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PROOF OF INSURANCE (2025),4` oRo CERTIFICATE OF LIABILITY INSURANCE DATE 25/202 Ii/zs/zo2q PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Alberto O Ocon AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 829 E. Colorado St. Ste F CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Glendale, CA 91205 COVERAGE AFFORDED BY THE POLICIES BELOW. Ph. (818) 507-9705 Fax: (818)662-9996 INSURERS AFFORDING COVERAGE NAIC INSURED INSURER A: Scottsdale Insurance Compnay 41297 Bubblemania and Company Inc, INSURER B: 12405 Venice Blvd #384 INSURER C: Los Angeles, CA 90066 Immmm� _............. _. INSURER D: -. mmmINSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUDt, POLICY EFFECTIVE POLICY EXPIRATION ...........�_ LTR IN,TYPE OF INSURANCE POLICY NUMBER DATE MMADOlYY RATE MMIDD LIMITS ® GENERAL LIABILITY CPS8108921 12/01/2024 12/01/2025 EACH OCCURENCE $1,000,000 .__......._._- ® COMMERICAL GENERAL LIABILITY DAMAGE TO RENTED $ lOa,OOO ❑❑ CLAIMS MADE ® OCCUR _.._�_ RD person ..... ......................... EISP (Ana one ME X y one person) ❑ ❑ . .. PERSONAL BADVINJURY loa $ . 1000, 000 "'..... GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PROJECT ❑ LOC PRODUCTS - COMP/OP AGG ........................... $2,000,000 ..'. $ ❑ AUTOMOBILE LIABILITY ''COMBINED SINGLE LIMIT $ ❑ (Each Occurrence) ANY AUTO ❑ ALL OWNED AUTOS BODILY INJURY ❑ SCHEDULED AUTOS (Per person) $ '... ❑ HIRED AUTOS BODILY INJURY ❑ NON -OWNED AUTOS (Per accident) $ ,.,.,.,........_..�......�. ❑ .................... .......,....____...._....-...,.......... PROPERTY DAMAGE $ .....- --....._. (Per accident) ❑ GARAGE LIABILITY .AUTO ONLY - EA ACCIDENT $ ❑ ANY AUTO OTHER THAN EA ACC $ '.. ❑ AUTO ONLY: AGG $.. .. ...... .. ElEXCESS/UMBRELLA LIABILITY EACHOCCURRENCE$ ------------------------ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE $ ❑ DEDUCTIBLE ...............................$...._. RETENTION $ $ WORKERS COMPENSATION AND E:]OT ❑ WC ❑ EMPLOYERS' LIABILITY TORLIMITS ER ANY PROPRIETOR/PARTNER/EXECU- E.L. EACH ACCIDENT $ TIVE OFFICER/MEMBER EXCLUDED? _®®®®®®®®®®®®.... ........................"" If yes, describe under E.L. DISEASE - EA EMPLOYEE $ SPECIAL PROVISIONS below mmmmm E,L.. DISEASE - POLICY LIMIT ............................. $ ❑ OTHER '.. DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Additional Insured: City of El Segundo, its officers, officials, employees, agents and volunteers 350 Main Street El Segundo, CA 90245 CERTIFICATE HOLDER CANCELLATION City of El. S eg und.o , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE _l_t,> officers, officials, . employees, .. EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL AO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT agents and Volunteers FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 350 Main Street INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTAT El Segundo, CA 90245 Alberto O Ocon ACORD 25 (2'001188) © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contact between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Bubblemania and Co. 12405 Venice Blvd #384, Los Angeles, CA 90066 Bubblemania87@gmail.com (310) 446-6115 Worker's Com ensatinn Affidavit cif Exemption The undersigned swear or affirms that he/she is not required to provide worker's compensation insurance under the provision of the California Worker's Compensation Law Business and Professions code section 7125 for one of the following reasons, as indicated: X Contractor with no employees Religious exemption under the Worker's Compensation Kaw Owner performing all the work In consideration of Services to be provided by Bubblemania and Co Print name: Joseph Ferri, owner Signature: 4tf� Date: 4117/25