1. E.L.DISEASE EACH AC TQRYLIMIDENT ----1,000,000 WCA2012614-14 AOS 09 ANY EMPLOYERS' A BILITYEXECUTIVE /03/18 A C (Mandatory in NH) 1,000,000.. ................................ If yes,describe under A EMPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance 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 ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE �/�/f E1 Segundo, CA 90245 0�_/�/ � � USA F= ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD MWing 53164091 Policy#WCA2012614-14 Effective:09/03/2017--09/03/2018 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 04 84 WAIVER OF OUR RIGHT" TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any Principal wherein such waiver has been included before loss as part of a contractual undertaking by the Named Insured. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri,this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. WC 00 03 13 04 84 © 1983 National Council on Compensation Insurance Page 1 of 1