ICRMA 2019 - University California Los Angeles (UCLA)Independent Cities Risk Management Authority
18201 Von Karman Ave., Suite 200, Irvine, CA 92612
949.349.9882
Liability Certificate of Coverage
Additional Covered Party
Certificate Number: 2018-0083
Certificate Holder: University California Los Angeles(UCLA)
10990 Wilshire Boulevard, Suite 1450
Los Angeles, CA, 90024
Covered Party: City of El Segundo
Description of As respect pre -hospital care for continuing education and oversightofthe Citywide AED Program under
Covered Activity: Contract No. 3375, Certificate Holder is included as an Additional Covered Party with regard to any
negligentacts oromissionsofthe Member, its employees, and its elected orappointed officials.
Memorandum of
Coverage Number: ICRMA GL 2018
Effective Date: 7/1 /18 Expiration Date: 7/1 /19
Limits: $5,000,000 (per occurance)
Self -Insured Retention: $ 750,000
The Following General and automobile liabilityas defined in the memorandum of coverage on file with the covered party
Coverage is in named above. Sexual misconduct notspecificallyexcluded for the city.
effect:
This is to certify that the coverage listed above has been issued to the Covered Party named above for the coverage
period indicated, notwithstanding anyrequirement, term, or condition of any contract or other document with respect
to which this certificate maybe issued or may pertain. The coverage afforded as described herein is subject to all
the terms, exclusions, and conditionsofthe Liability Memorandum ofCoverage of the ICRMA, which is available for
your review upon request.
Pursuantto the definition of Covered Party in the Liability Memorandum ofCoverage, the certificate holdernamed
above is an additional covered party for covered claims arising outofthe covered activity stated above and is
subjectto the limits stated above. *Such limits are inclusive ofthe city's SIR.
Coverage is in effect from 12:01 a.m. Pacific Standard Time of effective date to 12:01 a.m. Pacific Standard Time of
expiration date as stated above and will not be canceled, limited, orallowed to expire except upon 30-day notice to
the certificate holder.
Date Issued: 7/4/2018
Renewal: Yes
Authorized Representative Signature: