PROOF OF INSURANCE (2005) CLOSEDALLSTATE LIENHOLDER SERVICE CENTER
PO BOX 660349
DALLAS, TX 75266 -0349
CITY OF EL SEGUNDO
350 MAIN STREET
EL SEGUNDO CA 90245 -3813
CERTIFICATE OF INSURANCE
Date: 05/26/04
Coverages designated below are afforded for each described vehicle:
BI $250,000 EA.PERS.- $500,000 EA.00C.
EFFECTIVE DATE
PD $100,000 EA.00C.
OF CERTIFICATE
ALLSTATE INSURANCE COMPANY
JULY 17, 2004
Northbrook,Illinois, certifies that the following insurance is in force:
POLICYHOLDER
POLICY NUMBER POLICY PERIOD
ROGER B NEWMARK
0 04 692077 01/17 JULY 17, 2004
1355 LOMAY PLACE
JANUARY 17, 2005 S;�,'f7im
PASADENA CA 91103 -1959
PD $100,000 EA.00C.
The person or organization designated below is described in the policy as:
CITY OF EL SEGUNDO
Comprehensive- $50 DED.
350 MAIN STREET
LIENHOLDER
EL SEGUNDO CA 90245 -3813
(Loss Payable Clause)
X ADDITIONAL
D1697
INTERESTED PARTY
AGENT MAX J OCON
PHONE (818) 662 -6999
Coverages designated below are afforded for each described vehicle:
BI $250,000 EA.PERS.- $500,000 EA.00C.
1989 ASTRO
PD $100,000 EA.00C.
1GCDM15Z3KB197336
Collision- DED.
Comprehensive -No Comprehensive Coverage
BI $250,000 EA.PERS: $500,000 EA.00C.
1995 GCHER
PD $100,000 EA.00C.
1J4GZ78Y6SC660207
Collision- $250 DED.
Comprehensive- $50 DED.
BI $250,000 EA-PERS.- $500,000 EA.00C.
1997 740IL
PD $100,000 EA.00C.
WBAGJ832XVDL40759
Collision- $250 DED.
Comprehensive- $50 DED.
See reverse side for provisions concerning Loss Payable
Clause and Additional Interested Party.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage
afforded by the policy referred to above.
D1697
I *000006405639406691600101*
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