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PROOF OF INSURANCE (2020) CLOSED A�® CERTIFICATE OF LIABILITY INSURANCE I DATE3/5/2019 ) 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. 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 NAME: Connie Jones Wood Gutmann&Bogart I PHONE FAX 15901 Red Hill Ave., Suite 100 (A/C.No.Ext). 714-505-7000 (A/C,Nor 714-573-1770 Tustin CA 92780 I E-MAIL ADDRESS:ADDREss: Connie INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:TRAVELERS CAS INS CO OF AMER 19046 INSURED PUN&M-1 INSURER B:Travelers Property Casualty Co of Amer 25674 The Pun Group, LLP I INsuRERc:Argonaut Insurance Company 200 East Sandpointe Avenue, Suite 600 Santa Ana CA 92707 I INSURER D:Travelers Cas Ins. Co.of Amer INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1002926775 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY 6807G592120-19 3/1/2019 3/1/2020 EACH OCCURRENCE $2,000,000 � OCCUR DAMAGERENTED CLAIMS-MADE PREMISESSf(Ea occurrence) $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY� PRO- POLICY 1:1 LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER $ D AUTOMOBILE LIABILITY BA81_4678831942 3/1/2019 3/1/2020 COMBINED SINGLE LIMIT $ (Ea accident) 1.000.000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ B UMBRELLA LIAB IX I OCCUR CUP4H25314819-42 3/1/2019 3/1/2020 EACH OCCURRENCE $1,000,000 EXCESS LIAB HI CLAIMS-MADE AGGREGATE $1,000,000 DED I I RETENTION$ $ B WORKERS COMPENSATION UB3K6534011942 3/1/2019 3/1/2020 X IPER STATUTE OERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C E&O 121APL000334800 3/1/2019 3/1/2020 3,000,000 agg 1,000,000 Retro 12/29/11 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 on a Primary and Non-Contributory basis with respects to the General Liability per attached AICGD1050494 as required by written contract subject to the terms and conditions of the policy. Workers'Compensation Waiver of Subrogation applies to workers compensation per attached form#WC040306 THIS CERTIFICATE SUPERCEDES ANY PREVIOUSLY ISSUED. 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 ©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 ��U� ����U�~�������^�� ���� ����u�� uo����� Uv��D��� This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. \88H[J IS AN INSURED(SECTION ||) is amended in a written contract for this insurance to to include as an insured any person or orgmnizm- apply on a primary or contributory basis. tion (called "additional in�unad") vvhonn ` ' 3. This insurance does not apply: you have agreed in avvhtten contract, executed prior to loss, to name as additional insured, but �. on any basis to any person or organization onk/ vvdh respeotto |i�bi|h» �h�ing out of .\/our for whom you have purchased an Owners^ ' ^ mnd(�ontrmm{ons�robaotk/�po|i�Y work" oryour ongoing operations for that addi- tional insunadpedornledbvyouorforyou. b. to "bodily injury," "property damage," "per- 2. pn� 2. With respect to the insurance afforded to Addi sona| injury," or "advertising injury" arising tiona| Insureds the following conditions apply: out ofthe rendering oforthe failure torender any professional services by orfor you, in- a. Limits of Insurance — The following limits of m|udinQ: |iabi|hv�ppk/� ' ' 1' The prepmhnQ, approving or failing to 1. The limits which you agreed to provide; napana or approve maps, drawinOs, or opinions' reports, sun/eys, change or- 2. The limits shown on the declarations, ders, designs or specifications; and whichever ieless. 2. Supervisory, inspection or engineering b. This insurance is excess over any valid and services. collectible insurance unless you have agreed CG D1 05 0404 Copyhght, The Travelers Indemnity Connpmny, 1994. Page 1 of Includes Copyrighted Material from Insurance Services Office, Inc. A W_ TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 04 03 06 (01) — 015 POLICY NUMBER: UB-3K653401-19-42-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 CITY OF EL SEGUNDO 350 MAIN INSURED'S PREMISES STREET EL SEGUNDO, CA 90245 DATE OFISSUE: 12-26-18 ST ASSIGN: Page 1 of 1