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PROOF OF INSURANCE (2019) CLOSED "Irp DATE(MMIDDM'YY) .�9LIC�"R" CERTIFICATE OF LIABILITY INSURANCE ^I ". 11/2/2018 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 ' CONTACT I NAME; Connie Jones Wood Gutmann& Bogart PHONE FAX ,. 15901 Red Hill Ave., Suite 100 IAIc„No Ext); 714-505-7000 t4,tc,40I:714-57'3.1770 Tustin CA 92780 E-MAILD 'ss; conllie@wgt)il).com wgbll).com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:TRAVELERS CAS INS CO OF AMER 19046 INSURED PUN&M-1 INSURER 13:Travelers Property Casualty Co of Amer 25674 The Pun Group, LLP 200 East Sandpointe Avenue, Suite 600 INSURER C:Argonaut Insurance Company Santa Ana CA 92707 INSURERD: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:233888926 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, ILN.TR TYPE OF INSURANCE ADbL S'UBR POLICY EFF POLICY EXP LIMITS INS12- POLICY NUMBER (MM/DDIYYYY) (MMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY 68076592120-10 3/1/2018 3/112019 EACH OCCURRENCE S"00110P(4 .. r"I RIMS MADF X (?(,(,I IR ,IRErh 3S t 911kocruY:3 . .. �� �A'ASE�:'^tE'1x.AC.»i.lnre,yl;e) `"300.000 MED EXP(Any one person) ;G 1 oID PERSONAL d ADV INJURY AC;('_1021-C.AlF l_INIII AIPPLIBISP4 I, GENERAI_AGGREGATE $4,DrJ0000 "t PRODUC FS-COMPIOP AGO $4 000 000 POLICY X jlli:(„11' j I t..0 .„ 01 HE-; 5 .A AUTOMOBILE LIABILITY BA-BG076r0318 3/1/2018 3(1(2019 CLIINIBIC'JkD Sirw i LE".I„dhdl't"I �IEa'1 ac�cne+�l) "'1 003 LIDO ANY AU FO I3(:AN..Y I"LRIRY(Pe,r pr,rsoo1) .$ AI_I.OWNED SCHEDULED BODILY IIJJURY(Per areident) AUTOS AUTOS . NON-OWNED M . _ R'�F�4:)I�'Ef�7"r'l'1APe4�F4GE 8, X tiIRED AU O5 X AUTOS EPer,atycatS&nta , B X UMBRELLA LIAB Xr; GUP-D04H253148l8 3/112018 ':3111201St EACH OCCURRENCE $1 000000 oc;.ur•: EXCESS LIAB CLAIMS MACE AGGREGA rE $1 000,000 I DED RE.TC:NTION$ $ B WORKERS COMPENSATION lJB3K65340116 :311/2018 3/112019 X PER OTH AND EMPLOYERS'LIABILITY YIN STATUTE FR ANY PROPRIETOR/PARTNER/EXECUTIVE r E L. EACH ACCIDENT 1.01411,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) """"""" E I_ DISEASE-EA EMPLOYEF, 'C IJ)W,000 If yes,describe under DESCRIPTION OF OPERATIONS below E I_ DISEASE POLICY LIMIT $'I,000.000 C E'LO IAC4207440 3/1(2018 3/1/2019 ':i'000'000agy 1,000,000 Retro 12129/19 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of EI Segundo,its officials,and employees are inciuded as Additional Insured on a Primary and Non-Contributory basis with respects to the General Liability per attached AICGD1050494 as required by wrillen contract'subj'ect to the terms and conditions of the 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 EI Segundo 350 Main Street AUTHORIZED REPRESENTATIVE EI Segundo CA 90245 \ �]� DI ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. WHO IS AN INSURED (SECTION II) is amended in a written contract for this insurance to to include as an insured any person or organiza- apply on a primary or contributory basis. tion (called hereafter "additional insured") whom 3. This insurance does not apply: you have agreed in a written contract, executed prior to loss; to name as additional insured, but a. on any basis to any person or organization only with respect to liability arising out of "your for whom you have purchased an Owners work" or your ongoing operations for that addi- tional insured performed by you or for you. b. to "bodily injury," "property damage," "per- 2. With respect to the insurance afforded to Addi- sonal injury," or "advertising injury" arising tional Insureds the following conditions apply: out of the rendering of or the failure to render any professional services by or for you, in- a. Limits of Insurance — The following limits of cluding: liability apply: 1. The preparing, approving or failing to 1. The limits which you agreed to provide; prepare or approve maps, drawings, or opinions, reports, surveys, change or- 2. The limits shown on the declarations, ders, designs or specifications: and whichever is less. 2. Supervisory, inspection or engineering b. This insurance is excess over any valid and services. collectible insurance unless you have agreed CG D1 05 04 94 Copyright,The Travelers Indemnity Company, 1994. Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. " "R +�/� �" �� WORKERS COMPENSATION !� AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 04 03 06(01) — 013 POLICY NUMBER: UB-3K653401-18-42-G 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 5.00% OF THE CALIFORNIA WORKERS, COMPENSATION PREMIUM OTHERWISE DUE ON SUCH REMUNERATION. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION INSURED IS PERFORMING ACCOUNTING SERVICES City of EI Segundo 350 Main Street EI Segundo, Ca. 90245 DATE OF ISSUE: 08-27-18 ST ASSIGN: Page 1 of 1