Loading...
PROOF OF INSURANCE (2026 - 2026)....... DATE ( 6/20 5 _ __...._ _....._...... 6/2025 ER OF LIABILITY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H W ILITY INSURANCE 1v1 THIS CERTIFICATE IS ISSUED CERAS�IMAT�-TER OF INFORMATI OLDER. 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 be endorsed. If SUBROGATIONIS 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 +endorsernenb(s_). AHERN INSURANCE BROKERAGE LLC/PHS 0; - 72165838 PHONE (866)467-8730 FAx' A/C, No, Ext): ( VC, No) The Hartford Business Service Center _. ...... 3600 Wiseman Blvd E-MAIL San Antonio, TX 78251 ADDRESS: SURER(S) AFFORDING COVERAGE NAIC# INSURED....�...,...._...........�._.V. �............ INSURER A i.�._._... .�..�...____... .... Hartford Underwriters Insurance Company 30104 Debra L. Reilly, APLC DBA Reilly Workplace Investigations INSURER smmmm Hartford Casualty Insurance Company 29424 2240 ENCINITAS BLVD STE D104 _.._.__. ... INSURER C : ENCINITAS CA 92024-4345 - """"- "" ..... "" INSURER D : _. ........, _................... ..._, INSURER E : INSURER F P. ._... ............... ._ �.- ................ ........... ......._.._� COVERAGES _ CERTIFICATE NUMBER: _ REVISION NUMBER: ......... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED D 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. POLICY IL7R COMMERCIAL GENERAL LIABILITY INS CE L WvQ WWWWWWWPOLICYNUMBER .. Hlt,l'. I?+Y°�" F._.. I"OI ExP ...._....�. LIMITS ......... _. YY...�Y.L11 EACH OCCURRENCE $".(.It7I,t11.�0 CLAIMS -MADE X OCCUR DAMAGB7° ENDED $1,000,000 X ....._. � i s1rds1�/..� General LiabilityMED EXP (Any one person) $10,000 _. A X X 72 SBW BN9VRC 08/22/2025 08/22/2026 P'E!RSONAL & ADv IN IURY $2 000,000 ...._ �.. ..... LITA �.�.... ....._.. .._.�.. ...... ..._...... GEN' AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4 000,000 1xPoL, CY PRO- LOC PRODUCTS COMP/OPAGG $4,000,000 EW ....._........................._ _......................... .....................,.,�� .............. ._.._....._...,. - ......_ ......_.... COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY a ram).__........._ ._.... ANY AUTO BODILY INJURY (Per person) ...... ...... _..__ .............-. ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS HIRED NON -OWNED (,711P�ERIYDA11AGE AUTOS AUTOS t Cr acciddrrab,)'. ......_.�._.. ......._ ......................... _ ....... ......... ................. UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DID RETENTION $ WORKERS COMPENSATION X PER _. 10,711. AND EMPLOYERS' LIABILITY TA:CLdRiE EWt •••• ................ •••• ANY YIN. E.L. EACH ACCIDENT $1,000,000 B PROPRIETOR/PARTNER/EXECUTIVE ••••••••••• NIA 72 WEG BBOZAM 12/15/2025 12/15/2026 ED.I -' .. OFFICER/MEMBER EXCLUDED? E, L, DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 Dk..SCRIPTION OF OPERATIONS be cW ,...,.....,_.. _..._......._. ......... ......._. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101. Additional Remarks Scedule, may be attached if more space is eq _ __ ...._.... ......... ( y required) Those usual to the Insured's Operations. City of El Segundo, its elected and appointed officials, employees, and volunteers are additional insureds per _......... A - ......._ policy. _ next page) the SL30421018mFO ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION attached to this. Continued on CERTIFICATE HOLDER_.......... _. __. NOTICE EXPIRATION DATE THEREOF, C ND YAo VON City of El Segundo SHOULD ANDESCRIBED Y WILL BE CANCELLED F THE ABOVE its elected and appointed officials BEFORE THE EWILL BE DELIVERED and its volunteers IN ACCORDANCE WITH THE POLICY PROVISIONS 350 MAIN ST AUTHORIZED REPRESENTATIVE EL SEGUNDO CA 90245 0 .................... ...... .._..,........ ...... .__,...,. .......... . �............ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page 2 of ..............�...,..__...... ......,..w.-. ...... NAMED .....,..�. _............®,... .._. .............,. ... AGENCY INSURED AHERN INSURANCE BROKERAGE LLC/PHS DEBRA L. REILLY, APLC DBA REILLY WORKPLACE POLICY NUMBER ...._..............,_. INVESTIGATIONS SEE ACORD 25 2240 ENCINITAS BLVD STE D104 ....._...... CARRIER ...NalccoDe-_..— ENCINITAS CA 92024-4345 SEE ACORD 25 EFFECTIVE DATE: SEE ACORD 25 .......... A lln1T1f%kJ A 1 OCU A DWQ ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ".—. -To DATE (MMIDDIY" A� `"�°" VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE 6/2/2025 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. This form is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 for that purpose. CONTACT - PRODUCER NAME LISA HILL Rancho Santa Fe Insurance AlC, ft Eart): (5S) 756-4444 1 Adc. No): 6105 Pasco Delicias, Ste. L ACrDREBs° Visa ralrslfDxUratrca,caarll PO Box 550 CUSTOMER ID e: Rancho Santa Fe CA 92067 1NSVRER(Sy AFFORDING COVERAGE NAIC # INSURED INSURER A : FEDERAL INS CO 20281 D0111a Reilly INSURER B : INSURER C t INSURER D : Encinitas CA 92024 INSURER E DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKEIMANUFACTURER MODEL BODY TYPE IDENnFICATIONNUMBER 2024 Tesla Model Y PP DESCRIPTION VEHICLE / EQUIPMENT VALUE SERIAL NUMBER GLaVtt:l'L% XCD U161A III NV/"Y w... HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW DOCUMENT WITH RESPECT TO PERIODS) INDICATED NOTWITHSTANDING ANY REQUIREMENT„ TERM OR CONDITION OF ANY CONTRACTOR OTHER BY THE POLICY(IES) DESCRIBED HEREIN IS/ARE SUBJECT TO WHICH THIS CERT'IF1CATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). aN:SR AWLPOLICYEFFECTIVE. POLICYP..ItPIRATION LTR W*R0 TYPE OF INSURANCE POLICY NUMBER L DATE (MMIDDNYYY) DATE (MWDD/YYY`I) LIMITS CONSiNCD SINGLE LIMIT... $ 1,000,000 VEHICLE LIABILITY BODILY INJURY (Per person) $ A 1435636903 05/24/2025 05/24/2026 " BODILY INJURY (Per Ziderd) PROP . ." ... ,.,.... ERTY DAMAGE $ GENERAL.LIABILITY EACH OCCURRENCE $ GENERALAGGREGATE $ OCCURRENCE $ CLAIMS MADE pN',SR LTR ,PAYEE TYPE OF INSURANCE POLICY NUMBER POLICYE,FFECTIVE. DATE (MMIDDIYYYY) POLIC'YEXPIRATION DATE (MMIDDIYYYIf) LIMITS! DEDUCTIBLE VEH COLLISION LOSS ❑ ACV ❑ AGREED AMT $ LIMIT A 0ex 1435636903 05/24/2025 05/24/2026 El ❑ STATED AMT $ 1,000 DED VEH COMP VEH OTC ACV E]AGREEDAMT $ LIMIT A 1435636903 05/24/2025 05/24/2026 0 ❑ STATED AMT $ 1,000 DEC) EQUIPMENT ACV E]AGREEDAMT $ LIMIT BASIC BROAD RC ❑ STATED AMT $ DED SPECIAL R ❑ REMARKS (INCLUDING SPECIAL CONDITIONS i OTHER COVERAGES) (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) ADDITIONAL INTEREST 1 AnL.el.uaalw'cv Select elate+ of the following., SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED I"lie additional Interest described below has been added to the policy(ies) listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE A taaqquesl etas bean submllted to add the additional interest described below to the policy(ies) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Is hatom by poPo Y nwnboe a). VEHICLE / EQUIPMENT INTEREST I LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST ADDITIONAL INSURED LOSS PAYEE NAME AND ADDRESS OF ADDITIONAL INTEREST Loss PAYABLE LOAN I LEASE NUMBER Debra L. Reilly, A Professional Law Corporation 2240 Encinitas Blvd, Ste D-104 AUTHORIZED REPRESENTATIVE L"01 M. Fi 1�u Encinitas CA 92024 ©199T-2015 ACORD CORPORATION. All rights reserved. ACORD 23 (2016103) The ACORD name and logo are registered marks of ACORD DEBRLRE-01—.--tWVj19 A� Q� DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 5r3r2o5 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(les) 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 tale certificate holder in Ileu of such endorsements . Acrisure Southwest � � �. Partners i PHONE Ext) 858) 571 9 —.. tad Ne),((858' 57 PRODUCER 1��A�MRM� ' outhwest Partners Insurance Services, LLC df�nsorr acr030 1-9010 4000 Westerly Place"`isLlre Cit " Suite 110 s�_NATAoCM ITt __ Newport Beach, CA 92660r rcovrro _..W _ itp 1 INSURED Debra L. Reilly, APLC, dba Reilly Workplace Investigations 2240 Encinitas Blvd, Ste D104 Encinitas, CA 92024 COTHIS INDICATED. CERTIFICATE INSR EXCLUSIONS IS OTO CERTIFY TH NOTWITHSTANDINGRESPECT MAY BE ISSUED OR MAY AND CONDITIONS OF 9UCM CONDITIONS � TYPE of INSURANCE UIFREMEPT PERTAIN, PtOLICIES. D L suS ERM OR CONDIOTONAOF ANYNCONTRACTORONHER THE INSURANCE AFFORDED BY W IMITS S POLtlCY NUM RWJE BEEN REpoL" THE POLICIES CYDE Y DE fDLtiO E PS IBRR. D NAMED OR THE OCUMENAWITH ED HEREIN IS SUBJECT frs POLICY PERIOD TO WHICH THIS ALL THE TERMS, O ... ... u COMMERCIAL GENERAL LIABILITY __ s- A`1LE iAC 1' ... ... -MADE OCCUR .R,r'4h0aa.+CURR dRPT6EF .- ANED'�XA�rj+�uw�v,1„wm�n,�.,...'�......_.� .... ENr RAL AGREGATF CEA%AGGREG„L° E LIMff APPLIES PER: P qP AGG P/-ODU4E0 POL[CY �. �G Y � LOC � ...�..w ... OTwuEJa .n.... 4Md'G S NGLE UM �f^Fr.�LE 9. AUTOMOBILE LIABILITY ��.VS��+0.9 5 .. _ ANY AUTO EMLY XWWX OWNED �. SCHEDULED DOOILY INJURY IPer aneltlq,�,,,nl, .i ......... .m AIUT��Opp5 ONLY .AUTOS pp ,.... AURTOS ONLY .. .'. AUOT47t'u PROPERTY' PAMAL I .' I'„6'RprBGt9arrawj UMBRELLA LWB OCCUR EAC„�H O :O IiRP/'�CF EXCESS LIAR CLAIMS -MADE A_P".w,RECA..TE_,,,,,, -. DED p p RET. ........ ENTION $ PER O1H N'WORKIFi.SCSSAPENSATIOB AiYO EMPLOYERS" LtlABdLrIY ANY PRoPRtlETOR,IPARTNER)EXECUTIVE Y E;9CCLUOEO? N/A E��CH�'OCpD'PN� �_. ,___.� � """""""'� .......... .....IT. ... (A-11 R 1 M )gran tTsr'�enY�n � .. ...; : ,.�:w?��.ta1SEJM� � EA E d'��Y....'� mm . .�............._.............. If as,d''beunder CR'IPTIO�li cis fAPEC+,P1Or^tS o6ovi 612812025 612'8P2026 E.L DI:3EA.S-POLMYLIME See Below A ES,O - Lawyers LP017940 DESCRIPTION OF OPERATIONS dTIONS / NAL LS CORD 101, Additional Remarks Schedule, may be attached If more space Is required) CLAIMS MADE LAWYERS PRO LIMITS OF LIABILITY: $1,000,000 PER CLAIM 1$2,000,000 AGGREGATE DEDUCTIBLE: $10,000 PER CLAIM RETROACTIVE DATE; 11/1512017 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE I ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD