Loading...
PROOF OF INSURANCE (2025 - 2026)t$a DATE (MM/DDNYYY) C"R " CERTIFICATE OF LIABILITY INSURANCE �, 6/24/2025 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 endorsement(s). PRODUCER CONTACT NAME Christina Hernandez, CIC m _ EdgeWood Partners Insurance Center PHONE FAX 425 California Street, Suite 2400 (ArC.Na..Elpt 6t 45 1374 I (Add " EMAIL San Francisco CA 94105 ADDRESS hrihherrla e csITdea icbroke'rs' com 11a .p„ .. INSURERS) AFFORDING COVERAGE NAIC # INSURERA Atlantic Specialty Insurance Company 27154 .......... ...... . .M ,� a .,�W.., .,�.,.,, ,,, ........ -- INSURED BELLEVE-01 INSURERS CompWest Insurance Company 12177 Bell Event Services, Inc. "" ""' 531 Main St. #228 In(suRrtc El Segundo CA 90245 iNsuRER D INSURER E .... INSURER F ^013 1I71/1ATC RFVISIIZ'N N11111VI ": 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. .. OLICY LIMITS ILTR TYPE OF INSURANCE w .m � 46MC61JU _ POLICY NUMBER 1 IIPiYMkOOdYYVY MOMIDD E%no A X �-...,,, COMMERCIAL GENERAL LIABILITY � 8750003550000 9/2512024 9/25/2025 EACHOCCURRENCE$1,000000 � .. ..... .,.,...., . CLAIMS MADE OCCUR X..,� PR('MIiL,a t sscrlrrmemcua ,) $ 500,000 MED EXP Any one person) �,,,F $ 15 000 PERSONAL & ADV INJURY $ 1 000 000. GE N'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE ......... ,PRODUCTS $ 2,000,000, ...,. POLICY X JPEt T LOC COPA M -.......I...OP GG $ 2,,000,000 ... _ i uJT9(E.It: $ A i AUTOMOBILE LIABILITY I 7100396780004 9125/2024 9125/2025 ( - tT $ 1,000 000 Ee sea idani 1 ANY AUTO BODILY I J RY ( person) f INJURY (Per person) $ OWNED SCHEDULED X.... INJURY $ X..� AUTOS ONLYHIRED NON -OWNED I X„., �P'CD7RTYDRY(Peraecident) AI,AAGE. !} AUTOS ONLY AUTOS ONLY 1 ' „ HP„el�wdLedC,) $ Included i 'redAutoPhs cial Dm eluded I ACV A X i UMBRELLA X I O 8730004880000 9I25I2024 9/25/2025 ACH OCCURRENCE $ 3 000 000 1 EXCESS gBAB CLAIMCCUSR -MADE 1 f AGGREGATE $ 3 000 000 $� DED RETENTION $ B WORKERS COMPENSATION CWWCP100094052 5/2512025 5125/2026 X STATUTE 1 ER AND EMPLOYERS' LIABILITYY/N I ... j ACCIDENT 1 $ 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE 0 OFFICER/MEMBEREXCLUDED? ' NIA ^ E,L EACH .""". '.... ....... ....... "..,...."""..""'.... .,..._ DISEASE EA EMPLOYEE $ 1 000,000 (Mandatory in NH) E.L, _...,.. ,.._._._._ .. ..........,__ ---. ... IF yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 1,000,000 A Misc. Equipment 7100396780004 912512024 9/25/2025 Limit Deductible $310.000 $5,000 Rented/Owned I i 1 DESCRIPTION OF OPERATIONS,! LOCATIONS 1 VEHICLES (ACORD 101„ Additional Romado Schaifula may be aitacbad if more space is raqulrad) The certificate holder is included as Additional Insured oil the General Liability, on a Primary & Contributory basis„ as required by a written contract or agreement. Waiver of Subrogation in favor of the Additional Insureds applies to the General LiabilUty & Auto Liability policies, as required by a written contract or agreement. The certificate holder is included as Additional Insuredand Loss Payee an the Auto Liability regard#n1 any/all leased/rented vehicles, as required by a written contract or agreement, and as their interest may appear, Coverage is subject to $1,000 Comprehensive & Collision Deductibles. The certificate holder is included as Additional Insured and Loss Payee regarding leased/rented equipment, as required by written contract or agreement, and See Attached... ULK I IFIt:A 1 t MULLD tK 5rrna a 4rc1_> r 1 Ivn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of El Segundo its officers, officials, employees, ACCORDANCE WITH THE POLICY PROVISIONS. agents, and volunteers 3501 Main St. AUTHORIZED REPRESENTATIVE El Segundo CA 90425° U litt$15-,dUlO AL,UKU L,UKrUKAI Ivry. AIR nyncs FVbVI VI;U. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: BELLEVE-01 LOC #: AMITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED e Center Bell Event Services, Inc. Edgewood Partners Insurance 531 Main St. #228 POLICY NUMBER I El Segundo CA 90245 CARRIER I NAIC CODE EFFECTIVE DATE: knnITIn NIA1 RFMARKR THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:, CERTIFICATE OF LIABILITY INSURANCE as their Interest may appear. y pp ar. Coverage is included worldwide and in transit. Umbrella is following form; $2,000,000 Umbrella limit effective 9/25/24 - 10/26/24 and $3,000,000 Umbrella limit effective 10/27/24 - 9/24/25. ACORD 101 (2008101) U ZUUts AL;UKU UUKI'UKA I IUn. AD rlgnis reserves, The ACORD name and logo are registered marks of ACORD