PROOF OF INSURANCE (2006) CLOSEDDEC, 20.2005 11:43AM NUVIS
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N0, 103 P. 2
AC12R CERTIFICATE OF LIABILITY INSURANCE
NSF TYPE OF INSURANCE POLICY NUMBEa POLICY EFFE DTNE OUCY EXPIRATION IJMRB —
A
ti;9OMID5D"Y)
PRODUCER
Dealey, Renton & Associates
P. 0. Box 10550
Santa Ana, CA 92711 -0550
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
10/29/06
714 427.6810
INSURERS AFFORDING COVERAGE
INSURED
NUVIS
Cos Airway Avenue Suite J3
Costa Mesa, CA 92626
INSURERA: United States Fidelity & Guaranty
INSURER B; St. Paul Fire & Marine Ins, Co.
IN$URERC: Hudson Insurance Company
INSURER D:
INSURER E.
rnvPRAr.FS
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
POLICES. AGGREGATE LIMITS SHOWN MAY HAVE etm-m REotmi J BY PLAID CLAIMS.
NSF TYPE OF INSURANCE POLICY NUMBEa POLICY EFFE DTNE OUCY EXPIRATION IJMRB —
A
GENERAL LIASILRY
SKOI237004
10129105
10/29/06
EACH OCCURRENCE
$1 000'!Z0 0
FIRE DAMAGE Anyenorire)
51,0001000
)( COMMERCNL GENERAL LIABILITY
CLAIMS MADE FX7 OCCUR
MEO 4XF (Any one person )
;10 000
PERSONAL B ADV INJURr
$1,000,000
GENERAL AGGREGATE
;2 000 000
PRODUCT$ -COMPIOP AGO
s2,000,000
MGEN'LAOOREGA'IELIMITAPPLIESPER:
POLICYEIMI-71.00
A
AUTOMOBILE
LIABILITY
ANY AUTO
BKO1237004
10129/05
10/29/06
COMBINED OINGLE LIMIT
(Ea Ileeidenl)
51 00
BODILY INJURY
(Par parson)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
X
HIRED AUTOS
NON- OWNEDAUTOS
BODILY INJURY
(Pereaoldeno
$
PROPERTY DAMAGE
(For deptlenl)
E
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
EA ACC
OTHER THAN
AUTO ONLY; AGG
S
ANYAUTO
5
EXCESS UABIUTT
DCCUR CLAIMS MADE
EACH OCCURRENCE
S
AGGREGATE
S
$
S
DEDUCTIBLE
RETENTION
S
WO41sR3 COMPYNSATJON AND
WVAZ731894
10/29/05
10/29/06
X We STATU- OTH-
MPLOYERS'LILTTY
E IAB
E.L. EACH ACCIDENT
S1,000,000
E.L. DISEASE -EA EMPLoyrmrzl
0,000,000
E.L. DISEASE - POLICY UMIT
$1.000.000
C
OTHER Professional
AEE7102701
12/01/05
12101106
$2,000,000 per claim
iablilty
$2,000,000 annl aggr.
[aims Made
DESCRIPTION OF OPERATIONS IIOCATIONSIVENICLESIEXCLUMONS ADDED BY ENDORSENNENTISPEcULL PROVISION3
General Liability policy excludes claims arising out of the performance of
professional services.
RE: All operations as pertains to named insured
The City of El Segundo,its offieers,officials,employees & volunteers
City of El Segundo
Attn:Rec. & Parks Director$
350 Main Street Room 5
El Segundo, CA 902453813
ACORD 25-S (71901 of 1 #51461S M145131
BH OU LD ANYOF THEABOVE D ESCRIBSO POLICIES B E CANCELLED BEFORE TN E EXPIRA'nom
DATE THEREOF, TNEISSUIND INSURER W4IX089jX= TO MAIL 311 DAYSWRRTEN
NOTICETOTHE CERTIFICATE NOLDERNAMEDTOTNELEFr K
REPRESENTATIVE:
JMC o ACORD CORPORATION 1986
DEC -20 -2005 11:40 714 754 7346 99%
P.02
.M
DEC, 20.2005 1' .4EAM NUVIS
Policy Number: BKO1237004
Owners Lessees or Contractors (Form B)
ADDITMAL INSURED
Change(s) Effective: 12/19/o5
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY. This endorsement modifies insurance policy under the following:
LIABILITY COVERAGE PART:
Schedule
Name of person or Organization:
City of El Segundo
Attn:Rec. & Parks Directori
350 Main Street Room 5
El Segundo, CA 90245 -3813
SECTION 11- WHO IS AN INSURED is amended to include as an insured the
person or organization shown in the Schedule, but only with respect to liability
arising out of "your work" for that insured by or for you.
N0. 103 P. 3
City of El Segundo,its off icers,officials,employees & volunteers
PRIMARY INSURANCE:
IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED
SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS
INSURANCE.
CL/BF 22 40 03 95
DEC -20 -2005 11:40 714 754 7346 99%
P.03