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PROOF OF INSURANCE (2005) CLOSED
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID G DATE(MMIDWYYM PURSU -1 05/07/04 PRODUCER ISU /Valley Insurance Service THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Licensed 0566246 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 861 South Oak Park Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LIMITS B Covina CA 91724 Phone: 626 - 966 -3664 Fax: 626 - 966 -3895 INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURER A: Golden Eagle Insurance Company $1,000,000 INSURER B: Colony Insurance Company. $ Pursuit Technology Inc. Tonyy 9riego and Joanne M. Grteqo 540 E . J8ime AVge La Habra CA 9063i INSURER C: lied Underwriters PERSONAL & ADV INJURY INSURER D: INSURER E: GENERAL AGGREGATE s2,000,000 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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. INDK LTR Fw1Q NS TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY POLICY EXPIRATION DATE MM/DDIYY LIMITS B X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR GP3004109 04/15/04 04/15/05 EACH OCCURRENCE $1,000,000 PR 'Em ISES(Eaoccurenca) $ MED EXP (Any one person) $1,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY 7 PRO ECT LOC J PRODUCTS - COMP /OP AGG $1,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CBP9583332 04/15/04 04/15/05 COMBINED aaccdentSINGLELIMIT $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ A GARAGE LIABILITY ANY AUTO X OTHER THAN AUTO CBP9583332 04/15/04 04/15/05 AUTO ONLY - EA ACCIDENT $1,000,000 OTHER THAN EA ACC AUTO ONLY: AGG $1,000,000 $1,000,000 EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 00500007280 04/15/04 04/15/05 X TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of El Segundo, its officers, officials, employees and volunteers are added as additional insured. Re: equipment maintenance, Police conversion, City of E1 Segundo. 10 day notice of cancellation for non pay of premiums. CERTIFICATE HOLDER CANCELLATION CITYELS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 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 Atn: City Clerk Office REP AUTH REPRESEN 350 Main St. El Segundo CA 90245 ` AGORU ZO (ZUUIIUU) © ACORD CORPORATION 1988 ,01 'q -'7r)'I-- POLICY NUMBER:GP3004109 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage For. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: Named Insured: Pursuit Technology, Inc. SCHEDULE (Authorized Representative) Name of Person(s) or Organization(s): City of El Segundo, its officers, officials, employees and volunteers Re: equipment maintenance, Police conversion, City of El Segundo (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20480299 Copyright, Insurance Services Office, Inc., 1998 Page 1