PROOF OF INSURANCE (2021 - 2021) CLOSEDDATE IMMiDl
CERTIFICATE OF LIABILITY INSURANCE 1111212020
. ........... .
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN 'THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the II
terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the 1
certificate holder In Ilou of such endorsement(s).
PRODUCER Brian Hunt Insurance Agency
FAX
Brian Hunt, Lic# OE02545 0,17,
5693 Woodruff Ave IhISUR ISI F111DRI COVERA , G , E NAIC N
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RAILakewood, CA 90713
. ........ INSURER A: State Farm Fire and Casuall�-Cnl
INSURIED ALLISON, ROBBY DBA ALLISON TFWNING INSURER 8:
PERSPECTIVES & SERVICESLNURER C . . 1111— -1 — .111, — ----- -
4067 HARDWICK ST ST E 495 JNSURER 0
LAKEWOOD CA 90712
. ... . ......... INSPIPREAll ......
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAI' THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED N07WTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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 CLAII
POUCY III POLICY EXP
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CERTiFtCATE HOLDER
Additional Insured.
City of El Segundo
300 Main St.
EI Segundo, CA 90245
L. . . ...... . — P --
ACORD 25 (2010/05)
CANCELLAJtON
flALL. ....... . .. — - — - — ---------------
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F PQiEFI 'A::ASIP� EJ', E M I
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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
AU7M4RIZE0 RFPRESENTAnVE
I q 8,, 111 . 2 0 1 CO C ION. All rights reserved.
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The ACORD name and logo are registered marks of ACORD 100 i,aO,iEi 1 9 7 ()'-1) % -2 012
CMP — 4616.1
DESIGNATED PERSON OR
ORGANIZATION
0
Policy No: 92 -EL -6253-8 G
Named Insured:
ALLISON, ROBBY
DBA ALLISON TRAINING
PERSPECTIVES & SERVICES
40157 HARDWICK ST STE 49S
LAKEWOOD CA 90712-2350
Name and address of Additional Insured
Person or Organization:
1. WHO IS AN INSURED is amended
to include, as an additional insured,
any person or organization shown in
the Schedule above, but only with
respect to liability for "bodily injury"
or "property damage" caused, in
whole or in part, by "your work"
performed for that additional insured
and included in the "products -
completed operations hazard".
However, Paragraph 1. above is subject to
the following:
a. The Insurance afforded to the additional
Insured only applies to the extent permitted
by law;
b. If coverage provided to the additional
Insured is required by a contract or
agreement, the insurance provided to the
additional insured will not be broader than
Haat which you are required by the contract
or agreement to provide for such additional
insured; and
c. If the contract or agreement between you
and the additional insured is governed by
California Civil Code Section 2782 or
2782,05, the insurance provided to the
additional insured is the lesser of that which:
(i) Is allowed for the satisfaction of
a defense or indemnity obligation
by California Civil Code Section
2782 or 2782,05 for your sole
liability; or
(2) You are required by contract or
agreement to provide for such
additional insured.
We have no duty to defend or indemnify the
additional insured under this endorsement
until a claim or "suit" is tendered to us.
2. Any insurance provided to the
additional insured shall only apply
with respect to a claim made or a
"suit" brought for damages for which
you are provided coverage.
3. With respect to the insurance
afforded to the additional Insured,
the following is added to
SECTION 11 — LIMITS OF
INSURANCE:
If coverage provided to the additional
Insured is required by contract or
agreement, the most we will pay on behalf
of the additional Insured will be the lesser of
the amount of insurance:
a. Required by the contract or
agreement; or
b. Available under the applicable Limits
Of Insurance shown in the
Declarations.
Page I of Z
CMP -4616.1
This endorsement shall not increase the
applicable Limits Of Insurance shown in the
Declarations.
4. With respect to the insurance
afforded to the additional insured,
the following is added to Paragraph
3. Duties In The Event Of
Occurrence, Offense, Claim Or
Suit of SECTION If
— GENERAL CONDITIONS:
The additional insured must:
a. See to It that we are notified as soon, as
practicable of an "occurrence" or an offense
which may result in a c)aim, To the extent
possible, notice should include:
(1) How, when and where the
Aoccurrence" or offense took place;
(2) The names and addresses of any
injured persons and witnesses; and
(3) The nature and location of any
injury or damage arising out of the
"occurrence" or offense;
b. Tender the defense and indemnity of any
claim or "suit"to us and to, all other insurers
who may have insurance potentially vailable
to the additional insured; and
c. Agree to make available any other
insurance the additional insured has
for defense or damages for which
we would provide coverage under
SECTION 11-- LIABILITY.
5. With respect to the insurance afforded
the additional insured, the following
replaces SECTION 11 — LIABILITY of
Paragraph T. Other Insurance of SECTION
I AND SECTION 11 —
COMMON POLICY CONDITIONS:
a. This insurance is primary to and will not
seek contribution from any other insurance
available to the additional insured, provided
that the additional insured is a named
insured under such other Insurance.
b. Regardless of any agreement between
you and the additional insured, this
insurance is excess over any other
insurance whether primary, excess,
contingent or on any other basis for which
the additional insured has been added as
an additional insured on other policies.
All other policy provisions apply.
Page 2 of 2
MAILHING ADIDrRESS
ROBBY JAY ALLISON
mow
GEICO GENERAi IINSURA14CE COMPANY
VERIFICATION OF COVERAGE
(SEE Bl[:.1 OW UNDER CAUTIONARY NOTE)
Policy IMunriber: 4438734776
lEffective Date. 'I 1-11-20
Expiration DaW 05-11-21
Registered State- CALIFORNIA
To whom it may concern:
This Ietter is to verify that we have issued coverage under the above poficy number for the dates indicated in the
effective and expiration date fieIds for the vehicle listed. This shouId serve as proof that the below mentioned vehicle
meets or exceeds the financiaI responsibRity requirement for your state..
This verification of coverage does not amend, extend or alter the coverage afforded by this policy.
Vehicle Yearn 2004
Make:: FORD
Model: Ii: :XPX1 S/SIPT
VIN, - F006OWN
COVERAGES
Bodily Injury Liability
Each Person/Each Occurrence
State Minimum $15,000530,000
Property Damage Liability
State Minirnum $5,000
Uninsured & Underinsured Motorists
Each Person/Each Occurrence
Uninsured Motorists Property Damage
Additional Insured
Additional Inforimation:
iSSI-Ied 11/12/2020
ILIMITS
$25,000/$50,000
$25,000
$3,500
Interested IParty
If you have any additional questions, please call) 1-800-841-3000.
CAUTIONARY NOTE: THE CURRENT COVERAGES, LIMITS, AND DII: DuanBILES MAY DIFFER FROM THE COVIDRAGES, UMrTS AND DEDUCTIBLES IN EFFECT AT
OTHER TWES DUMNGTHE POLICY IPERDOD.THIS vERIFI CATION OF COVERAGE REFLECTS THIH COVERAGES, (LIMITS, AND DEDUCTIBLES AS OF THE ISSUED
DATE OF THIS DOCUMENT WFUCH IS SHOWN UNDER "ADI)ITIONAL INFORMATION` OR IF AN ISSUED DATE IS NOT SHOWN, THE DATE OF THIS FACSIMR.E OR
EIWAR-
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