Loading...
PROOF OF INSURANCE (2024 - 2024) CLOSED'�I C R TIFICATE OF LIABILITY INSURANCE DATE 03/23//2023Y) 023 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 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 NState Farm Insurance PHONE JOHN DIEHL „FAX d. 9�t) 626-791 9915 (, nLoJ; 626 791 9918 835 E Mariposa St. moE-MAIL JOHN __ JDIEHL.COM Altadena, CA 91001 PR DUCE _..60 _ PRcv^.co OD75608 ^dae�,~v.��� mr, .. 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. ILTR. ....................._.._ � . ,_ P POLICY....._.______ TYPE OF INSURANCE _ -BR) NUMBER '... MLVPR Ei?F M MID IY Y) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 2,300,000 X COMMERCIAL GENERAL LIABILITY -DAW GE'"TO( RET�ITtD Ea $ 300,000 Y y Y � 92-XV-7702-4 03/01/2023 03/01/2024 PREMISES occurrence CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5.000 PERSONAL & ADV INJURY $ 2,000,000 ''.. GENERALAGGREGATE _ $ 4,000,000 ............ _— GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000.000 .... ...... XJE—_. POLICY7­1 P .� LOC .... .... ....____...._ $ AUTOMOBILE ............... LIABILITY P COMBINED SINGLE LIMIT (Ea (Ea accident)$ ANY AUTO BODILY INJURY Perperson) $ ALL OWNED AUTO ... BODILY INJURY (Per accident)SCHEDULED $ ........... AUTOS R...,.,_.-.�_ PERT ��...,-n,n .�.PROPERTY POPERTYDAMAGE .......... ...... $ H RED AUTOS accident) NON -OWNED AUTOS ......- .. ... $ .... I...... $ A UMBRELLA LIAB X OCCUR 92-EO-Y230-0 03/01/2023 03/01/2024 EACH OCCURRENCE 2,000,000 $ . EXCESS LIAB CLAIMS -MADE ...� rX AGGREGAT E $ 2,000,000 DEDUCTIBLE ....._...... $ .........�, RETENTION $ $ B WORKERS COMPENSATION X_ Tf1RY LIMITS WC STATU I OTR - AND „ .,,,,,",,, ..m^m 1.000.000 ANY ED7 PROPRIETOR/PARTNER/EXECUTIVE OFFIC RR ME BER EXCLU N IA 92-MW-F722-4 03/01/2023 03/01/2024 "mE.L. 4Y qI tory irp NH) DISEASECeA EMPLOYEE $ 000 000 yes, qpr da ntseunder L. DISEASE -POLICY LIMIT g 1,000,000� B &OMISSIONS ' 342018 02111I2023 02111/2024 $2000,000-EACH WRONGFUL ACT TECHNOLOGY ERRORS $2,000,000 - TOTAL LIMIT OF LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) DATA AND INFORMATION STORAGE CANCELLATION NOTICE: IF ANY POLICIES ARE CANCELED BEFORE THE EXPIRATION DATE, STATE FARM WILL TRY TO MAIL A WRITTEN NOTICE TO THE CERTIFICATE HOLDER 30 DAYS BEFORE CANCELLATION. CERTIFICATE HOLDER The City of El Segundo, its officials, and employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 350 Main Street POLICY PROVISIONS. El Segundo, CA 90245 ''.. AUTHORIZED REPRESENTATIVE VICTORIA MARTINEZ ©1988- 2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 1001486 132849.4 02-11-2010 -••'�"""�' DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/22/2023 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 be endorsed. If SUBROGATIONIS 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 CONTACT USAA INSURANCE AGENCY INC/PHS 65812846 PHONE (888) 242-1430 Ax (A/C, No, Ext): (A8C„ No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# INSURED INSURER A : Hartford Accident and Indemnity Company 22357 NETFILE INSURER B PO BOX 70 INSURER C AHWAHNEE CA 93601-0070 INSURER D INSURER E : INSURER F t ��ir rwi+rc/+C QTI Cl/�ATC \I11\IIQCQ• 't�" �.i14w.ii�'thl, NI IMQFf?• 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE OCCUR DAMAGE TO RENTED PREWSE51iLfd.Im.�rP _. MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG POLICY JECT LOC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) X ANY AUTO A AUUTOSS AUTOS AOSCHEDULED X X 65 UEC IY4482 04/20/2023 04/20/2024 ''.. BODILY INJURY (Per accident) HIRED NON -OWNED X AUTOS X AUTOS PROPERTY' DAMAGE (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- MADE AGGREGATE E RETENTION $ WORKERS COMPENSATION JYIN PER OTH- AND EMPLOYERS' LIABILITY TAT TF E,L EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVEN/A OFFICER/MEMBER EXCLUDED? E,L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT DESCRIPTION F P RATI N below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. The City of El Segundo, it and employees 350 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 REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#:. ` ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY USAA INSURANCE AGENCY INC/PHS NAMED INSURED NETFILE PO BOX 70 POLICY NUMBER SEE ACORD 25 AHWAHNEE CA 93601-0070 CARRIER NAIC CODE SEE ACORD 25 LIEC�TIIEDITI. SEE ACORD 25 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Certificate holder is an additional insured per the Commercial Auto Broad Form Endorsement HA 99 16, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Commercial Auto Broad Form Endorsement HA 99 16, attached to this policy. Coverage is primary and non-contributory per the Commercial Auto Broad Form Endorsement HA 99 16, attached to this policy. Notice of Cancellation will be provided in accordance with Form IH0313, attached to this policy. ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD