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PROOF OF INSURANCE (2019) CLOSEDDATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/20/2018 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), PRODUCER CONTACT Aon Risk Insurance Services West, Inc. NAME. � ,NN . Ext): (866) 283-7122 FAX No.): (800) 363-0105 Los Angeles CA Office 707 wi 1 shire Boulevard E-MAIL Suite 2600 ADDRESS: Los Angeles CA 90017-0460 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Arch Indemnity Insurance Company 30_830 ACCO Engineered Svstem5, Inc. (INSURER B: Arch Insurance Company 11150 6265 San Fernando Road Glendale CA 91201 USA INSURER c: National Fire &Marine Ins Co 20079 IjINSURER D: Berkley Assurance Company 139462 III INSURER E: steadfast Insurance Company 126387 INSURER F: COVERAGES CERTIFICATE NUMBER, 5't03123841 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED T'O'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 CLAMS. Limit's shown are as requested LTR �,,,E .. ADD SUER pbB. cy ei' F POLICY EXP GNSR TYPE OF INSURANCE AAPS qP rb POLICYNUMBER MWD,OIYYYYq ffMM�IDWYYYYI LIMITS X I COMMERCIAL GENERAL LIABILITY Y 71PKG8949201 �O/U1/201f1 YU/R)1/YU19 EACHOCCURRENCE $2,000,000 UAMAU❑10 KLNILU CLAIMS -MADE � OCCUR _eREMISES dEa occurmace) $300,000 MED EXP (Any one person) $5,000 GEN'LAGGREGA'TE LIMITAPPLIES PER: POLICY MPRC LOC JECT a X l OTHER: B AUTOMOBILE LIABILITY X I ANYAUTO OWNED SCHEDULED AUTOS ONLYAUTOS HIRED AUTOS NON -OWNED ......_.. ONLY AUTOS ONLY C X UMBRELLALIAB X OCCUR ® EXCESS LIAR CLAIMS -MADE ® DED I �RET'ENTI'ON B WORKERS COMPENSATION AND Y Y 71PKG8949201 Y Y 42XSF30305803 EMPLOYERS LIABILITY Y I N ANY PROPRIETOR I PARTNER/EXECUTIVE et, A OFFICER/MEMBER EXCLUDED? NIA Y 71WCIB949101 AOS 74WCIB949001 PERSONAL& ADV INJURY $2,000,000 a GENERAL AGGREGATE $4,000,000 N _._. ,CTS-COMP/OP AGG mm $4,000,000 .. c 10/01/2018 10/01/2019 ND SINGLE LIMIT COMBO( 0 r 000, 000 $2,000,000 (Ea accident) BODILY INJURY (Per person) G Z BODILY INJURY (Per accident) a) PROPERTY DAMAGE v (Per accident) C d 10/01/2018 10/01/20191 EACH OCCURRENCE l $4,000,000 V AGGREGATE 1 $4,000,000 PERY 10/01/2018 10/01/2019 )(I STATUTE LjgH.l 10/01/2018 10/01/2019 E.L. EACH ACCIDENT I $1,000,000 (Mandatory in NH) CA E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 �. D Env Contr Prof IPCADB50050601018 10/01/2018 10/01/2019'Aggregate/Each LOSS $1,000,000 Claims Made Prof Agg SIR $600,000 SIR applies per policy terns & condi-ions Prof Each Claim SIR $200, 000a DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 107, Additional Remarks Schedule, may be attached if more space is required) [Re: Service, All operations at the City of El Segundo] 2i [AI: City of E1 Segundo, its officials, officers, agents, and employees] are included as Additional Insured with respect to the General Liability, Automobile Liability and Umbrella Liability policies; granted a waiver of Subrogation for General Liability, IzA Automobile Liability, Umbrella Liability and workers' Compensation policies; and the General Liability policy evidenced herein is Primary and Non -Contributory to other insurance available, as required by written contract, but limited to the operations ofV the Insured under said contract. CERTIFICATE HOLDER CANCELLATION ANY O OTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE HALL BE DELIVERED IN ACCORDANCE WITH THE .r-„�p POLICY PROVISIONS. mi City of El Segundo AUTHORIZED REPRESENTATIVE its officials, officers, agents and employees Public Works Department 350 Main Street, E1 Segundo CA 90245 USA ©1988-2075 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 71 PKG8949201 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, S, LESSENS OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s) All parties where required by a written contract Where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but 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 for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 location of the covered operations has been completed; or 2. 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. CG 20 10 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 2010 0413 POLICY NUMBER: 71 PKG8949201 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES ES OIC CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART , SCHEDULE Name Of Additional Insured Person(s) Or Location And Description Of Completed Operations Organization(s) All parties where required by a written contract Where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; 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. CG 20 37 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 71 PKG8949201 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF FIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization where waiver of our right to recover is permitted by law and is required by written contract provided such contract was executed prior to the loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: 71 PKG8949201 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO SIS (WAIVER. OF SUBROGATIION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: ACCO ENGINEERED SYSTEMS, INC. Endorsement Effective Date: October 1, 2018 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization where waiver of our right to recover is permitted by law and is required by written contract provided such contract was executed prior to the loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 44 1013 0 Insurance Services Office, Inc., 2011 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - BLANKET This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM Under Covered Autos Liability Coverage, the Who is An Insured provision is amended to include as an "insured" the person or organization who is required under a written contract to be included as an "insured" under this policy, but only with respect to their legal liability for your acts or omissions or the act or omissions of a person for whom Covered Autos Liability Coverage is afforded under this policy. All other terms and conditions of this policy remain unchanged. Endorsement Number: Policy Number: 71PKG8949201 Named Insured: ACCO ENGINEERED SYSTEMS, INC This endorsement is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date: 10-01-18 00 CA0115 00 10 13 Page 1 of 1 POLICY NUMBER: 71 PKG8949201 COMMERCIAL GENERAL LIABILITY CG 20 0104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ffewaff.: 1� �q fj I %L 04 oil I I ff§ 9 a This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) 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 INCL % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization ANY PERSON OR ORGANIZATION WHERE WAIVER OF OUR RIGHT TO RECOVER IS PERMITTED BY LAW AND IS REQUIRED BY WRITTEN CONTRACT PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO DATE OF LOSS Schedule Job Description 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 10-01-18 Policy No. 74WCIB949001 Endorsement No. Insured ACCO ENGINEERED SYSTEMS, INC. Premium $ INCL. Insurance Company ARCH INDEMNITY INSURANCE COMPANY Countersigned By © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers Compensation Insurance Forms Manual ©1999.