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PROOF OF INSURANCE (2024) CLOSED
DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE _------ - - - ----- _.. 06/13/2023 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 ........................ .CONTAdf......... ......... .. ................................................. USAA INSURANCE AGENCY INC/PHS .N .mgg..................................................._ ..._._....m._.._..._...__................................................................_.... ........... 65812845 PHONE (888)242-'1430 (A/C, No, Ext): 1pXx (AJC.., No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: ....................... INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURERA: Sentinel Insurance Company Ltd. 11000 Steven Belisle DBA S Belisle & Associates INSURER B. 15241 NEWCASTLE LN-......-.-.-.-......_______..__..__. ...................... _. HUNTINGTON BEACH CA 92647-2632 INSURERC: INSURER D : INSURER E INSURER F: COVERAGES 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. INISR TR TYPE OF INSURANCEINSR ADDL SUER WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 OCCUR � DAMAGE TO RENTED PR MI F aoccurron $1,000,000 MED EXP (Any one person) $10,000 _CLMMS•MADE X General Liability A X X 65 SBM AA6894 05/10/2023 05/10/2024 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PE R: GENERAL AGGREGATE $4,000,000 POLICY PELT LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY (Per person) ALL OWNED ',. SACHEDULED AUTOS UTOS BODILY INJURY (Per accident) m. HIRED NON -OWNED PROPEW"T_yDAMAGE - AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE _ EXCESS LIAB CLAIMS- MADE AGGREGATE ERETENTION $ _.............. -......... _ WORKERS COMPENSATION _ ..n PER OTH _ ..... AND EMPLOYERS' LIABILITY STATUTE I IgR. E.L EACH ACCIDENT ANY YIN PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N/ A E.L., DISEASE -EA EMPLOYEE (Mandatory in NH) _...... .._._....... ..... ._.._..m.m...m.m._ If yes, describe under E.L, DISEASE - POLICY LIMIT DESCRIPTI N FOPERATIONSbel 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. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. CERTIFICATE HOLDER CANCELLATION City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED a municipal corporation and general law BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED City IN ACCORDANCE WITH THE POLICY PROVISIONS. 350 MAIN ST AUTHORIZED REPRESENTATIVE EL SEGUNDO CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 City of El Segundo a municipal corporation and general law city 350 MAIN ST EL SEGUNDO CA 90245 Account Information: Policy Holder Details : Steven Belisle DBA S Belisle 8� Associates June 13, 2023 Contact Us Need Help? Chat online or call us at (866) 467-8730. We're here Monday - Friday. Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTRO05