PROOF OF INSURANCE (2025)BODYWORK
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Solutions, LLC
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INSURANCE GROUP
Great American Alliance Insurance Company
301 E. Fourth Street, 25 S
Cincinnati, OH 45202-4201
COMMERCIAL GENERAL LIABILITY COVERAGE FORM — CLAIMS MADE COVERAGE
SPECIFIED PROFESSIONAL LIABILITY COVERAGE FORM — CLAIMS MADE COVERAGE
THIS POLICY IS WRITTEN ON A CLAIMS MADE COVERAGE FORM.
IT IS AGREED THAT THIS CERTIFICATE IS ISSUED TO THE CERTIFICATE HOLDER LISTED BELOW TO CERTIFY COVERAGE
UNDER THE COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY LISTED BELOW.
INSURANCE COMPANY: GREAT AMERICAN ALLIANCE INSURANCE COMPANY
NAMED INSURED: BEAUTY HEALTH & TRADE ALLIANCE
CERTIFICATE HOLDER: Ivonne De La Torre
ADDRESS: 15821 Firmona Avenue, Lawndale, CA 90260
POLICY PERIOD: 03101 /2024 TO 03/01/2025 12:01 A M, STANDARD TIME AT YOUR ADDRESS SHOWN,
ENTITY: r Corporation r Partnership or Joint Venture
r LLC V Individual/Sole Proprietor
POLICY NUMBER:
PLE974344
CERTIFICATE NUMBER:
B W 1477320
IN RETURN FOR PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL OF THE TERMS OF THE POLICY, WE AGREE WITH YOU TO PROVIDE
THE INSURANCE AS STATED IN THIS POLICY.
A. Specified Products, Goods, Operations and Premises Covered: Health and beauty related products and
goods normal and incidental to the practice of those Professional Services of which the Insured is a practitioner
or student practitioner; all related premises and operations of the Insured
B. Professional Services: Massage and Related Modalities; Animal Massage and Related Modalities; Esthetics,
Cosmetology, Nail Technician, Aromatherapy, Reflexology and Energy Work Including Their Related Modalities; Face &
Body Painting; Hair Stylist/Barbers, Massage Therapist, Esthetician, Cosmetologist, Hair Stylist, Barber, Nail Tech,
Reiki / Energy Worker, Lash Artist, Body / Face / Henna Painter, Aromatherapy, Animal Massage, Reflexology, Fitness
Trainer, Acupuncture
C. Technician Covered: Ivonne De la Torre
LIMITS OF INSURANCE
General and Professional Aggregate Limit (Other than Products -
Completed Operations)
Products -Completed Operations Aggregate Limit
Personal and Advertising Injury Limit
General and Professional Each Occurrence Limit
Damage to Premises Rented to You Limit
Medical Expense Limit
RETROACTIVE DATE:
RATE:
PREMIUM:
3,000,000
3,000,000
INCLUDED
2,000,000
300,000 Any One Premises
5,000 Any One Person
03/01 /2023
FLAT
$57.00
BHTA FEE: $39.00
TOTAL POLICY COST: (The cost is 100% earned/non refundable) $96.00
THIS INSURANCE IS SUBJECT TO ALL THE TERMS AND CONDITIONS, INCLUDING APPLICABLE ENDORSEMENTS, OF THE
COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY. A COPY OF THE COMMERCIAL GENERAL LIABILITY
INSURANCE MASTER POLICY ACCOMPANIES THIS CERTIFICATE. ADDITIONAL COPIES WILL BE PROVIDED TO THE
CERTIFICATE HOLDER IF REQUESTED BY THE CERTIFICATE HOLDER., PLEASE READ THE POLICY AND ALL
ENDORSEMENTS.
NO ADMISSION OF LIABILITY MAY BE MADE EITHER VERBALLY OR IN WRITING
FULL DETAIL OF ANY INCIDENT SHOULD BE SENT IMMEDIATELY BY EMAIL TOLAdMViP9NIvl OR BY LETTER
TO VERACITY INSURANCE SOLUTIONS, LLC 260 SOUTH 2500 WEST SUITE 303, PLEASANT GROVE, UT 84062.
Administrated b
Veracity Insurance Solutions, LLC
260 South 2500 West Suite 303
Pleasant Grove Utah 84062
888-568-0548
.com
ADMINISTRATOR'S SIGNA'TUR
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BODYWORK BBI Insurance Card
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EFFECTIVE DATES
NAMED INSURED
03/01/2024 to 03/01/2025
Ivonne De La Torre
GENERAL LIABILITY
LIMIT
$2,000,000 $3,000,000
CERT. NUMBER
BW1477320
INSURED BY
Great American Alliance
This card Is for information purposes only. Referto policy for exact coverages, limitations, and exclusions.
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CITY OF EL SEGUNDO
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000),
IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES.
I affirm under penalty of perjury under the laws of California one of the following declarations:
(x,) I have and will maintain a certificate of consent of self -insure for workers' compensation, issued by the Director
of Industrial Relations as provided for by Labor Code § 3700 for the performance of the work set forth the agreement
with the City of El Segundo.
Policy No.
(�) I have and will maintain workers' compensation insurance as required by Labor Code § 3700 for the performance
of the work for which the agreement with the City of El Segundo is executed. My workers' compensation insurance
carrier and policy number are:
Carrier l3eauty andwork Policy Number Expiration Date
Name of Agent Ray Phone # O"-Fga ono"
(�) I certify that, in the performance of the work set forth in the agreement with the City of El Segundo, I will not
employ any person in any manner so as to become subject to the workers' compensation laws of California, and
agree that, if I should become subject to the workers' compensation provisions of Labor Code § 3700 1 must
immediately comply with those provisions or the agreement will automatically become void.
Signature of Applicant Date
Print Name lvonT
Agreement for:
Dated: j—
Reviewed by:r"r'h