PROOF OF INSURANCE (2009) CLOSEDFrom:Peggy Gelpi FaxID:United Agencies Inc
Page 2of6
Date:ID 2009 11:19 AM Page:2 of 6
ACORQ, CERTIFICATE OF LIABILITY INSURANCE OP 10 ADVA FI
DATE(MMIDI / o9 /os /09 o9
PRODUCER
United Agencies , . Inc. (C)
CA License 40252636
301 E. Colorado Blvd. Ste. 200
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POLICY NUMBER
pATE (MMIDDM
Pasadena CA 91101
Phone:626 -449 -5197 Fax:626- 577 -1346
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: Snrtror4 rire meurance Co.
19682
INSURER B: Preparty s Casualty Ina Ce o!
34690
EACH OCCl1Rf2ENCE
INSURER C: Delos Insurance Company
PREMISES (Es occurems)
Advanced Electronics, Inc.
Redon 8eachnC Beach Blvd.
INSURER D: Federal Insurance company
20281
INSURER E.
$1,000,000
cvv r_rvaaaca
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 OOCIINENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13E 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,
LTR
NS
TYPE OF INSURANCE
POLICY NUMBER
pATE (MMIDDM
DATE MM/
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE XX OCCUR
72CESOA2654
10/31/06
10/31/09
EACH OCCl1Rf2ENCE
$1,000,000
PREMISES (Es occurems)
$ 100,000
MED EKP (Any one person)
$ 1.0,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
s2,000,000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /0P AGG
$1,000,000
Eny Ben.
1,000,000
POLICY r JJERCT LOC
8
AUTOMOBILE
LIABILITY
ANY AUTO
72UEWU96117
10/31/08
10/31/09
COMBINED SINGLE LIMIT
(Es accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
!AUTO ONLY: AGG
$
ANY AUTO
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
D
X-1 OCCUR �CLAIMSMADE
•79817852
10/31/08
10/31/09
S
$
DEDUCTIBLE
$
X RETENTION $ 0
0
WORKERS COMPENSATION AND
X TORY LIMITS ER
E.L. EACH ACCIDENT
$ 1,000,00
C
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERMEMBEREXCLUDED?
02DKRM12001408
10/31/08
10/31/09
E.L. DISEASE - EA EMPLOYEE
$ 1 000,000
E.L. DISEASE - POLICY LIMIT
$ 1 , 000 , 000 -
99If yyes, describe under
61AL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
As respects the General Liability coverage, the City Of El Segundo, The
Realty Association Fund VIII, LP and Essex Realty ManageIIent, Inc. are named
as an Additional Insureds.
cAmr _wl 1 n 1 lulu
EL SEGU
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City Of El Segundo
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Office of the City Cle
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn : Jennifer Tien
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
350 Main Street
El Segundo CA 90245 -3895
REPRESENTATIVES,
A O REP IENTATW
sr wn�en rile enaATln AI eCCO
ACORD 25 (2001/08)
From:Peggy Gelpi FaxID:United Agendes Inc Page 3 of 6
Date:9 /8/2009 11:19 AM Page:3 of 6
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 contract 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.
From:Peggy Gelpi FaxID:United Agencies Inc Page 4 of 6 Date:91812009 11:19 AM Page:4 of e
Policy Number: 72CESOA2654
Effective Date: 10/31/08
Named Insured and Address: Advanced Electronics, Inc.
2601 Manhattan Beach Boulevard
Redondo Beach, CA 90278
Endt. No. 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
BY CONTRACT, AGREEMENT OR PERMIT - OPTION III
SCHEDULE
Name Of Additional Insured Person(s)
Or Or anization s :
Designated Project(s) or Location(s)
Of Covered Operations
The City of El Segundo, The Realty
All work performed for the Additional
ssociates Fund Vlll LP and Essex
Insured.
Realty Management, In t)
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Solely with respect to the additional insured(s)
shown in the schedule above, the following will
apply:
1. WHO IS AN INSURED SECTION (II), item 5. is
deleted and replaced by the following:
5. The entity named in the schedule above with
whom you agreed pursuant to a written
contract, written agreement or permit, to
provide insurance such as is afforded under
this policy, but only to the extent that such
person or organization is liable for your acts
or omissions with respect to:
a. Your ongoing operations performed for
that additional insured; or
b. "Your work," included within the
"products- completed operations
hazard," but only to the extent required
by such written contract, written
agreement or permit, and
Form GIN 348213 (ED. 04104)
0 2004 The Hartford
c. At the locatlons(s) designated above or
facilities owned or used by you.
This provision applies only:
(1) If the injury or damage occurs
subsequent to the execution of such
written contract, written agreement or
issuance of permit;
(2) While such written contract, written
agreement or permit is in force, or until
the end of the "policy period," whichever
is earlier; and
(3) To any person or organization not an
insured under WHO IS AN INSURED
(SECTION II), item 6. under this policy
or any endorsements forming a part of
this policy.
In addition to the foregoing, none of the
following are insureds:
Page 1 of 3
From:Peggy Gelpi FaxlD:United Agencies [no Page 5 of 6 Date: 9/8/2009 11:19 AM Page:b of 6
(a) Lessors of equipment with respect to
injury or damage which takes place after
the equipment lease expires or arising
out of the sole negligence of the lessor.
(b) Owners, managers, or lessors of land or
premises, with respect to:
i. Any "occurrence" or "offense" which
takes place after you cease to lease
such land, or you cease to be a
tenant in that premises; or
ii. Structural alterations, new
construction or demolition
operations performed by or on
behalf of the owners, managers,
lessors or other interests from whom
land has been leased.
(c) Engineer, architect or surveyor with
respect to any "occurrence" or "offense"
arising out of the rendering of or the
failure to render any professional
services by or for you, including:
i. The preparing, approving, or failing
to prepare or approve maps,
drawings, opinions, reports,
surveys, change orders, designs or
specifications; and
ii. Supervisory, inspection, or
engineering services.
2. LIMITS OF LIABILITY SECTION 111.
For the purposes of this endorsement, the
following will apply:
The most we will pay on behalf of the
additional insured(s) shown in the schedule
above is the lesser of.
a. The limits of insurance specified in the
written contract or written agreement or
permit: or
b. The limits of insurance shown in the
Declarations of the policy.
3. CONDITIONS - SECTION IV DUTIES IN
THE EVENT OF OCCURRENCE,
OFFENSE, CLAIM OR SUIT.
For the purposes of this endorsement the
following will apply: .
The DUTIES IN THE EVENT OF
OCCURRENCE, OFFENSE, CLAIM OR
SUIT Condition is replaced by the following:
a. You or any additional insured must see
to it that we are notified as soon as
practicable of an "occurrence" or an
"offense" which may result in a "claim"
under this policy. This requirement
applies only when such "occurrence" or
"offense" is known to any of the
following:
(1) You;
(2) Any "executive officer" or insurance
manager of an insured; or
(3) Any elected or appointed official, if
an insured is a political subdivision
or public entity;
(4) Any partner, if an insured is a
partnership,
(5) Any member, if an insured is a joint
venture or limited liability company,
or
(6) Any additional insured.
To the extent possible, notice should
include:
(1) How, when andwhere the
"occurrence" or "offense" took
place;
(2) The names and addresses of any
injured persons and witnesses; and
(3) The nature and location of any injury
or damage arising out of the
"occurrence" or "offense."
b. If a "claim" is made or "suit" is brought
against any insured, you or the
additional insured must:
(1) Immediately record the specifics of
the "claim" or "suit" and the date
received; and
(2) Notify us in writing as soon as
practicable.
a You and any other involved insured
must:
(1) Immediately send us copies of any
demands, notices, summonses or
legal papers received in connection
with the "claim" or "suit;"
(2) Authorize us to obtain records and
other information;
(3) Cooperate with us in the
investigation or settlement of the
"claim" or defense against the "suit;"
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization which may
be liable to the insured because of
injury or damage to which this policy
may also apply; and
ON 34 82 13 (ED. 04/04) Page 2 of 3
From:Peaav Ge1oi FaAD:United Agencies Inc Page 6 of 6 Date:9 /8/2009 11:19 AM Page:6 of 6
(5) Promptly tender the defense of any
(3) That is insurance purchased by you
"claim" or "suit' to any other insurer
to cover your liability as a tenant for
which also has available insurance
"property damage" to premises
for a loss which we cover under this
rented to you or temporarily
occupied by you with permission of
policy,
However, this provision does not
the owner; or
apply to the extent that you have
(4) If the loss arises out of the
"aircraft,"
agreed in a written contract, written
maintenance or use of
agreement or permit that this
"auto" or watercraft to the extent not
insurance is primary and non-
subject to Exclusion g. of
contributory with the additional
COVERAGES (SECTION 1).
insured's own insurance.
When this policy is excess, we will have
d. No insureds will, except at that insured's
no duty under COVERAGES
own cost, make a payment, assume any
(SECTION Oto defend any "claim" or
obligation, or incur any expense, other
"suit' that any other insurer has a duty to
than first aid, without our consent.
defend. If no other insurer defends, we
4. CONDITIONS - SECTION IV OTHER
will undertake to do so, but we will be
entitled to the insured's rights against all
INSURANCE.
those other insurers.
For the purposes of this endorsement the
When this policy is excess over other
following will apply:
insurance, we will pay only our share of
The OTHER INSURANCE Condition is
the amount of the loss, if any, that
replaced by the following:
exceeds the sum of:
(a) Primary Insurance When Required By
(1) The total amount that all such other
Contract
insurance would pay for the loss in
This policy is primary if you have agreed
the absence of this policy; and
in a written contract, written agreement
(2) The total of all deductible and self.
or permit that specifically requires this
insured amounts under all that other
insurance be primary. If other insurance
insurance. We will share the
is also primary, we will share with all
remaining loss, if any, with any other
that other insurance by the method
insurance that is not described in
described in d. below.
this Excess Insurance provision and
(b) Primary And Non - Contributory to Other
was not bought specifically to apply
Insurance When Required By Contract.
in excess of the Limits of Liability
shown in the Declarations of this
If you have agreed in a written contract,
Policy
written agreement or permit that this
insurance is primary and non-
(d) Method Of Sharing
contributory with the additional insured's
If all other insurance permits
own insurance, we will not seek
contribution by equal shares, we will
contribution from that other insurance
follow this method also. Under this
issued directly to the additional insured.
approach each insurer contributes equal
(c) Excess Insurance
amounts until it has paid its applicable
This policy is excess over any of the
limit of insurance or none of the loss
remains, whichever comes first.
other insurance whether primary,
excess, contingent or any other basis:
If any of the other insurance does not
permit contribution by equal shares, we
(1) That is Fire, Extended Coverage,
will contribute by limits.
Builder's Risk, Installation Risk or
similar coverage for "your work;"
Under this method, each insurer's share
is based on the ratio of its applicable
(2) That is fire, lightning or explosion
limit of insurance to the total applicable
insurance for premises rented to
limits of insurance of all insurers.
you; or temporarily occupied by you
with permission of the owner;
GN 34 82 13 (ED. 04/04) Page 3 of 3
91 :6 WV 81 dIS Gal
301JJ0 SA3-10 1110
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