PROOF OF INSURANCE (2010) CLOSEDIE�?RL® CERTIFICATE OF LIABILITY INSURANCE OP ID KN DATE(MMIDD/YYYY)
HUNTE -2 1 08/07/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Stephens and Long Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Lic . #0401806 HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1091 N. Shoreline Blvd, POBox 39 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Mountain View CA 94042
Phone: 800- 964 -8121 Fax: 650 -964 -0816 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A' Nestchester Surplus Lines Ins
INSURER B: Safeco Insurance Company 24740
John L. Hunter and Associates INSURER C:
13310 Firestone Blvd. Ste. A2 INSURERD:
Sante Fe Springs CA 90607 — _.._.__..._..___. _— _.._ ...
INSURER E:
rnvGOer_Gc
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.
(NSR' AD _.._ ..... ................. ...._.._...._ ..... .......... .. ,..,._._ -. POLICY NUMB. _.. -,.... POLTCV iSCiCVFR, _... _. __... ...- _
LTR INSR TYPE OF INSURANCE ER DATE MMI00/YYYY DATE MMIDD/YYYY LIMITS
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 6"PA"R64040404HAIL
City of El Segundo
GENERAL LIABILITY
Attn: Mary Lewis
350 Main St.
$L Ch 90245.
EACH OCCURRENCE
$1,000,00
A
X
X COMMERCIAL GENERAL LIABILITY
624032644 002
08/05/09
08/05/10
DAMAGE'TO _ ..............
PREMISETS Ea' RENTED ocwrence)
.. .
$50,000
MED EXP (Any one Person)
$ 5 , 000
CLAIMS MADE OCCUR
[.",l
PERSONAL & ADV INJURY
$ 1 L 000, 000
—. __... ... _ - -- ...__.
GENERAL AGGREGATE ,52,0.00,000
.......... .......__
GEN'L AGGREGATE LIMIT APPLIES PER:
T -- _ ............_.....................
PRODUCTS - COMPIOP AGG
_...
$ 2 , 00 0, 00 0
POLICY PRO. 7 LOC
JECT
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
CO
B
X
ANY AUTO
02CE1863242
12/13/08
12/13/09
(Ea accident)
i$1,000,000
ALL OWNED AUTOS
BODILY INJURY
I $
SCHEDULED AUTOS
(Per person)
_
X
HIRED AUTOS
BODILY INJURY
$
X
NON-OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
I
(Per accident)
GARAGE LIABILITY
AUTO ONLY • EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
i
AUTO ONLY: AGG
$
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
$1,000,000
A
OCCUR CLAIMSMADE
G24084322001
08/05/09
08/05/10
AGGREGATE
$ 1 000 000
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION
it-
TORY LIMITS ER
AND EMPLOYERS' LIABILITY YIN
_,_ „_„
"� ” - --
ANY PROPRIETOR/PARTNERIEXECUTIVE[:]
E L EACH ACCIDENT
$
OFFICERIMEMBER EXCLUDED?
"..- "' "" ""
(Mandatory In NH)
E L DISEASE - EA EMPLOYEE
S
It s, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
j
OTHER
A
Pollution Liab and
G24032644002
08/05/09
08/05/10
I
Limit 2,000,000
Professional Liab
Claims Md
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is named as additional insured as required by written
contract.
*Except 10 Days Notice of Cancellation for Non - Payment of Premium.
f[e3�i�IY[�iri�:[�7>l�7�: N_1�[a3��$►c��[�72
ACORD 25 (2009/01) L✓/ 19-1988- 20VTAC.UI 'cORMRATi01ar-All r(gnts reservea.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL e DW MAIL *30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 6"PA"R64040404HAIL
City of El Segundo
Attn: Mary Lewis
350 Main St.
$L Ch 90245.
T(O9LN1it7tVES:
AU ORIZHD R PRESENTATIV
ACORD 25 (2009/01) L✓/ 19-1988- 20VTAC.UI 'cORMRATi01ar-All r(gnts reservea.
The ACORD name and logo are registered marks of ACORD
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
This Certificate of Insurance 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 (2009/01)
CERTHOLDER COPY
STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
COMPENSATION
INSLIRANCB
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
GROUP:
ISSUE DATE: 01 -01 -2008 POLICY NUMBER: 1113148 -2008
CERTIFICATE ID: 84
CERTIFICATE 1 -OEXPIRE. I20j/01 -01 -2010
CITY OF EL SEGUNDO SC
CITY CLERKS OFFICE
350 MAIN ST
EL SEGUNDD CA 80245 -3813
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
with �especL to listed whieh this Notwithstanding of insurance be issuedoor condition Whih it may pertaiin.tthe insurance current
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
lgf� (-��
RIZED REPRESENTATI L� PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $11000.000 PER OCCURRENCE.
ENDORSEMENT I ENTITLED LE EFFECTIVE I -01 IS
ATTACHED O AND FORMS A PARFTPOCY. MAKEOFADDITIONALINSURED
CITY OF EL SEGUNDO
ENDORSEMENT N 1000 - JOHN L. HUNTER, PRES,, SECRETARY TREASURER - EXCLUDED-
END ORS WENT #2065 ENTITLED CERTIFICATE HOLDERS, NOTICE EFFECTIVE 01 -01 -2000 IS
O AND FORMS
EMPLOYER
JOHN L. HUNTER & ASSOCIATES, INC. Sc
13310 FIRESTONE BLVD STE A2
SANTA FE SPRINGS CA 80870
PRINTED : 12-20-2008
IREV.2-05)
Sc