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PROOF OF INSURANCE (2013) CLOSED+CCOR DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/22/2013 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 pollcy(les) 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). PRODUCER ICONTACT NAME. HCC Specialty IPHONE -FAQ . . - 401 Edgewater Place, Suite 400 ADDRESS ftftld.. - - ------ __. __ ........ ...... .. Wakefield, MA 01880 IMB,II0F61QF _. - - - -- __1111 a....._...� — w..,....�m COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TERM'S, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, C"1'li TYPE OF INSURANCE GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X_ Host Liquor .----- -__ �.._..,....,..... .,_-.... A GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO.. JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROP RIETOR/PA RTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? NAIC A 23841 POLICYNUMBER MM/DD/YYYY i&;i56%YXY LIMITS SEL082845288 03/2612013 07/08/2013 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) I $ 300.000 PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY -URY (Per accident) ) $ PROPERTY DAMAGE .$- (Per accident) EACH OCCURRENCE AGGREGATE $ E.L. EACH ACCIDENT $ L. DISEASE - EA EMPLOYE $ E.L, DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The Certificate Holder is added as Additional Insured with respects to our Insured's operations only. This insurance is primary and non - contributory as required by written contract. This coverage is with respect to El Segundo Summer Concert Series event to be held 7!7/2013 - 717/2013 at Library Park El Segundo CA CANCELLATI 1„00% 00 2,000 000 1,000,000 City of El Segundo, its officers, official ; ployees, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED agents, and volunteers BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 350 Main Street IN ACCORDANCE WITH THE POLICY PROVISIONS, El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE Al ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD PNSURER(S) AFFORDING COVERAGE INSURED INSURER A: New I lam Shlre Insurance COm The Trip -- LL 11 Via Amistosa, Apt. C INSURER B: — Santa Margarita, CA 92688 INSURERC. INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TERM'S, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, C"1'li TYPE OF INSURANCE GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X_ Host Liquor .----- -__ �.._..,....,..... .,_-.... A GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO.. JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROP RIETOR/PA RTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? NAIC A 23841 POLICYNUMBER MM/DD/YYYY i&;i56%YXY LIMITS SEL082845288 03/2612013 07/08/2013 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) I $ 300.000 PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY -URY (Per accident) ) $ PROPERTY DAMAGE .$- (Per accident) EACH OCCURRENCE AGGREGATE $ E.L. EACH ACCIDENT $ L. DISEASE - EA EMPLOYE $ E.L, DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The Certificate Holder is added as Additional Insured with respects to our Insured's operations only. This insurance is primary and non - contributory as required by written contract. This coverage is with respect to El Segundo Summer Concert Series event to be held 7!7/2013 - 717/2013 at Library Park El Segundo CA CANCELLATI 1„00% 00 2,000 000 1,000,000 City of El Segundo, its officers, official ; ployees, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED agents, and volunteers BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 350 Main Street IN ACCORDANCE WITH THE POLICY PROVISIONS, El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE Al ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD I This endorsenient modfflas insuirdsmce provided under the fray k-ming: COMMERCIAL GENFFRAki UA&UTY COVER-AGE"PART' 1, Desngr%afion of Premses (Part Leased to You): City of El Segundo, fts officef's, Offir'Ws' err q)lovees' agents, and VOilkInteers, 350 MWIn Street, S gu dov Q'k, fi I Name of Per bon x Oq;anozation (AddifionW Insurc..-,d); City of B Saq�-mtdo, I.,; afficer , offidWs, empkjyees, agents, and w,'nunleers, 350 Main StFraet, Elli Segundo, CA, 9 3. AdrOonb , M Praamk.m Included (If no entry appears "t �ve, the inforriatinny reqWredl to compkste Olh�is ren.dor, enientwffl he, shown ir, 'Elie Oec�ara- flons as app4cable to this endorsernent.) VIA-10 9 S AN INSURED (Siu*(.Aion U) is evrmnded to ine,:�,ude ms an insured the person or organizaban shown 41 ft Schedule but oMv witt! respecl, t� Nobility arising out of the owriersl"flp, fnailntenwrmef)r use ef that part of the prem- uses Seas ed to you and shown in the Sche.dWe and s�,,Jbject to fihe foOowinq art dNional exdus�lons: This '�nsuram;p does not slap y 'kv, 1, Anq "ir,�ccurrenm" which, takes plara etm—you cease to be a tenant m that PfeM [Seg. 2, Strui-A.urW aft�raxkmws, new cmnstavction or dernoyfifior, oper,,ifiorts pprformmed by or on behAffof"'he person or shmmn in the Schedule, O 'It.) I 10 1 96 Copyright, ern surance SeMcxm Offir,,-P, �nc, 1994 Pago I of I COMMERCIAL 1-INES POUCY COMMON POLICY DECLARATIONS GvhnNo . "gate Prmurartcp Company tflhiois fqatIormi` Insuranix., Ca, Mew I- fmrnpshirt Mmiranct Dornpaely (Each of die abme being a cspRal cfjmpa-,jy) 17501ater &met W"*'Aaar New York, Npw'wlo,-k 10036 2,12 468 5000 &E AL OF ter MSFR, POLICY NO 82846,288 NAMEGIiNSURED The T�ip MAILING ADDRESS I I Via Anriis for *_Afrt. G, Santa Margarita, CA 92688 POLICY PERIOD, rmm Mar 26'201':4 to Sul 08, 2(1,113 PRODUCER: HCC Spedaikly 84213 PA 12:01 O-W Sfandard Thile mdjour rnagffng address sh"n ahw#e BUSINESS DESCRIPTION El undo Summer Conceft Ser" to be- he 071OV2013 all Ubrary Park, 0 Segundo, CA 9 02 5 W RF-rURN F'ORTHE PAYMENT OF T IE PREWUM, AND ML)WECT '70 ALL THE. TERMS OF THIS POLICY, WEAGREE MTHI YO O N WDE 'F.'HLE tWSURANCE AS spyxrEm Iw. nits POLICY. 11-0 POUCY CONSISTS OF THE FOLLOWNG COVERAGE PAR73 FOR WIACH. A PRE M is 9.40iCATED, 'IMIS PRENHUM ALAY AF S UFUECT TO ADJUVINENT. PREMIUM Cornmercial ProperNt, C ge Part -N/ Comrrwrcial Gegrtoraf Uabiifty Cr:: wage, Part $100,00 commelycial Crime Coverage Part NIA Commercial Wand Marine Coverage Rao Bauer an Machinery Coverage Part NY\ Caryimercial Auto Cod rage Pan Liciuor Liability Coverago Pavt TR�A $ 11 00 TOTAL Premium shown is payable: $1 r1j, 00 avqnceptjorl. ist Ann-Wersary. 2nd AnnivPmary Form( s) and Sndoimernent(s) imade pa&t of #iifis fxAicy at firne of iS1AUq-- ..................... *Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations Counteirsigned: By . ........... .......... AkAhofted RepinsentatiVe NS rOGEfl it.:R WITHTHE COMMON 'POLK"'y CG..*01 10l4S, COVI �.PA(�C PAR",- DECL-AkPArIONS, 001,/ER,A.GE PAR9 ccw IESE DEGI ARATIO� I r .. ERAGE. FC*!iV,(S') AR!") FOIlW9 AND ENWRSEMBNTS, iF AN-Y', ISSI 6EUTO FORM A PART lHrd.! lE OF, r0l,4PL.ETE -rOE ABOVE NLJNABRR�D poI iGy Indud'es copy"io It ej rna0e6als of la Suv)nue Services t( fi ue, Inc., viffh its pennls"'On' copydwek' insuran.ce offioa, 8"c' 1983, -11q,"114 94 -858 I ADDEND1,51M TO I'M!" DECLARATIONS By s�,gjpir°, g below, the President and the SecreGry of t1he Insurer a,,ge-ei-,)n befim[f of tile Insurf.,.,r ba, all �ffie ferms oftiak Policy. flett,,rl Fuuw,,k,,n4A Gr�.-Iyliw State Inswri-once Company The Insiarance (',',<xrpuTn5, of the State M'PennsylvaTfia. Winois Natif-mal Irsurance Co. T,V'Cw J.-farnpshire lms,,urance Cunripwmy American Horne Assurance Coinpany Nationai Union 1"Ire Insur,,-,uac.e (--'oorq>,arxy r,�f Pittsburgh, Pa. Cornmerce wid, Jriulusfty irisurance Compan, Y his Poiicy shi:01 not be valid unims sigpied at the tirne of issuance by m authorized ,rep re.sentative, of the Instmer, eittier beh-,,m or on dhe Declau afion.s -j)age ofthe 11()Hcy IF,',tJI-ua i, 11), A e n AtFINIORIZED .0" CIOUNTEIR' 1� ICNED A'F Steve Bonino 11 Via Amistosa, Apt. C Rancho Santa Margarita, CA 92688 949 - 680 -6754 stevebonino@meetthetrip.com •, s