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PROOF OF INSURANCE (2019 - 2019) CLOSED Client#: 1291580 305CORRACON DATE(MM/DD/YYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE 12/18/2018 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 BYTHE 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER I ncONTACT Anglel'ique Lopez BB&T Insurance Services �HccaN Exup 714 FAX 7 9259 of Orange County 1E�L ang�q 41 28p z 1 bandt.com fAf. Nm( 9 877-29 ue to 2400 E Katella Ave Suite 1100 INSURER INSURER(S)AFFORDING COVERAGE NAIC# Anaheim CA 92806 ..°....°.. R°.p'..i...0 ..., L.......„ RE,,,,,, luny Insurance company �39993 INSURED INSURER B:State Compensation Ins,Fund of CA 35076 Corral Construction&Development Inc INSURER C:Ohioy ecur'1 Insurance Company li 24082 5211 E.Washington Blvd.#2-122 INSURER D Commerce, CA 90040 INSURER E 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 BEEV REDUCED BY PAID CLAIMS, ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE LIMITS INSR yyvD POLICY NUMBER �fAMIDDP'YYYY),ifuVMfOOf'd'WYY) ......°...°...°.. A XCOMMERCIAL GENERAL LIABILITY 101GL000316105 12/08/2018 12/08/2019 EACH OCCURRENCE 52,000,000........... CLAIMS-MADE I OCCUR _W fREMISt''M 50,000 X BI/PD Ded:500 MEDrEXP°.�°..°.:..:.°.."°..°°.ersoL....O RENTED 65,000 Ar'+�trn,�or r7 5 PERSONAL&ADV INJURY ,52,,000,000 GEIV°L AGGREGATE LIMIT APPLIES PER: ,GENERAL AGGREGATE 53,,00,0,,0,00 ______ PRO X POLICY JECT LOC 53PRODUCTS-COMP/OP AGO ,000,000 I AUTOMOBILE LIABILITY C.ca.J�ik II'"'11 I ,;1� 000,000 OTHER: C BAS57476683 12/08/2018 12/0812019 ,L ,t t ,,,,,;, ANY AUTO BODILY INJURY(Per person) 'S OWNED SCHEDULED ° ., ..... t' AUTOS ONLY AUTOSISOI711,Y I,PJJUI:Y,(Pr..l.,,Ide161) ..... .LL P Y DAMAGE AUTOS AUOTS ONLY X AUTOS NO r � UMBRELLA LIAB , .... .... .... „,,,,,.... ....I ..... EACH OCCURRENCE 5 .. CLAIMS-MADE AGGREGATE _ RETENTION 5 ', EXCESS Lli B DED ER B WORKERS COMPENSATION 903611818 12/01/2018 12/0112019:X STATUTE t P�" AND EMPLOYERS'LIABILITY YIN ANY PtR OFFICEI"IMEio1BERE'XCLUDEDY (Mandatory 4rp II r��'AmRE NER."IE XECUTIVE E L EACH ACCIDENT Pt r °N/A EL DISEASE-EA'E'I'+M .�b°E;E� S1,000,0001, 000„000' If yes,describe under D,E,SCRIPTION OF OPERATIONS bellow E,L DISEASE -POLICY LIMIT $1,000.,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of EI Segundo, its officials,and employees are included as additional insured with respect to general liability as required by written contract. Primary wording applies.Waiver of Subrogation applies to General Liability and Work Comp. Endorsements to follow. CERTIFICATE HOLDER CANCELLATION City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo,CA 90245 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S22554084/M22554047 ATMAR 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 AS DESIGNATED IN WRITTEN CONTRACT WITH THE All Commercial and/or Residential-Remodel/Repair NAMED INSURED work as required by written contract with the insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The insurance afforded by this Coverage Part for the additional insured shown in the Schedule is primary insurance and we will not seek contribution from any other insurance available to that additional insured. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to These include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury","property This insurance does not apply to"bodily injury"or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs)to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of"your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization other insured only applies to the extent permitted by than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement,the most we Applicable Limits of Insurance shown in The will pay on behalf of the additional insured is the Declarations. 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO ISS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV— Conditions: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or"your work"done under a contract with that person or organization and included in the "products-completed operations hazard" if: a. you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, U047-0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION 9036118-18 ® RENEWAL SP HOME OFFICE 2-83-35-91 SAN FRANCISCO PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC EFFECTIVE DECEMBER 19, 2018 AT 12.01 A.M. STANDARD TIME OR THE TIME INDICATED AT AND EXPIRING DECEMBER 1, 2019 AT 12 .01 A.M. PACIFIC STANDARD TIME CORRAL CONSTRUCTION & 5211 E WASHINGTON BLVD STE 2 COMMERCE, CA 90040 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF EL SEGUNDO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, CORRAL CONSTRUCTION & IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PEI ON THEE XS OF SITCH- EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: DECEMBER 20, 2018 / 2570 AUTHORIZED REPt�ESE'NT I'VE PRESIDENT AND CEO SCIF FORM 10217 IREV.4-2018) OLD DP 217