Loading...
PROOF OF INSURANCE (2023) CLOSEDVANLING-01 DATE (MMI TE(MMI DDIYYYYl CERTIFICATE OF LIABILITY INSURANCE 0/28/2001261 022 2 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(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions o'fthe policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such ondorsoment s . PRODUCER I RUJACTOreg Harlan Fog S Assocl Itos PH (FAX 21300 VictAlso Blvd. Ste. 700 N-� Exr : 818) 703-8057 (FAX. No : 81 ' 703-0935 Woodland H 1'% CA 91357 �; ssrg reg ploy -corn INSURED Van Lingen Body Shop Inc. 2756 Lomita Blvd. Torrance, CA 90505 F: w.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, F_NSR TYPE OF INSURANCE ADDL SUIIR POLICY NUMBER POLICY EF6 CY M LIMITS A X COMMERCIAL GENERAL LIABILITY C OCC. RR N E S 1,000,000 CLAIMS -MADE OCCUR X PC 4400004 11/1/2022 11/1/2023 DAMAGE TO RENTED 100,000 UQ P An one 5,000 P RSONAL&AOVINJURY.........�11Y1Y1 1,000,000 CENLAGG'RE ATE LIMIT APPLIES PER: X POLICY j LOC GENERA A R TE 3,000,000 PR D T - O PdO AGG 31000,000 S O HER, A AUTOMOBILE LIABILITY RMBINED SINGLE LIMIT wl s 1,000,000 BODILY INJURY ar n ANY AUTO X TPC 4400004 11/1/2022 1111/2023 OILY IN URY aeCdent J. OWNED M SCHEDULED AUTOS ONLYAUTOSg pp A�TO,S ONLY VOS�Y Ix CrBaERn AGE S UMBRELLA L1AB OCCUR EACH OCCVRRENrE AGGREPAT_E S EXCESS LIAB CLAIMS -MADE DED RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY .ANY PROPR�IMETgO�R�/PARTNER/EXECUTIVE YIN = � Rn.NH) EXCLUDED? Runde) NIA PER OTH- EA AC IDENT E,L E- EMP VE. .' §,,,,,,,,,,,,,,,,„ E.L. DIS SE - POLICY LIMIT 1 S If n, dssrakb' a r D IPTp .N OF OP TI N§ below A Garage Keepers TPC 4400004 11/112022 11/1/2023 Limit 500,000 A 10n Hook TPC 4400004 11/112022 11/1/2023 Limit 200,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required) Certificate Holder is listed as Additional Insured City of El Segundo Public Works Dept 360 Main St El Segundo, CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ACORD 26 (2016103) 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD VeNI ulut.ni A►+ �I "` N "'') CERTIFICATE OF LIABILITY INSURANCE°A10126 2 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, cortai'n policies may require an endorsement A statement on this certificate does not confer rights to the certificate' holder In lieu of such endorsements . PRODUCER , CT Greg Hanen PCF Insurance Services of the West LLC 21300 VictoryBlvd., Ste 700 Woodland Hills, CA 91367 PHONE FAX A!C No, Ext : (818) 703-8057 A, Ne ;(818) 703-0935 rG cfo .Com INSURER(PJAEFORPING COVERA01 NAIC# INSURER A.•National Interstate Insurance Com an 32820 INSURED INSURER INSURER C c Van Lingen Body Shop Inc. tMEMS 2765 Lomita Blvd. Torrance, CA 90505 INSURER E :. INSURER F : OV' RA('r-^a ir" G➢TlFld"ATI: NI1II APP. I' r-Aliqir1N N,IIIIMR'I-0- 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. ¢N R TYPE OF INSURANCE ADOL. SUeR POLICY NUMBER POLICY POU'C"b F.XP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH RRE C DAM¢A O 1NTEI D EXP LLny rang e2mM $ ER NAL.6ADVINJURY GEN'LAGGRIa ATEpLIMIT AN7'PLNESPER: POLICY E'r LOC GE GENERALAGGREGATE S PPA THER: AUTOMOBILE LIABILITY OMBINEO SINGLE LIMIT $ ANY ALTO MOED SCHEDULED A TDS ONLY AUTOS BODILY INJURY Perperson) $ BODILY' INJ¢JRY (Par ar�ldo¢vI S or ag AMAG' $ EE.¢¢�� AUTOS ONLY A �IJLY S UMBRELLA LIAR I IOCCUR EACH R N E. S T EXCESS LIAB CLAIMS -MADE DEC) RETENTIONS S A WODRKEEMRR C P NLUq ¢noTyl ANYPRo�ETORn+ARTNERIEXECUTIVE YIN FFhICKPOI I EXCL¢rDED9 CCIC kI ¢PY IfM 1"PT0b0under DESCRIPTION OF OPERATIONS below N!A X W4400004 11/1/2022 11/1/2023 PER OTH- UaLlIE Ea I .L IS .A E. �• EA. EMP Y 11000,000 £. 1,000,000 L DISEA I YLIMIT 110008000 DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be aBachad if more space Is required) Tow Truck Operations Waiver of Subrogation In favor of named Cert Holder City of El Segundo Public Works Dept 350 Main St El Segundo, CA 90246 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ACORD 25 (2016103) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD