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PROOF OF INSURANCE (2010) CLOSED/ ) ® DATE (MM /DI v CERTIFICATE OF LIABILITY INSURANCE SEACLHl 04/2' q THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION United Agencies, Inc. (A) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA License #0252636 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 638 Lindero Canyon IDA , Ste 302 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oak Park CA 91377 Phone:805- 212 -4890 Fax:805- 212 -4891 Sea Clear Pools, Inc. 23316 S Normandie Ave #B Torrance CA 90502 INSURERS AFFORDING COVERAGE NAIC # INSURER A. Delos Insurance Company INSURER B'. Golden Eagle Insurance Corp. 10836 INSURER C. United National Insurance Co. INSURER D'. Underwriters at Lloyd's London INSURER E. vvv cr�ewvv 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 AFFORDFD 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM /DD /YYYY) DATE MM /DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 C X X COMMERCIAL GENERAL LIABILITY L7217347 11/01/09 11/01/10 PREMISES (Ea occurence) $ 50,000 CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 1,000,000 X I POLICY PRO JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO BA8717789 10/03/09 10/03/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ (Per accident) X NON -OWNED AUTOS X Comp Ded $500 PROPERTY DAMAGE $ 1X Coll Ded $500 (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ _ WORKERS COMPENSATION X I TORY LIMITS I ER AND EMPLOYERS' LIABILITY A ANY PROPRIETOR /PARTNER /EXECUTIVE 01DKRMI- 2007-083 07/01/09 07/01/10 E L. EACH ACCIDENT $1,000,000 OFFICER /MEMBER EXCLUDED? E . DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E . DISEASE - POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below OTHER D Property BUE9532 11/01/09 11/01 /10 BPP 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of E1 Segundo is named as Additional Insured as required by written contract. *10 days notice of cancellation for non - payment of premium. ct11IWI .AI t r+Va.ucrc City of El Segundo 350 Main Street E1 Segundo CA 9024 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYELS 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ©1 YNVRV GU t�vv +iv ,, The ACORD name and logo are registered marks of ACORD TION. All rights reserved. vvv cr�ewvv 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 AFFORDFD 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM /DD /YYYY) DATE MM /DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 C X X COMMERCIAL GENERAL LIABILITY L7217347 11/01/09 11/01/10 PREMISES (Ea occurence) $ 50,000 CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 1,000,000 X I POLICY PRO JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO BA8717789 10/03/09 10/03/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ (Per accident) X NON -OWNED AUTOS X Comp Ded $500 PROPERTY DAMAGE $ 1X Coll Ded $500 (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ _ WORKERS COMPENSATION X I TORY LIMITS I ER AND EMPLOYERS' LIABILITY A ANY PROPRIETOR /PARTNER /EXECUTIVE 01DKRMI- 2007-083 07/01/09 07/01/10 E L. EACH ACCIDENT $1,000,000 OFFICER /MEMBER EXCLUDED? E . DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E . DISEASE - POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below OTHER D Property BUE9532 11/01/09 11/01 /10 BPP 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of E1 Segundo is named as Additional Insured as required by written contract. *10 days notice of cancellation for non - payment of premium. ct11IWI .AI t r+Va.ucrc City of El Segundo 350 Main Street E1 Segundo CA 9024 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYELS 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ©1 YNVRV GU t�vv +iv ,, The ACORD name and logo are registered marks of ACORD TION. All rights reserved. ct11IWI .AI t r+Va.ucrc City of El Segundo 350 Main Street E1 Segundo CA 9024 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYELS 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ©1 YNVRV GU t�vv +iv ,, The ACORD name and logo are registered marks of ACORD TION. All rights reserved. POLICY NUMBER: L7217347 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, CONTRACTORS - (FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organizat' City of El Segund LESSEES OR B) (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. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 ❑