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PROOF OF INSURANCE (2015) CLOSED
HIGHPOI OP ID: TO ,a►coRO CERTIFICATE OF LIABILITY INSURANCE DATE 08 /20 /2014Y) 08/20/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). OPRODUCER Fax: 213 - 741 -3005 PHONE A$$$Club insurance .�..._ FAQ___ Box 2 Services, LLC Phone: 888 - 416 -2402 IHc - 416- 240urance A enc LLC(��' Santa Ana, CA 92799 -5443 "m Shari Huggins ADDRt com NSURER AFFORDING COVERAGE S NAIC # INSURER A: CNA 120435 INSURED 23720 Posey Lane West mills, CA 91304 INSURER B: INSURER C INSURER D, INSURER E : COVERAGES CERTIFICATE NLIMRFR- 1 RFV'I.SION NIIMRF'R'- THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ��.._�.. tN R - TM___ ............. .....��........... �.........�. B'rF _��_. -__ - - - -- ..__ SLLC i w� kady I . LTR' PE OF INSURANCE POLICY NUMBER MMAODJYYYY MYw1dDDFYYYY' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL O LIABILITY X 5085364820 08/23/2014 08/23/2015 300,00 CLAIMS -MADE X � OCCUR MED EiXP A y one person) $� 10,00 X BUSineSsOwners PERSONAL _ &ADVINJURY $ 1,000,00 ...................$.... ..............................2 ............. ..................................... w....... ......ww....................... GENERAL AGGREGATE o0o,000 - GEN L AGGREGATE LIMIT APPLIES PER: . PRODUCTS COMP /OP AGG $ ................... ............................. ........ 2,000,000 X. POLICY P'C, LOO $ .... AUTOMOBILE LIABILITY ED SINGLE LIMIT 1,000,000 Ea c del � .... A ANY AUTO X 5085364851 08/23/2014 08123/2015 BODILY INJURY (Per person) $ .- ...... ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per . accident) ....$ ...................................... ............................... NON -OWNED F'I��ht'�"Y DAMAGE $ ........ HIRED AUTOS .,�._.. AUTOS ..Per �,cr�dent,) .......................................................... ............................... ............................... $ UMBRELLA LIAB W OCCUR EACH OCCURRENCE $ .,.....�......_,.w..... EXCESS LIAB CLAIMS -MADE X AGGREGATE E $ DED RETENTION $ $ WORKERS COMPENSATION �AT T OT AND EMPLOYERS' LIABILITY Y / N ,X JWC ER A ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ IN / A 5085365000 08/23/2014 08/23/2015 E.L. EACH ACCIDENT $ 1,000,00 (Mandatory in NH) E.L.. DISEASE -EA EMPLOYEE $ 1,000,00 desc be under DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ 1,000,000 A Professional Liab X 25600839 08/2312014 08123/2015 Limits 1,000,00 Retnetion 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The City of E1 Segundo is named as Additional Insured. *10 DAY NOTICE OF CANCELLATION APPLIES FOR NON - PAYMENT OF PREMIUM ONLY.* LLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y g ACCORDANCE WITH THE POLICY PROVISIONS. Attn: City Clerk 350 Main Street AUTHORIZED REPRESENTATIVE El Segundo, CA 90245- Shari Huggins © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD