PROOF OF INSURANCE (2004) CLOSEDOP ID T DATE (MM/DD/YYYY)
(ABILITY INSURANCE IEBE -1 12 23/03
_CORD- CERTIFICATE OF L L
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Narver Associates, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
641 W. Las Tunas Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO Box 1509
San Gabriel CA 91776
Phone:626- 943 -2200 Fax:626- 299 -1010
Liebert Cassidy Whitmore
Gary Connally
Lo33AngelestCA 90045 ' Ste-500
INSURERS AFFORDING COVERAGE _ NAIC #
INSURER A: Fireman's Fund Insurance Co. _
INSURER B: Westport Insurance Compan
INSURER C: —
INSURER D: - - - --
INSURER E:
COVERAGES
TO THE INSURED NAMED
ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH
RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
ANY REQUIREMENT,
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT
TO ALL
MAY
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LIMITS
TE�MMIDD/YY DATE MMIDD/YY
LTR NSR TYPE OF INSURANCE POLICY NUMBER
DO
EACH OCCURRENCE $ 1000000
GENERAL LIABILITY
PREMISES (Ea occurence) $ 100000
A X X COMMERCIAL GENERAL LIABILITY AZC80688894
MED EXP (Any one person) $ 10000
CLAIMS MADE licl OCCUR
12/14/03 12/14/04 PERSONAL BADVINJURY $ 1000000
- --
GENERAL AGGREGATE $ 2000000
__
—
PRODUCTS - COMP /OP AGG $ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY JECT LOC
COMBINED SINGLE LIMIT $ 1000000
AUTOMOBILE LIABILITY
(Ea accident)
12/14/03 12/14/04
A ANY AUTO AZC80688894
_
BODILY INJURY $
ALL OWNED AUTOS
(Per person)
SCHEDULED AUTOS
BODILY INJURY $
X HIRED AUTOS
(Per accident)
X NON -OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
GARAGE LIABILITY
EA ACC $
OTHER THAN -
ANY AUTO
AUTO ONLY: AGG $
EACH OCCURRENCE $2,000,000
EXCESSNMBRELLA LIABILITY
12/14/03 12/14/04 AGGREGATE —. $2,000,000
r l
A X OCCUR CLAIMSMADE AZC80688894
DEDUCTIBLE
$
RETENTION $
TORY LIMITS ER
WORKERS COMPENSATION AND
E.L. EACH ACCIDENT $ —
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE $
OFFICERIMEMBER EXCLUDED?
E.L. DISEASE - POLICY LIMIT $
It yes, describe under
SPECIAL PROVISIONS below
OTHER
E,TE -B71- 190432 -012
12/10/03 12/10/04 Per Claim 2000000
B Lawyers Prof. Liab
2000000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
insured under the general
Certificate holder is named as additional
liability policy only.
CANCELLATION
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
ELSEG -1
INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
DATE THEREOF, THE ISSUING
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of El Segundo
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
350 Main Street
RESENTATIVES.
El Segundo CA 90245
ORIZEDREPRESENTATIVE
LHarq
9��oiiiRD
ld Ma h ack
CORPORATION 1988
ACORD 25 (2001108)
911T