PROOF OF INSURANCE (2003) CLOSEDACO . CERTIFICATE OF
Monroe Insurance Brokerage,
201 Pearl Street
Monterey, CA 93940
(831)372 -4511
INSURED ran 11 anlc
At -Sinc
1623 Dawnview Drive
Brentwood, CA 94513
1925- 240 -6620
Inc
DATE (MM /DD/YY"
LIABILITY INSURANCE 1 09/26/2003
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.
INSURERS AFFORDING COVERAGE I NAIC#
INSURER A:
ric
INSURER B:
rani e e a ur oe omp y
INSURER C:
INSURER D:
INSURER E' '
COVERAGES
TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD INDICATED. NOTWITHSTANDING
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED
WITH RESPECT TO WHICH
THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT
IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN
RE ESENTATNES.
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
DDL POLICY EFFECTIVE POLICYEXPIRATION
1 POLICY NUMBER DATE MM /DD DATE MM /DD
LIMITS
EACH OCCURRENCE $ , '
GENERAL LIABILITY
$
COMMERCIAL GENERAL LIABILffY
71k
REMISES Ea occurence
MADE ® OCCUR
MED EXP (Any one person) $
CLAIMS
PPP1001863 11/04/02 11/04/03
PERSONAL & ADV INJURY $
NZ-1 OW
GENERAL AGGREGATE $
PRODUCTS - COMP /OP AGG $
GENT AGGREGATE LIMIT APPLIES PER:
POLICY JECT LOC
COMBINED SINGLE LIMIT
$ 1,000,000
AUTOMOBILE LIABILITY
(Ea accident)
ANYAUTO
ALL OWNED AUTOS
BODILY INJURY
$ 1,000,000
(Per person)
SCHEDULED AUTOS
X
01 -CG- 279562 -1
12/23/02
12/23/03
BODILY INJURY
1,000,000
B
HIRED AUTOS
(Peraccident)
$
NON-OWNED AUTOS
PROPERTY DAMAGE
$ 1,0001000
(Peracadent)
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
EA ACC
$
ANYAUTO
OTHER THAN
AUTOONLY: AGG
$
EXCESS /UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CI CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
RETENTION $
STATU
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
C- 518 -30 -68
12/08/02
12/08/03
T RYLIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
C
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - POLICY LIMIT $
If yes, describe under
SPECIAL PROVISIONS below
OTHER
Professional
PPP1001863
11/04/02
11/04/03
r i each C 81m
$1,000,000 aggregate
A
$1,000,000 deductible.
Liability
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Coverage (A); Professional Liability: Claims made and reported
policy.
Prior acts retroacitve date: 10/10/01
CERTIFICATE HOLDER
The City Of El Segundo
"^
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
350 Main Street, Room-5
NOTICE T E CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
El Segundo, CA 90245 -3895
IM OSE NO OBL TION OR LIABIL F ANY KIND UPON THE INSURER, ITS AGENTS OR
RE ESENTATNES.
U IZED PRESINTATIVE
0 AcoRDbORPORATION 1988
ACORD25(2001 108)
X3238