Loading...
PROOF OF INSURANCE (2003) CLOSEDACORD CERTIFICATE OF LIABILITY INSURANC�P�D J DATE(MMIDD/YY) A 1 07/07/03 PROOucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 1 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Valley Global Ins . Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 84 S. First Street, 2nd Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Jose CA 95113 Phone:408- 947 -7111 Fax:408- 947 -7115 INSURERS AFFORDING COVERAGE INSURED INSURER A: Hartford Insurance Company INSURER B: Lloyds of London Randall Funding Company Inc . INSURER C: Three Harbor Drive, Sure 315 INSURER D: Sausalito CA 94965 I INSURER E: COVERAGES 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FxI OCCUR 57SBAKQ6229 09/15/02 09/15/03 FIRE DAMAGE (Any one fire) $300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $excluded POLICY PRO T LOC JEC A AUTOMOBILE LIABILITY ANY AUTO 57SBAKQ6229 09/15/02 09/15/03 COMBINED SINGLE LIMIT (Ea accident) $1000000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTO ONLY: AGG $ A EXCESS LIABILITY OCCUR CLAIMS MADE 57SBAKQ6229 09/15/02 09/15/03 EACH OCCURRENCE s2,000,000 AGGREGATE $2,000,000 DEDUCTIBLE RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 57WECJU5904 09/15/02 09/15/03 X TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER B Professional AHJM010654 09/20/02 09/20/03 Per Claim 1000000 Liability Aggregate 1000000 DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS See attached CG2010 for Additional Insured. CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER: CANCELLATION ELSEUND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO El Segundo Police Department Attn: Carlos Mendoza, Administrative Sergeant 350 Main Street DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR El Segundo, CA 90245 REPRESENTATIVES. L AUTHORIZED REPRESENTATIVE Debbie A. Millar x Q UACORD'CT7RATION 1988 J 1/ � POLICY NUMBER: 57SBAKQ6229 COMMERCIAL GENERAL LIABILITY INSURED: Randall Funding & Development, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of El Segundo, its officials, and employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) 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. Project: Services provided under Contract It is further agreed that such insurance as is afforded by this policy for the benefit of the above Additional Insured(s) shall be primary Insurance as respects any claim, loss or liability arising out of the Named Insured's operations, and any other Insurance maintained by the Additional Insured(s) shall be excess and non - contributory with the insurance provided hereunder. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984