PROOF OF INSURANCE (2024 - 2025)1 ® DATE (MMIDDIYYYY)
ACC>Ro CERTIFICATE OF LIABILITY INSURANCE
091l/2024
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 endorsementis).
PRODUCER NAME ,_ ,,, ...... _..,.,..,....,
PHONE APC 'o BIBERK 844-472 0967 FAx
AI.ge Nq,.9A _ 9. w.._) 203 654-3613
P.O. Box 113247 E-MAIL oosl'n1°a�ersetl'vticC�B 'iBEltk"".con^i
Stamford, CT 06911
INSURED
Knight Leadership Solutions LLC
2439 E. Quincy Ave
Orange, CA 92867
COVERAGES CERTIFICATE NUMBER:
INSURER A: Berkshire i•Wth;away Direct Insurance Ooroupw" 10391
tlN:,URER.. e ` ......,..,.mm........ ....... ... . _.............
INsuRE
INsuRERD _ _.
7
INSURE:R. F :.
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.
ILTR
I TYPE OF INSURANCE IAINSO DDLI9U 1)
NUMBER
POLPOLICY
MMfDO YY1 MIDOnrY P
! LIMITS
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04/12/2024 U4/12/2025
. ptp(Ann one person) S 5
INJURY 9 InCIa000
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AUTOS ONLY AUTOSULED
HIRED NON -OWNED
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AUTOS ONLY AUTOS ONLY
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UMBRELLA LIAR I
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ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA
OFFICERIMEMBER EXCLUDED?
II
(Mandatory in NH)
E L DISEASE EA EMPLOYEEy S „
If yes des'Hbo under
DESCRIP ISON OF OPERATIONS below
E.L DISEASE POLICY LIMIT S
Professional Liability (Errors &
Per Occurrence/
Omissions): Claims -Made
Aggregate
I [
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
THE CITY EL SEGUNDO, ITS OFFICER ITS OFFICIALS, ITS EMPLOYEES, AND ITS AGENTS ARE NAMED AS ADDITIONALLY INSURED
ON THIS POLICY
rnnlcFl I nrinfu
THE CITY EL SEGUNDO
3501 MAIN ST
El Segundo, 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.
AUTHORIZEDREPRESENTATIVE 6 A !L
(0 19SS-ZUl5 AGUKU UUKYVKA I IUIv, tan n9uu IC�UI vcu.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
DATE (MMIDDIYYYY)
CERTIFICATE OF PROPERTY INSURANCE 09/19/2024
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.
PRODUCER I CNI111E`
`HQNt(844) 472-0967 jkc,No(203) 654-3613
WC, No .e,tj
E-MAIL biberk.com
I AI 5alessupport@
P.O,Box 113247 PRODUCER
Stamford, CT 06911 CQ$T0VFH INSVRFR(SI AFFORPItF3 CIOVERAGE
INSURED MSURERA:Berkshire Hatiiiway Direct Insurance CaImpaii 541611
IIh*QRFR 8
Knight Leadership Solutions I 04,5UREP C
2439 E. Quincy Ave INS0
Orange, CA 92867 INSURER I
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (A ftach ACORD 101, Additional Remarks Schedule, if more space is required)
Location: 2439 E, Quincy AveOrange, CA 92867
Bldg #001: Consultants - All Other - 4167702
W6 961;�_AM �DAR6�E FFOR TH`E POLICY PERIOD
THIS IS fd C IFYTHAT_� D f6"TPET
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 POLICYEFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS
LTR TYPE OF INSURANCE POLICY DATE (MMIDDIYYYY) DATE IMPNOWYYYYj
..........
X PROPERTY 0
PEIRSCINAL PROPERVY
CAUSES OF i. OSS DEOLX,tl BLES 0
UASIC BUIL I DlNG N9BP357874 04/12/2024 04/12/2025 151000
BROAl."i ?�U EXTRA EXPENa., 111
i�"INH NIP,
X M:11N�L'JAl IflF
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TYIFN_ OF PK�LICY
CAUSES (DF LOSS
. . ....... . .........
14AIMIF0 PERIIILS P01 Ml� L�H
CRAW
fro
BOILER & MACHINERY
EQUIPMENT BREAKDOWN
5
. ...................... .......... .... . . . ... . ..... _ . .......
SPECIAL CONDITIONS I OTHER COVERAGES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
* Business Income & Extra Expense is a combined limit on this policy,
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
THE CITY EL SEGUNDO ACCORDANCE WITH THE POLICY PROVISIONS.
3501 MAIN ST
El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE
----- --- ---
...... . .... . . . .... 1995-2015 ACORD CORPORATION. All rights reserved.
ACORD 24 (2016/03) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: N9BP357874
BUSINESSOWNERS
BP 04 48 01 06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON
OR ORGANIZATION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Name Of Additional Insured Persons Or Or anizaion s' ;.
THE CITY OF EL SEGUNDO ISAOA ATIMA
Information reouired to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph C. Who Is An
Insured in Section II — Liability:
3. Any person(s) or organization(s) shown in the
Schedule is also an additional insured, but only
with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by your acts or omis-
sions or the acts or omissions of those acting on
your behalf in the performance of your ongoing
operations or in connection with your premises
owned by or rented to you.
BP 04 48 01 06 cc ISO Properties, Inc., 2004 Page 1 of 1 0
EI Tel: 1-800-841-3000
goilco.com
GEICO General Insurance Company
P.O. Box 509090
San Diego, CA 92150-9090
Date Issued: May 2, 2024
MARIE ANN KNIGHT
2439 E QUINCY AVE
ORANGE CA 92867-6154
Email Address:
Named Insured
Marie Ann Knight
Vehicles
1 2014 Toyota Prius
2 2024 Kia Sportage
VIN
Declarations Page
This is a description of your coverage.
Please retain for your records.
Policy Number: 4116-07-68-96
Coverage Period:
06-05-24 through 12-05-24
12:01 a.m. standard time at the address of the named
insured.
Additional Drivers
Dolores Marie Knight
Vehicle Location Finance Company/-
Lienholder
ORANGE CA 92867-6154
ORANGE CA 92867-6154
Coverages*
Limits and/or Deductibles
Vehicle 1
Vehicle
Bodily Injury Liability
Each Person/Each Occurrence
State Minimum $15,000/$30,000
$100,000/$300,000
$118.20
$143.50
Property Damage Liability
State Minimum $5,000
$50,000
$94.70
$124.30
Uninsured & Underinsured Motorists
Each Person/Each Occurrence
$30,000/$60,000
$30.00
$33.40
Comprehensive(Excluding Collision
$250 Ded
$53.50
$128.70
Collision
$500 Ded/Waiver
$221.10
$392.40
Emergency Road Service,....
..... . ........ Full' .
-
$5.10
Rental Reimbursement
$50 Per Day
$1,500 Max
$32.60
$32.60
Mechanical Breakdown
$250 •Ded
$39.10
Six Month Premium Per Vehicle
$550.10
$899.10
Continued on Back
DEC_PAGE (03-14) (Page 1 of 4)
Renewal Page 7 of 78
Total Six Month Premium
*Coverage applies where a premium or $0.00 is shown for a vehicle.
$1,449.20
If you elect to pay your premiurn in installments, you may be subject to an additional fee for each installment. The fee amount
will be shown on your billing statements and is subject to change.
Discounts
California Persistency (All Vehicles)
Multi -Car (All Vehicles)
Subclass Factor (All Vehicles)
California Good Driver (All Vehicles)
Anti -Theft Device (All Vehicles)
New Car (Veh 2)
Group Insurance Plan:
Professional Group Insurance Plan
Contract Type: A30CA
Contract Amendments: ALL VEHICLES - A30CA SIGPGCW
Unit Endorsements: U99(VEH 2)
Class: A -N -44SF - T (VEH 1); A -B -14SF - V (VEH 2)
Important Policy Information
- You have elected to receive your insurance documents via electronic delivery at the electronic mail address
displayed on this Declarations Page. To change the address where you receive your policy documents, visit
geico.com or call 1-800-841-3000.
- No coverage is provided in Mexico.
- Reminder - Physical damage coverage will not cover loss for custom options on an owned automobile, including
equipment, furnishings or finishings including paint, if the existence of those options has not been previously reported
to us. This reminder does NOT apply in VIRGINIA, however, in Virginia coverage is limited for custom furnishings or
equipment on pick-up trucks and vans but you may purchase coverage for this equipment. Please call us at
1-800-841-3000 or visit us at geico.com if you have any questions.
- Congratulations! Your policy qualifies for the Professional Group Insurance Plan and includes a savings of $563.90.
- Subject to the policy carrying Comprehensive and/or Collision Coverage, if a non -owned auto, in operation while
leased or rented for a fee, has a Manufacturer Suggested Retail Price above $100,000, the limits of liability for loss
to the non -owned auto is the highest of the actual cash value of any owned auto shown on the Declarations
page.
- As your vehicle ages, the Multi -Risk Coverage you carry becomes nearly impossible to replace. Renew your policy
today and enjoy continuous coverage against costly mechanical breakdowns.
- For your protection, Catiforn a law requires the following to appear on this form: "'Any person who knowingly presents
false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is
guilty of a crime and may be subject to fines and confinement in state prison."
Continued on Next Page
DEC_PAGE (03-14) (Page 2 of 4) Renewal Page 8 of 78
Important Policy Information
- Confirmation of coverage has been sent to your lienholder and/or additional insured.
- In California, you have the right to designate one person to receive notices from GEICO if your policy is about to
cancel or expire for non-payment. Your designee will not have any rights or benefits under your policy other than the
right to receive the notice or make a payment. You can change or remove the designee at any time. If you would like
to add, change or remove a designee from your policy, simply log into your account at geico.com or call us at
1-800-841-3000.
- Claims incurred while an insured vehicle is being used to carry passengers for hire may not be covered by this
contract. Please review the contract for a full list of exclusions and contact us if you plan to use any of your insured
vehicles for this purpose.
- Please verify that the coverages you requested are accurately reflected on your Declarations Page. Visit geico.com to
review additional coverages and/or limits available to you.
- In accordance with Section 1872.87 of the California Insurance Code, in addition to your premium, a $0.88 charge per
vehicle is assessed to fund auto insurance fraud reduction initiatives. This charge is applied once per policy term per
vehicle.
- The annual mileage figures applicable to the vehicles on your policy for the current and upcoming policy
periods are:
Vehicle Current Mileage Upcoming Mileage
2014 Toyota Prius 12,000 12,000
2024 Kia Sportage 14,000 14,000
DEC —PAGE (03-14) (Page 3 of 4) Renewal Page 9 of 78
DEC_PAGE (03-14) (Page 4 of 4) Renewal Page 10 of 78