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PROOF OF INSURANCE (2019) CLOSED Client#: 1266412 305FLEMIENV ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) x8/3012018 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 endorsrrd. 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 any rights to the certificate holder in lieu of such ondorsemenl(s), PRoouc I u CONTACT rr_a Ex) 714 941.2900 --------- �r NAME: Allie Mosier BUT Insurance Services PPIONE (N, 877-297-1116 of Orange County E•MA14." )` A1C'Na); 2400 E Katella Ave Suite 1100 ADn9ESs: amosler bhandt.com Anaheim,CA 92806 FNSURER(8J±ff2RPy4G COVERAGE NAIC# INSURER A:Homeland Insurance Company of New York 34452 INSURED INSURER B:Redwood Fire and Casualty Insurance Co. 1167.3 FlemingEa Valencia Inc. INSURERC:rravelersProperty cesualtyCoofAmor 25674 1372 East Valencia Drive '- W-°� ....w..... INSURER D:American Automobile Insurance Ca .....�......�...... . 21849 Fullerton,CA 92831 INSURER E: I 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 CONTRACTOR 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 3Y PAID CLAIMS. —I TYPE Or .- AUDL SUB" POLIC 'E°p'F POLICYEXP " INSR VJVD POLICY NUMBER J LIMITS iMMrDD YYYY) MM„f,�D1YYYY, AL LIABILITY 79300505600D2 09/01/2018 0510112019 EACHOCCURRENCE $1fQl0a,aaa COMMERCIAL GENERAL � �� ) _.. - DAMAGE A RENTED CLAIMS-MADE X OCCUR PR M1SE9�. aS!ccarrenrz 000 O00 Pollution Liab MEDEXP_(Any one ints*n) $10,000 X' Professional Liab PERSONAL SADV INJURY x1,000,000 GEN'�O GREGATE LIMIT CY1 JECT s2,aOO,OOa PRO-APPLIES PER: GENERAL AGGREGAT DLE $ AUTOMOBII L LOC CTS-COMP/OP AGG s2,000,000 MXA80334818 09!0112018 05l0112m1-�"�ri�Ir�E�s�T't�e�tEut:wtiwi°° m...... Inelury �019 idunll �$1,000,000 X ANYAUTO BODILY INJURY(Per person) Is ” OWNED SCHEDULED NJURY(Peraccidenl) $ AUTOS ONLY AUTOS BODILY I HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY ,PeraCCid_P.nl1 $ UMBRELLA LIAR EXCESS ESS LIAR X ,p1t,,,,, OCCUR 7930050570002 0910112018 0510112019 EACH OCCURRENCE $5 0a010D0 X EX CLAIMS-MADE AGGREGATE $5,000,,000 — DEJ4RETENTIONSO .. ....... B WORKERS O EMPLOYERS'NATION.. .. .. FLWC909190 0................................. STA]T�UIE._-,..,...,N � ��....................m,...,._. s BILITY` 't ttlaN'V 5101!2078 0510112019,X PER OERTH- tWOR1K RdSMCOMPENX tUtdLDI NI NIA E.L.EACH ACCIDENT $1,000,000 ANY rRnPRpETr�, (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1.000,000 If under . .Edescribe DSCRPDQN,.OF .......... E.L.DISEASE-DOL.ICY LIMIT $1,000,000 C Rented/Leased QT6603L337320TIL18 9101/2018 05/01/2019 $160,000 Limit Equipment $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 161,Additional Remarks Schedule,may be attached It more space Is required) The City of EI Segundo,its officers,officials,employees,agents and volunteers are named as additional insured as respects general liability,this Insurance Is primary and noncontributory with any other insurance of the additional insured;and waiver of subrogation applies as respects workers compensation as required by written contract,per endorsements attached. (See Attached Descriptions) CER'T'IFICATE HOLDER CANCELLATION Cit f EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City ogunTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS, 150 Illinois Street El Segundo,CA 90245 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD #S209123981M20912372 ACMOS DESCRIPTIONS (Continued from Page 1) Should any policy be cancelled before the expiration date,BB&T Insurance Services will mail 30(thirty) days written notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non-payment of premium. i SAGITTA 25.3(2016103) 2 of 2 #S20912398IM20912372 PolicfNumbor793'O0-50'56'00O2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ|TCAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION _ FORM I This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name ofPerson orOrganization. – Any person or organization for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (If noentry appears above, information required tncomplete this mndormmnmen1 will be shown in the Qmdamadoma aoapplicable hothis ondomomontj � A. SECTION 8 –VVMO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE mbowa, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect\othe insurance afforded to1hamemdditiona|inxumUo.thefol|mwingoxuuuionisaddod� o. Exclusions This insurance does not apply to bodily [n]ory, property domo8o or environmental damage occurring after: (o) All work, including do equipment � � on the project n service, maintenance orrepairs) to be performed bymon / behalf of the additional insured(s) at the site of the covered operations has been � completed;or M That portion ofyour work out of which the injury or damage ahnoo has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a pert of the same project. All other terms and conditions remain the same. oosmvosxm1(0u11) Includes copyrighteumatena|ofInsurance Services Office,Inc. 1ur1 Copyright uo11.onooeauonInsurance Group LLC e'|wounso Fleming Environmental Inc. Policy Number: 793-00-50-56-0002 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY ENDORSEMENT This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IV-CONDITIONS, S.Other Insurance, is amended by adding the following paragraph: This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement,that this insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same. V OBENV GE 319(02 11) Includes copyrighted material of insurance Services Office,Inc. 1 of 1 Copyright,OneBeacon Insurance Group,2011 Policy Number:793-00-50-56-0002 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): I Location And Description Of Completed Operation S" Any person or organization for which the Any location or completed operation, but Named Insured has agreed to provide only to the scope of insurance agreed to insurance prior to loss as provided by by the Named Insured, this policy but only to the scope of insurance agreed to by the Named Insured, (If no entry appears above, information regtiirod to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the SCHEDULE above, but only with respect to liability for bodily injury, property damage or environmental damage caused, in whole or in part, by your work at the location designated and described in the SCHEDULE above performed for that additional insured and included in the products- completed operations hazard. All other terms and conditions remain the same. OBENV GE 304(02 11) Includes copyrighted material of Insurance Services Office,Inc. 1 of 1 Copyright 2011,OneBeacon Insurance Group LLC E-INSURED WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410B (Ed.9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have theright 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 appiies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shail be 2%of the total manual premium otherwise due on such remuneration.The minimum premium for this endorsement is$360. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver—Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations This endorsement changes the policy to which it is attached and is effective an the date issued unless otherwise stated. (The Information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 05/01/2018 Policy No. FLWC909190 Endorsement No. Insured Premium$ Insurance Company Redwood Fire and Casualty Co Countersigned by WC 99 04 10121 (Ed.9-14)