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PROOF OF INSURANCE (2019) CLOSED Client#: 25320 KIMLHORN DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1/02/2019 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. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL IN provisions or IMPORTANT INSURED p 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 INT ,ferry Noyola Greyling Ins. Brokerage/EPIC _0.F66 ............................... .... . .. . ......................... FA A1C Na ext 5y o NSI. 866-550-4082 BMansell Road, Suite 370 4I�Ss_jerry.no oia re Itn .co Alpharetta, GA 302INSURE (S)AFFORDING COVERAGE NAIC # INSURER A:National Union Fire Ins.Co. 119445 INSURED ................... ,.. ...............INSURER B:Aspen American Insurance Company.................... ........................ -- ... ............... 43460 Kimley-Horn and Associates, Inc. INSURER C:New Hampshire Ins.Co. 23841 421 Fayetteville Street, Suite 600 INSURER D:Lloyds of London 085202 Raleigh, NC 27601 INSURERE: ............................. ...................... . -- - „ INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 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 BEE J REDUCED BY PAID CLAIMS. INSR AlDDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMM/DD/YYYY) (MM/DD/YYYY) t A 'X' COMMERCIAL GENERAL LIABILITY 5268169 04/01/2018 04/01/2019 EACH OCCURRENCE „$1,000,000 CLAIMS-MADE I XI OCCUR IG T( RENTED occurrence) $500,000 DAMAGE X Contractual Liab. MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL $2,000,000 POLICY XI PRO- X � IOc oM OPAGG $2,000, PRODUCTS-�...........p� -._ ....... . ----. OTHER: ,6 A AUTOMOBILE LIABILITY 4489663 04/01/2018 04/01/2019 (aacctent)INGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS . hPFRorf CFiwAt XOX $ AUTOS ONLY NON-OWNED ONLY --- P ryir ci9 . ) B X UMBRELLALIABI—_X.. OCCUR CX005FT18 b4101/2018 04/01/20191 EACH OCCURRENCE $5,000,000 $ ExcEss LAB � � cLAIMs-MADE, AGGREGATE $5,000,000 AND.... DED „X RETENTION$0 A ANY PRP RIETRSR'ILIARBILITY N RrEXECUTIVE YIN 015893686(CA) ) 04/01/2018 04/01/2019 XL,;�TATLITE ORH- KERS COMPENSATION PER EACH ACCIDENT C IMandatoryIn1NHRd::X6.l.uDED' N 039326820 ME 04/01/2018 04/01/2019 E $1,000,000 NIA ( ) MPLOYEE $1,000,000 If yes,describe under EASE m,E,O,LICY LIMIT $1,000,00 DESCRIPTION OF OPERATIONS below ............ .......................... .......................... ., .... ...... .... E L DIS..., P .... 0..- -- D Professional Liab P070831800 04/01/2018 04/01/2019 Per Claim$2,000,000 Aggregate$2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: CEQA for the Lakes Specific Plan; R.Garcia.THh City, its officials&employees are named as Additional Insureds with respects to General Liability where required by written contract.The above referenced liability policies with the exception of workers compensation& professional liability are primary&non-contributory where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days'written notice(except 10 days for nonpayment of premium)will be provided to the Certificate Holder. 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 Insurance Administrator ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE I ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD 1tQ1'ARdSR'1/M1 n17Ann IAI�1V1 This page has been left blank intentionally. POLICY NUMBER: 5268169 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 p Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT,. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to complete this Schedule, if not shown above, will be shown in the Declaration p t s. A. Section II - Who Is An Insured is amended to that which you are required by the contract include as an additional insured the person(s) or or agreement to provide for such additional organization(s) shown in the Schedule, but only insured. with respect to liability for "bodily injury", B. With respect to the insurance afforded to these "property damage" or "personal and advertising additional insureds, the following additional injury" caused, in whole or in part, by: exclusions apply: 1. Your acts or omissions; or This insurance does not apply to "bodily injury" 2. The acts or omissions of those acting on or "property damage" occurring after: your behalf; 1. All work, including materials, parts or in the performance of your ongoing operations equipment furnished in connection with such for the additional insured(s) at the location(s) work, on the project (other than service, designated above. maintenance or repairs) to be performed by or on behalf of the additional insured(s) at However: the location of the covered operations has 1. The insurance afforded to such additional been completed; or insured only applies to the extent permitted 2. That portion of "your work" out of which by law; and the injury or damage arises has been put to 2. If coverage provided to the additional its intended use by any person or insured is required by a contract or organization other than another contractor or agreement, the insurance afforded to such subcontractor engaged in performing additional insured will not be broader than operations for a principal as a part of the same project. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 0 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 required by a contract or agreement, the most This endorsement shall not increase the we will pay on behalf of the additional insured applicable Limits of Insurance shown in the is the amount of insurance: Declarations. 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc 2012 CG 20 10 04 13 0 POLICY NUMBER: 5268169 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 SCHEDULE a Name Of `9. _..d - nal. Insures) Location And Description Of Completed Operations 0 O anization(s)Person ANY PERSON OR ORGAN17ATION PER THE CONTRACT OR AGREEMENT, WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. i Information required to complete shown in the Declarations this schedule, if not shown above, will be sho ns. M` A. Section II Who Is An Insured is amended to which you are required by the contract or include as an additional insured the person(s) or agreement to provide for such additional organization(s) shown in the Schedule, but only insured, with respect to liability for "bodily injury" or B. With respect to the insurance afforded to these "property damage" caused, in whole or in part, additional insureds, the following is added to by "your work" at the location designated and Section III - Limits Of Insurance: described in the Schedule of this endorsement If coverage provided to the additional insured is performed for that additional insured and required by a contract or agreement, the most included in the "products-completed operations we will pay on behalf of the additional insured hazard". is the amount of insurance: However: 1. Required by the contract or agreement; or 1. The insurance afforded to such additional 2. Available Linder the applicable Limits of Insu- insured only applies to the extent permitted rance shown in the Declarations; by law; and whichever is less. 2. If coverage provided to the additional insured is required by a contract or agree- This endorsement shall not increase the appli- ment, the insurance afforded to such addi- cable Limits of Insurance shown in the Decla- tional insured will not be broader than that rations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 ❑ This page has been left blank intentionally,