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PROOF OF INSURANCE (2024 - 2024) CLOSEDCC>RE" CERTIFICATE OF LIABILITY INSURANCE �• DATE 10l24/023 (MM/2023 Y) 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 CONTACT NAME. Bethany Hogue Merriwether & Williams Insurance Services Fp CON No,Fxt (415) 986-3999 _ FAX N (415) 986-3999 ____ ADDRESS: License No..: 0001378E-MAIL INSURERS AFFORDING COVERAGE NAIC 0 44 Montgomery St., Ste, 940 INSURERA: ACE Fire Underwriters Insurance Company San Francisco CA 94104 INSURED INSURER B : Hiscox Insurance Company Inc.. INSURER C : Security Design Concepts, Inc. '.. INSURER D : 17943 W. El Caminito Dr. ''. INSURER E : INSURER F : Waddell AZ 85355 COVERAGES CERTIFICATE NUMBER: CL2332120081 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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. 'LTR TYPE OF INSURANCE AubutlKI INSD WVD POLICY NUMBER POLICY EFF MM/DDIYYYY) POLICY UP (MM/DDIYYYYJ LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2-000-000 � 100,000 CLAIMS -MADE OCCUR '..., PREMISES Ea occurrence __ $ MED EXP (Any one person) $ 5,000 A D96051785 04/14/2023 04/14/2024 PERSONAL & ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY ,AECPRO} LOC ; t PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY CC 'AFINED SINGLE LIMIT Ea accid'ont) $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PR P' - DAMAGE $ AUTOS ONLY AUTOS ONLY IF& accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION PERTUTE. OTH- STAER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E, L EACH ACCIDENT ' $ [--�111 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E L, DISEASE- POLICY LIMIT $ B PROFESSIONAL LIABILITY P100.206.684.3 04/14I2023 04/14/2024 EACH CLAIM $1,000,000 11 AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE ADDITIONAL INSURED'S AS RESPECTS THE NAMED INSURED'S OPERATIONS WHERE REQUIRED BY WRITTEN AGREEMENT. INSURANCE IS PRIMARYAND NON-CONTRIBUTORY AND WAIVER OF SUBROGATION APPLIES. CITY OF EL SEGUNDO 350 MAIN ST. ELSEGUNDO CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 1988-2015 ACORD GORPORATWN. All rlgnts reserveO. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I w i pam)h- dMsp aaau%wm pp pun spe) mnwj'pry uo upw" W b ne wn maaovuP.a-. r 1ePwxue, *P4$-0y puextvp9aaxaXeujs}uno LJ Slate Farm Mutual Automobile Insurance Company M Rnr "M Bkomfnon IL 61702-2358 AT2 002158 0008 A-1357 RAMM, ROGER B Policy Number:—E29-03 PrAry Pwrirxt• NnvPmhar 24 2f123 to Mav 24 2f12d Vehicle: Principal Driver: ROGER RAMM A PAU IV Mr— HAL N'tt�tt��iPt C��C��t,c Your State Farm Agent ��INSURANCE AGCY INC Office. - Address: If you have anew ordMent cer, have added anydfiim orhae mowed, please corrfadyourwt I hanK you for choosing b'tate Farm. See yourpuGryfm en exp!ana:vn -fates= vte---s. H LI' Ilny Bodily Injury 250,0001500,000 Property Damage 100,000 �....-.�.. � ...___.�.._.__... ..�..a.,..m.,_$250.03 u 1,omplenenslve a 11 1 If G 500 Deductible Collision $148.93 RI VA Mwittal C IItlUCI C7lrRl1M Per flay„ $1,500 Max 518.91 - fcontr had on next ) Policy Number.—E29-03 Page number 3 of 5 Prepared October 6, 2023 10118123. 11.33 AM Policy Information 46 Policy Information Policy number 03-CD-D739-2 Policy type Personal Liability Umbrella Mailing address Phone number Email address U y"luciva'a aH ,v cficinm I I "urAaps�^ �91 rI'pdla'."yic Coverage Personal Ua !!-k Llmk E2,000,000 Self Insured ,,,. Retention Umft so Discount Class so ca Required Underlying Insurance Policies The Personal Liability Umbrella requires underlying insurance policies to be maintained at specific minimum limits that are listed on the Declarations page when the applications is accepted and the policy is Issued_ Failure to maintain the required underlying insurance at all times in an amount at least equivalent to the mlydmum underlying limits could affect your coverage in the event of a loss. Please contact yourAgent if you have any questions regarding these requirements. Declarations & Poft Informadon The IrtromtaGon presented In Ihl9 document is not a dedaration page, palmy, or endorsement. Recent changes to the policy may not be mnadod. It you have any prastions about ai's form or could We to obtnm a deciaraliai page or a copy or your poky, please contact you Stale Farm Agent for assistance, Contact Contact Us File a Claim https:llonline2.statelarm.comlapps/pvcMrelexecute.do?APPQS=ljS6KBKb6kLVHDnoeKOW591 q-xJfaKDulM-IG4smFggRTbes11 dS5zVyH4ONA-126o... 1 /2 DATE (MMIDD/YYYY) `�' CERTIFICATE OF LIABILITY INSURANCE 10/18/2023 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 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. Diana Spinoglio BMR Insurance Agency, Inc. PHONE (714) 838-1911 FAX G No(714193e-91s0 JAIC. No P.O. Box 1025",MA;.Q,, dianas@bmrins.com INSURERS AFFORDING COVERAGE NAIC # Tustin CA 92781 INSURERA:The Ohio Casualty Ins. Co, 24074 'INSURED — INSURER B: Security Design Concepts, Inc INSURER C: 17943 W E1 Caminito Dr INSURER D: INSURER E Waddell AZ 85355 INSURERF: COVERAGES CERTIFICATE NUMBER:21-22 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. INSR TYPE OF INSURANCE ADDIL jmqn r4JOR vivn POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 5AMAGEOR CLAIMS -MADE � OCCUR PREMISES DNcEDence $ MED EXP (Any one person) $ 9 PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ IECT PRODUCTS - COMP/OPAGG $ POLICY LOC RJEC'� $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT�den;� a acc_ $ BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE (Per accident) $ HIREDAUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE—d $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ I $ WORKERS COMPENSATION 0 - AND EMPLOYERS' LIABILITY YIN _LPTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S 1 , 000, 000 OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE- EA EMPLOYEE S 1,000,000 A (Mandatory in NH) y XR060828126 1/17/2023 1/17/2024 If yes, describe under 'DESCRIPTION OF OPERATIONS pelow 11 EI DISEASE - POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 30 days written notice of cancellation except 10 days notice for non-payment of premium„. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE Gary Arch/DIANA w-ivtsC-Lu'14 Auumu w unrumAl tum All rignis rese'rVeo. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)