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PROOF OF INSURANCE (2019 - 2020) CLOSED. 0 I DATE (MM/DD/YYYY) ,�""RC"R" CERTIFICATE OF LIABILITY INSURANCE 03/29/2019 Ili4� THIS CERTIFICATE IS ISSUED ASA 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). PRODUCER CONTACT Julie Wong NAME: IQ Risk Insurance Services, LLC 10DRESS� NE (949) 679-3700 V FATS (949) 679-3701 o, Sxtp; WC. NO: 38 Executive Park, Suite 320 AIL jwong@igrisk.com Irvine, CA 92614 I, INSURER(S) AFFORDING COVERAGE NAIC # wsURERA: Kinsale Insurance Company 38920 I INSURED INSURER B: Falls Lake Fire and Casualty Company 15884 CC LAYNE & SONS INC INSURER C ; 216 Standard Street INSURER D EI Segundo, CA 90245 INSURER E INSURER F: COVERAGES CER'TIFIC'ATE NUMBER: CL1913104485 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 AODL SUdH POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) IMM1001f'YYYy X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ��Y5AMAGE TO RENTED RE$ 100,000 CLAIMS-MADE OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) $ Excluded I A Y Y 010061552-1 02/01/2019 02/01/2020 PERSONAL&ADV INJURY s 1,000,000 GGEENT,A�G'G'REGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2000,000 _C F PRD 1:1 LOC PRODUCTS I $2,000,000 .-NJ PQtiICY T OTHER $ AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMVT $ _ tEa'acridcnl$ ANYAUTO 1 BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) I $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE � $ AUTOS ONLY AUTOS ONLY tPer aac'adentl X UMBRELLA LIAR OCCUR I EACH OCCURRENCE II $ 2,000,000 A - EXCES{SLIAB CLAIMS-MADE 0100061562-1 02/01/2019 02/01/2020 I AGGREGATE V $ DED p I RETENTION S $ WORKERS COMPENSATION I P I XI PER Y— OTH- AND EMPLOYERS' LIABILITY STATUTE ER YIN I 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA FLA008293-01 02/01/2019 02/01/2020 ` E L, EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? IIII 1,000,000 (Mandatory in NH) N E DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ _ I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) *10 Days Notice of Cancellation for Non-Payment of Premium City of EI Segundo is named as Additional Insured with respect to Genera( Liability policy. Blanket Additional Insured and Waiver of Subrogation Endorsement applied and attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of EI Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street AUTHORIZED REPRESENTATIVE EI Segundo, CA 90245 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD