PROOF OF INSURANCE (2011) CLOSEDACVRa CERTIFICATE OF LIABILITY INSURANCE 7DATEi7Mi2olo'
PRODUCER (415) 788 -9810 FAX: (415) 248 -3534 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ISU /San Francisco
201 California St., Suite 200
License # 0778092
San Francisco CA 94111 -5098
INSURED
Innovative Interfaces, Inc.
5850 Shellmond Way
CA 94608
nnvro n n_o0
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 #
INSURER A: Hartford Casualty Ins Co 29424
INSURER B:
INSURER C:
INSURER D:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTAN DING
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
DD'L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIYYYY)
POLICY EXPIRATION
DATE (MMIDDIYYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence)
$ 300,000
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one person)
$ 10,000
A
CLAIMS MADE X❑ OCCUR
57UUNTL9438
10/1/2010
10/1/2011
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP /OP AGG
$ 2,000,000
X POLICY PRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
57UUNTL9438
10/1/2010
10/1/2011
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESS /UMBRELLA LIABILITY
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
OCCUR CLAIMS MADE
$
A
DEDUCTIBLE
PX
57XHUTL9505
10 /1/2010
10/1/2011
$
$
RETENTION $ 0
WORKERS COMPENSATION
WC STATU- OTH-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER /EXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER /MEMBER EXCLUDED? ❑
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
1 $
If yes, describe under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
If required by written contract or agreement E1 Segundo Public Libray is included as an additional insured.
CFRTIFICOTF HnLDFR / CANCELLATION l
ACORD 25 (2009101) V IUtsts -zuua AGUKU I:UKVUKA f tUIN. Aii ngnm reserves.
INS025 (2oogot) The ACORD name and logo are registered marks of ACORD
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
El Segundo Public Library
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR. TO MAIL 30 DAYS WRITTEN
111 W. Mariposa Street
El Segundo, CA 90245
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
AUTHORIZED REPRESENTATIVE
Cathy Whelan /CATHYW
ACORD 25 (2009101) V IUtsts -zuua AGUKU I:UKVUKA f tUIN. Aii ngnm reserves.
INS025 (2oogot) The ACORD name and logo are registered marks of ACORD
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