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PROOF OF INSURANCE (2020) CLOSEDClient#: 1266412 305FLEMIENV ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE (MMM01YYYY) 1 0413012019 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 cortificalo holder Is an ADDITIONAL INSURED, the pollcy(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 andorsemenl(s). PRODUCER 04TAC NAMR7 Allie Mosier McGriff Insurance Services PH E (NC�11 No, PAX 2400 E Katella Ave Suite 1100 EMAIL Egl; 714 941-2900 f ADDarnosieTomcgriffinsturance.com :Anaheim, CA 92806 714 941.2800 Lq�!�TM�J,AFFORDING COVERAG NAIC N INSURER A Hamrkard laeurarcaCompany or New York 34452 INSURED INSURER B Oak River insurance company630 Fleming Environmental Inc. INSURER TFaVolers PrupojKCAsually Co of Amer 25674 1372 East Valencia Drive . . . . ...... ..... . . . .... . .......... Fullerton, CA 92831 I"YRIER D Arnaft-Aut.mobils. In .................ur a n 11. Co 21849 INS .......... 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 FORTHE 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 BEEN REDUCED BY PAID CLAIMS, SURANCE., 101M, F41 ............ .......... tpPA EXP DIT IMIDDly, oryyyyj I L TYPE POLICY NUMBERLIMITS X COMMERCIA, L GENERAL LIABILITY 7930050560003 651101120191 051011202e EAcHorcuRRE m c "I'll" ............. E S1,000 oqo CLAIMS -MADE OCCUR 000_fL,000 X Pollution L MED EXP,.ft one poFm,__ .... )_ $10,000 .......... X1 P19N"Ionaliab Liab PEASONAL & OV S1 Q00,000 RY_ GEN 'L AGGREGATE LIMIT APPLIES PER: AENERAk. AGGS2 ......... —REGATE A-09% 00 POLICY EXI E LOC P owcTs-ca.mpmf'AGG s2,000,000 OTHEk S DA AUTOMOBILE LIABILITY MXA80339812 -05101/2019 D'S/0112020 COMBINLU SINGLE LIMIT �IAOQ'000 ANY AUTO BODILY INJURY Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY Ix - AUTOS ONLY ........... BODILY INJURY (Per acxidenQ 6 PROPERDIDAMAGE (PIN ......... . ............. . UMBRELLA LIAB N......�xOCCUR 7930050570003 05/01/2019 05/011202Q EACH OC��Y�5ENCE 6 000 M X EXCESS LIAB QAIMS4MAD�' Ocoo I X1 REIENVONSO B WORKERS COMPENSATION AND EMPLOYERS'L(ABILITY FLWC011910 PER . . ............ 05101/2019 05/01);202J YIN ANY $Ii�OPRPETOMPARtt4Ef4jEXECU'ThVE — OFRCEWMEMDER EXCLUDED1 [N N/A E�.LEACH ACCIDENT Isi'000.000 [EE (Mondalcry In NH) _J On, DISEASE- EA EMPLOYC C 1 610010000 dosuibounder 'ON �f _()ME.nT!9NA'PeIoW E1. OtSEA$E � POL ICY LI S1,000,000 IN� C Rented/Leased QT6603L337320TIL19 05101/2019 05/0112020 $160,000 Limit Equipment $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1111, Additional Remarks Schedule, may be attached If more space Is required) RE: Maintenance Agreement No, 5331 The City of El Segundo, its officers, officials, employees, agents and volunteers are named as additional insured as respects general liability, this Insurance is primary and noncontributory with any other Insurance of the additional insured; and waiver of subrogation applies as respects workers compensation as required by written contract, per endorsements attached, (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 150 Illinois Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE @1988-2015ACORD CORPORATION, All rights reserved, ACORD 26 (2016/03) 1 of The ACORD name and logo are registered marks of ACORD #S234819591M23481944 ACMCIS DESCRIPTIONS (Continued from Page 1) Should any policy be cancelled before the expiration date, BBBT Insurance Services will mail 30 (thirly) days written notice to the certificate holders which require such action per written contract or agreement, except 10 days notice of cancellation for non-payment of premium. SAGITTA 25.3 (2016103) 2 Of 2 #S234819591M23481944 Policy Number:793-00-50-56-0003 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - FORM; I This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION It — WHO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (b) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain the same. OBENV GE 301 (02 11) Includes copyrighted material of Insurance Services Office, Inc. 101`1 Copyright 2011, OneBeacon Insurance Group LLC E -INSURED Policy Number: 793-00-50-56-0003 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oryanization(s): Location And Description Of Completed Operations: Any person or organization for which the Any location or completed operation, but Named Insured has agreed to provide only to the scope of insurance agreed to insurance prior to loss as provided by by the Named Insured. this policy but only to the scope of insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION 11 — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the SCHEDULE above, but only with respect to liability for bodily injury, property damage or environmental damage caused, in whole or in part, by your work at the location designated and described in the SCHEDULE above performed for that additional insured and included in the products - completed operations hazard. All other terms and conditions remain the same. OBENV GE 304(0211) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E -INSURED WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an Inyury covered by thls policy. We will not enforce our right against the person or organlzation named In the Schedule. (TAs agreement applies only to the extent that you perform work under a written contract, that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER PersonlOrganlzatlon Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations This endorsement changes the policy to which It is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 05101/2019 Insured Insurance Company Oak River Insurance Company WC 99 04108 (Ed. 9-14) Policy No. FLWC011910 Countersigned by Endorsement No. Premium $