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PROOF OF INSURANCE (2009) CLOSED
DATE (MM /DD/YYYY) ACOROn, CERTIFICATE OF LIABILITY INSURANCE 03/14/20oe PRODUCER (310) 476 -6561 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Dick Van Duzer & Assoc., Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3130 Wilshire Blvd., Suite 390 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ........, . ocnonrwr IIVFRArF I NAIC # Santa Monica CA 90403 - INSURED B: HARTFORD INSURANCE CO. El Segundo CA 90245— 1 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, THE INSURANCE AFFORDED BY THE POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXPIRATION INSR AD IL POLICY NUMBER POLICY EFFECTIVE POLICY DATE (MM /DD/YY) DATE (MM /DD/YY) LIMITS LTR INSRD TYPE OF INSURANCE EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY DAMAGE TO RENTED 300,000 $ X COMMERCIAL GENERAL LIABILITY 03/23/2008 03/23/2009 PREMISES Ea occurrence MEDEXP(Anyoneperson) 0 10,000 CLAIMSMADE [i]OCCUR 72SBAAGO538 1,000,000 PERSONAL & ADV INJURY S GENERAL AGGREGATE $ 2, 000, 000 PRODUCTS - COMPIOP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: / / / / X POLICY JECT LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY A $ (Ea accident) ANY AUTO BODILY INJURY S ALL OWNED AUTOS (Per person) SCHEDULED AUTOS BODILY INJURY HIRED AUTOS $ (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY OTHER THA EA ACC $ ANY AUTO AUTO ONLYN AGG $ EACH OCCURRENCE $ EXCESS /UMBRELLA LIABILITY $ OCCUR � CLAIMS MADE AGGREGATE S DEDUCTIBLE $ RETENTION $ WC STATU- OT 1- TORY LIMITS ER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. DISEASE - EA EMPLOYEE $ 0 °F'CFR1MEMBER EXi'LUDEO? IF If yes, describe under E.L. DISEASE - POLICY LIMIT I $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED CANCELLATION CERTIFICATE HOLDER OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE SHOULD ANY MAIL EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO 30 DAYS WRITTEN NOTICE TO T RTIFICATE HOLDER NAMED TO THE LEFT, BUT CITY OF EL SEGUNDO FAILURE TO DO SO SHALL IMPOS O OGATI ON OR LIABILITY OF ANY KIND UPON THE ATTN: CITY CLERK'S OFFICE INSURER, ITS AGENTS - REPR ENTAS. AUTHORIZED REPRESEN TIVE 350 MAIN STREET EL SEGUNDO CA 90245- ©ACORD CORPORATION 1988 ACORD 25 (2001/08) �� INS025 (oloe).o5 ELECTRONIC LASER FORMS, INC. - (800)327 -0545 Page 1 of 2 344