SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
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. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
6/26/2025
AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230
Lafayette CA 94549
Dani Schulze 714-202-0390 [email protected] License#: 6003745 Great American Assurance Company 26344 GRIFSTR-01 ARCH SPECIALTY INSURANCE COMPANY 21199 Griffin Structures Inc
1 Technology Dr., Building I Ste. 829
Irvine CA 92618
United Financial Casualty Company 11770 Oak River Insurance Company 34630 1148201112 A X 1,000,000 X 50,000 X Contractual Liab Excluded Included 1,000,000 2,000,000 X Y Y GLP5775546 12/31/2024 12/31/2025
2,000,000 Deductible 5,000
C
1,000,000 X
X X
Y Y 06409713 12/31/2024 12/31/2025
A X 1,000,000 XY Y EXC5775547 12/31/2024 12/31/2025
1,000,000
D Y GRWC529454 12/31/2024 12/31/2025
X
1,000,000 1,000,000 1,000,000
B Professional Liability Y PDCPP0038504 12/31/2024 12/31/2025 Per Claim Aggregate Limit
Deductible
$2,000,000
$4,000,000
$25,000
The following policies are included in the underlying schedule of insurance for umbrella/excess liability: General Liability/Auto Liability/Employers Liability.
Project: Fire Stations 1 and 2, rebuild the Main Police Station, and renovate the Police Annex Facility City of Redondo Beach, its officers, elected and appointed officials, employees are named as an additional insured as respects general liability and auto liability as required per written contract. General Liability and Auto Liability are Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsement(s).
30 Day Notice of Cancellation
City of Redondo Beach
415 Diamond Street
Redondo Beach CA 90277
Class 2 14054
06 CPP0011 00 04 15 Page 23 of 23
The first Named Insured shall act on behalf of all Insureds for all purposes, including but not limited to the payment or return of premium, receipt and acceptance of any endorsement issued to form a part of this Policy, complying with all applicable Claim provisions, giving and receiving notice of cancellation or nonrenewal, reimbursement to the Insurer of any Retention advanced and the exercise of the rights provided in Section 11. Extended Reporting Period or Section 24.
Subrogation.
24. SUBROGATION
In the event of any payment under this Policy, the Insurer shall be subrogated to all the rights of recovery against any person or organization and the Insured or Additional Insured (if applicable) shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured or Additional Insured (if applicable) shall do nothing to prejudice such rights.
The Insurer shall not exercise any such right against any Insured, Additional Insured (if applicable) or against any clients if prior to the Claim, a waiver of subrogation was so required and accepted under a specific contractual undertaking by such Insured. All recoveries obtained through subrogation shall be applied equally towards the Retention and the costs with any remaining balance payable to the Insurer. 25. TITLES The titles of the sections of and endorsements to, this Policy are for reference only. Such titles shall not be part of the terms and conditions of coverage.
Policy # PDCPP0038504
Endorsement Effective: Policy No.:
Insured:
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10 C (Ed. 01-19)
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 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.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Blanket Waiver
Person/Organization Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
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 No.: Premium $
Insurance Company: WC 99 04 10 C
Countersigned by ______________________________________ (Ed. 01-19)
Job Description
All CA Operations
Oak River Insurance Company
12/31/2024 GRWC529454
Policy # GLP5775546
Policy # GLP5775546
Policy # GLP5775546
Policy # GLP5775546