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PROOF OF INSURANCE (2020 - 2020) CLOSED
0 DATE (MM/DD/YYYY) AC40RL> CERTIFICATE OF LIABILITY INSURANCE 12/03/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 FAX (888) Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 202-3007 AX Nal 520 Madison Avenue EMAIL contact@hiscox.com 32nd Floor ADDRESS' New York, NY 10022 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Hiscox Insurance Company Inc 10200 INSURED INSURER B Maryam Eskandari 281 East Colorado Blvd wsuRE R c 155 !Ns.4.RER..R.I... Pasadena. CA 91102 INSURER E INSURER F . COVERAGES CERTIFICATE NUMBER: 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 SHOWNHAVE BEEN REDUCED PAID COLL INS EFF NUMB F1 LICYLI0 LTR TYPE OF INSURANCE P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X I 100,000ME'D' CLAIMS -MADE OCCUR PRFMSSES,ENncrivr� �n�e $ EXP Y one person) $ 5,000 A — ....... N UDC -4344593 -CGL -19 12/03/2019 12/03/2020 Y $ 1,000,000 . r GEN°L AGGREGATE LIMIT APPLIES PER: TER. GENERAL AGGREGATE $ 2,000,000 X ,POLICY I,'cCT LOC ��'IECw PRODUCTS COMP/OP AGO $ S/T Gen• A9 O'GHER $ AUTOMOBILE LIABILITY COMBINED cdSINGLE LIMIT $ ANYAUTO BODILY INJIURY (Per �terSrFri) p $ OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS ONLY AUTOS ...,, HIRED NON -OWNED DAMAGE $ AUTOS ONLY ATOS ONLY .PROPERTY (Par arodentl ....... $ UMBRELLALIAB OCCUR R-MADE EACHOCCURRENCE EACH $ ....... { I LAB .,,,.....l...E.EO,,,,,,,,,,,,,,,,,,,, AGGREGATE $..... EXCESS RETENTION__ $ S WORKERS COMPENSATION PER ( G�TIH fA t.:.ld AND EMPLOYERS' LIABILITY YIN - _ ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED N/A L� (Mandatory in NH) E L DISEASE - EA EMPLOYEE,i„ If yes, describe under .I ................................................ ............. DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT i S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) IT ro � CERTIFICATE HOLDER CANCELLATION MIIM Designs LLC 281 East Colorado Blvd, Ste #155 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Pasadena CA 91102 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC -4344593 -CGL -19 Maryam Eskandari 1 December 3, 2019 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any per- son(s) or organization(s) for whom you are performing operations or leasing a premises when you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia- bility for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing opera- tions; or 2. In connection with your premises owned by or rented to you. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. CGL E5421 CW (02/14) Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1 Evidence of Insurance GEIC01I California Evidence of Liability Insurance Here are your Evidence of Liability Insurance Cards. glaioo.com 1-800-841-3000 Two cards have been provided for each vehicle GEICO GENERAL INSURANCE COMPANY insured. One card must be carried in the proper P.O. Box 509090 • San Diego, CA 92150-9090 insured vehicle. Proof of insurance is required to NAIC Code: 35882 register or renew the registration of your vehicle. A Policy Number Effective Date Expiration Date law enforcement officer can ask you to prove that 4538-52-12-89 04-08-20 10-08-20 you have liability insurance meeting the basic requirements of California law. Year Make Model Vehicle ID No. A violation of these requirements can result in a fine 2018 TOYOTA COROLLA of up to: Insured: $1,000 for the first time Maryam Eskandari $2,000 for additional times PO Box 155 Also, a judge can have your vehicle impounded. Pasadena CA 91102-0155 False proof of insurance may result in a fine up to $750 and 30 days in prison. Due to space limitations on the ID card, only the hip r.tioeullp �4ol*'a by ft., aaa 'Ms IlhP Nnn um utWp yw u,oraeaura �"6 W95 R tR'5 0 K ,ad dNor. C'.aahnama Named Insured and the Co-insured are listed. Fora VagNdeC'048'ruiuv,armtuo'riIlquarta,,#auwr,Ipar4rOmdbu Cho 4w full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page, which is included with your insurance packet. MARYAM ESKANDARI If you would like additional ID cards you can go online to geico.com or call us at 1-800-841-3000. PO BOX 155 PASADENA CA 91102-0155 GEICIO California Evidence of Liability Insurance geico.com 1-800-841-3000 GEICO GENERAL INSURANCE COMPANY P O. Box 509090 • San Diego, CA 921509090 NAIC Code: 35882 Policy Number 4538-52-12-89 Year Make 2018 TOYOTA Insured: Effective Date 04-08-20 Maryam Eskandari Arjun Nair PO Box 155 Pasadena CA 91102-0155 Expiration Date 10-08-20 Vehicle ID No. The p.Volwb:f d In Olds Pgro,e unhainoi urn reep'WeRfler", ark V'-'Ir.V om' Hw% & ff'`411 !:t 01 %IPop if,nRuiprauumurr 'Vuphdo Codip, muu'uuuv urn Wmil,, Ilinos pmva;:ombeiri by tho W. e DATE(MMIDD/YYYY) 111111 12/03/2019 OF LIABILITY INSURANCE 12/03/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE (8,88) 202-3007 FAX .tA,IP..NP7 9-++., '____(APC, No); ., 520 Madison Avenue E-MAILcop'1tao4 copilact@hiscox.com INSUNew York, Floor 10022 ADpBEs....... Hiscox Insurance CompaR(S) AFFORDINGny .... Inc G.E..... ! 10200 ...... INSU,RER,A.... ... ....„ i.. 0 ...0 INSURED INSURER B: Maryam Eskandari INSURER 281 East Colorado Blvd c 155 INSURER D Pasadena, CA 91102 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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 ISN SD SWVp'POLICY NUMBER POLICY D/YEFF POLICY YYY) VDDFYY XP LIMITS _LTY'Y ) COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER. I 7;F . POLICY JECIX"r'D LOC I (';uTHER S AUTOMOBILE LIABILITY ANY AUTO s ....,, OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR CLAIMS -MADE EXCUESS LIAR ETFNTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRI ETOR/PARTN E R/EXECUTI VE OFFICERIMEMBER EXCLUDED N I A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE S uriiwA�� Y(�T2€Iv'1''�O _.P- SFS_Cta rrr.Cy/rri,�nr„) s ....,, MED EXP 1Anv one person} S PERSONAL & ADV INJURY 5 GENERAL AGGREGATE S PRODUCTS - COMPIOP AGO 5 S COMBINED SPVU,,E: L IRullli' S `9 ._ . .... BODILY INJURY ( Per person} S .. .... BODILY INJURY (Per accident) S EACH OCCURRENCE ;f', [AGGREGATE S C)TH , c, S JIIf FIR I E.L...EACH..ACCIDENT 5 DISEASE - EA EMPLOYE i.. E..L...DISEASE - POLICY LIIMITE .$ A Professional Liability N UDC -4344593-E0-19 12/03/2019 12/03/2020 Each Claim: $ 1,000,000 Aggregate: $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION MIIM Designs LLC 281 East Colorado Blvd, Ste #155 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Pasadena CA 91102 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „t ©1988-2015 ACORD CORPORATION. All rights reserved. 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