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PROOF OF INSURANCE (2007) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE (MMIDONYYY) 1 08/11/2006 PRODUCER (626)795 -7059 FAX (626)792 -2321 FIA Insurance Services, Inc. 99 South Lake Avenue, #300 Pasadena, CA 91101 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 NAIC # INSURED Christopher A. Joseph & Associates 11849 W. Olympic Blvd, Ste 204 Los Angeles, CA 90064 INSURERA Mitsui Sumitomo Ins Group POLICY EFFECTIVE INSURER B: LIMITS INSURER C: INSURER D: PKG312201603 INSURER E: 08/01/2007 COVFROCFS 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. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY PKG312201603 08/01/2006 08/01/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,001 CLAIMS MADE M OCCUR MED EXP (Any one person) $ 10 A PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2 000 GENL AGGREGATE LIMIT APPUES PER: PRODUCTS - COMP/OP AGG $ 1, 01m) T POLICYF_j JPERCOT LOC AUTOMOBILE LIABILITY PKG312201603 08/01/2006 08/01/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,0 BODILY INJURY $ ALL OWNED AUTOS A SCHEDULED AUTOS (Per person) BODILY INJURY $ X HIRED AUTOS X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY UMB540038203 08/01/2006 08/01/2007 EACH OCCURRENCE $ 1, 000, OR X OCCUR FI CLAIMS MADE AGGREGATE $ A $ 1,000,0 $ DEDUCTIBLE X RETENTION $ 10,000 $ WORKERS COMPENSATION AND WCP852215003 08/01/2006 08/01/2007 X STATU- oTH- A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000.0 E.L. DISEASE - EA EMPLOYEq $ 1,000,00( OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POUCY LIMIT 1 $ 1,000,000 OTHER RESCRIPTION OF PE TIONS /LOCATIONS / VEHI !? / EXCLUSIO ADDED Y ENDOR EMENT / SPECIAL PROVISIONS e City o E�1 Segundo, its o icers,oicTa�s,emp oyees,agents & certified volunteers are named s Additional Insured as their interest may appear, but only with respects to liability arising ut of the operations of the Named Insured. Form CG 20 11 11 85 attached. Except Ten (10) Days Written Notice of Cancellation for Non - Payment of Premium. City of E1 Segundo City Clerk Planning & Building Safety Director Richard Hogate 350 Main St. Room 5 E1 Segundo, CA 90245 -3813 ACORD 25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 1111 fo)(0M MAUL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AUTHORIZED REPRESENTATIVE, Jeannie Ching /JC OACORD CORPORATION 1988 POLICY NUMBER: PKG312201603 COMMERCIAL GENERAL LIABILITY INSURED: CHRISTOPHER A. JOSEPH & ASSOCIATES THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - (FORM B) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: THE CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS & CERTIFIED VOLUNTEERS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organaation shown in the Schedule, but only with respect to liability arising out of "your work' for that insured by or for you. This insurance will be deemed "primary" such that any other insurance that mya be carried by City of E1 Segundo will be excess thereto. This insurance will be on an "occurrence ", not a "claims made" basis or equivalent. It is agreed that this insurance will not be canceled, not renewed or the limits of coverage in any we reduced without at least (30) days advance written notice ten (10) days for non - payment of premium sent by certified mail, return receipt requested to: CITY OF EL SEGUNDO, CITY CLERK ATTN: PLANNING &BUILDING- •;SAFETY DIRECTOR 350 MAIN ST., ROOM 5 EL SEGUNDO, CA 90245 -3813 CG 20 10 111 85 Copyright, Insurance Services Office, Inc., 1884 Page 1 of 1 a 0 %4. -Oft ACOR, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO/YYYY) 05/24/2006 PRODUCER (9.{'..,833 -7126 FAX (949)833 -7127 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insur' •.xe Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DBA IOA Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR One Park Plaza, Suite 600 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Irvine, CA 92614 INSURERS AFFORDING COVERAGE NAIC # INSURED Christopher A. Joseph & Associates, Inc. INSURERA: Hudson Specialty Insurance Co. 11849 W. Olympic Blvd. INSURER B Suite 101 INSURER C LOS Angeles, CA 90064 INSURER D INSURER E. 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. I TA SR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7 OCCUR DAMAGE TO RENTED S -- MED PE (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE T LOC PRODUCTS - COMP/OP AGG S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY (Per person) on) S HIRED AUTOS BODILY INJURY (Per (Per aeadent) NON -OWNED AUTOS PROPERTY DAMAGE (Peracddent) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY. AGG $ EXCESS/UMBRELLA LIABILITY OCCUR 71 CLAIMS MADE EACH OCCURRENCE $ AGGREGATE S S DEDUCTIBLE S RETENTION $ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I WC STATU- OTH- I FR E.L. EACH ACCIDENT I S ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' E.L. DISEASE - EA EMPLOYE S It yes asacnoa under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT I S A rotessional Liability - Claims Made FEC61OS408 01/20/2006. 01/20/2007 $1,000,000 per claim $2,000,000 aggregate kitCRIPTION OF QPERATION / L ATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS operations of tie named insured. * A ten (10) day notice of cancellation will be given for non - payment of premium. ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MWaUM MAIL City of El Segundo 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: City Clerk's Office 350 Main Street, Room 5 El Segundo, CA 90245 -3895 AUTHORIZED REPRESENTATIVE Earl een Thongs BODENC ..vvrw w Icvv uvo/ GACORD CORPORATION 1988 0 t( -%3&k -a 7 21 T t 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 (2001/08)