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PROOF OF INSURANCE (2019 - 2019) CLOSED EAR
RHALAND-01 ...................... (. .O.
TE
ACORO' CERTIFICATE OF LIABILITY INSURANCE DA10/11616//22018018 Y)
1
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
her 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 cm
... confer ri8hts to the certificate holder in lieu of such endorsement(s).
mmmm
PRODUCER License#0757776 TACT Jennifer Housel
N 'E
HUB International Insurance Services Inc. PHONEFAX
PO Box 5345 IWC„No,ExO:(951)779-8581 INC.No'I,(9'5'1)231-2572
Riverside,CA 92517 E-MAIL ApI�'�E'S$�: �cal c hubinternational.com
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INSURER(S)AFFORDING COVERAGE NAICV
INs'u,FIEA: r" Insurance Company' 21857
Thp American
INSURED INSURER B, Security'National Insurance Company(Am Trust( 19879
�R
RHA Landscape Arch itects-Planners,Inc. INSURER call
CirteratCasUa,lty Compa,rly 20443
trn .
6800 Indiana Ave,Ste 245 INSURER D
Riverside,CA 92506
INSURER E
INSURER F'.
... w_�.w.......-__..-.. -..w.... . ..........................
COVERAGES CER'T'IFICATE NUP9IBER: REVISION NUMBER:
......�.__,�m.
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 NUMBER POLICY EFF POLICY EXP LIMITS
T, I .$1„?WF'VO (MMIDDIYYYYI IMMIDD/YYYYI_ „www„ .,
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE ii 2,000,000
CLAIMS-MADE X OCCUR �AZC80881836 02/03/2018 02/03/2019 �'A';�nF`¢rl �t.7RLNI"II.t 100,000
X Ni°l„Ilnl'y'W [I,dl tu'etrrly;r:;b $
MED EXP(Any one,person) ;S 10,000
PERSONAL&ADV INJURY $ 2,000,000
C',E',N; AGr,'SAEGdA�T'L I INII F I#PPCJES III::H GENERAL AGGREGATE $ 4,000,000
X POLICY JECT
PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000
_ OT'H'ER $
A AUTOMOBILE LIABILITY (,Ir,?,dlY'!)SIIVGI I IMI/I �.w.........................2,000,000
ANY AUTO AZC80881836 02/03/2018 02/03/2019 1 BODILY INJURY(rlc,p!DDsrrn) S
OWNED SCHEDULED
AUTOS ONLY AUTOS I3DDII-Y IINJUI Y II-Tei acx;i(,tr;ripY S
X HIRED X NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) „5
S
UMBRELLA LIAB OCCUR EACH OCCUIiItI.,MCC S
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DI 1) RETENTION S $
................................._.,—...............___........................................................ .,.....................
B WORKERS COMPENSATION X
TIN X .STATUTE FR
' ...,,,�
AND EMPLOYERS'LIABILITY SWC1203057 08/21/2018 08/21/2019 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED? N NIA 1,000,000
(Mandatory in NH) 1
{= L'il:i C.:A;>C. C.,A{,�IVIIrI„t'_YI:I� S
If yes,describe under 1,000,000
,.,.,..... D .. OF OPERATIONS below h 1. UI:�;I,ASI;: 1-'()LICY LIM11 $ „_.................
C Professional Liab LAH003011898 08/06/2018 08/06/2019 Each Claim 1,000,000
C PROF DED:$15,000 ILAH003011898 08/06/2018 08/06/2019 Aggregate 2,000,000
..,,'-,..........-
DESCRBPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be a'I�tac'hed if more space Is required)
Updated 10/16/2018 This certificate supersedes any and all prior certificates issued on'behalf of the named Insured.
RE:Recreation Park,401 Sheldon Street,EI Segundo,CA.
The City of EI Segundo,its officers,officials,employees,agents,and volunteers are Additional Insured with regard to the General Liability policy when
required by a written contract,per the attached endorsement form AB9189 08/07,Primary and Non-Contributory included.Waiver of Subrogation with regard
to the Workers Compensation policy applies when required by a written contract,per the attached endorsement form WC040306 04184.
...............................w.... ...............,................................._..........._.,.,....-....................................._...........................................................................................................................................................
CERTIFICATEHOLDE. ....... ......................................._ .............................._._CANCELLATION, ....................................................................................._..-..-..-..-....�
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Cit Of EI Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y 9 ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
EI Segundo,CA 90245
AUTHORIZED REPRESENTATIVE
....................................................................................................................................................................................................... ......
ACORD 25 2016/03 ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
RHA Landscape Architects-Planners,Inc.
Policy Number:AZC80881836
Policy Term:02/03/2018 to 02/03/2019
ABC MultiCover - AB 91 89 08 07
This endorsement modifies insurance provided under the following:
American Business Coverage
Your policy is broadened and clarified as follows: permanent lodging, or premises by or at
1. Non Employment Discrimination Liability the direction of any insured; or
(13) Arising out of discrimination, if insurance
Unless Personal Injury or Advertising Injury is thereof is prohibited by law; or
excluded from this policy:
(14) Pines, penalties, specific performance, or
A. Section III - Definitions, Item 17. Personal injunctions levied or imposed by a go-
Injury is amended to include: vemmental entity, or govemmental code,
f. Discrimination law, or statute because of discrimination
B. Section III - Definitions, Item 2. Advertising 2. Blanket Additional Insured
Injury is amended to include: Section II - Liability Coverage, Part I. Who Is An
e. Discrimination Insured, Item 2. is amended to include:
f. Any person or organization that you are re-
C. Section Ill - Definitions is amended to in quired by a written insured contract to include
cludo as an insured, subject to all of the following
30. Discrimination means the unlawful treat- provisions:
ment of individuals based on race, color, (1) Coverage is limited to their liability aris-
ethnic origin, gender, religion, age, or ing out of:
sexual preference.
D. Section II - Liability Coverage, Part H. Ex- (a) the ownership, maintenance or use
of that part of the premises, or land
elusions, Item Lp Personal Injury or Adver- owned by, rented to, or leased to
tising Injury is amended to include: you; or
(11) Arising out of discrimination directly or (b) your ongoing operations performed
indirectly related to the past employ- for that insured; or
ment, employment or prospective em-
ployment of any person or class of (c) that insured's financial control of
persons by any insured; or you; or
(12) Arising out of discrimination directly or (d) the maintenance, operation or use
indirectly related to the sale, rental, lease by you of equipment leased to you
or sub-lease or prospective sale, rental, by such person(s) or organization(s);
lease or sub-lease of any dwelling, or
This Donn must be attached to Change Endorsement when issued after the policy is written.
One of the Fireman's Fund Insurance Companies as named in the policy
A.
seal a y President
AB9169 6-07
Page 1 of 6
(e) a state or political subdivision per- assumption of liability in a contract
mit issued to you. or agreement. This exclusion does
not apply to liability for damages
(2) Coverage does not apply to any occur- that the vendor would have in the
rence or offense: absence of the contract or agree-
(a) which took place before the exe- ment;
cution of, or subsequent to the b. Any express warranty unauthorized
completion or expiration of, the by you,
written insured contract. or
(b) which takes place after you cease to C. Any physical or chemical change in
be a tenant in that premises. the product made intentionally by
the vendor;
(3) With respect to architects, engineers, or d. Repackaging, unless unpacked solely
surveyors, coverage does not apply to
Bodily Injury, Property Damage, Per- for the purpose of inspection, dem-
onstration, testing, or the substi-
sonal Injury or Advertising Injury arising tution of parts under instructions
of the rendering or the failure to
render any professional services by or for from the manufacturer, and then re-
you including: packaged in the original container.
a The preparing, approving, or failing, C. Any failure to make such in-
(') P P' b• PP c
to prepare or approve maps, draw- spcctions, adjustments, tests or str-
ings, opinions, reports. surveys, viein�" as the vendor has agreed to
change orders, designs or specifica- make or normally undertakes to
tions; and make in the usual course of busi-
ness, in connection with the distrib-
(b) Supervisory. inspection, or engi- ution or sale of the products;
neering services.
f. Demonstration. installation. servic-
lf an Additional Insured endorsement is attached ing or repair operations, except such
to this policy that specifically names a person or operations performed at the vendor's
organization as an insured, then this coverage does premises in connection with the sale
not apply to that person or organization. of the product;
3. Blanket Additional Insured for Vendors g. Products which, after distribution
or sale by you, have been labeled or
Unless the Products-Completed Operations Hoz- relabeled or used as a container, part
and is excluded from this policy. Section 1I - Li- or ingredient of any other thing or
ability Coverage, Part I. Who is an Insured Item substance by or for the vcndor.
2. is amended to include:
2. This insurance does not apply to any in-
g. Any vendor but only with respect to Bodily cured person or ori*anization, from
Injuryor Property Damage arising out of your whom you have acquired such products.
products which are distributed or sold in the
regular course of the vendor's business, sub-
or any ingredient, part or container. en-
ject to the following additional exclusions: tering into, accompanying or containing
such products.
1. The insurance afforded the vendor docs
not apply to: If an Additional Insured - Vendors endorsement
is attached to this policy that specifically names a
,�. Bodily Injury or Property Damage person or organization as an insured, then this
for which the vendor is obligated to coverage docs not apply to that person or organ-
pay damages by reason of the ization.
AB9189 8-07
Page 2 of 6
4. Blanket Waiver of Subrogation before you acquired or formed the or-
`*anization;
Section II - Liability Coverage, Part K. Liability
and Medical Pavments General Conditions, is (c) Coverage C does not apply to personal
amended to inclu&: injury, or advertising injury arising out of
an offense committed before you ac-
6. Transfer of Rights of Recovery Against Oth- quired or formed the organization.
ers to us and Blanket Waiver of Subrogation
6. Medical Payments
a. If the insured has rights to recover all or
part of any payment we have made under Unless Coverage D. Medical Payments is excluded
this Coverage Part, those rights are from this policy:
transferred to us. The insured must do
nothing after loss to impair those rights. A. Section II - Liability Coverage, Part H. Ex-
At our request. the insured will bring suit elusions, Item 2.f. is replaced with:
or transfer those rights to us and help its f Included within the products-completed
enforce them. operations hazard. However, this exclu-
b. if required by a written insured contract. sion docs not apply to expenses for den-
we waive any right of recovery we may tal services.
have against any person or organization B. Section II - Liability Coverage, Part G. Cov-
because of payments we make for injury erage, Item 2.. is amended to include:
or damage arising out of your operations
or your work for that person or organ- C. Coverage D. Medical Payments is pri-
7iition• mary and not contributing with an_y
other insurance, even if that other insur-
ance is primary also.
Section H - Liability Coverage, Part I. Who Is An 7. Tenant's Legal Liability
Insured Item 4. is replaced with:
A. Section III - Liability Coverage, Part J. Li-
4, All of your subsidiaries. companies, corpo- ability and Medical Payments Limits of In-
rations, firms, or organizations, as now or suranee, Item 3. is replaced with:
hereafter constituted, qualify as Named In-
sured under this policy if: 1 The most we will pay under Coverage C
- Liability for damages because of prop-
(a) you have the responsibility of placing in- erty damage to premises while rented to
in-
surance for each such entity; and you. temporarily occupied by you with
(b) coverage for the entity is not otherwise the permission of the owner, or managed
more specifically provided; and by you under a written agreement with
the owner:
(c) the entity is incorporated or organized
under the laws of the United States of a.. arising out of any Covered Cause of
Loss shall be the greater of:
America.
But each entity is insured only while you (1) $1,000,000; or
own, during the policy period, a controlling (2) The Tenant's Legal Liability
interest in such entity of greater than 50% of limit shown in the Declarations.
the stock or assets. However:
S. Chartered Aircraft
(a) Coverage tinder this provision is afforded
only until the end of the policy period, Section II - Liability Coverage, Coverage C, Part
or the 12 month anniversary of the policy H. Exclusions, Item 1.g. is amended to include:
inception date, whichever is earlier,
(5) An aircraft in which you have no ownership
(b) Coverage C does not apply to bodily in- interest and that you have chartered with
jury or property damage that occurred crew.
AB9189 6-07
Page 3 of 6
9. Coverage Territory Broadened Payments Definitions, Items 17.b., d. and e. are
replaced with:
Section III - Definitions, Item 5.a. is replaced with:
a. The United States of America (including its U, Malicious prosecution or abuse of process;
territories and possessions), Puerto Rico, Ca- d.. Oral, written, televised or videotaped publica-
nada, Bermuda, the Bahamas, the Cayman tion of material that slanders or libels a person
Islands and the British Virgin Islands. or organization or disparages a person's or
10. Broadened Advertising Injury organization's goods, products or services,
Unless Advertising Injury is excluded from this c. Oral, written, televised or videotaped publica-
policy: tion of material that violates a person's right
of privacy;
A. Section III - Definitions. Item 2. is replaced
with: 12. Broadened Personal or Advertising Injury
2, Advertising Injury means injury arising Unless Personal Injury or Advertising Injury is
out of one or more of the following of- excluded from this policy. Section I1 - Liability
fenses: Coverage, Coverage C, Part H. Exclusions, Item
I.p.(4) Exclusions is deleted in its entirety.
a, Oral, written, televised or videotaped
publication of material that slanders 13. Fellow Employees Coverage
or libels a person or organization or
disparages a person's or organiza- Section II - Liability Coverage, Part I. Who Is an
lion's goods, products or scnZiccs; Insured Item 2.a.(l) is amended as follows:
b. Oral, written, televised or videotaped (1) Personal Injury to you or to a co-employee
publication of material that violates while in the course of his or her employment,
a person's right of privacy, or the spouse. child, fetus, embryo, parent,
brother. sister or any member of the house-
c, Misappropriation of advertising hold of that employee or co-employee as a
ideas or style of doing business; or consequence of such Personal Injury, or for
any obligation to share damages with or repay
d. Infringement of trademark, copy- someone else who must pay damages because
right, title or slogan. of the injury;J ry: or
B. Section II - Liability Coverage, Coverage C, 14. Mental Anguish Is Included in Bodily Injury
Part H. Exclusions, Items l.p.(1) and (2) are
replaced with: Section III - Definitions, Item 4. is replaced with:
(1) Arising out of oral, written, televised or 4. Bodily injury means bodily injury sickness or
videotaped publication of material, if disease sustained by a person. It includes
done by or at the direction of the insured death or mental anguish which result at any
with knowledge of its falsity; time from such physical harm, physical sick-
(2) Arising out of oral. written, televised or ness or physical disease. Mental anguish me-
videotaped publication of material whose
ans any type of mental or emotional illness
first publication took place before the or disease.
beginning of the policy period; 15. Unintentional Failure to Disclose Hazards
11. Broadened Personal Injury Section II - Liability Coverage, Part K. Liability
Unless Personal Injury is excluded from this pol- and Medical Payments General Conditions. is
icy. Section III - Property, Liability and Medical amended to include:
AB9189 8-07
Page 4 of 6
6. Unintentional Failure to Disclose Hazards legal representatives are aware of the General
Liability occurrence offense, claim. or suit.
If you unintentionally fail to disclose any ha- Knowledge of an occurrence offense. claim.
zards existing at the inception date of your or suit by other employce(s) does not imply
policy, we will not deny coverage under this you also have such knowledge.
Coverage Form because of such failure.
However, this provision does not affect our b. To the extent possible, notice to us should
right to collect additional premium or exercise include:
our right of cancellation or non-renewal.
(1) How, when and where the occurrence or
16. Supplementary Payments. Increase Limits offense took place;
Section II - Liability Coverage, Part G. Coverage, (2) The names, addresses, and telephone
Items Le. (2) and (4) are replaced with: numbers of any injured persons and wit-
(2) The cost of bail bonds required because of nesses; and
accidents or traffic law violations arising out (3) The nature and location of any injury or
of the use of any vehicle to which the Bodily damage arising out of the occurrence, of-
Injury Liability Coverage applies. We do not fence, claim, or suit.
have to furnish these bonds.
19. Common Policy Conditions (AB 00 09 A 01 87),
(4) All reasonable expenses incurred by the in- Part H. Other Insurance Item 2. is replaced with:
cured at our request to assist us in the inves-
tigation or defense of the claim or suit 2. Coverage C - Liability
including substantiated loss of earnings up to
$500 a day because of time off work. If other valid and collectible insurance is
available to anv insured for a loss we cover
17. Per Location Aggregate under Coverage C of this Coverage Part our
A. Section II - Liability Coverage, Part J. Limits obligations are limited as follows:
of Insurance, Item 4. is amended to include: a. The insurance provided under this policy
The Aggregate Limit of Insurance applies se- is primary if you are required by a written
parately to each location owned by you. insured contract to include any person
rented to you. or occupied by you with the or organization as an insured, but only
permission of the owner. with respect to that insured's liability
arising out of the ownership, maintc-
B. Section III - Property, Liability and Medical nance, or use of that part of the premises
Payments Definitions, is amended to include: owned by or rented to you. or your work
for that insured by or for you. Any other
31. Location means premises involving the insurance available to that person or or-
same or connecting lots, or premises cranization is excess and noncontributory
whose connection is interrupted only by with this insurance, or;
a street, roadway, waterway or right-of-
way of railroad. b. Except for the circumstance described in
2.a., above, the insurance provided tinder
19. Amended Duties in the Event of an Occurrence, this policy is excess over any other li-
ability insurance available to any insured
Section II - Liability Coverage, Part K. Liability whether such other insurance is written
and Medical Pavments General Conditions, Items as primary, excess, contingent or any
2.a. and b. arc replaced with: other basis. An exception applies when
any insured specifically has purchased
a. In the event of an occurrence offense, claim, excess insurance to apply in excess of the
or suit, you must promptly notify us. Your limits of insurance shown in the Decla-
duty to promptly notify us is effective when rations of this Coverage Part for Cover-
your executive officers, partners. members, or age C.
AB9189 B-07
Page 5 of 6
20. Damage to Invitees' Automobiles from Palling kind and quality; subject to a limit of$25,000
Trees or Tree Limbs - Limited Coverage in any one policy period; and
The policy applies to direct physical damage to 5. This coverage is not subject to the General
automobiles owned by invitees subject to all of the Liability General Aggregate Limit.
following:
21. Expected or Intended Injury - Amendment to Ex-
t. Provided such damage originates from prem- elusion
ises owned, managed, leased or rented by an
insured; SECTION I. - 2. EXCLUSIONS a. Expected or
Intended Injury, is replaced by the following:
2. Coverage applies only to invitees of an in-
sured or an insured's tenant; a. Expected or Intended Injury
3. Such damage is directly caused by Bodily injury, or property damage expected or
wind-driven falling trees or tree limbs; intended from the standpoint of the insured.
This exclusion docs not apply to bodily injury
4. The most we will pay for any one loss is the or property damage resulting from the use of
lesser of the actual cash value of the damaged reasonable force to protect persons or prop-
automobile as of the time of the loss; or the erty.
cost of repairing or replacing the damaged
automobile with another automobile of like All other terms and conditions of the policy apply.
AB9189 8-07
Page 6 of 6
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed.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 2%Of the California workers'compensation premium otherwise due on
such remuneration.
Schedule
Person or Organization Job Description
Any 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 8/21/2018 Policy No SWC1203057 Endorsement No. 0
Insured RHA Landscape Architects-Planners, Inc. Premium$ 5072
Insurance Company Security National Insurance Company
Countersigned by..................... ..............
WC 04 03 06
(Ed..04-84)