PROOF OF INSURANCE (2010) CLOSEDACORO� CERTIFICATE OF LIABILITY INSURANCE DATE 00
THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION
PRODUCER ED BARNHART ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
502 MAIN ST, EL SEGUNDO, CA 90245 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
CA LIC N ST, EL A 90242 -8911 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURED
STUDIO PRINTING INC
446 MAIN ST
EL SEGUNDO CA 90245 -3002
INSURERS AFFORDING COVERAGE
INSURERA:State Farm Mutual Auto Insurance
INSURER 8:
INSURER C:
INSURER 0:
INSURER E:
25178
NAIC /
COVERAGE5
OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER DATE M DATE MMID
GENERALLIABMfiV 92 —QA- 6759 -5 03/15/2009 03/15/2010
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PERIOD INDICATED. NOTWITHSTANDING
THIS CERTIFICATE MAY BE ISSUED OR
EXCLUSIONS AND CONDITIONS OF SUCH
LIMITS
EACH OCCURRENCE $ 1,000,000
THE
ANY
MAY
POLICIES.
POLICIES
REQUIREMENT,
PERTAIN,
V=
LTR
ADD
M
X
PREMISES Ea occurrence)
S
MED EXP one
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMROPAGG
i
GENLAG REGATELNifAPPLESPER
POLICY PRO -
JECT LOC
AUTOMOBILE LIABILITY 127 6715—D15-75 10 / 15 / 2 0 0 9 04/15/2010
00 CHEVROLET VAN
COMBINED SINGLE LIMIT
(Ea accident)
$
X
X
ANY AUTO 1GCDM19W8YB150988
ALL OWNED AUTOS
BODILY INJURY
(Perpereon)
$ 500,000
X SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
(Per aoddent)
S 500,000
NON-OWNED AUTOS
PROPERTY DAMAGE
(Per accKWd)
S 250,000
AUTO ONLY - EA ACCIDENT
$ _
GARAGE LIABILITY
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY:
AGG
$
S
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
i
S
OCCUR FI CLAIMS MADE
s
DEDUCTIBLE
RETENTION S
wORKERSCOMPENSATIONAND
EMPLOYERS' LIABILITY
92— BD— U770 -6
03/15/2009
03/15/2010
WC LIMIT ER
ORY LIMITS ER
$
100,000
X
E. L. EACH ACCIDENT
_
S _
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER#AMBER EXCLUDED?
EL DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT $
M yse, describe Under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
PRINTING BUSINESS / DELIVERY LOCATIONS VARY
CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS,
EMPLOYEES, AGENTS & VOLUNTEERS.
C/O CTIY CLERK
350 MAIN STREET
EL SEGUNDO, CA 90245 -3813
132849
'ANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
NAMED TO THE LEFT.
AGENT
ACORD 25 (2001108)
POLICY NUMBER: %- (� " �, / i�- COMMERCIAL GENERAL UABILM,
c� xa 2r3 0� ba
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modilles insurance provided under the fo0owWW.
COMMERCIAL GENERAL LIABILITY COVERAGE PART
BCHEOULE
CITY OF EL BED, ITS OFFICERS, OFFICIALS, DRWYESS, AGMT8 i VOLUNTE8R8.
in
Section N - Who Is An Insured is amended to M-
aude as on additional insured the person(s) or argani-
zation(s) shown In the Schedule, but only with respect
to liability for "bodily injury", "property dam W or ole or
Innppamby your accts or�nMmloonns ewu or omis-
sions of those acting on your bew
A. in the per►ormance of your ongoing operations; or
B. In connection wig► your premises owned by or
rented to you.
CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 E3