PROOF OF INSURANCE (2024) CLOSED_b� - �- • . ert ytc;uce a insurunce
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ime Insured:
Named Additional Insured:
N Consulting EL SEGUNDO CITY OF - INDEPENDENT CITIES
D. Box 13235 RISK MANAGEMENT (SPECIAL EVENT)
;wport Beach, Ca 92658 350 MAIN STREET
EL SEGUNDO, CA 90245
rtificate Term 6/25/2024 to 6/25/2024 Certificate # ELSEG23-0001
)verage EL SEGUNDO CITY OF - INDEPENDENT CITIES
RISK MANAGEMENT (SPECIAL EVENT) Special Event Policy Company: Houston Casualty Company
Commercial General Liability Per Master Policy# H23TU00024
Master Policy Effective Date: 11/ 1/2023 to expiration
mits $2,000,000 General Aggregate / $1,000,000 Each Occurrence / $1,000,000 Products & Completed operations /
$1,000,000 Personal & Advertising Injury/$300,000 Damage to Rented Premises/ Medical Payments Excluded
!ductibles
$104.00 Premium (Fully Earned)
$3.31 Taxes (Fully Earned)
$39.69 Certificate Fee (Fully Earned;
TRIA
$147.00 Total Amount
arms &
arms ons 1. Premium and All fees are fully earned. No Cancellations Allowed.
2. Hazard Class: 1
3. Event Location: El Segundo City Hall
4. Event Description: Team Building Seminar
5. Total Attendance: 12 Vendors: None
6. Attachments: Limited Contractual Endt., Designated Premises, Classification Limitation Endt.
7. Event Date: 6/25/2024 to 6/25/2024
8. NO LIQUOR LIABILITY COVERAGE PROVIDED.
partment Community Services
clusions Assault & Battery; Total Pollution; Asbestos; Lead Contamination; Animals; Nuclear; Employment Related
Practices; Liquor Liability; Cross Suits; Independent Contractors; Communicable Disease; Subsidence; Non-
Owned/Hired Auto; New Entities; Unscheduled activities or Events; Athletic Participants; Fireworks and Explosives;
Punitive Damages; Professional Liability; Voluntary Labor (For a complete list of the forms, conditions and
exclusions of the policy, refer to Master Policy.)
The insurance afforded under the specified policy above is subject to all terms, conditions, and exclusions of such
policy. (A copy of the policy is available upon written request.) This coverage applies only to the contractor or event
noted above and does not extend to any other activities or work performed by the holder.
MERRIWETHER & WILLIAMS INSURANCE SERVICES, Inc. should be notified at once of any claim arising
from your operation. Call 1-800-420-0555 and a claims representative will assist you in the reporting process.
Coverage is primary and not contributing with any insurance maintained by the above public entitiy. The limits of
insurance apply to each event. If more than one named insured for any one event it will not increase the total limits
of liability available for that event.
Ingrid Merriwether, Presi° ent / Merriwether & Williams Insurance Services, Inc.
44 Montgomery St., Ste. 940 San Francisco, CA 94104 800.420.0555 415.986.3999 fax 415.986.4421 License# 0001378