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PROOF OF INSURANCE (2021 - 2022) CLOSED (2)A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYv) I_ __ ..- I 05/27/2021 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 ri hts to the certificate holder in lieu of such endorsements . PRODUCER CONTACT Denise Hudson �m 7rm Denise K Hudson Insurance Agency, Inc 714 633 611 $ W Katella Ave Ste 240 iC lYtlt7r_.4Y. ..... denise@denisekhudson.com denlse denlse Oran e, CA 92867 9 INsuRER s AFFORY.Nrx COVE IT ITIT NAIC # License # OB86530 INSURER A: State Farm Mutual Automobile Insurance Company 25178 ......... INSURED. INSURERS: State Farm Fire and Casual Company _ 25143 WESTERN A/V INC State Farm General In INSURER Insurance Company 25151 1592 N BATAVIA ST STE 2 INSURER D: ORANGE, CA 92867 INSURER E INSURER F COVERAGE$ 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. ..— __...................... PE OF INS.... .................... — s ...... ... ........... ..... �� tip - ----..... ........ ...__ --- ,.... ...... ADDL SYJ6681 POLICY POLICY EFF POLICY EXP LIMITS INSR n. INSURANCE LTR.. NUMBER MIM/DD X U COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 . ''.. j _ .DAMAG`E T'l�t NTED (rHtr9p 3 CLAIMS -MADE OCCUR Ea 4 ...�.F1 $ ._00,000........ . ....� F 5,000 C Y 92-GY-D812-0 05/16/2021 05/16/2022 PERSONAL P _._. 1,000,000 $ —, ._ AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4 000,000 X� POLICY LOC PRODUCTS - COMP/OPAGG $ 4000,000 OTHER; BUSINESS PROP $ 248,400 AUTOMOBILE LIABILITY 6392569E21-75 05/21/2021 11/21/2021 COMBINED SINGLE LIMIT t� aaw.:,idr�crlp 1,000,000 $ ......._ .... ANY AUTO BODILY INJURY (Per person) $ /\ . ..v. OWNED SCHEDULED /� ...._ ..... BODILY INJURY (Per accident) .. � $ AUTOS ONLY AUTOS X— v HIRED NON -OWNED X i� ROPEI�'TY DAMAGr. ..... AUTOS ONLY AUTOS ONLY t . kpkp UMBRELLA LIAB � OCCUR RRENCE $ 5 000 000 . C - X � EXCESS LIAB ADE CLAIMSM,,, N/A N/A 92-XC-0351-6 12/14/2020 12/14/2021 AGGREOGATE $ „, ..... ----- ..,, _ _� a DIED RETENTION $ t $ WORKERS COMPENSATION PER OTH- B AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTN ER/EXECUTIVE YIN NIA Y 92-GQ-64663 01/01/2021 01/01/2022 STATLI7E ID LEACH ACCIDENT E __ - - 1'000'000 $,,,,, OFFICER/MEMBER EXCLUDED? ER/MEn BE �E 1 000 (Mandatory' ) EMPLOYEE L DISEASE - PLOYEE $ '000 _ If yes, describe under DESCRIPTION OF OPERATIONS below '. E.L„ DISEASE - POLICY LIMIT 1,000,000 $ ,000� B SURETY BOND 92-W6-8753-3 11/17/2020 11/17/2021 $15,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) AUDIO VISUAL SYSTEMS INTEGRATION Business Location 1592 N Batavia St„ Ste 2, Orange, CA 92867 It is agreed that is is the intention of the Company to provide 30 days written notice prior to the cancellation of the policy designated in this certificate. However, the Company assumes no liability for failure to do so. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Information Systems Department City of El Segundo AUTHORIZED REPRESENTATIVE 350 Main Street El Segundo, CA 90245 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849„13 04-22-2020 AC Policy NO. 92 GYD812 0 3535—FB8A CPe 87 0.11 P of 1 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CMP-4870.1 ADDITIONAL INSURED — PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 92 GYD812 0 Named Insured: N: WESTERN A/V INC A: 1592 N BATAVIA ST STE 2 C: ORANGE CA 92867 3554 Name And Address Of Additional Insured Person Or Organization; N: CITY OF EL SEQUNDO — CITY, ITS OFFICIALS AND EMPLOYEES — N: INFORMATION SYSTEMS DEPARTMENT A: 350 MAIN STREET C: EL SEQUNDO CA 90245 This insurance is primary to and will not seek contribution from any other insurance available to an addi- tional insured under your policy provided that the additional insured is a named insured under such other insurance. All other policy provisions apply. CMP-4870.1 1007043 148021 08-18-2014 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 6.1 AC Policy No. 92 GYD812 0 3535—FB8A CPage 18of 2 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CMP-4786.1 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 92 GYD812 0 Named Insured: N: WESTERN A/V INC A: 1592 N BATAVIA ST STE C: ORANGE CA 92867 3554 Name And Address Of Additional Insured Person Or Organization: N: CITY OF EL SEQUNDO — CITY, ITS OFFICIALS AND EMPLOYEES — N: INFORMATION SYSTEMS DEPARTMENT A: 350 MAIN STREET C: EL SEQUNDO CA 90245 1. SECTION II — WHO IS AN INSURED of SECTION II — LIABILITY is amended to in- clude, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injury""„ Hproperty damage", or "personal and advertis- ing injury" caused, in whole or in part, by a. Ongoing Operations (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing opera- tions for that additional insured; or b. Products — Completed Operations "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 permit- ted by law; b. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance provided to the additional insured will not be broader than that which you are required by the contract or agreement to provide for such addition- al 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: (1) Is allowed for the satisfaction of a de- fense or indemnity obligation by Cali- fornia Civil Code Section 2782 or 2782.05 for your sole liability; or (2) You are required by contract or agreement to provide for such addi- tional insured. We have no duty to defend or indemnify the additional insured under this endorsement un- til a claim or "suit" is tendered to us. ©, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services office, Inc., with its permission. CMP-4786.1 Page 2 of 2 2. Any insurance provided to the additional in- (3) The nature and location of any injury sured shall only apply with respect to a claim or damage arising out of the `occur - made or a "suit" brought for damages for rence" or offense; which you are provided coverage. b. Tender the defense and indemnity of any 3. With respect to the insurance afforded to the claim or "suit" to us and to all other insur- additional insured, the following is added to ers who may have insurance potentially SECTION II — LIMITS OF INSURANCE: available to the additional insured; and If coverage provided to the additional insured c. Agree to make available any other insur- is required by contract or agreement, the most ance the additional insured has for de - we will pay on behalf of the additional insured fense or damages for which we would will be the lesser of the amount of insurance: provide coverage under SECTION II — a. Required by the contract or agreement; or LIABILITY. b. Available under the applicable Limits Of 5. With respect to the insurance afforded the ad - Insurance shown in the Declarations. ditional insured, the following replaces SEC- TION II —LIABILITY of Paragraph 7. Other This endorsement shall not increase the ap- Insurance of SECTION I AND SECTION II plicable Limits Of Insurance shown in the COMMON POLICY CONDITIONS: Declarations. a. This insurance is primary to and will not 4. With respect to the insurance afforded to the seek contribution from any other insurance additional insured, the following is added to available to the additional insured, provided Paragraph 3. Duties In The Event Of Occur- that the additional insured is a named in- rence, Offense, Claim Or Suit of SECTION sured under such other insurance. 11— GENERAL CONDITIONS: b. Regardless of any agreement between The additional insured must: you and the additional insured, this insur- ance is excess over any other insurance a. See to it that we are notified as soon as whether primary, excess, contingent or on practicable of an "occurrence" or an of- any other basis for which the additional in- fense which may result in a claim. To the sured has been addedas an additional in - extent possible, notice should include: sured on other policies. (1) How, when and where the "occur- There will be no refund of premium in the event rence" or offense took place; this endorsement is cancelled. (2) The names and addresses of any in- jured persons and witnesses; and All other policy provisions apply. CMP-4786.1 1007033 148011 08-21-2014 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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 otherwise due on such remuneration. CITY OF EL SEGUNDO CITY ITS OFFICIALS, EMPLOYEES INFORMATION SYSTEMS DEPARTMENT 350 MAIN ST EL SEGUNDO CA 90245-3813 5 % of the California workers' compensation premium Schedule CONTRACT $200 & CODE 8742 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12/20/20 Policy No. 92-GQ-B466-3 Endorsement No. Insured WESTERN A/V Insurance Company State Farm Fire and Casualty Company Countersigned By WC 04 03 06 (Ed.4-84) 1007722 124282.2 01-25-2019