PROOF OF INSURANCE (2022 - 2023) CLOSED-ryr y. 1 0' DATE (MM/DD/YYYY)
Lam/ " CERTIFICATE OF LIABILITY INSURANCE
05/24/2022
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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
NAME: CONTACT Kimberly Heller
John P Meehan Agency, Inc
PHO � (610) 853-2220 FAX
WC, No East .. AIC. Not.
1 N Belfield Avenue
E-MA$Es's; kheller@meehaninsurance.com
ADDRINSURER(S)
AFFORDING COVERAGE NAIC #
INSURERA: Selective Insurance Co. ofAmerica
12572
Havertown PA 19083
INSURED
INSURER B : Rated by Multiple Companies
00914
SKILLSURVEY INC
INSURER C :
INSURER D :
1 COUNTRY VIEW RD
INSURER E :
SUITE 102
INSURER F c
MALVERN PA 19355-1438
COVERAGES CERTIFICATE NUMBER: CL2232121064 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
I�N.TRADDLSUHR
TYPE OF INSURANCE
�Iy �
WVD�.
POLICY NUMBER
MM DDY EFF
POLICY EXP
MM/DD
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS-MADE FX OCCUR
NAB';' ,f
PREMISES Ea occurrence
$
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$
A
S 1981662
04/15/2022
04/15/2023
GENERAL AGGREGATE
$ 3,000,000
GEN"LAGGRFGATF LIMITAPPLIES PER:
POLICY NPEC"fRO LOC
J
PRODUCTS - COMP/OP AGG
$ 3,000,000
OTHERS
State surcharge 1
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ecrlen a a :t..
$ 1,000,000
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
'... S 1981662
04/15/2022
04/15/2023
BODILY INJURY (Per accident)
$
+�,,,r
✓"
PROPERTY DAMAGE
„SPe-r accident
$
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
Auto Elite Pac
$
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 2,000,000
A
EXCESS LIAB
CLAIMS -MADE
S 1981662
04/15/2022
04/15/2023
AGGREGATE
$ 2,000,000
DED RETENTION $
$
B
_
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERNEMSER EXCLUDED?
(Mandatory in NH)
N /A
i
39WBCBU3785
09/30/2021
09/30/2022
X1 STATUTE EOR
E.L. EACH ACCIDENT
1,000,000
$
E,L.DISEASE - EA EMPLOYEE
$ 1,000,000
0 vas, descr±be 'under
DESCRIPTION OF OPERATIONS. below
E.L., DISEASE - POLICY LIMIT
1,000,000
$
�m
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Corporate Officers are excluded from Worker's Compensation
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS.
350 Main Street
AUTHORIZED REPRESENTATIVE
ElSegundo CA 90245t1
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD