ICRMA - Southern California Edison Company - 2021-0074INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY
1802 Von Karman Ave., Suite 200, Irvine, CA 92612
949.349-9882
Workers'Compensation Certificate of Coverage
Evidence of Coverage
Certificate Number:2021-0074
Certificate Holder: Southern California Edison Company
(Attn:)
2 Innovation Way
Pomona, CA91768
Covered Party: City of El Segundo
Description of
Covered Activity: As respects the City of El Segundo's use of SCE property to display banners/signs from March 2018 through
February2023.
Memorandum of
Coverage Number: 21/22 WC Effective Date: 7/1/2021 Expiration Date: 7/1/2022
Limits: Statutory (per occurrence)
Member Retained $ S00,000
Limit:
The Following Workers' Compensation coverage as defined in the memorandum of coverage on file with the covered
Coverage is in party named above.
effect:
This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This
certificate does not amend, extend, or alter the coverage afforded bythe Workers'Compensation Memorandum of
Coverage.
This is to certifythat the coverage listed above has been issued to the Covered Party named above for the coverage
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 coverage afforded as described herein is subject
to all the terms, exclusions, and conditions of the Workers'Compensation Memorandum of Coverage ofthe ICRMA,
which is available for your review upon request.
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, or allowed to expireexcept upon 30-day
notice to the certificate holder.
Date Issued: 6/30/2021
Renewal: Yes
Authorized Representative Signature: