8/5/2022
Professional Concepts Insurance Agency, Inc.
1127 South Old US Highway 23
Brighton MI 48114-9861
[email protected]
(800)969-4041 (800)969-4081
[email protected]
Walker Consultants, Inc.
707 Wilshire Blvd., Suite 3650
Los Angeles CA 90017
Travelers Indem. Co of America 25666
Travelers Indemnity Co. of CT 36170
Travelers Indemnity Co 25658
XL Specialty Ins. Co. 37885
22-23 NEW #37
A
B
X
X
X Contractual Liability
X X,C,U
X
X Y 6801J1254172247 5/23/2022 5/23/2023
660-5N988754 -FL
6801J1669102247 -CA
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
C
X
X X
X Y BA8R00910A2247 5/23/2022 5/23/2023
1,000,000
C
X X
X 10,000 X Y CUP1D3197442247 5/23/2022 5/23/2023
10,000,000
10,000,000
C
N
UB5K3205582247 5/23/2022 5/23/2023
X
1,000,000
1,000,000
1,000,000
D Professional Liability DPR9992988 5/23/2022 5/23/2023 Per Claim 5,000,000 Aggregate 7,500,000
Re: Walker Project #37-009397.00, City of Redondo Beach 2021 Restoration North Pier, South Pier, and Plaza Parking Structures.
City of Redondo Beach, The City, its Officers, Elected and appointed Officials, Employees and Volunteers are considered additional insured's with respects to general and auto liability coverages as long as required within a written contract. Waiver of subrogation in favor of certificate holder and additional insured's as long as required within a written contract. Coverage is primary and non-contributory as it applies to general liability, auto liability and umbrella. 30 day written notice provided to certificate City of Redondo Beach
Public Works Department
Attn: Lauren Sablan
415 Diamond Street
Redondo Beach, CA 90277
[email protected]
Mike Cosgrove/MAEGAN
Y
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE
JECT LOC PRO- POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
CLAIMS-MADE OCCUR
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
DED RETENTION $
CLAIMS-MADE
OCCUR
$
AGGREGATE $
EACH OCCURRENCE $
UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTHER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under
DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
$
$
$
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.
INSD
ADDL
WVD
SUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
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 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
E-MAIL
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
holder and additional insured's for cancellation of coverages listed. 10 day notice for nonpayment of listed policies.
COMMENTS/REMARKS
OFREMARK COPYRIGHT 2000, AMS SERVICES INC.
EFFECTIVE DATE:
POLICY NUMBER:
ISSUE DATE:
680-1J125417-22-47
04/19/2022
05/23/2022
BUSINESSOWNERS (CONTINUED)
MP T5 31 05 10 MASSACHUSETTS CHANGES
MP T5 36 03 14 NORTH CAROLINA CHANGES
MP T5 45 01 18 NEW YORK CHANGES
CP T9 16 09 99 MASSACHUSETTS CHANGES - "POLLUTANTS"
MP T4 66 02 05 PENNSYLVANIA CHANGES
MP T4 81 01 00 GEORGIA CHANGES - "POLLUTANTS"
MP T5 01 01 20 GEORGIA CHANGES
MP T5 32 05 20 MINNESOTA CHANGES
MP T5 33 04 21 MICHIGAN CHANGES
MP T5 49 09 15 CONNECTICUT CHANGES
COMMERCIAL GENERAL LIABILITY * CG D4 69 02 19 TOT AGG LIMIT OTHER THAN PROJECTS * CG T0 07 04 09 DECLARATIONS PREMIUM SCHEDULE CG T0 08 07 86 KEY TO DECLARATIONS PREMIUM SCHEDULE
TABLE OF CONTENTS - COMMERCIAL GENERAL LIABILITY
COVERAGE FORM CG T1 00 02 19
CG T0 34 02 19
CG T1 00 02 19 COMMERCIAL GENERAL LIABILITY COVERAGE FORM GN 00 70 08 13 ILLINOIS EXCLUSION - LIQUOR LEGAL LIABILITY
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
COMPLETED OPERATIONS * CG 20 37 07 04 * CG 24 04 12 19 WVR OF TRANS OF RIGHTS OF RECOVERY
AMENDATORY ENDORSEMENT - PRODUCTS-COMPLETED OPERATIONS
HAZARD
CG D3 09 02 19
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORG * CG D3 61 03 05
SCHEDULED ADDITIONAL INSURED (ARCHITECTS, ENGINEERS
AND SURVEYORS) * CG D3 82 09 15
CG D4 23 07 08 COVERAGE TERRITORY LIMITATION
CG D6 75 02 19 AMEND-WHO IS INS-ARCHIT/ENG/SURVEY ACTIV * CG D9 10 09 21 AMENDMENT OF INTELLECTUAL PROPERTY EXCLUSION CG D2 03 12 97 AMEND - NON CUMULATION OF EACH OCC
CG F1 56 07 11 WAIVER OF IMMUNITY - PORT AUTHORITY * CG T8 01 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 02 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 03 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 04 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 05 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 06 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 07 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 08 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 09 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 10 05 22 GENERAL PURPOSE ENDORSEMENT * CG T8 11 05 22 GENERAL PURPOSE ENDORSEMENT * TEXT IN THIS FORM HAS CHANGED, OR THE FORM WAS NOT ON POLICY BEFORE.
IL T8 01 01 01 PAGE: 2 OF 5
COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method also.
Under this approach each insurer contributes
equal amounts until it has paid its applicable
limit of insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable limit
of insurance to the total applicable limits of
insurance of all insurers.
d. Primary And Non-Contributory Insurance If
Required By Written Contract
If you specifically agree in a written contract or
agreement that the insurance afforded to an
insured under this Coverage Part must apply on
a primary basis, or a primary and noncontributory basis, this insurance is primary to other insurance that is available to such insured
which covers such insured as a named insured,
and we will not share with that other insurance,
provided that:
(1) The "bodily injury" or "property damage" for
which coverage is sought occurs; and
(2) The "personal and advertising injury" for
which coverage is sought is caused by an
offense that is committed;
subsequent to the signing of that contract or
agreement by you.
5. Premium Audit
a. We will compute all premiums for this Coverage
Part in accordance with our rules and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only. At
the close of each audit period we will compute
the earned premium for that period and send
notice to the first Named Insured. The due date
for audit and retrospective premiums is the date
shown as the due date on the bill. If the sum of
the advance and audit premiums paid for the
policy period is greater than the earned
premium, we will return the excess to the first
Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.
The unintentional omission of, or unintentional error
in, any information provided by you which we relied
upon in issuing this policy will not prejudice your
rights under this insurance. However, this provision
does not affect our right to collect additional
premium or to exercise our rights of cancellation or
nonrenewal in accordance with applicable insurance
laws or regulations.
7. Separation Of Insureds
Except with respect to the Limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part 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 claim
is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of any payment we have made under this Coverage Part,
those rights are transferred to us. The insured must
do nothing after loss to impair them. At our request,
the insured will bring "suit" or transfer those rights
to us and help us enforce them.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we will
mail or deliver to the first Named Insured shown in
the Declarations written notice of the nonrenewal
not less than 30 days before the expiration date.
If notice is mailed, proof of mailing will be sufficient proof of notice.
SECTION V - DEFINITIONS
1. "Advertisement" means a notice that is broadcast or
published to the general public or specific market
segments about your goods, products or services
for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding websites, only that part of a website
that is about your goods, products or services
for the purposes of attracting customers or
supporters is considered an advertisement.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
POLICY NUMBER: BA-8R00910A-22-47-G
EFFECTIVE DATE: 05/23/2022
ISSUE DATE: 04/19/2022
LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS
BY LINE OF BUSINESS
IL TO 02 11 89
IL TB 01 01 01
IL TO 01 01 07
COMMERCIAL AUTO
CA TO 01 02 15
CA TO 03 02 15
CA TO 31 02 15
CA 00 01 10 13
CA 04 44 10 13
CA 20 48 10 13
CA T4 52 02 16
CA T4 59 02 15
CA T4 74 02 16
CA T3 53 02 15
CA TB 02 05 22
CA 01 10 11 20
INTERLINE ENDORSEMENTS
IL T3 20 05 19
IL T4 27 06 19
IL TB 00 05 22
IL T4 12 03 15
IL 00 21 09 08
IL 02 86 04 17
IL TS 01 01 01
COMMON POLICY DECLARATIONS
FORMS ENDORSEMENTS AND SCHEDULE NUMBERS
COMMON POLICY CONDITIONS
BA- COVERAGE PART DECS (ITEMS 1 & 2)
BUS AUTO COV PART DECLARATIONS-4&5
TABLE OF CONTENTS-BUSINESS AUTO COV FORM
BUSINESS AUTO COVERAGE FORM
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST
OTHERS TO US (WAIVER OF SUBROGATION)
DESIGNATED INSURED FOR COVERED AUTOS LIABILITY
COVERAGE
SHORT TERM HIRED AUTO - ADDITIONAL INSURED AND LOSS
PAYEE
AMENDMENT OF EMPLOYEE DEFINITION
BLANKET ADDITIONAL INSURED - PRIMARY AND
NON-CONTRIBUTORY WITH OTHER INSURANCE
BUSINESS AUTO EXTENSION ENDORSEMENT
PRIMARY AND NON CONTRIBUTORY
MICHIGAN CHANGES
NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US
ADDITIONAL BENEFITS
GENERAL PURPOSE ENDORSEMENT
AMNDT COMMON POLICY COND-PROHIBITED COVG
NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD
FORM)
MICHIGAN CHANGES - CANCELLATION AND NONRENEWAL
PAGE: 1 OF 1
ADDRESS:
POLICY NUMBER: ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED PERSON OR ORGANIZATION – NOTICE OF
CANCELLATION OR NONRENEWAL PROVIDED BY US
This endorsement modifies insurance provided under the following:
ALL COVERAGE PARTS INCLUDED IN THIS POLICY
SCHEDULE
CANCELLATION: Number of Days Notice:
WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice:
PERSON OR
ORGANIZATION:
IL T4 00 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1
ANY PERSON OR ORGANIZATION TO WHOM YOU
HAVE AGREED IN A WRITTEN CONTRACT THAT
NOTICE OF CANCELLATION OR NONRENEWAL OF THIS POLICY
WILL BE GIVEN, BUT ONLY IF:
1. YOU SEND US A WRITTEN REQUEST TO
PROVIDE SUCH NOTICE, INCLUDING THE
NAME AND ADDRESS OF SUCH PERSON OR
ORGANIZATION, AFTER THE FIRST NAMED
INSURED RECEIVES NOTICE FROM US OF
THE CANCELLATION OR NONRENEWAL OF THIS POLICY; AND
2. WE RECEIVE SUCH WRITTEN REQUEST AT
LEAST 14 DAYS BEFORE THE BEGINNING OF
THE APPLICABLE NUMBER OF DAYS SHOWN
IN THIS SCHEDULE.
THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US.
PROVISIONS
A. If we cancel this policy for any legally permitted
reason other than nonpayment of premium, and a
number of days is shown for Cancellation in the
Schedule above, we will mail notice of
cancellation to the person or organization shown
in such Schedule. We will mail such notice to the
address shown in the Schedule above at least the
number of days shown for Cancellation in such
Schedule before the effective date of cancellation.
B. If we do not renew this policy for any legally
permitted reason other than nonpayment of
premium, and a number of days is shown for
When We Do Not Renew (Nonrenewal) in the
Schedule above, we will mail notice of
nonrenewal to the person or organization shown
in such Schedule. We will mail such notice to the
address shown in the Schedule above at least the
number of days shown for When We Do Not
Renew (Nonrenewal) in such Schedule before the
effective date of nonrenewal.
45 45
BA-8R00910A-22-47-G 04-29-22
Endorsement Effective
Countersigned by
Policy No.
Insured Premium $
Insurance Company
Endorsement No.
All other terms and conditions of this policy remain unchanged. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
TO DESIGNATED PERSONS OR ORGANIZATIONS
NOTICE OF CANCELLATION
POLICY NUMBER:
ENDORSEMENT WC 99 06 R3 (00) -
EMPLOYERS LIABILITY POLICY
AND
WORKERS COMPENSATION
Notice Of Cancellation To Designated Persons Or Organizations Name and Address of Designated Persons or Organizations: Number of Days Notice The following is added to PART SIX – CONDITIONS :
SCHEDULE
If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation is to take effect.
You are responsible for providing us with the information necessary to accurately complete the Schedule below.
If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation.
ONE TOWER SQUARE
UB-5K320558-22-47-E
HARTFORD CT 06183 003
ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED IN A
WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY:
1. YOU SEE TO IT THAT WE RECEIVE A WRITTEN REQUEST TO PROVIDE SUC
H NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGAN
IZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US O F THE CANCELLATION OF THIS POLICY; AND
2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE
BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT.
THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US.
BLANKET NOTICE OF CANCELLATION
45 DATE OF ISSUE: ST ASSIGN: Page of
© 2013 The Travelers Indemnity Company. All rights reserved. 04-29-22 1 1
POLICY NUMBER: CUP-1D319744-22-47
EFFECTIVE DATE: 05/23/2022
ISSUE DATE: 04/20/2022
LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS
BY LINE OF BUSINESS
IL TS 01 01 01
UMBRELLA/ EXCESS
EU 00 02 09 20
EU 00 03 08 18
EU 00 01 07 16
EU 00 05 07 16
EU 02 34 07 16
EU 03 46 08 18
EU 01 44 07 16
EU 03 15 08 18
EU 00 07 07 16
EU 01 30 08 18
EU 01 48 08 18
EU 01 57 07 16
EU 02 86 09 20
EU 02 09 08 18
EU 02 90 07 16
EU 03 31 08 18
EU 03 44 08 18
EU 04 21 09 21
EU 00 49 11 16
EU 00 79 08 18
EU 00 80 08 18
EU 02 88 07 16
INTERLINE ENDORSEMENTS
IL T3 20 05 19
IL T3 68 01 21
IL 09 10 07 02
IL T4 00 05 19
POLICY HOLDER NOTICES
PN Tl 94 11 21
IL TS 01 01 01
FORMS ENDORSEMENTS AND SCHEDULE NUMBERS
POLICY DECLARATIONS EXCESS FOLLOW-FORM AND UMBRELLA
LIABILITY INSURANCE POLICY
SCHEDULE OF UNDERLYING INSURANCE
EXCESS FOLLOW-FORM AND UMBRELLA LIABILITY INSURANCE
SCHEDULE OF NAMED INSUREDS
AMENDMENT OF COVERAGE - DEFINITIONS
NON CUMULATION OF OCCURRENCE LIMIT
COVERAGE FOR FINANCIAL INTEREST IN FOREIGN INSURED
ORGANIZATIONS
AMENDMENT OF UNDERLYING INSURANCE DEFINITION
CAP LOSSES - CERT ACTS TERRORSM AND EXCL
ARCHITECT, ENGINEER OR SURVEYOR PROFESSIONAL SERVICES
EXCLUSION - COVERAGE B
DAMAGE TO PROPERTY EXCLUSION - COVERAGE A
DESIGNATED PROFESSIONAL SERVICES EXCLUSION - COVERAGE
B
UNMANNED AIRCRAFT EXCLUSION - COVERAGES A AND B
NUCLEAR ENERGY LIABILITY EXCLUSION (BROAD FORM) -
COVERAGES A AND B
WATERCRAFT LIABILITY EXCLUSION - COVERAGE B
DISCRIMINATION EXCLUSION - COVERAGE B
LEAD EXCLUSION - COVERAGE B
INTELLECTUAL PROPERTY EXCLUSION - COVERAGE B
MICHIGAN CHANGES
INDIANA CHANGES - DEFINITION OF POLLUTANTS
INDIANA CHANGES - WORKERS COMPENSATION EXCLUSION
WAIVER OF IMMUNITY - PORT AUTHORITY
NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US
FEDERAL TERRORISM RISK INSURANCE ACT DISCLOSURE
PENNSYLVANIA NOTICE
DESIG PERSON, ORG-NOTICE PROVIDED BY US
IMPORTANT NOTICE - LEAD EXCLUSION
PAGE: 1 OF 1