SECOND AMENDMENT TO THE AGREEMENT FOR CONSULTING SERVICES
BETWEEN THE CITY OF REDONDO BEACH
AND LUCCI & ASSOCIATES, INC.
THIS SECOND AMENDMENT TO THE AGREEMENT FOR CONSULTING SERVICES Second Amendment") is made between the City of Redondo Beach, a chartered municipal corporation (" City") and Lucci & Associates, a California corporation (" Contractor" or Consultant").
WHEREAS, on May 5, 2020, the parties entered into the Agreement for Consulting Services between the City and Consultant ( the " Agreement"); and WHEREAS, on May 3, 2022, the parties entered into the First Amendment to the Agreement to extend the term and raise the Contractor' s compensation limit ( the " First Amendment"); and
WHEREAS, the parties desire to amend the Agreement.
NOW THEREFORE, in consideration of the promises and mutual covenants contained herein, and intending to be legally bound, the parties hereby agree to make the following amendments to the Agreement:
1. TERM AND TIME OF COMPLETION. Exhibit " B" and Exhibit " B- 1" of the Agreement are hereby amended to add Exhibit " B- 2", which extends the Agreement to May 5, 2026. Exhibit" B- 2" is attached hereto and incorporated by reference. Consultant shall commence and complete all services described in Exhibit " A" in accordance with the schedule set forth in Exhibit " B- 2".
2. COMPENSATION. Exhibit " C" and Exhibit " C- 1" of the Agreement are hereby amended to add Exhibit " C- 2" to increase Consultant' s hourly rates and total compensation limit to $ 300, 000. Exhibit " C- 2" is attached hereto and incorporated by reference. Consultant shall be compensated for the services described in Exhibit " A" of the Agreement.
3. INSURANCE. Exhibit " D" of the Agreement is hereby amended to add Exhibit " D- 1" to raise the Consultant' s general liability coverage from $ 1 million to $ 2 million dollars.
Exhibit " D- 1" is attached hereto and incorporated by reference. Consultant shall comply with the insurance requirements in Exhibit " D- 1"
4. NO OTHER AMENDMENTS. Except as expressly stated herein, the Agreement shall remain unchanged and in full force and effect. The Agreement, First Amendment, and this Second Amendment constitute the entire agreement between the parties and supersede any previous oral or written agreement with respect to the subject matter hereof. In the event of any inconsistency between the terms of the Agreement, First Amendment, and this Second Amendment, the terms of this Second Amendment shall govern.
1 IN WITNESS WHEREOF, the parties have executed this Second Amendment in Redondo Beach, California, as of this 16t" day of April, 2024.
CITY OF REDONDO BEACH, LUCCI & ASSOCIATES, INC.,
a chartered municipal corporation a California corporation DocuSigned by: Dojccu Siig need by:/
J E6BC0853B8F544F1... By. L Re c acas nvam
James Light, Mayor Name: Kenneth Lucci
Title: President
ATTEST: APPROVED:
DocuSigned by: DocuSigned by:
elQ, a, M. 1Xj .., A, s.
Eleanor Manzano, City Clerk Diane Strickfaden, Risk Manager APPROVED AS TO FORM:
E
ADo'
c'ulSigneld b/y: ,
f,,
LII M R U)C. t,
669049EDE03D402...
Michael W. Webb, City Attorney
2 EXHIBIT " B- 2"
SCHEDULE FOR COMPLETION
TERM. The term of this Agreement shall be extended to May 5, 2026 (" Term"), unless otherwise terminated as herein provided.
3 EXHIBIT " C- 2"
COMPENSATION
Provided Consultant is not in default under this Agreement, Consultant shall be compensated as provided below.
I. AMOUNT. Effective April 16, 2024, Consultant shall perform the work for all City approved Task Proposal( s) in accordance with the attached hourly rate schedule, which is hereby incorporated.
II. EXPENSES. Consultant shall be reimbursed for expenses in accordance with the attached schedule. If Consultant requires reimbursement for expenses not provided on the attached schedule, including but not limited to, mileage, reproduction costs, and subcontractor markup, Consultant shall not be reimbursed without a subsequent written amendment, which shall be at the sole discretion of the city.
III. NOT TO EXCEED AMOUNT. In no event shall the total amount paid to the Consultant, including reimbursable expenses, exceed $ 300, 000 during the term of this Agreement.
IV. METHOD OF PAYMENT. Consultant shall provide monthly invoices to City for approval and payment for those services performed in the month prior to invoice submission. Invoices must include the following information.
A. Task number.
B. All personnel who performed work on the Task.
C. Description of the work performed.
D. Number of hours worked.
E. Hourly rate.
F. All city approved and documented subcontractor invoices.
G. If applicable, expenses incurred.
Invoice must be itemized, adequately detailed, based on accurate records, in a form reasonably satisfactory to the city. Invoices must attach the prior written authorization of the City and copies of receipts to substantiate expense requests. Consultant may be required to provide back- up material upon request. If no work is performed in a given month, no invoice is required.
Within the approved amount of each approved Task Proposal, and with the written approval of the city, a portion of the amount from the line item of the task may be allocated to another line item task so long as the total amount approved for the Task Proposal as described in Exhibit " A" in not exceeded.
V. SCHEDULE FOR PAYMENT. City agrees to pay Consultant within thirty ( 30) days after receipt of Consultant' s monthly invoice; provided, however, that services are completed to the City' s reasonable satisfaction and there is no dispute over the amount.
VI. NOTICE. Written notices to City and Consultant shall be given by registered or 4 certified mail, postage prepaid and addressed to or personally served on the following parties.
Consultant: Lucci & Associates, Inc.
3251 Corte Malpaso # 511
Camarillo, CA 93012- 8094
Attn: Ken Lucci
City City of Redondo Beach
Public Works Department, Engineering Services Division
415 Diamond Street
Redondo Beach, CA 90277
Attn: City Engineer
All notices, including notices of address changes, provided under this Agreement are deemed received on the third day after mailing if sent by registered or certified mail. Changes in the respective address set forth above may be made from time to time by any party upon written notice to the other party. 5 ASSOCIATES, INC.
ELECTRICAL ENGINEERS
BASIC FEE SCHEDULE
Consulting Electrical Engineers — Services
Effective 1/ 1/ 24
Classification Hourly Rate
Principal.................................................................$ 240. 00 Project Manager.....................................................$ 215. 00 Project Engineer.....................................................$ 200. 00 Design Engineer.....................................................$ 185. 00 Drafter ....................................................................$ 140. 00 Word/ Data Processing...........................................$ 115. 00 3251 Corte Madpaso # 511, CarnariHo, CA 012- 8094 0 Phone ( 805) 388- 6520 Fax ( 805) 389- 6519 N ww w. IluuccHand. com EXHIBIT " D- 1"
INSURANCE REQUIREMENTS FOR CONSULTANTS
Without limiting Consultant's indemnification obligations under this Agreement, Consultant shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, or employees.
Minimum Scope of Insurance
Coverage shall be at least as broad as:
Insurance Services Office Commercial General Liability coverage ( occurrence form CG 0001).
Insurance Services Office form number CA 0001 ( Ed. 1/ 87) covering Automobile Liability, code 1 ( any auto).
Workers' Compensation insurance as required by the State of California.
Employer's Liability Insurance.
Errors and Omissions liability insurance appropriate to the consultant' s profession.
Architects' and Engineers' coverage is to be endorsed to include contractual liability.
Minimum Limits of Insurance
Consultant shall maintain limits no less than:
General Liability: $ 2, 000, 000 per occurrence for bodily injury, personal injury and property damage. The general aggregate limit shall apply separately to this project/ location.
Automobile Liability: $ 1, 000, 000 per accident for bodily injury and property damage.
Employer' s Liability: $ 1, 000, 000 per accident for bodily injury or disease.
Errors and Omissions liability: $ 1, 000, 000 per occurrence.
Deductibles and Self- Insured Retentions
Any deductibles or self- insured retentions must be declared to and approved by the City. At the option of the City, either: ( 1) the insurer shall reduce or eliminate such deductibles or self- insured retentions as respects the City, its officers, officials, employees and volunteers or ( 2) the Consultant shall provide a financial guarantee satisfactory to the City guaranteeing payment of losses and related investigations, claim administration and defense expenses.
6 Other Insurance Provisions
The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions:
Additional Insured Endorsement:
General Liability: The City, its officers, elected and appointed officials, employees, and volunteers are to be covered as insureds with respect to liability arising out of work performed by or on behalf of the Consultant. General liability coverage can be provided in the form of an endorsement to the Consultant' s insurance, or as a separate owner' s policy.
Automobile Liability: The City, its officers, elected and appointed officials, employees, and volunteers are to be covered as insureds with respect to liability arising out of automobiles owned, leased, hired or borrowed by or on behalf of the Consultant.
For any claims related to this project, the Consultant' s insurance coverage shall be primary insurance as respects the City, its officers, elected and appointed officials, employees, and volunteers. Any insurance or self- insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Consultant' s insurance and shall not contribute with it.
Each insurance policy required by this clause shall be endorsed to state that coverage shall not be canceled by either party, except after thirty ( 30) days prior written notice by certified mail, return receipt requested, has been given to the City.
Each insurance policy shall be endorsed to state that the inclusion of more than one insured shall not operate to impair the rights of one insured against another insured, and the coverages afforded shall apply as though separate policies had been issued to each insured.
Errors and Omissions policy, if written on a claims made basis, shall be maintained by the Consultant for a period of one year after the completion of the project.
Each insurance policy shall be in effect prior to awarding the contract and each insurance policy or a successor policy shall be in effect for the duration of the project. The maintenance of proper insurance coverage is a material element of the contract and failure to maintain or renew coverage or to provide evidence of renewal may be treated by the City as a material breach of contract on the Consultant' s part.
Acceptability of Insurers
Insurance is to be placed with insurers with a current A. M. Best' s rating of no less than A:VII and which are authorized to transact insurance business in the State of California by the Department of Insurance.
7 Verification of Coverage
Consultant shall furnish the City with original certificates and amendatory endorsements effecting coverage required by this clause. The endorsements should be on the City authorized forms provided with the contract specifications. Standard ISO forms which shall be subject to City approval and amended to conform to the City's requirements may be acceptable in lieu of City authorized forms. All certificates and endorsements are to be received and approved by the City before the contract is awarded. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements affecting the coverage required by these specifications at any time.
Subcontractors
Consultant shall include all subcontractors as insured under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the requirements stated herein.
Risk Management
Consultant acknowledges that insurance underwriting standards and practices are subject to change, and the City reserves the right to make changes to these provisions in the reasonable discretion of its Risk Manager.
8 DATE( MM/ DD/YYYY) A" CERTIFICATE OF LIABILITY INSURANCE 1/ 11/ 2024 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
NAME: Maurice Thornton
AssuredPartners Design Professionals Insurance Services, LLC PHONE FAX 3697 Mt. Diablo Blvd Suite 230 A/C No EXt: 510- 272- 1476 A/ c, No):
Lafayette CA 94549 ADDRESS: CertsDesignPro@AssuredPartners. com INSURER( S) AFFORDING COVERAGE NAIC#
License#: 6003745 INSURER A: Travelers Property Casualty Company of America 25674 INSURED LUCC& AS- 01
INSURER B: The Travelers Indemnity Company of Connecticut 25682 Lucci & Associates, Inc.
3251 Corte Malpaso,# 511 INSURER C: Travelers Casualty and Surety Co of America 31194 Camarillo CA 93012 INSURERD: Hartford Casualty Insurance Company 29424 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 223107064 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
TYPE OF INSURANCE
ADDL SUBR POLICY EFF POLICY EXP
LTR LIMITS I POLICY NUMBER MM/ DD/YYYY MM/ DDIYYYY
A X COMMERCIAL GENERAL LIABILITY Y Y 6806H320610 1/ 11/ 2024 1/ 11/ 2025 EACH OCCURRENCE 2, 000,000
DAMAGE TO RENTED
CLAIMS- MADE OCCUR PREMISES Ea occurrence $ 1, 000, 000 X Contractual Liab MED EXP( Any one person) $ 10, 000
Included PERSONAL& ADV INJURY $ 2, 000,000
GEN' L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4, 000,000 POLICY ECT LOC PRODUCTS- COMP/ OPAGG $ 4, 000,000
OTHER:
B AUTOMOBILE LIABILITY Y Y BA3R587874 1/ 11/ 2024 1/ 11/ 2025 COMBINED SINGLE LIMIT $ 1, 000,000 Ea accident
ANY AUTO BODILY INJURY( Per person) $
OWNED SCHEDULED BODILY INJURY( Per accident) $
AUTOS ONLY AUTOS
X
HIRED X
NON- OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident
A X UMBRELLALIAB X OCCUR Y Y CUP91< 023174 1/ 11/ 2024 1/ 11/ 2025 EACH OCCURRENCE 4, 000, 000 EXCESS LIAB CLAIMS- MADE AGGREGATE 4, 000,000
DED X RETENTION$ n
D WORKERS COMPENSATION Y 57WEGAB8WKG 1/ 31/ 2024 1/ 31/ 2025 X PER OTHAND EMPLOYERS' LIABILITY YIN
STATUTE ER
ANYPROPRIETOR/ PARTNER/ EXECUTIVE E. L. EACH ACCIDENT 1, 000, 000 OFFICER/ MEMBER EXCLUDED? NIA
Mandatory in NH) E. L. DISEASE- EA EMPLOYEE $ 1, 000,000 If yes, describe under
DESCRIPTION OF OPERATIONS below E. L. DISEASE- POLICY LIMIT $ 1, 000,000 C Professional Liability 107569705 1/ 31/ 2024 1/ 31/ 2026 Per Claim 1, 000,000 Aggregate Limit 2, 000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Insured owns no company vehicles; therefore, hired/ non- owned auto is the maximum coverage that applies. The Umbrella Policy is follow form to its underlying Policies: General Liability/ Auto Liability/ Employers Liability.
All Operations of the Named Insured The City of Redondo Beach, it's officers, elected and appointed officials, employees and volunteers are named as additional insureds as respects general and auto liability as required per written contract. General Liability is Primary/ Non- Contributory per policy form wording.
Insurance coverage includes waiver of subrogation per the attached endorsement( s). SEE CANCELLATION SECTION of Certificate for 30 Days CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Redondo Beach ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Andrew Winje
415 Diamond Street AUTHORIZED REPRESENTATIVE
Redondo Beach CA 90277
7 @ 1988- 2015 ACORD CORPORATION. All rights reserved.
ACORD 25( 2016/ 03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: O8O' 0H32OM10
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY_ PLEASE READ IT CAREFULLY.
ADDITA U UINSURED LESSEES oIONAL n' n nn " m n "
CONTRACTORS x
n n
x
m COMPLETED~ x U U OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person( a) Or Or8on| zat| wn( o):
Any person or organization that you agree in awritten contract to include as an additional insured nn this Coverage Part for" bodily injury" or" property damage" included in the products- completed operations hazard, provided that such contract was signed by you before, and is in effect when, the " bodily injury or" property damage" occurs.
Location And Description Of Completed Operations
Any project to which o written contract with the Additional Insured Pernnn( n) or0rganizaUnn( e) in the Schedule applies.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section U — Who Is An Insured is amended to in- location designated and described in the schedule of o| ude as an additional insured the person( s) or or- this endorsement performed for that additional inganizaUon( o) shown in the Sohodu| o, but only with nun* d and included in the " products- completed operarespect to liability for " bodily injury" or " property dam- tiona hazand" ago" oauoed, in vvhn|o or in part. by "your work" at the CG 30 37 07 04
co T8 Oz 01 u« @ ISO Properties, Inc., 2004
DATE OF ISSUE: 11/ 27/ 2023 Page 1 of 1
POLICY NUMBER: O8O' OH32OG1O COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY' PLEASE READ IT CAREFULLY' ADDITU U UINSURED ~ y IONAL nn_ n m~ nn n-~* n~ n`, ~~~~ LESSEES n n` CONTR n n SCHEDULED n n
n»~ ACTORS u n *~ n` n n~~~ n- ~ n`* o won^
U U
n` m n n~ u~ u n n» n
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Names of Additional Insured Person( a) or( Jrgan| oat| mn( s):
Any person or organization that you agree in awritton contract to include as an additional insured on this Coverage Pad, provided that such written contract was signed by you beforo. and is in effect when, the " bodily injury" or" property damage" occurs or the " personal injury" or" advertising injury" offense in committed.
Location of Covered Operations:
Any project to which a written contract with the Additional Insured Person( s) or Organization( s) in the Schedule applies.
Information required to complete this Schedu| e, if not shown above, will be shown in the Declarations.) A. Section || — VVho Is An Insured is amended to in- This insurance does not apply to " bodily injury" or n| ude as an additional insured the person( s) or property damage" nnourring, or " personal injury" organization( s) ohnvvn in the Snhndu| o, but only or " advertising irjury" arising out of an offense with respect to liability for" bodily injury". " property committed, after:
damage". " personal injury" or " advertising injury" 1. All wmrk, including matorio| n, parts or equipnauoed, in whole or in pad, by: mentfurniohod in connection with such work,
1. Your acts or omissions; or on the project ( other than service, maintn2. The acts or omissions of those acting on your nenne or repairs) to be performed by or on
behalf; behalf ofthe additional insured( s) at the locationiinn of the covered operations has been onmin the performance nf your ongoing operations for p|* t* d; or the additional insured( s) at the location( s) designated above.
2. That portion of " your work" out of which the
injury or damage arises has been put to its inB. With respect to the insurance afforded to these tended use by any person or organization additional inouredo, the following additional exo| u- other than another contractor or euboontraceiona apply: tor engaged in performing operations for a principal as a part ofthe same project.
CG D3 61 03 05
Copyhght2UO5 The St. Paul Travelers Companies. Inc. All rights reserved.
CG T8 03 Ol 2Jndudnn copyrighted material of Insurance Services {} Oioe. Inc. with its permission.
DATE OF ISSUE: 11/ 27/ 2023 Page 1 of 1
Policy# 6806H320610
COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares, we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable
c. We have issued this policy in reliance upon
limit of insurance or none of the loss remains,
your representations.
whichever comes first.
The unintentional omission of, or unintentional error
If any of the other insurance does not permit in, any information provided by you which we relied contribution by equal shares, we will contribute
upon in issuing this policy will not prejudice your
by limits. Under this method, each insurer' s
rights under this insurance. However, this provision
share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal in accordance with applicable insurance emu
d. Primary And Non- Contributory Insurance If laws or regulations.
Required By Written Contract 7, Separation Of Insureds
If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an
any rights or duties specifically assigned in this
insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies:
contributory basis, this insurance is primary to
a. As if each Named Insured were the only
other insurance that is available to such insured
Named Insured; and
which covers such insured as a named insured,
and we will not share with that other insurance, b. Separately to each insured against whom claim provided that: is made or" suit" is brought.
1) The " bodily injury' or" property damage" for 8• Transfer Of Rights Of Recovery Against Others which coverage is sought occurs; and To Us
2) The " personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us. The insured must subsequent to the signing of that contract or
do nothing after loss to impair them. At our request,
agreement by you.
the insured will bring " suit" or transfer those rights to us and help us enforce them.
5. Premium Audit
9. When We Do Not Renew
a. We will compute all premiums for this Coverage
If we decide not to renew this Coverage Part, we will
Part in accordance with our rules and rates.
mail or deliver to the first Named Insured shown in
b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only. At not less than 30 days before the expiration date. the close of each audit period we will compute
If notice is mailed, proof of mailing will be sufficient the earned premium for that period and send
notice to the first Named Insured. The due date proof of notice. for audit and retrospective premiums is the date SECTION V— DEFINITIONS shown as the due date on the bill. If the sum of 1. " Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured. supporters. For the purposes of this definition:
c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website
6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy# 6806H320610 COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your " employees" therapy assistant, physical therapist or for " bodily injury" that arises out of providing speech- language pathologist; or or failing to provide " incidental medical b) First aid or " Good Samaritan services" services" to any person to the extent not by any of your" employees" or" volunteer
subject to Paragraph 2. a.( 1) of Section II —
workers", other than an employed or
Who Is An Insured.
volunteer doctor. Any such " employees" K. MEDICAL PAYMENTS— INCREASED LIMIT or" volunteer workers" providing or failing The following replaces Paragraph 7. of to provide first aid or " Good Samaritan
services" during their work hours for you
SECTION III — LIMITS OF INSURANCE:
will be deemed to be acting within the 7. Subject to Paragraph 5. above, the Medical scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of " bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III — LIMITS OF
a. $ 10, 000; or
INSURANCE:
For the purposes of determining the
b. The amount shown in the Declarations of
applicable Each Occurrence Limit, all related this Coverage Part for Medical Expense acts or omissions committed in providing or
Limit.
failing to provide " incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or " Good Samaritan CONDITION— PROFESSIONAL LIABILITY services" to any one person will be deemed
The following is added to Paragraph 4. b., to be one" occurrence".
Excess Insurance, of SECTION IV —
4. The following exclusion is added to COMMERCIAL GENERAL LIABILITY Paragraph 2., Exclusions, of SECTION I — CONDITIONS:
COVERAGES — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE This insurance is excess over any of the other LIABILITY: insurance, whether primary, excess, contingent Sale Of Pharmaceuticals
or on any other basis, that is Professional
Liability or similar coverage, to the extent the
Bodily injury" or " property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION —
pharmaceuticals committed b or with the
WHEN REQUIRED BY WRITTEN CONTRACT knowledge or consent of the Insured.
OR AGREEMENT
5. The following is added to the DEFINITIONS
Section: The following is added to Paragraph 8., Transfer Incidental medical services" means:
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
a. Medical, surgical, dental, laboratory, x LIABILITY CONDITIONS:
ray or nursing service or treatment,
If the insured has agreed in a written contract or
advice or instruction or the related
furnishing of food or beverages; or
agreement to waive that insured' s right of
recovery against any person or organization, we
b. The furnishing or dispensing of drugs or waive our right of recovery against such person medical, dental, or surgical supplies or
or organization, but only for payments we make
appliances.
because of:
6. The following is added to Paragraph 4. b.,
a. " Bodily injury" or " property damage" that
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIABILITY
occurs; or
CONDITIONS: b. " Personal and advertising injury" caused by This insurance is excess over any valid and an offense that is committed; collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement.
CG D3 79 02 19 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy: BA3R587874 COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following is added to Paragraph c. in A. 1., Who between you and that person or organization, that is Is An Insured, of SECTION II — COVERED AUTOS signed by you before the " bodily injury" or " property LIABILITY COVERAGE in the BUSINESS AUTO damage" occurs and that is in effect during the policy COVERAGE FORM and Paragraph e. in A. 1., Who Is period, to name as an additional insured for Covered An Insured, of SECTION II — COVERED AUTOS Autos Liability Coverage, but only for damages to LIABILITY COVERAGE in the MOTOR CARRIER which this insurance applies and only to the extent of COVERAGE FORM, whichever Coverage Form is that person' s or organization' s liability for the conduct part of your policy: of another" insured".
This includes any person or organization who you are
required under a written contract or agreement
f+ A TA 77 n11 AC I, A ri__ r.__.._ i___ .__ i___._ e....-._.__.__._.. nu i_._.____._.__ i I),.,.,. 4 _ r 4 Policy# BA3R587874
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A. 5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any " accident" or ' loss", provided that the CONDITIONS Section: accident" or ' loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver apers To Us plies only to the person or organization desigWe waive any right of recovery we may have nated in such contract. against any person or organization to the extent
CA T3 40 02 15 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
El
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: 57WEGAB8WKG Endorsement Number:
Effective Date: 0 1/ 31/ 2024 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: Lucci & Associates, Inc.
3251 Corte Malpaso, # 511
Camarillo, CA 93012
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 2 % of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
Countersigned by
Authorized Representative
Form WC 04 03 06 1) Printed in U. S. A.
Policy Expiration Date: 01/ 31/ 2025
FIRST AMENDMENT TO THE AGREEMENT
FOR CONSULTING SERVICES BETWEEN
THE CITY OF REDONDO BEACH
AND LUCCI & ASSOCIATES, INC.
THIS FIRST AMENDMENT TO THE AGREEMENT FOR CONSULTING SERVICES First Amendment") is made between the City of Redondo Beach, a chartered municipal corporation (" City") and Lucci & Associates, a California corporation Contractor" or" Consultant").
WHEREAS, on May 5, 2020, the parties entered into the Agreement for Consulting Services between the City and Consultant ( the " Agreement"); and WHEREAS, the parties desire to amend the Agreement.
NOW THEREFORE, in consideration of the promises and mutual covenants contained herein, and intending to be legally bound, the parties hereby agree to make the following amendments to the Agreement:
1. SCHEDULE FOR COMPLETION. Exhibit " B" of the Agreement is hereby amended to add Exhibit "B- 1", which extends the Agreement to May 2, 2024.
Exhibit "B- 1" is attached hereto and incorporated by reference. Consultant shall commence and complete all services described in Exhibit " A" in accordance with the schedule set forth in Exhibit " B- 1".
2. COMPENSATION. Exhibit " C" of the Agreement is hereby amended to add Exhibit " C- 1" to increase the limit for the total compensation paid to Consultant by 100, 000 for a total compensation limit of$ 200, 000. Exhibit " C- 1" is attached hereto and incorporated by reference. Consultant shall be compensated for the services described in Exhibit " A" of the Agreement.
3. NO OTHER AMENDMENTS. Except as expressly stated herein, the Agreement shall remain unchanged and in full force and effect. The Agreement and this First Amendment constitute the entire agreement between the parties and supersede any previous oral or written agreement with respect to the subject matter hereof. In the event of any inconsistency between the terms of the Agreement and this First Amendment, the terms of this First Amendment shall govern.
1 IN WITNESS WHEREOF, the parties have executed this First Amendment in Redondo Beach, California, as of this 3rd day of May, 2022.
CITY OF REDONDO BEACH, LUCCI & ASSOCIATES, INC.,
a chartered municipal corporation a California corporation By: rigimoimar
William C. Brand, Mayor Name: Kenneth L
1_
oar Title: President
ATTEST: APPROV D:
Oehea Q4.,
Eleanor Manzano, ' Clerk Di- ne Strickfaden, Risk Manager APPROVED AS TO FORM:
Lull
is W. Webb, City Attorney
2 EXHIBIT " B- 1"
SCHEDULE FOR COMPLETION
TERM. The term of this Agreement shall be extended to May 2, 2024 (" Term"), unless otherwise terminated as herein provided.
3 EXHIBIT " C- 1"
COMPENSATION
Provided Consultant is not in default under this Agreement, Consultant shall be compensated as provided below.
I. AMOUNT. Consultant shall perform the work for all City approved Task Proposal( s) in accordance with the attached hourly rate schedule, which is hereby incorporated.
II. EXPENSES. Consultant shall be reimbursed for expenses in accordance with the attached schedule. If Consultant requires reimbursement for expenses not provided on the attached schedule, including but not limited to, mileage, reproduction costs, and subcontractor markup, Consultant shall not be reimbursed without a subsequent written amendment, which shall be at the sole discretion of the City.
Ill. NOT TO EXCEED AMOUNT. In no event shall the total amount paid to the Consultant, including reimbursable expenses, exceed $ 200, 000 during the term of this Agreement.
IV. METHOD OF PAYMENT. Consultant shall provide monthly invoices to City for approval and payment for those services performed in the month prior to invoice submission. Invoices must include the following information.
A. Task number.
B. All personnel who performed work on the Task.
C. Description of the work performed.
D. Number of hours worked.
E. Hourly rate.
F. All City approved and documented subcontractor invoices.
G. If applicable, expenses incurred.
Invoices must be itemized, adequately detailed, based on accurate records, in a form reasonably satisfactory to the City. Invoices must attach the prior written authorization of the City and copies of receipts to substantiate expense requests.
Consultant may be required to provide back- up material upon request. If no work is performed in a given month, no invoice is required.
Within the approved amount of each approved Task Proposal, and with the written approval of the City, a portion of the amount from the line item of the task may be allocated to another line item task so long as the total amount approved for the Task Proposal as described in Exhibit" A" is not exceeded. 4 V. SCHEDULE FOR PAYMENT. City agrees to pay Consultant within thirty (30) days after receipt of Consultant' s monthly invoice; provided, however, that services are completed to the City' s reasonable satisfaction and there is no dispute over the amount.
VI. NOTICE. Written notices to City and Consultant shall be given by registered or certified mail, postage prepaid and addressed to or personally served on the following parties.
Consultant: Lucci & Associates, Inc.
3251 Corte Malpaso # 511
Camarillo, CA 93012- 8094
Attn: Ken Lucci
City City of Redondo Beach
Public Works Department, Engineering Services Division
415 Diamond Street
Redondo Beach, CA 90277
Attn: City Engineer
All notices, including notices of address changes, provided under this Agreement are deemed received on the third day after mailing if sent by registered or certified mail. Changes in the respective address set forth above may be made from time to time by any party upon written notice to the other party. 5 LUCCI & ASSOCIATES, INC.
CONSULTING ELECTRICAL ENGINEERS
BASIC FEE SCHEDULE
Consulting Electrical Engineers — Services
Effective 6/ 30/ 21
Classification Hourly Rate
Principal 215.00
Project Manager 200. 00
Project Engineer 185. 00
Design Engineer 155. 00
Drafter 125. 00
Word/ Data Processing 90.00
3251 Corte Malpaso # 511, Camarillo, CA 93012- 8094 Phone ( 805) 389- 6520 Fax ( 805) 389- 6519 www. lucciland. com AC p ® DATE( MM/ DOIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 1/ 20/ 2022
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 poticy( 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
NAME: The Certificate Team
AssuredPartners Design Professionals Insurance Services, LLC PHONE FAX 3697 Mt. Diablo Blvd Suite 230 IANC. No. Extl: A/ C, No):
Lafayette CA 94549 AADDRIEss: CertsDesignPro@AssuredPartners. com
INSURER( S) AFFORDING COVERAGE NAIC H
License#; 6003745 INSURER A: HARTFORD INSURANCE COMPANY 38288 INSURED LUCCSAS- 01
INSURER a: Travelers Property Casualty Company of America 25674 Lucci& Associates, Inc.
3251 Corte Malpaso,# 511 INSURER c: The Travelers Indemnity Company of Connecticut 25682 Camarillo CA 93012 INSURER o: Travelers Casualty and Surety Co of America 31194 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 959513306 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 ADDL;
LTR TYPE OF INSURANCE SUBRI POLICY EFF 1 POUCYEXP INSD I WVO POLICY NUMBER MMIDD/ YYYYI,( MM/DDtYYYY), LIMITS B x COMMERCIALGENERAL LIABILITY Y Y 6806H320610 1/ 11/ 2022 1) 11/ 2023 EACH OCCURRENCE 52, 000, 000
DAMAGE TO
CLAIMS- MAGE X OCCUR PREMISES(
occurrence) 51, 000, 000
X Contractual Lab MED EXP( Any one person) S 10, 000
Included PERSONAL 8 ADV INJURY 5 2, 000, 000
GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 4, 000, 000 POLICY X ECT X LOC PRODUCTS- COMP/ OP AGG 5 4, 000, 000 OTHER. 5
C AUTOMOBILE LIABILITY Y Y BA3R587874 1/ 11/ 2022 1/ 11/ 2023 COMBINED SINGLE LIMIT S 1, 000, 000 Ea accident) ANY AUTO BODILY INJURY( Per parson) 5
OWNED SCHEDULED BODILY INJURY( Per accident) S
AUTOS ONLY AUTOS
X
HIRED yN
OWNED PROPERTY DAMAGE S
AUTOS ONLY AUTOS ONLY Per accident)
5 B X UMBRELLALIAB X OCCUR Y Y CUP9K023174 1/ 11/ 2022 1/ 11/ 2023 EACH OCCURRENCE 54, 000, 000 ____ EXCESS UAB CLAIMS- MADE AGGREGATE 5 4, 000, 000
I DED X RETENTION S n S
A MOWERS COMPENSATION rY 57WEGABBWKG 1/ 31/ 2022 1/ 31/ 2023 XI PER OTHMD EMPLOYERS' LIABIUTY Y/ N
STATUTE ER
MYPROPRIETOR/ PARTNERIEXECUTIVE - E L EACH ACCIDENT S 1, 000, 000 CFFICER/ MEMBEREXCLUDED? NIA
Yanditory In NH) E L DISEASE- EA EMPLOYEE 51, 000. 000
liras, describe under
DESCRIPTION OF OPERATIONS below E L DISEASE- POLICY LIMIT S 1, 000, 000 D Professional Liability 107569705 1/ 31/ 2022 1/ 31/ 2023 Per Claim 1, 000, 000 Aggregate Limit 2, 000,000
1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES( ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) LJ nbella Liability policy is a follow- form underlying General Liability/ Auto Liability/ Employers Liability. Insured owns no company vehicles; therefore, hired+non- owned auto is the maximum coverage that applies.
F e All Operations of the Named Insured- The City of Redondo Beach, it' s officers, elected and appointed officials, employees and volunteers are named as additional insureds as respects general and auto liability as required per written contract or agreement. General Liability is Primary/ Non- Contributory per policy fonnwording. Insurance coverage includes waiver of subrogation per the attached endorsement( s). SEE CANCELLATION SECTION of Certificate for 30 Days Notice of Cancellation.
CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Redondo Beach ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Jesse Reyes
531 N. Gertruda Ave. AUTHORIZED REPRESENTATIVE
Redondo Beach CA 90277
I
1988- 2015 ACORD CORPORATION. All rights reserved.
0400 25( 2016/ 03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680- 6H320610 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person( s) Or Organization( s):
Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part for" bodily injury" or" property damage" included in the products- completed operations hazard, provided that such contract was signed by you before, and is in effect when, the" bodily injury or" property damage" occurs.
Location And Description Of Completed Operations
Any project to which a written contract with the Additional Insured Person( s) or Organization( s) in the Schedule applies.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section II — Who Is An Insured is amended to in- location designated and described in the schedule of clude as an additional insured the person( s) or or- this endorsement performed for that additional inganization( s) shown in the Schedule, but only with sured and included in the " products- completed operarespect to liability for" bodily injury" or" property dam- tions hazard". age" caused, in whole or in part, by" your work" at the CG 20 37 07 04
CG T8 01 01 22 ISO Properties, Inc., 2004
DATE OF ISSUE: 11/ 24/ 2021 Page 1 of 1
POLICY NUMBER: 680- 6H320610 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Names of Additional Insured Person( s) or Organization( s):
Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed by you before, and is in effect when, the" bodily injury" or" property damage" occurs or the" personal injury" or" advertising injury" offense is committed.
Location of Covered Operations:
Any project to which a written contract with the Additional Insured Person( s) or Organization( s) in the Schedule applies.
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 in- This insurance does not apply to" bodily injury" or clude as an additional insured the person( s) or property damage" occurring, or " personal injury" organization( s) shown in the Schedule, but only or " advertising injury" arising out of an offense with respect to liability for" bodily injury"," property committed, after:
damage", " personal injury" or " advertising injury" 1. All work, including materials, parts or equipcaused, in whole or in part, by: merit furnished in connection with such work,
1. Your acts or omissions; or on the project ( other than service, mainte2. The acts or omissions of those acting on your nance or repairs) to be performed by or on behalf; behalf of the additional insured( s) at the location of the covered operations has been cornin the performance of your ongoing operations for pleted; or the additional insured( s) at the location( s) designated above.
2. That portion of " your work" out of which the
injury or damage arises has been put to its inB. With respect to the insurance afforded to these tended use by any person or organization additional insureds, the following additional exclu- other than another contractor or subcontracsions apply: tor engaged in performing operations for a principal as a part of the same project.
CGD3610305
Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved.
CG TB 03 01 2) ncludes copyrighted material of Insurance Services Office, Inc. with its permission.
DATE OF ISSUE: 11/ 24/ 2021 Page 1 of 1
Policy# 6806H320610
COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares, we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable
c. We have issued this policy in reliance upon
limit of insurance or none of the loss remains,
your representations.
whichever comes first.
The unintentional omission of, or unintentional error
If any of the other insurance does not permit in, any information provided by you which we relied contribution by equal shares, we will contribute
upon in issuing this policy will not prejudice your
by limits. Under this method, each insurers rights under this insurance. However, this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal in accordance with applicable insurance d. Primary And Non- Contributory Insurance If laws or regulations.
Required By Written Contract 7. Separation Of Insureds
If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an
any rights or duties specifically assigned in this
insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies:
contributory basis, this Insurance is primary to
a. As if each Named Insured were the only other insurance that is available to such insured Named Insured; and
which covers such insured as a named insured,
and we will not share with that other insurance, b. Separately to each insured against whom claim provided that: is made or" suit" is brought.
1) The" bodily injury' or" property damage" for 8. Transfer Of Rights Of Recovery Against Others which coverage is sought occurs; and To Us
2) The " personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us. The insured must subsequent to the signing of that contract or
do nothing after loss to impair them. At our request,
agreement by you.
the insured will bring " suit" or transfer those rights to us and help us enforce them.
5. Premium Audit
9. When We Do Not Renew
a. We will compute all premiums for this Coverage
If we decide not to renew this Coverage Part, we will
Part in accordance with our rules and rates.
mail or deliver to the first Named Insured shown in
b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only. At not less than 30 days before the expiration date. the close of each audit period we will compute
If notice is mailed, proof of mailing will be sufficient the earned premium for that period and send notice to the first Named Insured. The due date
proof of notice.
for audit and retrospective premiums is the date SECTION V— DEFINITIONS shown as the due date on the bill. If the sum of 1. " Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured. supporters. For the purposes of this definition:
c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website
6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement.
Includes copyrighted material of Insurance Services Office, Inc, with its permission.
Policy# 6806H320610 COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your " employees" therapy assistant, physical therapist or for" bodily injury" that arises out of providing speech- language pathologist; or or failing to provide " incidental medical b) First aid or " Good Samaritan services" services" to any person to the extent not by any of your" employees" or" volunteer
subject to Paragraph 2. a.( 1) of Section II —
workers", other than an employed or
Who Is An Insured.
volunteer doctor. Any such " employees" K. MEDICAL PAYMENTS— INCREASED LIMIT or" volunteer workers" providing or failing The following replaces Paragraph 7. of to provide first aid or " Good Samaritan
SECTION III— LIMITS OF INSURANCE:
services" during their work hours for you
will be deemed to be acting within the 7. Subject to Paragraph 5. above, the Medical scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of " bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III — LIMITS OF
a. $ 10, 000; or
INSURANCE:
For the purposes of determining the
b. The amount shown in the Declarations of
applicable Each Occurrence Limit, all related
this Coverage Part for Medical Expense
acts or omissions committed in providing or
Limit.
failing to provide " incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or " Good Samaritan CONDITION— PROFESSIONAL LIABILITY services" to any one person will be deemed
The following is added to Paragraph 4. b., to be one" occurrence".
4. The following exclusion is added to
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIABILITY
Paragraph 2., Exclusions, of SECTION 1 — CONDITIONS:
COVERAGES — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE This insurance is excess over any of the other LIABILITY: insurance, whether primary, excess, contingent Sale Of Pharmaceuticals
or on any other basis, that is Professional
Liability or similar coverage, to the extent the
Bodily injury" or " property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION — pharmaceuticals committed by, or with the WHEN REQUIRED BY WRITTEN CONTRACT knowledge or consent of the insured.
5. The following is added to the DEFINITIONS
OR AGREEMENT
Section: The following is added to Paragraph 8., Transfer Incidental medical services" means:
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment,
If the insured has agreed in a written contract or
advice or instruction, or the related
furnishing of food or beverages; or
agreement to waive that insured' s right of
recovery against any person or organization, we
b. The furnishing or dispensing of drugs or
waive our right of recovery against such person
medical, dental, or surgical supplies or
or organization, but only for payments we make
appliances.
because of:
6. The following is added to Paragraph 4. b.,
a. " Bodily injury" or " property damage" that
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIABILITY
occurs; or
CONDITIONS: b. " Personal and advertising injury" caused by This insurance is excess over any valid and
an offense that is committed;
collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement.
CG D3 79 02 19 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy: BA3R587874 COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following is added to Paragraph c. in AA., Who between you and that person or organization, that is Is An Insured, of SECTION II — COVERED AUTOS signed by you before the " bodily injury" or " property LIABILITY COVERAGE in the BUSINESS AUTO damage" occurs and that is in effect during the policy COVERAGE FORM and Paragraph e. in A. 1., Who Is period, to name as an additional insured for Covered An Insured, of SECTION II — COVERED AUTOS Autos Liability Coverage, but only for damages to LIABILITY COVERAGE in the MOTOR CARRIER which this insurance applies and only to the extent of COVERAGE FORM, whichever Coverage Form is that person' s or organization' s liability for the conduct part of your policy: of another" insured".
This includes any person or organization who you are
required under a written contract or agreement
CA T4 37 02 16 2016 The Travelers Indemnity Company, All rights reserved Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc with its permission Policy# BA3R587874
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A. 5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any" accident" or" loss", provided that the CONDITIONS Section: accident" or " loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver apers To Us plies only to the person or organization desigWe waive any right of recovery we may have nated in such contract. against any person or organization to the extent
CA T3 40 02 15 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: 57WEGAB8WKG Endorsement Number:
Effective Date: 01/ 31/ 2022 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: Lucci& Associates, Inc.
3251 Corte Malpaso,# 511
Camarillo, CA 93012
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 2% of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
11.44 Countersigned by
Authorized Representative
Form WC 04 03 06 1) Printed in U. S. A.
Policy Expiration Date: 01/ 31/ 2023
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- MAILADDRESS:
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
WVD
ADDL
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
AUTOSAUTOS ONLY
NON- OWNED
SCHEDULEDOWNED
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
ANYPROPRIETOR/ PARTNER/ EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
STATUTEPER EROTHMM/ DD/ YYYY) LIMITS(
POLICY EXP(
MM/ DD/ YYYY) NUMBERTYPEEFFPOLICYPOLICY INSURANCELTRINSR OF 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
PROJECT 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
1/11/2024
AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230
Lafayette CA 94549
Maurice Thornton
510- 272- 1476
CertsDesignPro@AssuredPartners. com
License#: 6003745 Travelers Property Casualty Company of America 25674 LUCC& AS-01
25682Lucci& The Travelers Indemnity Company of ConnecticutAssociates, Inc. 3251 Corte Malpaso,# 511
Camarillo CA 93012
Travelers Casualty and Surety Co of America 31194
Hartford Casualty Insurance Company 29424
1780263914
A X 2,000, 000
X 1,000, 000
X Contractual Liab 10,000
Included 2,000, 000
4,000, 000
X X
Y Y 6806H320610 1/11/2024 1/11/2025
4,000, 000
B 1,000, 000
X X
Y Y BA3R587874 1/11/2024 1/11/2025
A X X 2024Y 000YCUP9K0231741/ 11/ 1/11/2025 4,000,
4,000, 000
X
0 D XY57WEGAB8WKG1/ 31/2024 1/31/2025
1,000, 000
1,000, 000
1,000, 000
C Professional Liability 107569705 1/31/2024 1/31/2026 Per Claim Aggregate Limit
1,000, 000
2,000, 000
Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. The Umbrella Policy is follow form to its underlying Policies: General Liability/ Auto Liability/ Employers Liability.
Re: All Operations of the Named Insured - The City of Redondo Beach, it's officers, elected and appointed officials, employees and volunteers are named as additional insureds as respects general and auto liability as required per written contract. General Liability is Primary/ Non-Contributory per policy form wording.
Insurance coverage includes waiver of subrogation per the attached endorsement( s). SEE CANCELLATION SECTION of Certificate for 30 Days Notice of Cancellation.
30 Day Notice of Cancellation
City of Redondo Beach
Attn: Jesse Reyes
531 N. Gertruda Ave.
Redondo Beach CA 90277
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 methoo, 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 perioo 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. Ifthe 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 orto 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 not ice 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, prooucts 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 # 6806H320610
COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your " employees" providingtherapy assistant, physical therapist or for " bodily injury" that arises out of medicalspeech- or failing to provide " incidental language pathologist; or services" to any person to the extent not( b) First aid or " Good Samaritan services" subject to Paragraph 2.a.(1) of Section II – by any of your " employees" or " volunteer Who Is An Insured. workers", other than an employed or
volunteer doctor. Any such " employees" K. MEDICAL PAYMENTS – INCREASED LIMIT or " volunteer workers" providing or failing
oftoThe following replaces Paragraph 7.provide first aid or " Good Samaritan SECTION III – LIMITS OF INSURANCE: services" during their work hours for you Medicalwill be deemed to be acting within the 7. Subject to Paragraph 5. above, the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of " bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III – LIMITS OF
orINSURANCE: a.$ 10,000;
ofFor b. The amount shown in the Declarations the purposes of determining the Expenseapplicable this Coverage Part for Medical Each Occurrence Limit, all related Limit. acts or omissions committed in providing or
failing to provide " incidental medical L. AMENDMENT OF EXCESS INSURANCE services", LIABILITYservices" first aid or " Good Samaritan CONDITION – PROFESSIONAL to any one person will be deemed
The following is added to Paragraph 4.b., to be one " occurrence".
Excess Insurance, of SECTION IV –
4. The following exclusion is added to
LIABILITYParagraph2., COMMERCIAL GENERAL
Exclusions, of SECTION I – CONDITIONS:
COVERAGES – COVERAGE A – BODILY
otherINJURY This insurance is excess over any of the AND PROPERTY DAMAGE contingentLIABILITY: insurance, whether primary, excess, ProfessionalSale or on any other basis, that is
Of Pharmaceuticals Liability or similar coverage, to the extent the Bodily injury" or " property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION – pharmaceuticals committed by, or with the CONTRACTknowledge WHEN REQUIRED BY WRITTEN or consent of the insured.
AGREEMENT5. OR
The following is added to the DEFINITIONS
TransferSection: The following is added to Paragraph 8., Of Rights Of Recovery Against Others To Us,"
Incidental medical services" means: of SECTION IV – COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment,
oradvice If the insured has agreed in a written contractor instruction, or the related offurnishing agreement to waive that insured' s right of food or beverages; or recovery against any person or organization, we
b. The furnishing or dispensing of drugs or
personmedical, waive our right of recovery against suchdental, or surgical supplies or makeappliances. or organization, but only for payments we because of:
6. The following is added to Paragraph 4.b.,
thatExcess a." Bodily injury" or " property damage" Insurance, of SECTION IV – orCOMMERCIALoccurs; GENERAL LIABILITY
byCONDITIONS: b." Personal and advertising injury" caused an offense that is committed; This insurance is excess over any valid and orcollectible other insurance, whether primary, subsequent to the signing of that contract excess, contingent or on any other basis, agreement.
CG D3 79 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # 6806H320610
COMM AUTOE RCIAL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorseme nt modifies insurance provided under the following:
BUSRMI NESS AUTO COVERAGE FO
MRMO TOR CARRIER COVERAGE FO
The foaphl lowing is added to Paragr c. in A.1., Who beistrt ween you and that pe son or organiza ion, that Is An Insuedr, of SECTION II COOVERED AUT S sityg ned by you before the " bodil " y injury or " proper LAGEI ABILITY COVER in the BUSIN AUTE SS O damcya " ge occurs and that is in effect during the poli COMVR ERAGE FO and Paagraphr e. in A.1., Who Is peredretr iod, to nam as an addi ional insured fo Cove An Insuedr, of SECTOIV ON II CO ERED AUT S Autoos Liabil ity Coverage, but only for damages LERAGEI ABILITY COV in the MOTCARRIEOR R whiocs h this insurance applie and only to the extent f COMVR, ERAGE FO whichev ser Coverage Form is that perso 'n s or organizat io 'n liaductb ility for the con part of your polic :y of another "insured".
Thiares includes any person or organization who you
rentq uired under a written contract or agreem
CA 16T 4 37 0 ©2 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material ofOfIf nsurance Services ice, Inc. with its permission.
Policy: BA3R587874
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any " accident" or "loss", provided that the CONDITIONS Section:" accident" or " loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver apers To Us plies only to the person or organization desigWe nated in such contract. waive any right of recovery we may have against any person or organization to the extent
CA T3 40 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # BA3R587874
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by
Authorized Representative
Form WC 04 03 06 1) Printed in U.S.A.
Policy Expiration Date:
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: Endorsement Number:
Effective Date: Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address:
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 2 % of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
57WEGAB8WKG
01/31/2024
Lucci & Associates, Inc.
3251 Corte Malpaso,# 511
Camarillo, CA 93012
01/31/2025
LUCCI & ASSOCIATES, INC.
CONSULTING ELECTRICAL ENGINEERS
BASIC FEE SCHEDULE
Consulting Electrical Engineers — Services
Effective 6/ 30/ 21
Classification Hourly Rate
Principal 215. 00
Project Manager 200. 00
Project Engineer 185. 00
Design Engineer 155. 00
Drafter 125. 00
Word/ Data Processing 90.00
3251 Corte Malpaso # 511, Camarillo, CA 93012- 8094 Phone ( 805) 389- 6520 Fax ( 805) 389- 6519 U www. lucclland. com d
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- MAILADDRESS:
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
WVD
ADDL
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
AUTOSAUTOS ONLY
NON- OWNED
SCHEDULEDOWNED
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
ANYPROPRIETOR/ PARTNER/ EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
STATUTEPER EROTHMM/ DD/ YYYY) LIMITS(
POLICY EXP(
MM/ DD/ YYYY) NUMBERTYPEEFFPOLICYPOLICY INSURANCELTRINSR OF 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
PROJECT 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
1/11/2023
AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230
Lafayette CA 94549
The Certificate Team
CertsDesignPro@AssuredPartners. com
License#: 6003745 Travelers Property Casualty Company of America 25674 LUCC& AS-01
25682Lucci& The Travelers Indemnity Company of ConnecticutAssociates, Inc. 3251 Corte Malpaso,# 511
Camarillo CA 93012
Travelers Casualty and Surety Co of America 31194
Hartford Casualty Insurance Company 29424
823158129
A X 2,000, 000
X 1,000, 000
X Contractual Liab 10,000
Included 2,000, 000
4,000, 000
X X
Y Y 6806H320610 1/11/2023 1/11/2024
4,000, 000
B 1,000, 000
X X
Y Y BA3R587874 1/11/2023 1/11/2024
A X X 2023Y 000YCUP9K0231741/ 11/ 1/11/2024 4,000,
4,000, 000
X
0 D XY57WEGAB8WKG1/ 31/2023 1/31/2024
1,000, 000
1,000, 000
1,000, 000
C Professional Liability 107569705 1/31/2023 1/31/2024 Per Claim Aggregate Limit
1,000, 000
2,000, 000
Umbrella Liability policy is a follow-form underlying General Liability/ Auto Liability/ Employers Liability. Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies.
Re: All Operations of the Named Insured - The City of Redondo Beach, it's officers, elected and appointed officials, employees and volunteers are named as additional insureds as respects general and auto liability as required per written contract or agreement. General Liability is Primary/ Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsement( s). SEE CANCELLATION SECTION of Certificate for 30 Days Notice of Cancellation.
30 Day Notice of Cancellation
City of Redondo Beach
Attn: Jesse Reyes
531 N. Gertruda Ave.
Redondo Beach CA 90277
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 methoo, 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 perioo 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. Ifthe 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 orto 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 not ice 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, prooucts 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 # 6806H320610
COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your " employees" providingtherapy assistant, physical therapist or for " bodily injury" that arises out of medicalspeech- or failing to provide " incidental language pathologist; or services" to any person to the extent not( b) First aid or " Good Samaritan services" subject to Paragraph 2.a.(1) of Section II – by any of your " employees" or " volunteer Who Is An Insured. workers", other than an employed or
volunteer doctor. Any such " employees" K. MEDICAL PAYMENTS – INCREASED LIMIT or " volunteer workers" providing or failing
oftoThe following replaces Paragraph 7.provide first aid or " Good Samaritan SECTION III – LIMITS OF INSURANCE: services" during their work hours for you Medicalwill be deemed to be acting within the 7. Subject to Paragraph 5. above, the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of " bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III – LIMITS OF
orINSURANCE: a.$ 10,000;
ofFor b. The amount shown in the Declarations the purposes of determining the Expenseapplicable this Coverage Part for Medical Each Occurrence Limit, all related Limit. acts or omissions committed in providing or
failing to provide " incidental medical L. AMENDMENT OF EXCESS INSURANCE services", LIABILITYservices" first aid or " Good Samaritan CONDITION – PROFESSIONAL to any one person will be deemed
The following is added to Paragraph 4.b., to be one " occurrence".
Excess Insurance, of SECTION IV –
4. The following exclusion is added to
LIABILITYParagraph2., COMMERCIAL GENERAL
Exclusions, of SECTION I – CONDITIONS:
COVERAGES – COVERAGE A – BODILY
otherINJURY This insurance is excess over any of the AND PROPERTY DAMAGE contingentLIABILITY: insurance, whether primary, excess, ProfessionalSale or on any other basis, that is
Of Pharmaceuticals Liability or similar coverage, to the extent the Bodily injury" or " property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION – pharmaceuticals committed by, or with the CONTRACTknowledge WHEN REQUIRED BY WRITTEN or consent of the insured.
AGREEMENT5. OR
The following is added to the DEFINITIONS
TransferSection: The following is added to Paragraph 8., Of Rights Of Recovery Against Others To Us,"
Incidental medical services" means: of SECTION IV – COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment,
oradvice If the insured has agreed in a written contractor instruction, or the related offurnishing agreement to waive that insured' s right of food or beverages; or recovery against any person or organization, we
b. The furnishing or dispensing of drugs or
personmedical, waive our right of recovery against suchdental, or surgical supplies or makeappliances. or organization, but only for payments we because of:
6. The following is added to Paragraph 4.b.,
thatExcess a." Bodily injury" or " property damage" Insurance, of SECTION IV – orCOMMERCIALoccurs; GENERAL LIABILITY
byCONDITIONS: b." Personal and advertising injury" caused an offense that is committed; This insurance is excess over any valid and orcollectible other insurance, whether primary, subsequent to the signing of that contract excess, contingent or on any other basis, agreement.
CG D3 79 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # 6806H320610
COMM AUTOE RCIAL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorseme nt modifies insurance provided under the following:
BUSRMI NESS AUTO COVERAGE FO
MRMO TOR CARRIER COVERAGE FO
The foaphl lowing is added to Paragr c. in A.1., Who beistrt ween you and that pe son or organiza ion, that Is An Insuedr, of SECTION II COOVERED AUT S sityg ned by you before the " bodil " y injury or " proper LAGEI ABILITY COVER in the BUSIN AUTE SS O damcya " ge occurs and that is in effect during the poli COMVR ERAGE FO and Paagraphr e. in A.1., Who Is peredretr iod, to nam as an addi ional insured fo Cove An Insuedr, of SECTOIV ON II CO ERED AUT S Autoos Liabil ity Coverage, but only for damages LERAGEI ABILITY COV in the MOTCARRIEOR R whiocs h this insurance applie and only to the extent f COMVR, ERAGE FO whichev ser Coverage Form is that perso 'n s or organizat io 'n liaductb ility for the con part of your polic :y of another "insured".
Thiares includes any person or organization who you
rentq uired under a written contract or agreem
CA 16T 4 37 0 ©2 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material ofOfIf nsurance Services ice, Inc. with its permission.
Policy: BA3R587874
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any " accident" or "loss", provided that the CONDITIONS Section:" accident" or " loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver apers To Us plies only to the person or organization desigWe nated in such contract. waive any right of recovery we may have against any person or organization to the extent
CA T3 40 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # BA3R587874
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by
Authorized Representative
Form WC 04 03 06 1) Printed in U.S.A.
Policy Expiration Date:
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: Endorsement Number:
Effective Date: Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address:
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 2 % of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
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01/31/2023
Lucci & Associates, Inc.
3251 Corte Malpaso,# 511
Camarillo, CA 93012
01/31/2024
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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- MAILADDRESS:
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
WVD
ADDL
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
AUTOSAUTOS ONLY
NON- OWNED
SCHEDULEDOWNED
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
ANYPROPRIETOR/ PARTNER/ EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
STATUTEPER EROTHMM/ DD/ YYYY) LIMITS(
POLICY EXP(
MM/ DD/ YYYY) NUMBERTYPEEFFPOLICYPOLICY INSURANCELTRINSR OF 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
PROJECT 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
1/5/2022
AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230
Lafayette CA 94549
The Certificate Team
CertsDesignPro@AssuredPartners. com
License#: 6003745 HARTFORD INSURANCE COMPANY 38288
LUCC& AS-01
25674Lucci& Travelers Property Casualty Company of AmericaAssociates, Inc. 3251 Corte Malpaso,# 511
Camarillo CA 93012
The Travelers Indemnity Company of Connecticut 25682
US Specialty Insurance Company 29599
787460867
B X 2,000, 000
X 1,000, 000
X Contractual Liab 10,000
Included 2,000, 000
4,000, 000
X X
Y Y 6806H320610 1/11/2022 1/11/2023
4,000, 000
C 1,000, 000
X X
Y Y BA3R587874 1/11/2022 1/11/2023
B X X 2022Y 000YCUP9K0231741/ 11/ 1/11/2023 4,000,
4,000, 000
X
0 A XY57WEGAB8WKG1/ 31/2022 1/31/2023
1,000, 000
1,000, 000
1,000, 000
D Professional Liability USS2131551 1/31/2021 1/31/2022 Per Claim Aggregate Limit
1,000, 000
2,000, 000
Umbrella Liability policy is a follow-form underlying General Liability/ Auto Liability/ Employers Liability. Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies.
Re: All Operations of the Named Insured - The City of Redondo Beach, it's officers, elected and appointed officials, employees and volunteers are named as additional insureds as respects general and auto liability as required per written contract or agreement. General Liability is Primary/ Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsement( s). SEE CANCELLATION SECTION of Certificate for 30 Days Notice of Cancellation.
30 Day Notice of Cancellation
City of Redondo Beach
Attn: Jesse Reyes
531 N. Gertruda Ave.
Redondo Beach CA 90277
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 methoo, 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 perioo 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. Ifthe 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 orto 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 not ice 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, prooucts 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 # 6806H320610
COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your " employees" providingtherapy assistant, physical therapist or for " bodily injury" that arises out of medicalspeech- or failing to provide " incidental language pathologist; or services" to any person to the extent not( b) First aid or " Good Samaritan services" subject to Paragraph 2.a.(1) of Section II – by any of your " employees" or " volunteer Who Is An Insured. workers", other than an employed or
volunteer doctor. Any such " employees" K. MEDICAL PAYMENTS – INCREASED LIMIT or " volunteer workers" providing or failing
oftoThe following replaces Paragraph 7.provide first aid or " Good Samaritan SECTION III – LIMITS OF INSURANCE: services" during their work hours for you Medicalwill be deemed to be acting within the 7. Subject to Paragraph 5. above, the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of " bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III – LIMITS OF
orINSURANCE: a.$ 10,000;
ofFor b. The amount shown in the Declarations the purposes of determining the Expenseapplicable this Coverage Part for Medical Each Occurrence Limit, all related Limit. acts or omissions committed in providing or
failing to provide " incidental medical L. AMENDMENT OF EXCESS INSURANCE services", LIABILITYservices" first aid or " Good Samaritan CONDITION – PROFESSIONAL to any one person will be deemed
The following is added to Paragraph 4.b., to be one " occurrence".
Excess Insurance, of SECTION IV –
4. The following exclusion is added to
LIABILITYParagraph2., COMMERCIAL GENERAL
Exclusions, of SECTION I – CONDITIONS:
COVERAGES – COVERAGE A – BODILY
otherINJURY This insurance is excess over any of the AND PROPERTY DAMAGE contingentLIABILITY: insurance, whether primary, excess, ProfessionalSale or on any other basis, that is
Of Pharmaceuticals Liability or similar coverage, to the extent the Bodily injury" or " property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION – pharmaceuticals committed by, or with the CONTRACTknowledge WHEN REQUIRED BY WRITTEN or consent of the insured.
AGREEMENT5. OR
The following is added to the DEFINITIONS
TransferSection: The following is added to Paragraph 8., Of Rights Of Recovery Against Others To Us,"
Incidental medical services" means: of SECTION IV – COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment,
oradvice If the insured has agreed in a written contractor instruction, or the related offurnishing agreement to waive that insured' s right of food or beverages; or recovery against any person or organization, we
b. The furnishing or dispensing of drugs or
personmedical, waive our right of recovery against suchdental, or surgical supplies or makeappliances. or organization, but only for payments we because of:
6. The following is added to Paragraph 4.b.,
thatExcess a." Bodily injury" or " property damage" Insurance, of SECTION IV – orCOMMERCIALoccurs; GENERAL LIABILITY
byCONDITIONS: b." Personal and advertising injury" caused an offense that is committed; This insurance is excess over any valid and orcollectible other insurance, whether primary, subsequent to the signing of that contract excess, contingent or on any other basis, agreement.
CG D3 79 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # 6806H320610
COMM AUTOE RCIAL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorseme nt modifies insurance provided under the following:
BUSRMI NESS AUTO COVERAGE FO
MRMO TOR CARRIER COVERAGE FO
The foaphl lowing is added to Paragr c. in A.1., Who beistrt ween you and that pe son or organiza ion, that Is An Insuedr, of SECTION II COOVERED AUT S sityg ned by you before the " bodil " y injury or " proper LAGEI ABILITY COVER in the BUSIN AUTE SS O damcya " ge occurs and that is in effect during the poli COMVR ERAGE FO and Paagraphr e. in A.1., Who Is peredretr iod, to nam as an addi ional insured fo Cove An Insuedr, of SECTOIV ON II CO ERED AUT S Autoos Liabil ity Coverage, but only for damages LERAGEI ABILITY COV in the MOTCARRIEOR R whiocs h this insurance applie and only to the extent f COMVR, ERAGE FO whichev ser Coverage Form is that perso 'n s or organizat io 'n liaductb ility for the con part of your polic :y of another "insured".
Thiares includes any person or organization who you
rentq uired under a written contract or agreem
CA 16T 4 37 0 ©2 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material ofOfIf nsurance Services ice, Inc. with its permission.
Policy: BA3R587874
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any " accident" or "loss", provided that the CONDITIONS Section:" accident" or " loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver apers To Us plies only to the person or organization desigWe nated in such contract. waive any right of recovery we may have against any person or organization to the extent
CA T3 40 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # BA3R587874
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by
Authorized Representative
Form WC 04 03 06 1) Printed in U.S.A.
Policy Expiration Date:
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: Endorsement Number:
Effective Date: Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address:
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 2 % of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
57WEGAB8WKG
01/31/2022
Lucci & Associates, Inc.
3251 Corte Malpaso,# 511
Camarillo, CA 93012
01/31/2023
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- MAILADDRESS:
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
WVD
ADDL
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
AUTOSAUTOS ONLY
NON- OWNED
SCHEDULEDOWNED
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
ANYPROPRIETOR/ PARTNER/ EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
STATUTEPER EROTHMM/ DD/ YYYY) LIMITS(
POLICY EXP(
MM/ DD/ YYYY) NUMBERTYPEEFFPOLICYPOLICY INSURANCELTRINSR OF 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
PROJECT 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
1/11/2026
AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230
Lafayette CA 94549
Lisa Shimizu- Fookes
714- 427- 3482
CertsDesignPro@AssuredPartners. com
License#: 6003745 Travelers Property Casualty Company of America 25674 LUCC& AS-01
25682Lucci& The Travelers Indemnity Company of ConnecticutAssociates, Inc. 3251 Corte Malpaso,# 511
Camarillo CA 93012
Travelers Casualty and Surety Co of America 31194
Hartford Casualty Insurance Company 29424
700980811
A X 2,000, 000
X 1,000, 000
X Contractual Liab 10,000
Included 2,000, 000
4,000, 000
X X
Y Y 6806H320610 1/11/2026 1/11/2027
4,000, 000
B 1,000, 000
X X
Y Y BA3R587874 1/11/2026 1/11/2027
A X X 2026Y 000YCUP9K0231741/ 11/ 1/11/2027 4,000,
4,000, 000
X
0 D XY57WEGAB8WKG1/ 31/2025 1/31/2026
1,000, 000
1,000, 000
1,000, 000
C Professional Liability 107569705 1/31/2024 1/31/2026 Per Claim Aggregate Limit
1,000, 000
2,000, 000
Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. The following policies are included in the underlying schedule of insurance for umbrella/ excess liability: General Liability/ Auto Liability/ Employers Liability.
Re: All Operations of the Named Insured - The City of Redondo Beach, it's officers, elected and appointed officials, employees and volunteers are named as additional insureds as respects general and auto liability as required per written contract. General Liability is Primary/ Non-Contributory per policy form wording.
Insurance coverage includes waiver of subrogation per the attached endorsement( s). SEE CANCELLATION SECTION of Certificate for 30 Days Notice of Cancellation.
30 Day Notice of Cancellation
City of Redondo Beach
Attn: Jesse Reyes
531 N. Gertruda Ave.
Redondo Beach CA 90277
ÐÑÔ×
ÝÇÒËÓÞÛÎæ COMMERCIAL GENERAL
LIABILITY
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ßÞ×Ô×ßÔÙÛÒÛÎßÔÔ× ÌÇÝÑÊÛÎßÙÛÐßÎÌ
ͽ¸»¼«´» º±®³¿¬·±²®»¯«·®»¼¬±½±³°´»¬»¬¸·- ô·º²±¬-¸±©²¿¾± ô©·´´¾»-¸±©²·²¬¸» Ü»½´¿®¿¬·±²- ª» ó ´±½¿¬·±²¼»-·¹²¿¬»¼¿²¼¼»-½®·¾»¼·²¬¸»-½¸»¼«´»± ºø-÷±®±® ó ¬¸·-»²¼±®-»³»²¬°»® ò º±®³»¼ óø-÷-¸±©²·²¬¸» ͽ¸»¼«´» º±®¬¸¿¬¿¼¼·¬·±²¿´·²
ó½±³°´»¬»¼±°»®¿ ô¾«¬±²´§©·¬¸ -«®»¼¿²¼þ°®±¼«½¬- ó º±®þ¾±¼·´§·²¶«®§ þ±®þ°®±°»®¬§¼¿³ ó ¬·±²-¸¿¦¿®¼ þòþ½¿«-»¼ ô·²©¸±´»±®·²°¿®¬ ô¾§þ§±«®©±® µþ¿¬¬¸» ÍÑЮ±°»®¬·»- ôײ½òôîððì п¹» ﱺïAny person or organization that you agree ina written contract toinclude as an additional insured onthis Coverage Part for "bodily injury" or "property damage" included in the "products- completed operations hazard", provided that such contract was signed andexecuted by youbefore, and is ineffect when, the bodily injury or property damage occurs. Any projecto which anapplicable contract described in the Name of Additional Insured
Person(s) or
Organization( s)
section of
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LIABILITY
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ø-÷¿¬¬¸»´±½¿¬·±² º¬¸»½± ºå ¬·±²± º§±«®±²¹±·²¹±°»®¿¬·±²- 󷲬¸»°»® å±®¬¸»¿¼¼·¬·±²¿´·²-«®»¼ º±®³¿²½»± ª»®»¼±°»®¿¬·±²-¸¿-¾»»²½±³ º±®°´»¬»¼ ø-÷¼»-·¹ ó ̸¿¬°±®¬·±²± É·¬¸®»-°»½¬¬±¬¸»·²-«®¿²½»¿ óò ·²¶«®§±®¼¿³¿¹»¿®·-»-¸¿-¾»»²°«¬¬±·¬-·² ª»µþ±«¬± º©¸·½¸¬¸»²¿¬»¼¿¾± ºþ§±«®©±® ºº±®¼»¼¬±¬¸»-»¬»²¼»¼«-»¾§¿²§°»®-±²±®±®¹¿²·¦¿¬·±ô¬¸» º±´´±©·²¹¿¼¼·¬·±²¿´»¨½´« ó ±¬¸»®¬¸¿²ó-·±²-¿°°´§ æ ¬±®»²¹¿¹»¼·²°»® º±®³·²¹±°»®¿¬º±®¿ º¬¸»-¿³»°®±¶»½¬ òݱ°§®·¹¸¬ îððë̸»Í¬òп«´ Ì®¿ª»´»®Ý±³°¿²·»ôײ½òß´´®·¹¸¬-®»-»® ª»¼òп¹» ﱺïº×²-«®¿²½» Í»®ª·½»- Ѻº·½» ôײ½ò©·¬¸·¬-°»®³·--·±² ò Any person or organization that you agree in a written contract toinclude as anadditional insured onthis Coverage Part, provided that such written contract was signed by you before, andisineffect when, thebodily injury" or " property damage"
occurs or the "personal injury"
or "advertising injury"
offense is committed.
Any project
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 methoo, 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 perioo 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. Ifthe 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 orto 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 not ice 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, prooucts or services
for the purposes of attracting customers or
supporters is considered an advertisement.
Includes copyrighted material of Insurance Services Office, Inc. with its permiss ion.
Policy # 6806H320610
COMMERCIAL GENERAL LIABILITY
occupational therapist or occupational that is available to any of your " employees" providingtherapy assistant, physical therapist or for " bodily injury" that arises out of medicalspeech- or failing to provide " incidental language pathologist; or services" to any person to the extent not( b) First aid or " Good Samaritan services" subject to Paragraph 2.a.(1) of Section II – by any of your " employees" or " volunteer Who Is An Insured. workers", other than an employed or
volunteer doctor. Any such " employees" K. MEDICAL PAYMENTS – INCREASED LIMIT or " volunteer workers" providing or failing
oftoThe following replaces Paragraph 7.provide first aid or " Good Samaritan SECTION III – LIMITS OF INSURANCE: services" during their work hours for you Medicalwill be deemed to be acting within the 7. Subject to Paragraph 5. above, the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of " bodily injury" sustained by any
3. The following replaces the last sentence of one person, and will be the higher of:
Paragraph 5. of SECTION III – LIMITS OF
orINSURANCE: a.$ 10,000;
ofFor b. The amount shown in the Declarations the purposes of determining the Expenseapplicable this Coverage Part for Medical Each Occurrence Limit, all related Limit. acts or omissions committed in providing or
failing to provide " incidental medical L. AMENDMENT OF EXCESS INSURANCE services", LIABILITYservices" first aid or " Good Samaritan CONDITION – PROFESSIONAL to any one person will be deemed
The following is added to Paragraph 4.b., to be one " occurrence".
Excess Insurance, of SECTION IV –
4. The following exclusion is added to
LIABILITYParagraph2., COMMERCIAL GENERAL
Exclusions, of SECTION I – CONDITIONS:
COVERAGES – COVERAGE A – BODILY
otherINJURY This insurance is excess over any of the AND PROPERTY DAMAGE contingentLIABILITY: insurance, whether primary, excess, ProfessionalSale or on any other basis, that is
Of Pharmaceuticals Liability or similar coverage, to the extent the Bodily injury" or " property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of
M. BLANKET WAIVER OF SUBROGATION – pharmaceuticals committed by, or with the CONTRACTknowledge WHEN REQUIRED BY WRITTEN or consent of the insured.
AGREEMENT5. OR
The following is added to the DEFINITIONS
TransferSection: The following is added to Paragraph 8., Of Rights Of Recovery Against Others To Us,"
Incidental medical services" means: of SECTION IV – COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS:
ray or nursing service or treatment,
oradvice If the insured has agreed in a written contractor instruction, or the related offurnishing agreement to waive that insured' s right of food or beverages; or recovery against any person or organization, we
b. The furnishing or dispensing of drugs or
personmedical, waive our right of recovery against suchdental, or surgical supplies or makeappliances. or organization, but only for payments we because of:
6. The following is added to Paragraph 4.b.,
thatExcess a." Bodily injury" or " property damage" Insurance, of SECTION IV – orCOMMERCIALoccurs; GENERAL LIABILITY
byCONDITIONS: b." Personal and advertising injury" caused an offense that is committed; This insurance is excess over any valid and orcollectible other insurance, whether primary, subsequent to the signing of that contract excess, contingent or on any other basis, agreement.
CG D3 79 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 3ROLF \ +
COMM AUTOE RCIAL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
This endorseme nt modifies insurance provided under the following:
BUSRMI NESS AUTO COVERAGE FO
MRMO TOR CARRIER COVERAGE FO
The foaphl lowing is added to Paragr c. in A.1., Who beistrt ween you and that pe son or organiza ion, that Is An Insuedr, of SECTION II COOVERED AUT S sityg ned by you before the " bodil " y injury or " proper LAGEI ABILITY COVER in the BUSIN AUTE SS O damcya " ge occurs and that is in effect during the poli COMVR ERAGE FO and Paagraphr e. in A.1., Who Is peredretr iod, to nam as an addi ional insured fo Cove An Insuedr, of SECTOIV ON II CO ERED AUT S Autoos Liabil ity Coverage, but only for damages LERAGEI ABILITY COV in the MOTCARRIEOR R whiocs h this insurance applie and only to the extent f COMVR, ERAGE FO whichev ser Coverage Form is that perso 'n s or organizat io 'n liaductb ility for the con part of your polic :y of another "insured".
Thiares includes any person or organization who you
rentq uired under a written contract or agreem
CA 16T 4 37 0 ©2 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material ofOfIf nsurance Services ice, Inc. with its permission.
Policy: BA3R587874
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
The following replaces Paragraph A.5., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any " accident" or "loss", provided that the CONDITIONS Section:" accident" or " loss" arises out of the operations
5. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver apers To Us plies only to the person or organization desigWe nated in such contract. waive any right of recovery we may have against any person or organization to the extent
CA T3 40 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Policy # BA3R587874
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by
Authorized Representative
Form WC 04 03 06 1) Printed in U.S.A.
Policy Expiration Date:
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: Endorsement Number:
Effective Date: Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address:
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 2 % of the California workers' compensation premium otherwise due on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us
57WEGAB8WKG
01/31/2025
Lucci & Associates, Inc.
3251 Corte Malpaso,# 511
Camarillo, CA 93012
01/31/2026