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PROOF OF INSURANCE (2004) CLOSED
ACORD , CERTIFICATE OF LIABILITY INSURANCE 11 /1MID2003) PRODUCER (415)957 -0600 FAX (415)957 -0577 11/18/2003 Maroevi ch 0' Shea & Co hl an THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 9 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Johnson & Anton HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 425 Market Street, 10th Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Francisco, CA 94105 INSURERS AFFORDING COVERAGE INSURED Innovative Interfaces NAIC # INSURER A: Travelers 5850 Shellmound Street INSURERB: Emeryville, CA 94608 INSURER C: I I INSURER D: INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT ITHSTANDIN, ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ED OR ISSU MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AND CONDITIONS OF SUCH INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY X 63015913221TILO3 11120/2003 11/20/2004 EACH OCCURRENCE LIMITS $ COMMERCIAL GENERAL LIABILITY 1 , 000 , 000 CLAIMS MADE a OCCUR DAMAGE TO RENTED $ 300,000 A MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000.000 GENERAL AGGREGATE $ 2 , 000 , OOO GENT AGGREGATE LIMIT APPLIES PER: POLICY jE LOC PRODUCTS - COMP /OP AGG $ 1,000,00C AUTOMOBILE LIABILITY 8100795B225TIL03 11/20/2003 11/20/2004 X ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS (Ea accident) 1,000,000 A SCHEDULED AUTOS BODILY INJURY $ X HIRED AUTOS (Per person) X NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY ( Per accident) AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ EXCESSIUMBRELLA LIABILITY CUP079SO237TIL03 11/20/2003 AUTO ONLY: AGG $ 11/20/2004 X OCCUR CLAIMS MADE EACH OCCURRENCE $ 5 , 000 , 000 A AGGREGATE $ 5 , 000 , OOO DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSA rION AND EMPLOYERS' LIABILITY YEUB8933A97503 10/01/2003 WC STATU- OTH- 10/01/2004 X $ A ANY PROPRIETOR/ R/EXECUTIVE EXCLUDED? OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ 11000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OTHER E.L. DISEASE - POLICY LIMIT $ 1 , 000, 000 DESCRIPTION ertificate OF OPERATIONS / LOCATIONS I VEHICLES Holder below is named / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS as an Additional uto Liability as their interest Insured with respects to General Liability and may appear. CERTIFICATE HOLDER PAAIP`el I A'rj^ &1 City of E1 Segundo Attn: Patti Kight 350 Main Street City Clerks Office -Room 5 El Segundo, CA 90245 -3895 AGURD 25 (2001/08) FAX: (310)615 -0529 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 TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AUTHORIZED REPRESENTATIVE Kim Baur ©ACORD CORPORATION 1988 ,Za36-