PROOF OF INSURANCE (2015) CLOSED4020E
Jim's Exotic Fish
Oct 09 14 12:31 p jims exotic fish 1-310-322-3474 p.1
16/09/2014 11:11 'JIUJdbybYL L3SC.1'41 I wfl•ILVLI♦ iI - -
,� " CERTIFICATE OF LIABILITY INSURANCE °1�oroa2
i-ws- Wilm C:ATE la 1"U M As A MATTER CW tNFORMM1A*nON OII4LY AND CONFEW111 NO RG44M UPON T"E FR71FIC,ATE MtOLVEML
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B 'T"8 CERTIFICATE OF ONURAWX OOES NOT CONSMIAE A CONMCT 110WEEN IWE 153UM Imo" URMS), A"MR290
REpRoENTATrVE OR P Rt'DUCEft,AND TK CUMFICItTE HOLDEFIL
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Brent K WhiBvt*Insurance Agency Inc --- rill-
7740 W Manchester Ave.Ste 105
stakre m Playa Del Rey,CA 90293 MAIC It
WSUIPARA IStWO PAM O Cry
INSURED James and Mary Bellisslmo, F L. "
Rm[)BA,lien's Exotic dish r' 'Fwm Fir! �I C
630 N Sepulveda Blvd.,Ste 14 A 14B a'
El Segundo,CA 90245
'THIS IS O C OTIMTH3 ArtTHE POLICIES M S INSURANCE IPtw ED NAMED NUMBER. 7 TO ill P THIS
OF MtVSllrrtJANM LdSBc D BELOW itA�ItEEtMI�t1EEY TO THE tNS"iMJMtI 14Af4t"ED ABO"L/E FOR Tlttz M•OLMC'y I�tERLOM�
INDICATED, N IREIWMENT.°TERM OR CONOMON OF ANY CONTRACT OR o"N"49M^R,OOC WeNIT YWIT}t 1tE""+Pt C
CERTIFICATE MAY BE LSSUED OR MAY PERTAIN, THE INGURANcE AFFORDED By THE POLICIES DESCRIBED REM-71N IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMIT$&40MMAY HAVE BEEN REWCED BY PAID CIPvMAS,
LJMrra
Will OF 410RUIll I
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The City of EJ Segundo Is named Addilionel Insured
CERTIFICATE HOLDER CANCELLATION
The C1 of 1;1 undo all ANT E T or 71 ABOVE QE ErCES SCFMl PO OR CI RMI•"^15till
tY 1 1NI
Ac00RIIWJ T H TK POLWY P"O IO Will BE oEUVEREG IN
Ci
350 IMaIR 84 • 1 �,
El Segundo,CA 50245 1° `
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ACORD 25(2010f08? the ACORD name and)logo are regbtamd Mill Of ACORD 10014M 132849.8 01-23-2013
Oct 09 14 12:31 p jims exotic fish 1- 310- 322 -3474 p.2
L0/{!]5/2i914 11:11 ,lludubjuzz DRGIII WrlILUWn a,.,i - __
SECTION II ADDITIONAL INSURED ENDORSEMENT
Policy No.: 92 -24- 3672 -7
Named Insured,
13ELLISSIMO, JAMES J & MARY E
DSA AWS EXOTIC FISH
630 N SEP IUL+VEDA BLVD STE 14A
EL SIr(3UNC)0 CA 90245-3470
Additional Insured (include address):
CITY OF EL SEGUNDO'
350 MAIN ST
ELSEGUNDOCA 90245 -3613
FE -6609
Pape 1 of 1
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WHO IS AN INSURED, tinder SECTION II DESIGNATION OF INSURED, is amended to include as an insured the
Additional Insured shown above, but only to the wens that Ilabllly Is lmposed.on that Additional Insured solely Wause
of your work performed for that Additional Insured shown above.
Any insurance provided to the Additional Insured shall only apply with respect to a claim made or suit brought for
damages for which you are provided coverage.
The Primary Insurance coverage below applies only when there is an"Vin the box
[] f►rirnary Insurance. The insurance provided to the Additional Insured shown above shall be primary insurance.
Any insurance carried by the Additional insured shall be noncontributM with respect to.coverage provided to
you.
AM other provisions Di the policy apply.
FF --SMP