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PROOF OF INSURANCE (2009) CLOSEDACORV CERTIFICATE OF LIABILITY INSURANCE OP ID SN FD7ATE,(MM/DD1rM) SASSMA2 05/09/08 PRODUCER NHC Insurance Services Inc 796 W. 9th Street San Pedro CA 90731 Phone: 310- 221 -0917 Fax: 310- 221 -0966 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO 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 # INSURED 2028 Palos Verdes CA 90274 INSURER A: GOLDEN EAGLE INSURANCE COMPANY 10836 INSURER B: PHILADELPHIA INDEMNITY INS CO INSURER C: REPRESENTATIVES. INSURER D: INSURER E: $1,000,000 wr_Cc 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. NSK LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMFDDIYY E PDATE MMIDDIRI LIMITS 350 MAIN STREET GENERAL LIABILITY REPRESENTATIVES. A D REPRESENTATI AAl7�1 A^ll!f^�ATI^ \1 A EACH OCCURRENCE $1,000,000 PREMISES(Eaocourence) $ 100,000 A X X COMMERCIAL GENERAL LIABILITY CBR8278131 06/02/08 06/02/09 MED EXP (Any one person) $5,000 CLAIMS MADE F?�] OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ A X xx HIREDAUTOS NON -OWNED AUTOS CBP8278131 06/02/08 06/02/09 PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ H ANY AUTO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ _ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND I TORY LIMITS ER E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under SPECIAL PROVISIONS below OTHER B PROF LIABILITY PHSD256015 06/02/08 06/02/09 EACHCLAIM 1,000,000 AGGREGATE 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *10 DAY NOTICE CANCELLATION APPLIES FOR NON - PAYMENT OF PREMIUM. THOSE USUAL TO INSUREDS OPERATIONS. CITY OF EL SEGUNDO, ITS OFFICERS AND EMPLYEES ARE NAMED AS ADDTIONAL INSURED PER ATTACHE ENDORSEMENT FORM #GECG602. f% 15T1C1PATC LV11 r%CD CYNCF_LLAL IUN CITYEL1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF EL SEGUNDO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN CITY CLERKS OFFICE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ATTN : RISK MANAGER IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 350 MAIN STREET EL SEGUNDO, CA 90245 -3895 REPRESENTATIVES. A D REPRESENTATI AAl7�1 A^ll!f^�ATI^ \1 A ACORD 25 (2001/08) " ^"" 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 The Certificate of Insurance on the reverse side of this form 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. Policy Number: CBP 8278131 Coverage Is Provided In GOLDEN EAGLE INSURANCE CORPORATION Named Insured: Agent: DR. MAUREEN SASSOON NHC INSURANCE SERVICES Agent Code: 4296021 Agent Phone: (310)- 221 -0917 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) IN RESPECTS TO LOCATION # 1: THE CITY OF EL SEGUNDO 350 MAIN STREET, ROOM 5 EL SEGUNDO, CA 90245 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 (07104) 06102/2008 8278131 NEUSXNVA3004 © ISO Properties, Inc., 2004 OTHER COPY PGDM06DD J29109 GCAOPPN 00010600 Page 29 i RENEWAL J ltl� Golden Eagle Insurance. Member of Liberty Momal Gmop d will. P ro� v• Policy Number: CBP 8278131 Coverage Is Provided In GOLDEN EAGLE INSURANCE CORPORATION Named Insured: Agent: DR. MAUREEN SASSOON NHC INSURANCE SERVICES 1,000,000 Agent Code: 4296021 Agent Phone: (310)- 221 -0917 TOTAL ADVANCE PREMIUM FOR ALL LIABILITY COVERAGE PARTS $ 536.00 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS LIMITS OF INSURANCE Each Occurrence Limit $ 1,000,000 Damage To Premises Rented To You Limit $ 100,000 Any One Premises Medical Expense Limit $ 5,000 Any One Person Personal and Advertising Injury Limit $ 1,000,000 Any One Person or Organization General Aggregate Limit (Other Than Products/Completed Operations) $ 2,000,000 Products/Completed Operations Aggregate Limit $ 2,000,000 LOCATION OF PREMISES Location Number Address of All Premises You Own, Rent or Occupy 001 27056 SHOREWOOD ROAD RANCHO PALOS VERDES CA 90275 PREMIUM Class Classification Description Code Rates Advance Premium Premium Territory Prods/ All Prods/ All Base Code Comp Ops Other Comp Ops Other CA LOCATION 001 22 -19 (12/02) OTHER COPY 08102 =8 8278131 NEUSXNVA3004 PGDMO60D J29109 GCAOPPN 00010594 P896 23 RENEWAL Forminn a Bart of Policy Number: CBP 8278131 Coverage Is Provided In GOLDEN EAGLE INSURANCE CORPORATION Named Insured: Agent: DR. MAUREEN SASSOON NHC INSURANCE SERVICES CG2011 Agent Code: 4296021 Agent Phone: (310)- 221 -0917 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS (continued) FORMS AND ENDORSEMENTS Forms and Endorsements applying to this Coverage Part and made part of this policy: Form Number Description IL0017 -1198 COMMON POLICY CONDITIONS 17 -22 -1202 EXCLUSION - LEAD 17 -98 -1202 EXCLUSION - ASBESTOS 22 -90CA - 0105 EXCLUSION -SILICA CG0001 -1001 COMMERCIAL GENERAL LIABILITY COVERAGE FORM CGO067 - 0305 EXCLUSION- VIOLATION OF STATUTES CG2011 - 0196 ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES CG2026 - 0704 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION CG2147 - 0798 EMPLOYMENT RELATED PRACTICES EXCLUSION CG2165 - 0999 TOTAL POLLUTION EXCL -WBLDG AND HOSTILE FIRE EXCEPT CG2167 - 0402 FUNGI OR BACTERIAL EXCLUSION CG2426 - 0704 AMENDMENT OF INSURED CONTRACT DEFINITION CG3234 -0105 CALIFORNIA CHANGES GECG602 - 0904 COMMERCIAL GENERAL LIABILITY GOLD ENDORSEMENT GECG635 - 0504 AMENDMENT OF COVERAGE B IL0270 -1104 CA CHANGES - CANCELLATION AND NONRENEWAL Includes copyrighted material of Insurance Services Office, Inc. with Its permission. Copyright, Insurance Services Office, Inc. 1982,1983, 1984, 1985, 2000. 22 -19 (12/02) OTHER COPY Date Issued: 0429/2008 O8/022pp8 8278131 NEUSXNVA3004 PGDMO60D J29109 GCAOPPN 00010596 Page 25 RENEWAL V ITEM ONE Gnnninn a nart of 10� Golden Eagle Insurance. M—hc MUbemy M.".4 Group Policy Number: CBP 8278131 Coverage Is Provided In GOLDEN EAGLE INSURANCE CORPORATION Named Insured: Agent: DR. MAUREEN SASSOON NHC INSURANCE SERVICES loss Agent Code: 4296021 Agent Phone: (310)- 221 -0917 COMMERCIAL AUTO COVERAGE PART BUSINESS AUTO COVERAGE FORM DECLARATIONS ITEM TWO SCHEDULE OF COVERAGES AND COVERED AUTOS Each of the coverages below will apply only to those "autos" shown as covered "autos." "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO section of the Business Auto Coverage Form next to the name of the coverage. COVERAGES COVERED AUTOS LIMITS The most we will pay for any one accident or PREMIUM loss LIABILITY 8& 9 $ 1,000,000 $ 226.00 PREMIUM FOR ENDORSEMENTS $ ESTIMATED TOTAL PREMIUM $ 226.00 This policy may be subject to final audit FORMS AND ENDORSEMENTS Forms and Endorsements applying to this coverage part and made a part of this policy: Form Number Description CA0001 -1001 BUSINESS AUTO COVERAGE FORM CA0143 -0505 CALIFORNIA CHANGES CA2384 -0106 EXCLUSION OF TERRORISM CA9917 -1001 INDIVIDUAL NAMED INSURED IL0270 -1104 CA CHANGES - CANCELLATION AND NONRENEWAL 16 OTHER COPY 6/94) 8278131 NEUSXNVA3004 PGDM080D J29109 GCAOPPN 00010804 Page 33 COMMERCIAL LIABILITY GOLD ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions Item 2.g. 2) is replaced with the following. 2.g. 2) A watercraft you do not own that is: a) less than 50 feet long; and b) Not being used to carry persons or property for a charge. Item 2.g. 6) is added. 6) An aircraft in which you have no ownership interest and that you have chartered with crew. The last paragraph of 2. Exclusions is replaced with the following. Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. SECTION I - COVERAGES COVERAGE C. MEDICAL PAYMENTS If Medical Payments Coverage is provided under this policy, the following is changed.- 3. Limits The medical expense limit provided by this policy shall be the greater of: a. $10,000; or b. The amount shown in the declarations. Coverage C. Medical Payments is primary and not contributing with any other insurance, even if that other insurance is also primary. GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page I of I The following is added: COVERAGE D. PRODUCT RECALL NOTIFICATION EXPENSES Insuring Agreement We will pay "product recall notification expenses" incurred by you for the withdrawal of your products, provided that: a. Such withdrawal is required because of a determination by you during the policy period, that the use or consumption of your products could result in "bodily injury" or "property damage "; and b. The "product recall notification expenses" are incurred and reported to us during the policy period. The most we will pay for "product recall notification expenses" during the policy period is $100,000. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B Item b. and d. are replaced with: b. The cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit' including actual loss of earnings up to $500 a day because of time off from work. SECTION II -WHO IS AN INSURED Item 4. is replaced with: 4. Any subsidiaries, companies, corporations, firms, or organizations you acquire or form during the policy period over which you maintain a controlling interest of greater than 50% of the stock or assets, will qualify as a Named Insured if: a) you have the responsibility of placing insurance for such entity; and b) coverage for the entity is not otherwise more specifically provided; and c) the entity is incorporated or organized under the laws of the United States of America. However; coverage under this provision does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the entity, or "personal injury" or "advertising injury" arising out of an offense committed before you acquired or formed the entity. Coverage under this provision is afforded only until the end of the policy period, or the twelve (12) month anniversary of the policy inception date whichever is earlier. SECTION III - LIMITS OF INSURANCE Paragraph 2 is amended to include: The General Aggregate Limit of Insurance applies separately to each 'location" owned by you, rented to you, or occupied by you with the permission of the owner. GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 2 of 2 Paragraph 6. is replaced with the following: 6. Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for damages because of "property damage" to premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner, arising out of any one fire, explosion or sprinkler leakage incident. The Fire Damage Limit provided by this policy shall be the greater of: a. $500,000. or b. The amount shown in the Declarations. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS Item 2 a. is replaced with: 2. Duties In The Event of Occurrence, Offense, Claim or Suit a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive officers, partners, members, or legal representatives is aware of the "occurrence ", offense, claim, or "suit". Knowledge of an "occurrence ", offense, claim or "suit" by other employee(s) does not imply you also have such knowledge. To the extent possible, notice to us should include: 1) How, when and where the "occurrence" or offense took place; 2) The names and addresses of any injured persons and witnesses; and 3) The nature and location of any injury or damage arising out of the "occurrence ", offense, claim or "suit". Item 4. b. 1) b) is replaced with: b. Excess Insurance 1) b) That is Fire, Explosion or Sprinkler Leakage insurance for premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner; or Item 6. is amended to include: 6. Representations d. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. Item 8. is replaced with: 8. Transfer of Rights Of Recovery Against Others To Us a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 3 of 3 b. If required by a written "insured contract ", we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under that written "insured contract' for that person or organization and included in the "products- completed operations hazard ". Item 10. and Item 11. are added: 10. Cancellation Condition If we cancel this policy for any reason other than nonpayment of premium we will mail or deliver written notice of cancellation to the first Named Insured at least 60 days prior to the effective date of cancellation. 11. Liberalization If we adopt a change in our forms or rules which would broaden your coverage without an extra charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. SECTION V- DEFINITIONS The following definitions are added or changed: 9. 'Insured contract' a. Is changed to: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, explosion or sprinkler leakage to premises while rented to you, or temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner is not an "insured contract'. 23 and 24 are added. 23. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right -of -way of a railroad. 24. 'Product recall notification expenses" means the reasonable additional expenses (including, but not limited to, cost of correspondence, newspaper and magazine advertising, radio or television announcements and transportation cost), necessarily incurred in arranging for the return of products, but excluding costs of the replacement products and the cash value of the damaged products. The following Provisions are also added to this Coverage Part: A. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT Paragraph 2. under SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy to provide insurance such as is afforded under this Coverage Part. Such person or organization is not entitled to any notices that we are required to send to the Named Insured and is an additional insured only with respect to liability arising out of: a. Your ongoing operations performed for that person or organization; or b. Premises or facilities owned or used by you. GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 4 of 4 With respect to provision 1.a. above, a person's or organization's status as an insured under this endorsement ends when your operations for that person or organization are completed. With respect to provision 1.b. above, a person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such premises or facilities ends. 2. This endorsement provision A. does not apply: a. Unless the written contract or agreement has been executed, or permit has been issued, prior to the "bodily injury", "property damage" or "personal and advertising injury"; b. To "bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, in the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project; c. To the rendering of or failure to render any professional services including, but not limited to, any professional architectural, engineering or surveying services such as: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities; d. To "bodily injury", "property damage" or "personal and advertising injury" arising out of any act, error or omission that results from the additional insured's sole negligence or wrongdoing; e. To any person or organization included as an insured under provision B. of this endorsement; f. To any person or organization included as an insured by a separate additional insured endorsement issued by us and made a part of this policy. B. ADDITIONAL INSURED —VENDORS Paragraph 2. under SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization (referred to below as "vendor") with whom you agreed, in a written contract or agreement to provide insurance such as is afforded under this policy, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 5 of 5 d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. To "bodily injury" or "property damage" arising out of any act, error or omission that results from the additional insured's sole negligence or wrongdoing. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 6 of 6 JUL -18 -1999 21:42 'r li JUST THE FAX To: Steve Jones Fax: (310) 640 - 2543 From: Dr. Maureen Sassoon ph. (33 10) 544 2912 $ fx. (310) 544 0752 IIi Steve, 1999 SUL 20 Ll 8'. �O OD Date: July 19, 1999 RE: Insurance Questions Pages Attached: zero Forgive me for sending this to you, but I am not certain to whom I'm suppose to send this information. P.01 I was asked to provide a note stating that the following are true statements: 1. That I do not have any employees, therefore f do not have workers' compensation insurance for them. "Phis is a true statement, 2. "that I have my own medical insurance. This is also a true statement. My health insurance is with Kaiser, as it has been since 1965. I trust this will answer your questions and put to rest this entire insurance matter. Except of course the policy due you from Fireman's Fund. As you know, I recently purchased the requested insurance coverages pursuant to your request, and there is a lag time between receiving the actual coverage (which occurs immediately) and receiving the actual paperwork. If you have any additional questions, please feel free to contact my agent Sheri Lopez, at NHC insurance Services (310) 540 5332, directly. Thank you - - Maureen C OA ` �~ TOTAL P.01 CITY CLERK'S DEPARTMENT INTEROFFICE MEMO DATE: July 20, 1999 TO: Mark Hensley FROM: Patti Adlen Re: Meeting Insurance Requirements Dr. Maureen Sassoon has submitted Liability, last week. The attached is a copy r Workers Compensation. I assume that this should be sufficie Thank you 0 and sional Liability Insurance by she is unable to have Page 1 of 2 Shilling, Mona From: Kozykoski, Betsy Sent: Wednesday, March 18, 2009 1:56 PM To: Shilling, Mona Subject: FW: ins Importance: High Here you go! Thanks Mona! From: Marlene Richardson [mailto:mrichardson @brakkeschafnitz.com] Sent: Saturday, February 14, 2009 2:49 PM To: Sassoon, Maureen Cc: Kozykoski, Betsy Subject: RE: ins Importance: High Hi Maureen: NO problem in taking out the "endeavor to" etc ... on the certificate of insurance. ONce everything is firmed up Tuesday I'll issue the certificate to the City as needed. Regards, Mar Richardson BSW Insurance Services 840 Apollo Street Suite 150 El Segundo, CA 90245 310 -524 -1343 - Direct 310 - 944 -2048 - Mobile 310 -524 -1344 - Fax License #0428915 mrichardson @bsw- ins -com *************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** This communication, including attachments, is for the exclusive use of the addressee and may contain proprietary, confidential and/or priviledged information. If you are not the intended recipient, any use, copying, disclosure, dissemination or distribution is strictly prohibited. If you are not the intended recipient, please notify the sender immediately by return e-mail, delete this communication and destroy all copies. ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** From: Dr.M.Sassoon [mailto:msassoon @cox.net] Sent: Saturday, February 14, 2009 12:52 PM To: Marlene Richardson 3/26/2009 Cc: Kozykoski, Betsy subject: ins Marlene - The City of El Segundo has requested that the wording on my Proof of Insurance be modified as explained below: The City Clerk's Office provided me with your Proof of Insurance (attached), but there is one correction required on the first page, (Certificate of Liability Insurance Acord), the Cancellation Clause. The following wording needs to be crossed off or removed; "endeavor to" and "but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives." The NHC folks looked in to this last week and said that it can't be done... please check this out. I believe that the NHC response is the correct one but thought I'd get a second opinion. (Actually yours will be the third opinion as I had the second opinion.) You may respond directly back to both me and to Betsy - the person in HR who shared this request. Thanks maureen 3/26/2009