PROOF OF INSURANCE (2006) CLOSED,MR Ro52
A. CERTIFICATE OF LIABILITY INSURANCE R °ATE
03 -17 -20
FROM "R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TOLMAN & WIKER INSURANCE /PHS ONLY AND CONFERS RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
252361 P:(866)467-8730 Ft(877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. BOX 33015 INSURERS AFFORDING COVERAGE
SAN ANTONIO TX 78265
CEO INSURER A:Hartford Casualty Ins Co
JOHN BARNA, DBA: ANRAB ASSOCIATES INSURER C!
2155 VERDUGO BLVD #207 INSURER D:
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.
AYSR
A
TYPE OF IINSGRAMCE
Lf1YERA! LASBLITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
X Business LZCU
POLICY ANAMER
72 SBA AF 6 5 5 3
POLICVEFFECTNE
O 1/ 10 / 0 5
POLICY EXPAPATWR
01 / 10 / 0 6
LAWS
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE )Any one Rrel
$300,000
MED EXP IAro/ ono pw )
$10,000
PERSONAL a ADV INJURY
$1,000,000
GENERAL AGGREGATE
Ls2, 000, 000
PRODUCTS - COMP /OP AGG
4 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO X LOC
A
ALTTOM088E
LLABlTTY
ANY AUTO
72 SBA AF6553
01/10/05
01/10/06
COMBINED SINGLE LIMIT
(E. accident)
$1,000,000
ALL OWNED AUTOS
BODILY INJURY
(Per person)
4
SCHEDULED AUTOS
X
X
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY (Per accident)
4
PROPERTY DAMAGE
IPer accident)
4
GARAGE uAerz rry
ANY AUTO
AUTO ONLY - EA ACCIDENT
4
OTHER THAN EA ACC
AUTO ONLY: AGG
4
4
EXCESS UABTUTY
OCCUR CLAIMS MADE
EACH OCCURRENCE
4
AGGREGATE
4
9
4
DEDUCTIBLE
RETENTION $
WC STATU- OTH-
E
WORIFRS COMPEAISA TLONAAID
EMIIOVERS' 1018111TV
E.L. EACH ACCIDENT
4
E.L. DISEASE - EA EMPLOYEE
4
E.L. DISEASE - POLICY LIMIT
4
OTHER
OESCR 7XW OF OFMATW AISAWATVNM1#CU51EXCLUSLONS ADDED 8Y EMXaRSEAKAIW ISPECJAL PROWSOVS
Those usual to the Insured's Operations. Certificate holder is an Additional
Insured - Owners, Lessees or Contractors and Coverage is primary &
non - contributory per the Business Liability Coverage Form SS0008 per the
Business Liability Coverage Form SS0008, A General Liability Waiver of
Subro ation apRlies to the certificate holder er form SS1215 attached to this
CERTIFICAI L HOLDLH I 2< 1 A°w X10U INavneo; ar+u.rc�.cr ��-
�-- - �� - • _
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE 110 DAYS FOR NON - PAYMENT) TO THE CERTIFICATE
HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
city of E1 Segundo
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
350 Main Street
REPRESENTATIVES.
E1 Segundo, CA 90245 -3895
q fOMZEO WRESENTA
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ACORD 25 -S (7/97)
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