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PROOF OF INSURANCE (2020) CLOSEDC, I DATE (MM/DD/YYYY) 111 CERTIFICATE OF LIABILITY INSURANCE 9/25/2019 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. IMPORTAN'T': If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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). CONTPRODUCER NAME. T Nancy Ferrick Renton & PHONE FAX License # 00207396Associates E-MAIL rxEss Infer pck deptleyrentot .com 90 ^ No):510-452-2193 P O. o Oakland CA 94604-2675 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Sentinel Insurance Company ,11000 INSURED AKMCONSUL INSURER 13: Travelers Casualty and Surety Co of America ,31,194 AKM Consulting Engineers, Inc. INSURER C: Hartford Casualty Insurance Company 29424 553 Wald Street Irvine CA 92618-4627 INSURER D7 INSURER E: INSURER F � COVERAGES CERTIFICATE NUMBER: 195222723 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, INSR ��.�.�TM, „,, iALiD�b�; PO'L' POLICY EFF ' POLICY EXP „ PE OF INSURANCE ICV NUMBER (MMI IYYVYI (MMIDD/YYYVI LIMIT S A X COMMERCIAL GENERAL LIABILITY Y Y 57SBWLUB719 9/20/2019 9/20/2020EACH OCCURRENCE $2,000,000 I .., OAMAG= 1'�PO P�kENI'ED CLAIMS -MADE XOCCUR PVYMNp'�E,S,(c,� occaa(rerlaa) S 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) All Operations of the Named Insured, City of EI Segundo, its officers„ officials, employees and volunteers are named as Add'it'ional Insured as respects General and Auto Liab'il'ity as required by written contract or agreement. General Liabilily Insurance is Primary/Non Conlrrbutory per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsernent(s). 30 ay Notice of Cancellation, CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of EI Segundo 350 Main Street EI Segundo CA 90245-3895 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MED EXP (Any one person) $ 10,000 s 2,000,000 PERSONAL 8 ADV INJURY i GENLAGG EG ROT APP XTEP PRO - POLICY ®C ...„, JE.C.'r PRODUCTSGCOMP OP AGG $4,000,000 0T'HER: A AUTOMOBILE LIABILITY Y Y 57SBWLUB719 9/20/2019 9/20/2020 L.CO BmINED INGLELIMIT $2000000 ANY AUTO I BODILY INJURY (Per person) $ II OWNEDSCHEDULED (Per accident) $ X AUTOS ONLY X AUTOS0061RLYRICJJ HIRED NON -OWNED DA0AG�E AUTOS ONLY AUTOS ONLY t t�'el amglarc( ) A X UMBRELLALIAB X OCCUR Y Y 57SBWLUB719 9/20/2019 9/20/2020 EACH OCCURRENCE $1,000,000 EXCESS LII I CLAIMS -MADE I AGGREGATE $1,000_,000 pESS RETE RETENTION $ C WORKERS GOERS Y 157WEGZS0250 9/20/2019 9/20/2020 'PER OTH- X UTE ER AND LI TIOIN IN ANYPROPRIETOR/PARTNER/EXECUTIVE CYN E EACH OFFICER/MEMBEREXCLUE N/A I (Mandatory in NH) E L, DISEASECEAEEMPLOYEE$ 1,000,000 If yes, describe under DISEASE LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below EL -POLICY B Professional Liability 105344511 9/20/2019 9/20/2020 $2,000,000 per Claim $2,000,000 Annual Aggregate DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) All Operations of the Named Insured, City of EI Segundo, its officers„ officials, employees and volunteers are named as Add'it'ional Insured as respects General and Auto Liab'il'ity as required by written contract or agreement. General Liabilily Insurance is Primary/Non Conlrrbutory per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsernent(s). 30 ay Notice of Cancellation, CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of EI Segundo 350 Main Street EI Segundo CA 90245-3895 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Policy Number: 57sBwLue719 EXCERPTS FROM: Hartford Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. f. Any Other Party (1) Any other person or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury, "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products- completed operations hazard, but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products - completed operations hazard. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily injury, "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: inspection, or engineering E.5. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought. E.7.b.(7).(b) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. E.8.b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. EXCERPT FROM Hartford Form SS 04 38 09 09 HIRED AUTO AND NON -OWNED AUTO B. With respect to the operation of a "non -owned auto", WHO IS AN INSURED is replaced by the following: The following are "insureds": d. Anyone liable for the conduct of an "insured", but only to the extent of that liability. Insured Policy Number: AKM Consulting Engineers, Inc, 57WEGZS0250 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by 01' r Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: Policy Expiration Date: