PROOF OF INSURANCE (2022) CLOSEDM
1--lim"ll 1 GATE,Y)
ACCOR& CERTIFICATE, OF'LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDE . 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 INSURFO, the polic"es) must be endorsed. ff SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement A statement an this certificate does not confer rights to the
certificate holder In lieu of such endorsemenqs).
PRODUCER Brian Hunt Insurance Agency 2=11y
Brian Hunt, Lic# OE02545
5693 Woodruff Ave
Lakewood, CA 90713
ALLISON, ROBBY DBA ALLISON TRAINING
PERSPECTIVES & SERVICES
.- -W
4067 HARDWICK ST STE 495 INSURER D
M E
LAKEWOOD CA 90712 INSU
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS, TO CERTIFY THAT THE (MES OF INSURANCE LISTED BELOW HAKE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR tHE POuCY KaIOD
WDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONI)ITION OF ANY CONTRACT OR OTHER DOCUMENT WMA RESPECT Two WHICH THIS
CERTIFICATE MAY BE RSSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED, BY THE POLfCMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOM MAY HAVE BEEN REDUCED BY PAID CtAfln.
SIr TYPE OF FNSURAMCE TknT Mbi POUCY Rums Y Exp UKITS
GENERAL LIABILITY 10112F2021 10)1212022 EACH OCCLF4tEMCE $ 1,000,000
COMMOMM Ge4lERAL uASKM fit -EL43253-8 S 300,000
CLAMS44ACE IK OCCUR MED EXP 06-ry am pvw) S 5.000
PEF40MAL & ACV NAM S 1,000,000
GENERAL AGGREGATE S 2.000.000
GEM... raT'C UMrT APPUES PER: PRODUCTS - COMPIOP AGO 5 ZOOOOOD
3?1
POLICY
BusinessProp" S 1,800 r7 —LM WiT
AVMKOWLE UADMM
BODLY INJURY (Pa P—) S
ANY AUTO
AILOWNED SCHEDULED BODILY MJURY Mv
AUTOS AUTOS -FW�FRTY OANA, , 0 E
NON -OWNED
HD;MDAUTOS AUTOS
A
A 'L INED H2AUTOS UMBRELLA 61A6L
OCCUR EACH CURRENCE Is
EXCESS UAB
CLAMis4AADE AGGREGATE
DED F� 5,
CO
W0WM COMPENSATION
ANDEM'LOYERS
ND EMIqJOYERS'L1ABflJTY YIN
ANY M=UW TTNER� F-L EACH A=004T
Om EX7 = El MIA E.L. sE - EA EmKOM S
(M-ft" In ""I
9 ym dmwft urdw El- DISEASE - P&UCY UIAIT $
DFWROMON OF OPERATHM I LOCAPONS I YEKWAES JANwh ACORD 10, Addoona ReffaM Schbduw ""WO Vazg Is fwQu&oq
Additional Insured:
City of El Segundo
300 Main Street
. ... . .. ........ . oisaa�Mo AcoRd' CORPORA710N, All rights reserved.
ACORD 25 (201 DIOS) The ACORD name and logo are mg1stored marks of ACORD 1001486 132S49.7 03-01-2012
CM - 4616,1
«« ««
• • y rr
44,-
FORM
Policy No: 92-EL-8253-8 G
Named Insured:
ALLISON, ROBBY
DBA ALLISON TRAINING
PERSPECTIVES & SERVICES
4067 HARDWICK ST STE 495
LAKEWOOD CA 90712-2350
Name and address of Additional Insured
Person or Organization:
1. O IS AN INSURED isamended
to include, as an additional insured,
organizationany person or ~
above,the Schedule
respect,« liability for "bodi�ly injiury"
o"property «w .« .caysed
whole in
or
part,
performed for d
and included In the . products -
operations haza«
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;
or a
insured; and
c. If the contract or agreement between you
and the additional insured is governed by
California Civil Code Section 2782 or
2782,0 , the insurance provided to the
additional insured is the lesser of that which;
(1) 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.
S. with respect to the insurance
afforded to the additional insured,
the following is added to
SECTION li — LIMIT'S OF
INSURANCE:
If coverage provided to the additional
insured is required by contract or
agreement, the most vie 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 1 of Z
CMP - 4516.1
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 11
— GENERAL CONDITIONS:
The additional insured must:
(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:
10 "00111MA 0
111111��2-16011111 01110W
'1', 70&,
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 — LIABIUTY
S. With respect to the insurance afforded!
the additional insured, the following
replaces SECTION It — LIABILITY Of
Paragraph 7. Other Insurance of SECTION
1, 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.
Is. 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
"'PROM W1,10,11",
Tel. -800-841-300C
7 "'10. is
ROBBY JAY ALLI�SON
M.
Email Address:
.. .........
• Insured
Robby Jay Allison
Declarations Page
This is a description of your coverage.
Please retain for your records.
Policy Number: 4438-73-47-76
Coverage Period:
05-11-21 through 11 -11-21
12:01 a.m. standard time at the address of the named
insured.
Vehicle VIN Vehicle Location Finance Company/
Lienholder
1 2004 Ford ExpXLS/Spt LONG BEACH CA 90808-1313
Coverages* Limits and/or Deductibles Vehicle I
Bodily Injury Liability
Each Person/Each Occurrence
State Minimum $15,000/$30,000
$25,000/$50,000
Property Damage Liability
State Minimum $5,000
$25,000
Uninsured & Underinsured Motorists
Each Person/Each Occurrence
$25,000/$50,000
Uninsured Motorists Property Damage
$3,500
Total Six Month Premium
$140.50
$37.10
$6.80
$284.30
*Coverage applies where a premium or $0.00 is shown for a vehicle.
If you elect to pay your premium in installments, you may be subject to an additional fee for each installment. The fee
amount will be shown on your billing statements and is subject to change.
I (- X-dc-)2b