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PROOF OF INSURANCE (2019 - 2020) CLOSED1 00
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
3/31/2019
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 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 rights to the certificate holder in lieu of such endorsement(s).
Half
Arthur J. Insurance ila Iyer & Co.ry. 8"18.539.1463ficates L.FA ..
PRODUCER CC)NTAf.T
NAME:
Robert
0. PHONE FAX
Gallagher ' .� k.r._........_........................�. rc,.mant: 818 -539-1801
Brokers of CA, Inc. License #0726293 _ cDn1
505 N. Brand Boulevard, Suite 600 at o" ,s: "oberlllalf cerlificatcs,�ra
Glendale CA 91203
INSURER(S) AFFORDING COVERAGE NAIC#
INSURER A: Federal Insurance Company 20281
INSURED ROBEHAL-03
INSIIJIfVII?.I1 B Ansi., lance America, Inc, 24554
:,
Robert Half International Inc
'y I r'Er•I Ori -I
� I sT�TUTs:' I::II �
2613 Camino Ramon
INSURER C: Lloyds' Syndicate 2623/623 (Boazlcy f�urlonge 11 td)
San Ramon, CA 94583
INSURER D:
INSURER E :
INS'U'RER F'
COVERAGES CERTIFICATE NUIMBER:235982'80
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,
ILTR TYPE OF INSURANCE wqD y n POLICY NUMBER
(M DD YYMY) (t�%10.� 0DIYY YY1' LIMITS
A X COMMERCIAL GENERAL LIABILITY 35796687
6/1/2018 6/1/2019 EACH OCCURRENCE $ 2,000,000
PerCfMmrOgfiregete $5,000,000
DAI°JIAGE'T'o RENTED
CLAIMS -MADE I X I OCCUR
i_PIaLMISES(E oerll,Irrurrc) _ $2,000,000
X "' I
MED EXP (Any one person) $'80,000
X n+;,, VP II' H'
PER50NAII. A ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER',
GENERAL AGGREGATE 21MIMIM
X POLICYI"1141• LOC
1EC1
PRODUCTS • COMP/OP I Tat, ''.1: 2,00101,V1101(i
OTH'ET^
Employer Liability ",llA''8Y;:8
A AUTOMOBILE LIABILITY 73233217
6/1/2018 6/1/2019 COMBINED SINGLEI,.lrM1. $1,000,000
(Ea accident)
X ANY AUTO
901.91LY Ill 1Y (11er l:x+nrrrosrl I
OWNED
SCHEDULED
90UII...Y INJ6.11••iV'(I-Ior;aocadont)
,I AUTOS ONLY
AUTOS
HIRED
NON -OWNED
11 I'll 0r Iti II,IPI W II IIIA Ill
AUTOS ONLY
AUTOS 0NI.Y
,u,,cldonlp
Cumpfcall'oold: $1,0001$1,000
UMBRELLALIAB i X 79217107
A X I� C:U�•�"JI"t
6/1/2018 6/1/2019 EACH OCCURRENCE $5,000,000
EXCESS LIAB t;t„M,IVv1S C 1A�JE
r
I, AGGREGATE i' $ 5,000,000
DEEP X I F'CI::,aC-I+Y°1 NSIn
B WORKERS COMPENSATION Y
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUIIVE IN N/A
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
A PP.rscnalProi,.re0y w/TIB
C PrglessilarnalI rlan,d'Illy
C Ca IfTlel[`Idellly
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required)
Rights of Subrogation have been waived with respects to Workers Compensation as required by written contract executed prior to loss.
CERTIFICATE HOLDER
City of EI Segundo
350 Main Street
EI Segundo CA 90245-3813
USA
ACORD 25 (2016/03)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
©1988.2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
2' of 10 5233
$
Supplemental
See attached Su DP
6/1/2018
6/1/2019
'y I r'Er•I Ori -I
� I sT�TUTs:' I::II �
E.L. EACH ACCIDENT x'1,000,000
E DISEASE - EA EMPLOYEE! $ 1,000,000
E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000
35798687
6/1/2018
6/1/2019
Pto)rnlly1.ln'1h $500,000
W26BC2190101
3/31/2019
3/31/2020
PerCfMmrOgfiregete $5,000,000
W26978190101
3/31/2019
3/31/2020
Each Loss $5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required)
Rights of Subrogation have been waived with respects to Workers Compensation as required by written contract executed prior to loss.
CERTIFICATE HOLDER
City of EI Segundo
350 Main Street
EI Segundo CA 90245-3813
USA
ACORD 25 (2016/03)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
©1988.2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
2' of 10 5233
Liability Insurance
Endorsement
Policy Period
Effective Date
Policy Number
Insured
Name of Company
Date Issued
This Endorsement applies to the following forms:
GENERAL LIABILITY
Who Is An Insured
Additional Insured -
Scheduled Person
Or Organization
JUNE 1. 2018 TO JUNE I, 2019
JUNE I, 2018
3579-66-67 SFO
ROBERT HALF INTERNATIONAL, INC
FEDERAL INSURANCE COMPANY
JUNE I, 2017
Under Who Is An Insured, die following provision is added.
Persons or organizations shown in the Schedule are Insureds; but they are insureds only if you are
obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by
this policy.
However, the person or organization is an insured only:
• if and then only to the extent the person or organization is described in the Schedule;
• to the extent such contract or agreement requires the person or organization to be afforded
status as an insured;
• for activities that did not occur, in whole or in part, before the execution of the contract or
agreement; and
• with respect to damages, Ws, cost or expense for injury or damage to which this insurance
applies.
No person or organization is an insured under this provision:
• that is more specifically identified under any other provision of the Who Is An Insured
section (regardless of any limitation applicable thereto).
• with respect to any assumption of liability (of another person or organization) by them in a
contract or agreement. This limitation does not apply to the liability for damages, loss, cost or
expense for injury or damage, to which this insurance applies, dial (lie person or organization
would have in the absence of such contract or agreement.
Liability Insurance continued
Form 80.02-2367 (Rev. 5-07) Endorsement Page t
UabAlty Endorsement
(continued)
Under Conditions, the following provision is added to the condition titled Other Insurance.
Condldons
Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization
Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case
Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person
Person Or Organization or organization.
Schedule
Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with
such insurance as is afforded by this policy,
All other terms and conditions remain unchanged.
Authorized Representative��,�
Liabitity Insurance Iastpage
Form 80-02-2367 (Rev. 5.07) Endorsement Page 2
II "' do 91 tII I•"II" A 'aMR I,„ „, 1" 11. N c .
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III VI"I''�II'i i, L' VI,I'r �.' II''I 11h,'',; Eli'�i,'t I',I��,,u' I'I^"Pp II'v' I.I I11,li,'II 1:"IIi Iii p �'II,' IJJII41Nll a.'diJMl I�1
1. III II;h�III','
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If I
I° I,'��11'L I,'�II""I'�I„' 111 ",1, lil II'91I ���,^�, !I,,;��V�'r„'1o, N11,°.'ll''Il �•, V"'"„,
2018-2019 RHI Workers Compensation Policy Numbers
P la Icvlk States Pcaticv t.nl 01 Mato I-xDate N sisin _0R a20
lRobert Half International. Inc, and Protiviti Inc.
AOS: AL, AR, AZ, CA, CO, CT,
DC, DE, FL, GA, HI, IA, ID, IL, IN,
KS, KY, LA, MA, MD, ME, MI, MN,
MO, MS, MT, NO, NE, NH, NJ,
NM, NV, NY, OK, OR, PA, RI, SC,
RWD3001140-02 SD, TN, TX, UT, VA, VT, WV RHI/ Protiviti
RWR3001141-02 WI RHI/ Protiviti
Protiviti Government Services, Inc.
6/1/2018 6/1/2019 XL Insurance America, Inc.
6/1/2018 6/1/2019 XL Insurance America, Inc.
AOS: AZ, CO, DC, IL, MA, MD,
RWR3001142-02 INE, NH, NJ, NY, TX, VA Prot. Govt. Svs. 6/1/2018 6/1/2019 XL Insurance America, Inc.
WORIKIERS EMPLOYll LI, BILfTYINS'l NtAti f."GUCY W'C 00 03'13
WAIVER OF OU11:1 RIGHT 111"0 RECOVER FROM OTHERS ENDORSEMENT
We have the right to reclover our payments from aryone fiable for an injury covered by this policy. We w1fl not enforce
our right against the person or organization nanned In the Schedule. (Thiis agreement applies only to the extent tt'ial
you perform work tnider a wrRten contract that requk,es you to obtain Ws agreement frorn us,)
This agreernent Du ll not operate direcifly or indirectly to benefit anyone not narned Vn the Schedl.fle
Schedule
Where required by written agreemeant !signed prior to ioss.
I I I I 1 1111111 11 Jill 11 illill I q
T
(The informati.n, to equired only when this endorsement is issued subsequent to preparation of the pill
Endorsement Effective 06/01/2018 Policy No, Endorsement No
' ,�,A
Insured
Robert Half International, Inc.
Insurance Company Countersigned by
XL Insurance America, Inc,
0 1983 National Council an Compensation Insurance,