PROOF OF INSURANCE (2019 - 2020) CLOSEDAC H CERTIFICATE OF LIABILITY INSURANCE DATB(MWODR'M
_ 0810812018
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 terms and conditions of thepolicy, sr Is an ADDITIONAL INSURED, the policy(los) must be endorsed. If SUBROGATION 18 WAIVED, subject to
lay, oartaln policies may nquln on endorsement. A statement on this certificate doers not confer rights to the
cert'ific'ate Molder In lieuof such andorsomant(s).
PRODUCER CDsianza Ins, Agency, Inc CONTACT
9101 LBJ Freeway PrLorIE(9'72991-084.PA* (972991'-2139
Suite 150 a..E,�l:.�.m.m....._ ,.�.�............trac.atalw_ . _...ii
DpA�:....
Dallas TX 75243•
1 uIAU. A,Sleacllasl Insurance 6387
INSURED J'.w._ ...
Lawies Entarpdess, Inc, IHBUWAA s .. w _
752 Bungalow Drive
EI Segundo CA 90245-
ftR ._ .--.—_� ,—
.l.1141PBMA .... .. _.
COVERAGESCERTIFICATE NUMBER:
.... ,., .,.,...
REVISION NUMBERI
THIS I$ 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 ANL? CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADDLSUSR§
y r TYPE HISURAMCi� IPOLICY
NUMDER
T S5 !I" FaLaCw exi, UNITY'S
X ' GOMMERCIALGENERAL LIABILITYgCyy�g
d '
A cuIMB MADE OCCUR IEOL8322518»12
{IRREpyCE
j D'AIIArI'E TO'nEiITEO -
8410/2018 90811012019 Pis
U00,000.. 0000
100,000
�s.�.
x,000
ERRORS AND OMISSIONS
; P1ERS0NAL S A0V r 9LIRw
2,000,000
N'L AGGREGI LIMIT APP PER.
C wt (YAT IS 21000,000
POLICY L�ECT LJ Loc
y
ry u'I T.P sena 1 _ 2,000,000
9 l �-
AUTDMpOS E LIABUN Y I
�tANY
COMBINED SINGLE vM11' 3 1,000,000
A
�EOL93'2251BA2
'(0811012018 ° &10f201g BODILYI (arperson)
p
X
ALLOWNED SCHEDULED
�� AUTOS
X NON -OWNED
B—ODIL RY(Pa geode SI S _rt
I PIIOPERrY DAMAGE
HIRED AUTOS ' AUTOS
i tGeIC#aAontz S
I
S
V
UMBRELLALIABOCCUR
�" HEICE�w�
EXCESS UAB CLALV MAGE
f f _AMG ATE S
_AMGJ
WOR I( SFIOETCArilIM COMPENSATION
ANDLIABILITYd
C
,
j •_,L..�.II . , , ,,.._ ,
FT
ANY 'iECd.77tV
MSEREXCLUDED7
FMCEPrSE
#
Etf�i Ai CI Eh
j
.E DTE�E EA EMIL
d ma u nddT
I
61, . IFIL
DESCRIPTION OF OPPRAn''GNS1 LOCATIONS tVEMCLNS A'CORD SOL, AddlltenalRamaaias Sthed'ule, ane Sa aRaghod II mote a eaa Ia aawluirad
CERTIFICATE HOLDER IS INCLUDED A Air ADDITIONAL INSURED UNDER WINFRAL LIABILK WITH RE PECTS TO THE OPERATIONS OF THE
NAMED INSURED AS REQUIRED BY WRTTEN CONTRACT OR WRITTEN AGREEMENT.
.. 0000
CERTIFICATE HOLDER CANCELLATION At 014458
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of E) Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
$ ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
EL Segundo CA 80245- 1 AUTHORIZED REPRESENTATIVE
. v
0 1988 2014 ACORD CORPORATION. All rights reamed.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
Additional Insured - Owners, lessees Or 0 k,
Contractors - scheduled Person Or Organization ZURICH
Policy No.18- Add'I. Prem Return Prem,
EOL93225 08/10/2018 �l 08/10/201 g Pol. Eff. Date of End. 21894000
1
2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured:
Address (including ZIP Code):
Lawles Enterprises, Inc.
752 Bungalow Drive
EI Segundo CA 90245
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s)
CITY OF EL SEGUNDO
Location And Description Of Covered Operations
350 MAIN ST EL SEGUNDO CA 90245
A. Section II — Who Is An Insured is amended to include as an additional insured the person or organization
shown in the Schedule above, whom you are required to add as an additional insured on this policy under a
written contract or written agreement. Such person or organization is an additional insured only with respect to
liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf,
in the performance of your ongoing operations or "your work" as included in the "products -completed
operations hazard", which is the subject of the written contract or written agreement at the Location designated
and described in the Schedule above.
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted bylaw; and
2. Will not be broader than that which you are required by the written contractor written agreement to provide
for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:
This insurance does not apply to:
U -GL -1177-F CW (04/13)
Page 1 of 2
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure
to render any professional architectural, engineering or surveying services including:
a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which
caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising
injury', involved, the rendering of or the failure to render any professional architectural, engineering or
surveying services.
C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section
IV —Commercial General Liability Conditions:
The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
2. We receive written notice of a claim or "suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued
by another insurer under which the additional insured may be an insured in any capacity. This provision
does not apply to insurance on which the additional insured is a Named Insured, if the written contract or
written agreement requires that this coverage be primary and non-contributory.
D. For the purpose of the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This Insurance is primary to and will not seek contribution from any other insurance available to an
additional insured provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.1b. of the Other Insurance Condition of Section IV —
Commercial General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an
additional insured, in which the additional insured on our policy is also covered as an additional insured on
another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does
not apply to any policy in which the additional insured is a Named Insured on such other policy and where
our policy is required by written contract or written agreement to provide coverage to the additional insured
on a primary and non-contributory basis.
E. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added
to Section III — Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement referenced in Paragraph A. of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms and conditions of this policy remain unchanged.
U -GL -1177-F CW (04/13)
Page 2 of 2
Includes copyrighted material of Insurance Services Office, Inc„ with its permission.
Hired And Nonowned Auto Liability Coverage ZURICH
Throughout this policy the wor<is 'yet;" and "your' refer to the Named Insured shown in the Declarations. The words
.we", "us" and 'our" refer to the company providing this insurance. Other words and phrases that appear in
quotation marks have special meaning. Refer to Section H. DEFINITIONS.
A. COVERAGE
We will pay all sums an "insured" legally must pay as damages because of "bodily injury" or "property damage"
to which this insurance applies, caused by an "accident' and resulting froin the ownership, maintenance or use
of:
1. An ""auto" you lease, hire, rent or borrow, This does not include any "auto" you lease, hire, rent, or borrow
from any of your "employees", partners (if you are a partnership), members (if you are a limited liability
company) or members of their households.
2. An "auto" you do not own, lease, hire, rent or borrow that is used in connection with your business 'rhis
includes "autos" owned by your "employees", partners (if you are a partnership), members (if you are a
limited liability coinpany),, of members of their households but only while used in your, business or your
personal affairs.
We will also pay all sums an "insured" legally must pay as a "covered pollution cost or expense" to which tnis
insurance applies, caused by an "accident" and resulting from the ownership, maintenance or use of covered
autos". However, we welt only pay for the "covered pollution cost or expense" it there is either "bodily injury" or
property damage" to which this 'insurance applies that is caused by the same "accident'.
We have the right and duty to defend any "insured" against a "suit" asKing for such damages or a "covered
pollution cost or expense". However, we have no duty to defend any against a "suit" seeking
damages for "'bodily injury" or "property damage'" or a, "covered pollution cost or expense" to which this
insurance does not apply,. We may investigate and settle any claim or "suit" as we consider appropriate. Our
duty to defend or settle ends when the Hired and Nonowned Auto Liability Coverage Limit of Insurance has
been exhausted by payment of judgments or settlements.
B. WHO IS AN INSURED
The following are "insureds":
1. You for any covered "auto".
2. Anyone else while using with your permission an "auto" you hire except:
a. The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not
apply if the covered "auto" is a "trailer" connected to a covered "auto" you own
b. Your "employee" if the "auto" is owned by that "employee" or a member of his or her household.
c. Someone using an "auto" while he or she, is working in a business of selling, servicing, repairing,
parking at storing "autos" unless that business is yours.
d. Anyone other than your "employees:", partners (if you are a partnership), members (if you are a limited
liability company), or a lessee or borrower or any of their "ernployees", while moving property, to or from
an "auto".
e. A partner (if you are a partnership) or a member (if you are a limited liability company) for a covered
"auto"" owned by him or her or a member of his or her household.
3. Anyone liable for the conduct of an "insured" described above but only to the extent of that liability.
U -CA -543-B CW (03110)
Page I of 9
Includes copyrighted material of Insurance Services Office, Inc., with its permission,
C. COVERAGE EXTENSIONS
1. Supplementary Payments
We will pay for the "insured":
a. All expenses we incur.
b- Up to $2,000 for cost of bail bonds (including bonds for related traffic law violations) required because
of an "accident'" we cover. We do not have to furnish these bonds.
c. The cost of bonds to release attachments, in any "suit" against the "insured" we defend, but only for
bond amounts within our Limit of Insurance.
d. All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up
to $250 a day because Of time off from work,
e. All court costs taxed against the "insured" in any "suit" against the "insured" we defend. However,
these payments do not include attorneys' fees or attorneys' expenses taxed against the"Insured",
f. All interest on the full amount of any judgment that accrues after entry of the judgment in any "suit"
against the "Insured" we defend, but our duty to pay interest ends when we have paid. offered to pay or
deposited in court the part of the judgment that is within our Limit of Insurance
These payments will not reduce the Limit of Insurance.
D. EXCLUSIONS
This insurance does not apply to any of the following:
1. Expected Or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the "insured".
2. Contractual
Liability assumed under any contract or agreement.
But this exclusion does not apply to liability for damages-,
a. Assumed in a contract or agreement that is an "insured contract" provided the "bodily injury" or
"properly damage" occurs subsequent to the execution of the contract or agreement; or
b. That the "insured" would have in the absence of the contract Or agreement.
3. Workers' Compensation
Any obligation for which the "insured" or the "insured's" insurer may be held liable under any workers'
compensation, disability benefits or unemployment compensation law or any similar law.
4. Employee Indemnification And Employees Liability
"Bodily injury" to:
a. An "employee" of the "insured" arising out of and in the course of:
(1) Employment by the "insured"; or
(2) Performing the duties related to the conduct of the "insured's" business; or
b. The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph a.
above.
This exclusion applies:
(1) Whether the "insured" may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay damages because
of the injury.
U -CA -543-B GW (03/10)
Page 2 of 9
Includes copyrighted material of Insurance Services Office, Inc, with its permission.
But this exolusion does not apply to "bodily injury"' to domestic "employees" not entitled to workers'
compensation benefits or to liability assunied, by the "insured" under an "insured contract", For the
purposes of the coverage form, a dornestic "employee" is a person engaged in household or domestic work
performed p6ricipally in connection with a residence premises.
5, Fellow Employee
"Bodily injury" to:
a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's"
employment or white performing duties related to the conduct of your bvs0nes% or
b. The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of Paragraph a.
above.
6. Care, Custody Or Control
"Property damage" to or "covered pollution cost or expense" involving property owned or transported by the
"insured" or in the "insured's" care, custody or control. But this exclusion does not apply to liability assumed
under a sidetrack agreement
7. Handling Of Property
"Bodily injury" or "property damage" resulting from the handling of property:
a. Before it is moved from the place where it is accepted by the "insured" for movement into or onto the
covered "auto"; or
b. After it is moved from the covered "auto" to the place where it is finally delivered by the "insured",
8. Movement Of Property By Mechanical Device
"Bodily injury" or "property damage" resulting from the movement of property by a mechanical device (other
than a hand truck) unless the device is attached to the covered "auto".
9. Operations
"Bodily injury" or "property damage" arising out of the operation of:
a. Any equipment listed in Paragraphs f.(2) and f.(3) of the definition of "mobile equipment'; or
b. Machinery or equipment that is on, attached to or part of a land vehicle that would qualify under the
definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or
other motor vehicle insurance law where it is licensed or principaliy garaged,
10. Completed Operations
"Bodily injury" or "property damage" arising out of your work after that work has been completed or
abandoned,
In this exclusion, your work means:
a. Work or operations performed by you or on your behalf; and
b. Materials, parts or equipment furnished in connection with such work or operations.
Your work includes warranties or representations, made at any time with respect to the fitness, quality,
durability or performance of any of the iterns included in Paragraph a. or b, above,
Your work will be deemed completed at the earliest of the following times-.
(1) When all of the work called for in your contract has been completed.
(2) When all of the work to be done at the site has been completed if your contract calls for work at
more than one site.
(3) When that part of the work done at a job site has been put to its intended use by any person or
organization other than another contractor or subcontractor working on the same project.
Work that may need service, maintenance, correction, repair or replacement, but which is otherwise
complete, will be treated as completed.
U -CA -543-3 CW (03/10)
Page 3 of 9
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
11. Pollution
"Bodily injury" or "properly dailiage" arising out of the actual, alleged or threatened discharge, dispersal,
seepage, migration, release or escape of "pollutants",
a. That are, or that are contained in any property that is:
(1) Being transported or towed by, handled or handled for movement into, onto or from the covered
'"auto";
(2) Otherwise in the course of transit by or on behalf of the "insured"; or
(3) Being stored, disposed of, treated or processed in or upon the covered ""auto"";
b. Before the "pollutants" or any properly in which the ""pollutants"" are contained are moved from the place
where they are accppted by the "insured" for movement into or onto the covered "auto", or
c. After the "'pollutants" or any property in which the "pollutants" are contained are moved from the
covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured".
Paragraph a. above does not apply to fuels, lubricants, fluids, exhaust gases or other similar "polluta ills"
that are needed for or result from the normal electrical, hydraulic or mechanical functioning of the covered
"auto" or its parts, if:
(1) The "pollutants" escape, seep, migrate or are discharged, dispersed or released directly from an
"auto" part designed by its manufacturer to hold, store, receive or dispose of such "pollutants"; and
(2) The "bodily Injury", "property damage" or "covered pollution cost or expense" does not arise out of
the operation of any equipment listed in Paragraphs f.(2) and f.(3) of the definition of "mobile
equipment".
Paragraphs b. and o. above of this exclusion do not apply to "accidents" that occur away from premises
owned by or rented to an "insured" with respect to "pollutants" not in or upon a coveted "auto" if:
(a) The "pollutants" or any properly in which the "pollutants" are contained are upset, overturned or
damaged as a result of the maintenance or use of a covered ""auto"; and
(b) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused
directly by such upset, overturn or damage.
12. War
"Bodily injury" or "property damage" arising directly or indirectly out of.
a. War, including undeclared or civil war;
b. Warlike action by a military force, including action in hindering or defending against an actual Or
expected attack, by any government, sovereign or other authority using military personnel or other
agents; or
c. Insurrection, rebellion, revolution, usurped power or action taken by governmental authority in hindering
or defending against any of these
13. Racing
Covered "aulos" while used in any professional or organized (acing or demolition contest or stunting
activity, or while practicing for such contest or activity, This insurance also does not apply while that
covered "auto" is being prepared for such a contest or activity.
E. LIMIT OF INSURANCE
Regardless of the number of covered "autos", "insureds", premiums paid, clairris trade or vehicles involved in
the "accident", the most we will pay for the total of all damages and "coveted pollution cost or expense"
combined resuAmg from any one "accident" is the Limit of Insurance for Hired and Nonowned Liability
Coverage,
All "bodily injury", "property damage" and "covered pollution cost or expense" resulting from continuous or
repeated exposure to substantially the same conditions will be considered as resulting from one "accident",
No one will be entitled to receive duplicate payments for the same elements of "loss" tinder this coverage form
and any Medical Payrnen(s Coverage endorsement, Uninsured Motorists Coverage endorsoillent or
Underinsured Motorists Coverage endorsement attached to this Coverage Part
U -CA -543-B CW (03/10)
Page 4 of 9
Includes copyrighted material of Insurance Services Office, Inc, with its permission.
F. CONDITIONS
1. Duties In The Event Of Accident, Claim, Suit Or Loss
We have no duty to provide coverage under this policy unless there has been full compliance with the
following duties:
a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative
prompt notice of the "accident" or "loss". Include:
(1) How, when and where the "accident" or "loss" occurred;
(2) The "insured's" name and address,, and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
b. Additionally, you and any other involved "insured" must:
(1) Assume no obligation, make no payment or incur no expense without our consent, except at the
"insured's" own cost.
(2) Immediately send us copies of any request, demand, order, notice, summons or legal paper
received concerning the claim or "suit".
(3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit'.
(4) Authorize us to obtain medical records or other pertinent information.
(5) Submit to examination, at our expense, by physicians of our choice, as often as we reasonably
require.
c. If there is "loss" to a covered "auto" or its equipment you must also do the following:
(1) Promptly notify the police if the covered "auto" or any of its equipment is stolen.
(2) Take all reasonable steps to protect the covered "auto" from further damage. Also keep a record of
your expenses for consideration in the settlement of the claim.
(3) Permit us to inspect the covered "auto" and records proving the "loss" before its repair or
disposition.
(4) Agree to examinations under oath at our request and give us a signed statement of your answers.
2. Legal Action Against Us
No one may bring a legal action against us under this coverage form until:
a. There has been full compliance with all the terms of this coverage form; and
b. Under Liability Coverage. we agree in wnting that the "insured" has an obligation to pay or until the
amount of that obligation has finally been determined by judgment after trial, No one has the right
under this policy to bring us into an action to determine the "insured's" liability.
3. Transfer Of Rights Of Recovery Against Others To Us
If any person or organization to or fos whom we, make payn)vni, Linder this coverage form has rights to
recover damages frorn another, those rights are transferred to US. That person or organization must do
everything necessary to secure our rights and ►must do nothing after "accident"" or "loss" to impair them
G. GENERAL CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obligations
under this coverage form.
2. Concealment, Misrepresentation Or Fraud
This coverage form is void in any case of fraud by you at any time as it relates to this coverage form. It is
also void if you or any other "insured", at any time, intentionally conceal or misrepresent a material fact
concerning:
a. This coverage form;
b. The covered "auto";
U -CA -543-B CW (03110)
Page 5 of 9
Includes copyrighted material of Insurance Services office, Inc., with its permission.
c. Your interest in the covered "auto": or
d. A claim under this coverage form.
3. Liberalization
If we to -vise this coverage form to provide more coverage without additional premium charge, your policy
will automatically provide the additional coverage as of the day the revision is effective in your state,
4. Other Insurance
The insurance provided by this coverage form is excess over any other collectible insurance.
a. This coverage form's Uabiiity Coverage is primary for any liability assumed under an "insured contract'.
b. When this, coverage form and aily other coverage forrn or policy covers on the same basis, either
excess or ptimary, we will pay only our share. Our shares the proportion that tile, I-imit of Insurance (if
our coverage form bears to the total of tile limits of all the coverage forms and policies covering on the
same basis.
5. Premium Audit
a, The estimated premium for this coverage form is k)ased on the exposures you told us you would have
when this policy began 'We will compute the final prernium due when we determine your actual
exposures The estirriated total premiurn will be credited against the final premium due and tile first
Named Insured will be billed for the balance, if any The due date for the final premium or retrospective
premium is tile date shown as the due date on ,he bill if ti,ie, eStima
. teo total premiurn exceeds (fie final
premium due, the first Named Insured will get a refund
b. If this policy is issued for more than one year, the premium for this coverage form will be computed
annually based on our rates or premiums in effect at the beginning of each year of the policy.
6. Policy Period, Coverage Territory
Under this coverage form, we cover "accidents" and "losses" occurring:
a. During the policy period shown in the Declarations; and
b. Within the coverage territory.
The coverage territory is:
(1) The United States of America:
(2) The territories and possessions of the United States of America;
(3) Puerto Rico-,
(4) Canada: and
(5) Anywhere in the world if:
(a) A covered "auto" of the private passenger type is leased, hired, rented or borrowed without a driver
for a period of 30 days or less; and
(b) The "insured's" responsibility to Pay damages is determined In a "'still" on the merits, in the United
States of America, the, territories and possessions of the United States of Amence, Puerto Rico. or
Canada or in a settlement we agree to,
We also cover "loss" to, or "accidents" involving, a covered "auto" while being transported between any of
these places.
7. Two Or More Coverage Forms Or Policies Issued By Us
If this coverage form and any other coverage: form or policy issued to YOU by us or any company affiliate($
w4h us apply to the same "accilderil", the aggregate maxim0ril Ornit Of Insurance underr all file
. rout rage
forms or policies shall not exceed the highest applicable Liri of Insurance under any one coverage form or
policy. This condition does not apply to any Coverage form or policy issued by us of all affillated company
specifically to apply as excess insurance over this coverage form.
U -CA -543-B CW (C311 0)
Page 6 of 9
includes copyrighted material of Insurance Services Office, Inc., with its permission.
INIFINIVNNIM
1. "Accident' includes continuous or repeated exposure to the same conditions resulting in "bodily injury" or
"property damage".
2. "Auto" means:
a. Aland motor vehicle, "trailer"cr semitrailer designed for travel on public roads; or
b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor
vehicle insurance law where it is licensed or principally garaged.
However, "auto" does not include "mobile equipment'.
3. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death resulting
from any of these.
4. "Covered pollution cost or expense" means any cost or expense arising out of:
a. Any request, demand, order or statutory or regulatory requirement that any "Insured" or others test for,
monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the
effects of, "pollutants"; or
b. Any claim or "suit' by or on behalf of a governmental authority for damages because of testing for,
monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way,
responding to, or assessing the effects of, "pollutants"
"Covered pollution cost or expense" does not include any cost or expense, arising out of the actual, alleged
or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants":
(1) That are, or that are contained in any property that is. -
(a) Being transported or towed by, handled or handled for movement into, onto or from the covered
'"auto";
(b) Otherwise in the course of transit by or on behalf of the "insured"; or
(c) Being stored, disposed of. treated or processed in or upon the covered "auto";
(2) Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place
where they are accepted by the "insured" for movement into or onto the covered "auto", or
(3) After the "pollutants" or any property in which the "pollutants" are contained are moved from the
covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured".
Paragraph (1) above does not apply to fuels, lubricants, fluids, exhaust gases or other similar "pollutants"
that are needed for or result from the normal electrical, hydraulic or mechanical functioning of the covered
"auto" or its parts, if.,
(a) The "pollutants" escape, seep, migrate or are discharged, dispersed or released directly from an
"auto'" part designed by its Manufacturer to hold, store, receive or dispose of such "pollutants"; and
(b) The "bodily injury", "properly damage" or "covered pollution cost or expense" does not arise out of
the operation of any equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile
equipment".
Paragraphs (2) and (3) above do not apply to "accidents" that occur away from premises owned by or
rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" it:
(I) The "pollutants" or any properly in which the "pollutants" are contained are upset, overturned or
damaged as a result of the maintenance or use of a covered "'auto"; and
(11) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused
directly by such upset, overturn or damage.
5. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker'.
S. "Insured" means any person or organization qUaldying as an insured in the Who Is An Insured provision of
this coverage folinr Except with respect to the Limit of Insurance, the coverage afforded applies separately
to each insured who is seeking coverage or against whom a claim or "suit" is brought.
U -CA -543-B CW (03/10)
Page 7 of 9
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
T. "Insured contract" means:
a. A lease of premises;
b. A sidetrack agreement,
c. Any easement or license agreement, except in connection with construction or demolition operations
on or w3hin 50 feet of a railroad;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for
a municipality,
e. That p;jn of any other contract or agreement pertaining to your business (including an indemnification
of a municipality in connection with work performed fora municipality) under which yoo assume the tort
liability of anolher to pay for "bodily injury" or "properly damage" to a third party or organization, Tort
liability means a liability that would be imposed by law in the absence of afiy contract or agreement:
f. That part of any contract or agreement entered into, as part of your business, pertaining to the rental or
lease by You or any of your **employees", of any "auto". However, such contract or agreement shall not
be considered an "insured contract" to the (,xlent that it obligates you or any of your "employees" to pay
for "properly damage" to any "aulo" rented or leased by you or any of your ""employees'".
An "insured contract' does not include that part of any contract or agreement:
(1) That indemnifies a railroad for "bodily Injury" or "property damage" arising out of construction or
demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or
trestle, tracks, roadbeds, tunnel, underpass, or crossing;
(2) That pertains to the loan, lease or rental of an "auto" to you or any of your "employees!', if the
"auto" is loaned, leased or rented with a driver; or
(3) That holds a person or organization engaged in the business of transporting property by "auto" for
hire harmless for your use of a covered "auto" over a route or territory that person or organization is
authorized to serve by public authority.
8. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you
and the labor leasing firm to perform duties related to the conduct of your business. "Leased worker" does
not include a "temporary worker" -
9. "Loss" means direct and accidental loss or damage
10. "Mobile equipment' means any of the following types of land vehicles, including any attached machinery or
equipment:
a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads, -
b. Vehicles maintained for use solely on or next to premises you own or rent;
c. Vehicles that travel on crawler treads-,
d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently
mounted:
(1) Power cranes, shovels, loaders, diggers or drills, or
(2) Road construction or resurfacing equipment such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a-, b-, c. or d. above that are not self-propelled and are
maintained primarily to provide mobility to permanently attached equipment of the following types:
(1) Air compressors, pumps and generators, including spraying, welding, building cleaning,
geophysical exploration, lighting and well -servicing equipment, or
(2) Cherry pickers and similar devices used to raise or lower workers; or
f. Vehicles not described in Paragraph a,, b c. or d. above maintained primarily for purposes other than
the transportation of persons or cargo. However, self-propelled vehicles with the following types of
permanently attached equipment are not "mobile equipment" but will be considered "autos",
(1) Equipment designed primarily for:
U -CA -543-B CW (03/10)
Page 8 of 9
Includes copyrighted material of Insurance Services Office, Inc., with its permission
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning,
(2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or
lower workers; and
(3) Air compressors,, pumps and generators, Including spraying, welding, building cleaning,
geophysical exploration, lighting or well -servicing equipment.
However, "mobile equipment" does not include land vehicles that are subject to a compulsory or
financial responsibility law or other motor vehicle insurance law where it is licensed or principally
garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle
insurance low are considered "autos".
11, "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, inclurAng srooke, vapor,
soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or
reclaimed.
12. "Property damage" means damage to or loss of use of tangible property.
13. "Suit" means a civil proceeding in which:
a. Damages because of "bodily injury" or "property damage"; or
b. A "covered pollution cost or expense";
to which this insurance applies, are alleged.
"Suit" includes:
(1) An arbitration proceeding in which such damages or "covered pollution costs or expenses" are claimed
and to which the "insured" must submit or does submit with our consent; or
(2) Any other alternative dispute resolution proceeding in which such damages or "covered pollution costs
or expenses" are claimed and to which the insured submits with our consent.
14. '"Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on
leave or to rneet seasonal or short-term workload conditions.
15. "Trailer" includes semitrailer.
U -CA -543-B CW (03/10)
Page 9 of 9
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
ENDORSEMENT AGREEMENT BROKER COPY
WAIVER OF SUBROGATION
9227676-19
RENEWAL
NA
HOME OFFICE
SAN FRANCISCO PAGE 1 OF 2
ALL EFFECTIVE DATES ARE
AT 12-01 AM PACIFIC EFFECTIVE MARCH 14, 2019 AT 12.01 A.M.
STANDARD TIME OR THE AND EXPIRING MARCH 9, 2020 AT 12.01 A.M.
TIME INDICATED AT
PACIFIC STANDARD TIME
LAWLES ENTERPRISES INC
400 CONTINENTAL BLVD FL 6
EL SEGUNDO, CA 90245
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,
LAWLES ENTERPRISES INC
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 PREMIUM ON THE EARNINGS OF SUCH
EMPLOYEES SHALL BE INCREASED BY 03%.
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
AO'TI9OR6ED REPRESEN"I" IVE
SC1F FORM 10217 (REV.7-2014)
MARCH 18, 2019 2570
PRESIDENT" AND CEO
OLD OF 217