PROOF OF INSURANCE (2004) CLOSEDMAY, 27.2003_ 9:26AN(_.__000IA NO 702-'-'
ACORD DATIP• 2)Dm)
TM. CERTIFICATE OF LIABILITY INSURANCE MAY 2703
� d1 ROHRER INSURANCE AGENCY THIS CRRTIFICATE IS I5SU9D AS A MATTER OF INFORMATION
19581 VON ROHRER, GTE. 120 ONLY AND CONFERS NO RIGHT8 UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
IRVINE CA 92812 ALWR " GE 6MCMDED RY THE :2mzs an
PHONE: 949.982.4900
FAX: 949.752.2990 Uc#, 0560759 INSURERS AFFORDING COVERAGE NAIL 0
INSURIID W4URER A: C N A INSURANCE COMPANY
ROSENOW SPEVACRK GROUP, INC. INSURER B; EVERST NATIONAL INSURANCE COMPANY
CIO DEBBIE WEINSTEIN INSURER C: ROYAL SURPLUS LINES INSURANCE COMPANY
217 NORTH MAIN STREET SUITE 300
SANTA ANA CA 92701.4622 INSURER D: _
INSURER E:
�COVEMES
THE POLICIES OF INSURANCE LIST60 !FLOW HAVE @FEN ISSUED TO THE 0 9URED NAMED ABOVE FOR THE POLICY P
ANY REQUIREMENT, TERM OR COHOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS,
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN E SUEJSCT TO ALL THE TERMS, EXC
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CWMS.
L TYPE OP INSURANCE POLICY NUMBER RIOT sMTrA °XY ftTm
GENERAL UABLITY B 2054919498 MAR 103 MAR 104
X pMMERCIAL GENERAL IM�ITY
MAIMS MADE [j] OCCUR
A
GEML AOOWCATE LIMIT APPL&S PSI
POLICY
AUiOMON LE UABI ITY B 205491 OW MAR 103 MAR 104
ANY MM
ALL OWNED AUTOS
A SCHEDUM AUTOS
X HIRED AUTOS
X NONOWNEDAUTOS
ANY AUTO
FIfCES I I LMBEILELLA UMILITY 8 2056919344
x OCCUR a CLAIMS MADE
A
DEDUCTIBLE
RETENTION i
WORKERS COMPENSATM AND 3900008168 -031
EMPLOYERS' LIANLITY
AMYL w ENIAIE
K2HRB01093
C
CITY OF EL SEGUNDO IS A NAMED ADOMONAL INSURED
CITY OF EL SEGUN00
350 MAIN STREET
EL SEGUNDO, CA 90245
MAR 103 1 MAR 104
MAR 103 1 MAR 104
MAR 103 1 MAR 104
4WD INDICATED. NOTWITHSTANDING
ZRTIFICATS MAY BE ISSUED OR
,USIONB AND CONDITIONS OF SUCH
LNUTS
EACH OCCURRENCE 1
0~916MISPaw
S 250,000
MIF,D. EXP (AAY O- PwW)
S 5,000
P¢RSONAL 4 ADV IILNRV
i 1.000,000
GENERAL AGGREGATE
$ 2,000,000
PIOODUCTS-COMPIOPAGO.
i 2,000.000
COMBINED LIMIT
s 1.000,000
)SOKILE
900ILY INJURY
(PIN Paso )
S
BODILY INJURY
=
PROPERTY DAMAGE
S
AUTO ONLY • EA ACCIDENT
S
OTHERTNAN EAACC
i
AUTO ONLY-
i
EACH OCCURRENCE
S 1,000,000
AGGREGATE
i 11000,000
s
s
i
v+t RAiTF y�g
E.L, EACH ACCMGNT
i 1,000,000
E.L. DIVASE•EA EMPLOYEE
18 11000.000
6.L. DIMASWPOLICY LIMIT Is 1,000,000
$2,000,000 GENERAL AGGREGATE
52,OD0,000 EACH CLAIM
ECIAL PROVISION$
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED iEFaRETHE
EXPIRATION OATS THEREOF, THE ISSLSNG COMPANY WILL MARL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
Attention: PATTI KNIGHT
ACORD 26 (2M/M Certificate 9 19875