PROOF OF INSURANCE (2024 - 2024) CLOSED0 b6Aff---' wofwyyyy)
CERTIFICATE OFLIABILITY INSURANCE I 1 (30,20III III 23
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PRODUCER
K&K insurance Croup, Inic,
1712 Magnavox Way
Fort Wayne IN 46804
CONTACTNAMC�
1 8,0,0,328.93 t 1 1..260-459-55012'
. . . . . .. ............ ..... ...............
info@everyfinsurance-K.com
MISUIRED 20011033029 CPSI 764
I Juld I U
Markel Insuar,Co '
,! �Gongl.?� roe
..... . . .. .... .... .........
Sandra DeIgado
INsaIRER 6-.—
DBA. Welcorne Spanish LLC
INSURER C:
217 Aviabon Place
7miv A e A —o"""
Manhattan Beach, CA 910266
............................................... .. . . . .. .. .. .. .. ....... . . .......
INSURER E.
A Member of the Sports,,, Leisure & Entertainment RPG
INSURER f;
COVERAGES; CERTIFICATE NUMBER. 201001601 30!9 REVISION NUMBER*
711 IIIS IS TO CEF711IFY TI IAT TI IF POLICIES OF INSURAINCE USTED BF1,QW HAVE BEEN ISSUED TO THE INSUSED NAMED AROVF FOR TiIF IPa ICY PERIOD IIN;7—
NOTWITHISTAN DING ANY IFREOUIIREMENT, r1FHM OR CONDRION OF ANY CONTRAC
r OR OTHER DOCUMENTWITH RESPECT TO WIlICI A THIS CERTII-`IC/VrE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY I IHE POLICIES DESCRIBED HEREIN IS SURA-iC I r0 ALL THE TERMS, EXCLUSIONS AND COND11TIONS OF
SUCH, POLIC-IES, LImjTs SHOWN IMAAY HAVE BEEN REDUCED BY PAID CLAIMS,
1NSIR TYPE Of INSURANCE ADDL SUOR POUCY NU MR ER
LTR INS WVD
POLACY Eff UNUTS
. . ..........
X COMMERCLAL GENERAL LIA5ILqY X MIRPGO0000001161400 12102V23 12)02124 EACI� OCCUMIENCE S1,0100,0001
CLA(MG MADC OCCUR
1ZOI AM 12D'I AM
. ... ... ... .. . ....
$5,0001
2�i2 --- — ---
PC$1,000,0001
A±L
- — ----------
GEN'L AGGREGATE J'r API-JES PER
rXNFRAL AGjGFGA7F ,00,00W
"I "y PRwrCT LOC
PROZKJCTS- COMPMIP MxG $1,000,0001
OTHER:
PRQFFSSIONAL L A811LI'IY $ 1 "000,0w,
LEGAL UA670 FART01PANTS $1,000,00o
AUTONICEILE LIABILnY
— - - ------- - --- r;r�KaRr; rjUTTE Tmr jEa
nrl.- - ------ - — ------
ANY AUI 0
W,)fjl[LY INJURY Ple, OPTISON
OWNED SCHLOULFID
Al� TOS ONLY AJU ros
8000-Y rQURY (Per wcdem�)
tL I A PD NON OWNED
AUTOS OW y AU70S ON11 Y
- -- - --- --------
ULAUB OCCUR
ILACHOCCUdRVENVCE
EXCESS LIAB CLAIMS -MADE
AGGREGAIE
CiED , HEW II'EN[10104
WORKERS COMPENSATION NiA
AND CIMPLOYEAS'UAMUTY
ANY 111H,0111HrElONPAHTINEW YVN
Ik=V FA43HA,C.C110EN,r
E OiCUl I *.' 0 FFK' F WMEMBER
EXCLUDED? (Maindalli
...... . .......
tf gs' describe
D SCRVPTIOIN,","1018"ERATIOIqSbe4ot
MEDICAL PAYMENTS FOR PAR'nCIPANTS
PBIfAARY fALIDCAL__—
EYCESS MITWk
DESCRIPTION OF OPERATIONS I LOCATIONS d VEHICLES (ACORD'101, Additional Remarks Schedule, may be aftched If alare space Is raqwred)
Instructor of Language
The cerlificate holder is added as an ad6tional Insured, but onily lor fiability causect, in whole or in part, by the acts or ornissions ofthe narned insured.
CERTIFICATE HOLDER
CANCELLATION
The City of El Segundo, its officers, officials, employees, agents, and
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE
volunteers
EXP41RATION DATE THERCOF, NO ICE WIILL BE DELIVERED IN ACCORDANCE WITH
3511 Main Street
THE POLICY PROVISION&
El Segundo, CA 90245
AUTHORIZED REPRESFNTAlIVE
Owner/Mainago0t-cssor of Pronflses
0 1988-2015 ARO CORPORATION, AJI1 rights reserved.
Coverage is oNy exlended to, U.S. evens and activiVes,
- NOTICE TO TEXAS INSURED& The Insurer for this purchasing group may Got be subject to all the inw surance las and regulations of the State of Tr axes.
ACORD 25 (2016/1013) The ACORD name and logo aire registered Mmarks of ACORD
The CRy of EI Segundo, its officers, officials, employeals, agents, and volunteers
3�50, Main Street
El Slegundo, CA 90245
Named Insured: Sandra Delgado
DBAd Welcomie Spariish J
A. section 11 - Who Is An Insuiredl is amended to indude, as ain
additional insured the Person(s) or orgahzallon(s) shown in the
Schedule, but only with respect to (lability for '(bodily injury',
"property darnagia" or "personal' aind advertising injury" caused, in,
whole or in parl, by your acts or ornissil or the acts or olmAssioils
of those acting on your behalf
1. In the performance of your ongiolingi operations; or
2. 1 n connection M)h your pirernises owned by or rented to you,
However:
1. The insurance afforded to, such addilonal insured only
applies to the extent permitted by law: and
2. If coverage provided to the additional insured us, required by a
contract or agreerniont, [tie insurance afforded to such
additional insured will not be broader thian that which you are
reqluired by the contract at agreeineril lio provide fair sucil
additioinall insured,
CG 20 26 04 13
ii r �� irlfri I i im 1 irnolmm
RMITMOOTNIMMIMEM
Bl. Oth respect to the linsurance afforded to Thiese additional insureds,
the followling is, added to Section Hil — Urnilits Of Insurance,
If coverage provided to the additional insured Is ireqluited by a
contract or aglreernent,, the inost we M11 pay on behalf of the
additional insured iis the amount of insurance.
1. Required lby the contract or agreement; or
2. AvalfaWe under the applicable I irn[ts of insurance shown Jr
the Declarations'.
whichever is Illess,
Thilis endiors'ement shaV not increase the applicable Limits of
Insurance shown in the Declarations.
CG 20 26 04 13 Q insurance Services Office, Inc., 20112 Page 2 lot 2
Fold Mere Cut along edge
Allstate.
Please use th e printed Insura nice Cards belo i
Please use the printed Insurance Cards below,
A Allstate.
please use the printed Insurance Cards below.
Please use the printed Insurance Cards below.
California Proof of
Allstate.
If you have an accid4nit or loss:
Auto Insurance Card
Get medical attention if needed,
a
Allstate Northbrook indernini Comp1
PO Box 660596, Dallas, TX 71�'1266-059'1
N,A1C# 36455,
Rofify the police immediately.
Dario Delillaid; Sandra Dolpidis
217 Ai I
Obtain nannies., addresses,phone numbers (work & home) and,
Manitialftain kirith CA 9,0266-7018
license plate nivnibeis of aillplersonsiinivodved,ki,cludiiing
passengers and witnesses,
Call 1-8001-ALISTATE, 0-8004M78281
This poficy meets the toquoFerneks of the
applicable California bran dal
lagon to aNIstatexam or contaict your Allstate agent
as soioni as
rasp orv-,ibJ11Ry law(s),
possWe.
POLICY NIUMBER
YEAR? MAKE / MODEL
Mike Hermain
067'307 147
EFFECTIVE DATE 09/05123
200STauiCari 1,
VENCLEf nNUMBER
(310) 376-0231
719 S Pacific CS Hlwy
WHRAWNDATE 03105/24
This card roust he caii in 6e vehicle at ant firritsiasevii enceofinsurani
Redondo, Beach, CA,90217
cartforliria Proof of
Allstate,
If you have an accildent, air loss.:
Auto Insurance Card
- Get medical attentiott !if ritteded.
AIll�stateNorthbooklndolinut C7'
n, Box 660598, Dai�arTX 16'0
NPC4 36455
- Notify the police immediately.
Dodo 00 de, Saindra Delgada
217Avia t on Pi
1
* Obtaininarnes,addresses, onenumbers(warkikhorric0and
!i1persons
Mainhafto Beach CA 9,026,6.7018
licianse Pilate nuimb in14ved inditidlng
passengers and witnesses,
- Caill I BOO-ALLSTATE (1-800-255-7828),
This policy meets the requirements, of the
applicable Califfornmi finandat
logon to afistaitecom or contaict your Allstate agent
as soon as possible.
responsibility NawKsT
POLICY NUMBER
YEAR I MAKE /'MO,D El
Mike Herman
067307147
EFFECTIVE DATE 09/0,5/23
2007 Hoi 011'"
VEHICLEIII)INUM, ER
(310)1376-0131
7191 5 Pacific Cs Hwy
ExPERATioli DATE 03/05124
This card must be carried ir the vehWr at all times as evidence of insurance.
I I I
Redondo BaKfi, CA 90277
[f04
(MmAmmaryyy^A)
CERTIFICATE IC F LIA BIILITY I SU NCE AIiS( 01 4
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION I ONLY AND CONFERS NO RIGHTS IIJPCN THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR, NEGATIVELY AMEND, EXTEND OR ALTER THE COVIER'AIGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE LIMES NOT CONSTITUTE AA CONTRACT (BETWEEN THIN ISSUING INSIURIER(S)„ AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an AADIDITIIONAL INSURED, the p ollicy/(Ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement an
this certificate does not confer rights to the certificate holder In tied of such endlersermemt(s),
71NIVC�
K g AAgTencyP, Inc.
PRODUCERAAutruurwatic I aIa Pro c s�im NuIrAlwuamce
���AAuto matic Mahe Proc ssing Insurance Agency . (Inc, 11O0 Exwy+ t-BCIi-S 4 7fA�4 — I�+�crNltL.....
I AdlI Boulevard
INSURER(S) AEF��TkN Cev„„.E....RAI;F
�NAIL .............
RaseOand NJ 0117068
INSURERA: Iv �AriaA IrA
IaAa'rAPISAErA Irror�InrAurrcw. C"nrn... .. ..
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INSURED Welcome Spanlshd VLLC
INSURER e
INSURER C ,
t "A AvIakinr Race
INSURER C ; ..
INSURER E ; ......., .
Manhattanl3paICIIM CAA 90266
INSURER r
COVERAGES CERTIFICATE NUMBER: 3568887
REVISION NUIIIAIII ER;
THIS I TO CERTIFY THAT THE I"nUD ICIES OF INSLRAANCE LISTED BELOW HAVE BEEN ISSUED TO THE (INSURED NAMED ABOVE FOR
THE POLICY IPERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH( THIS
CERTIIFIICAATIE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
BY 'THE POLICIES DESCRIBED HEREIN IS SUBJECT
TO ALL TIME TERMS,.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, SHOWN MAY HAVE BEEN REDUCED a
JWLmmIIMIITS
IN AItI
TYPE OFIINSURANCE I LIICYNUMBER
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DESCRIPTION OFOPERATIONS I LOCAA'FIONS I VEHICLES QACCIRp 101, Additional (Remarks Schedule, may , he aliaol ad If maraw wp ....._ ...... .
�II�b is urawrMulxwndl
CERTIFICATE HOLDER
CANCELLATION
The City of E'I Segundo, Its Officers, officals, employees, agents,
and volunteers
350 Main) Street
El Segundo
+ -Iw n .w, w
AUTHORIZED REPRESENTATIVE
w r.r CORPORATIONo rights
ACORD (20116,10ww M name and.». are registered marks of Rw Iw
11 affirm under penalty of perjury ulnd'er the taws of Call forma one of the foillowing decliaration s:
ill, 11111111 Trilil !Ill I
111V All L'U11,21 %��ftic
wilth the City of Ell Segundo.
Imn"IM
or the work for which Ine agreement wim jine 1.,Hy or Ill beguniaoi is exect W-0, illy IvOlKelis cOulp"FlibilkNull 111,mlltjmx�-
cartlier and policy number arw
Carrier Automatic Data Processing, Insurance Agency Pollicy Number Expiration Date 019/15/24
Name of Agent Errni, Joseph 800-524-7024j
Phione #:
11 Emil oil,sl rE jvj AM— R-
;lignature of Applicant Date
Print Name
Agreement for Welcome Spanishl! LLC
j(X4M"k-
Reviewill by.,