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PROOF OF INSURANCE (2010) CLOSED
B C:IIenw. DV - ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDIYYYY) 08/14109 THE POLICIES OF INSURANCE LISTED BELOW ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SUC TO ALL THE TERMS, EXCLUSIONS AND CONDD OF F S H THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ER MAY PERTAIN, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis Ins. Srvcs of CA, Inc. POLICY EFFECTIVE POLICY EXPIRATION LIMITS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR THE COVERAGE AFFORDED BY THE POLICIES BELOW. 18101 Von Karman Ave A GENERAL LIABILITY 6804880L652 ALTER X COMMERCIAL GENERAL LIABILITY Suite 600 CLAIMS MADE � OCCUR INSURERS AFFORDING COVERAGE NAIC # Irvine, CA 92612 Travelers Property Casualty Co of Am 36161 INSURED BUCKNAM & ASSOCIATES, INC. PRO- POLICY E LOC 68048BOL652 INSURERA: INSURER B: Travelers Casualty Insurance Co of A 190 30131 TOWN CENTER DR STE 295 ANY AUTO INSURER C: Continental Casualty Company 20443 LAGUNA NIGUEL, CA 92677 SCHEDULED AUTOS INSURER D: X HIRED AUTOS ACORD 25 (2001/08) 1 of 2 #M457482 CCL © ACORD CORPORATION 1988 INSURER E: COVERAGES HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ISSUED ISSUED THE POLICIES OF INSURANCE LISTED BELOW ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SUC TO ALL THE TERMS, EXCLUSIONS AND CONDD OF F S H THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT MAY PERTAIN, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICIES. AGGREGATE POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM DD —DATEIMMIDDMI 09/01/09 09/01/10 EACH OCCURRENCE $1 OOOOOO A GENERAL LIABILITY 6804880L652 DAMAGE TO RENTED $1 000 000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $10000 CLAIMS MADE � OCCUR PERSONAL & ADV INJURY $1 000 000 GENERALAGGREGATE s2,000,000 PRODUCTS - COMP /OP AGG s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY E LOC 68048BOL652 09/01 /09 09/01/10 COMBINED SINGLE LIMIT $INCLUDED A AUTOMOBILE LIABILITY (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ (Per accident) X NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY EA ACC $ ANY AUTO OTHER THAN AUTO ONLY: AGG $ CUP7637Y444 09101 /09 09/01110 EACH OCCURRENCE $4 000 000 A EXCESS /UMBRELLA LIABILITY AGGREGATE s4000,000 X OCCUR F-1 CLAIMS MADE $ $ DEDUCTIBLE $ X RETENTION $ 0 UB711OY58A WC STATU- OTH- 09/01/09 09/01/10 X B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - POLICY LIMIT $1,000,000 It yes, describe under SPECIAL PROVISIONS below C OTHER AEA113988680 01/02/09 01/02/10 $1,000,000 Per Claim Professional $2,000,000 Aggregate Liability DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ALL OPERATIONS OF NAMED INSURED. CANCELLATION Tan Day Notice for Non-Payment of Premium CERTIFICATE HOLDER POLICIES BE CANCELLED BEFORE THE EXPIRATION SHOULD ANY OF THE ABOVE DESCRIBED DATE THEREOF, THE ISSUING INSURER WILL KbOOMM11i MAIL _30 _ DAYS WRITTEN CITY OF EL SEGUNDO NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, MXK* K ATTN: MARYAM JONAS > aaeUx> Kx> Rx» ewxxw�eotr�xxKUax>' ucxxx> �vax�Kxl tQCwxKel�K�n[xr�tmcos�oc�cxx 350 MAIN ST. El Segundo, CA 90245 x�tleJSAxe�v�exx AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 of 2 #M457482 CCL © ACORD CORPORATION 1988 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. ACORD 25-S (2001/08) 2 of Z ifm471404