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PROOF OF INSURANCE (2014) CLOSEDRIAZI Sedt Adsm6 Insuranea 12794 Hwy 8 8il8.ine88 bhitR #4 El Cla3ou, CM6 92021 TE=x & lym ika"lM 11659 RIVMR8=Z IM. #171 LARESIDE, CA 92040 561 -366D i�suR�ys�ose��cr A- IIEUC C INSURMCM CYf'TATY'K IE ORMC: lmaftAeft M; 561 -4283 0 ACORD 25 {2010145} The AC URD name and logo are regisWrid N u rkr of AWRD ,Commercial Certificate of Liability Agency Seat Adams Name 13794 Highway 8 Business Ste. #4 & El Cajon, CA 92021 Address ..nsurance .m.. � � ...... � -. I FARMERS Issue Late /DD /YY)L,.. -_ 12 1^18 /1mm2 ........ This cerlifiEal<e is as a d idly moon s t upon the cer0kM holier. ills CWWiWW 60 Wt X71 W ametld, exteml or alter the avMP at%rded by rite PNcies slelwd lelow. St 99 Dist. l l Agent ll�� � oettirmate of - , dies at coeedw a caetrast letwm the issuig msu*s), aetheri>!ed 1W--- dtaAl+R or pradew, add the mt"t hddw. Insured AMERICAN OIJTFn TERS com"I&S FMVWWO cowev PC #): 11659 RIVERSIDE DR. #171 Company Letter A `!"ruck Insuratt F�CCI�aa t 21709 Name Company Leitt.e,r B Farmers Insurance Exchange 21652 & LAKESIDE, CA 92040 Address Company Letter C Mid - Century hsurance Company 21687 Cornpny Letter D � . Coma" This fyf that the policies of insurance listed below have been issued to the insured Harmed 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 -- � ..ro.._ e: o-. t a...,— .v^ %vr li —PA i t*n IrYafii9d'M by Maid clannS _ ._. Type of Insurance Policy Number Policy Limits Commercial Ge Liabil" Occurrence - » merciai General Dab axaaa t ,n�awners Liability are ccur.) edicai Bus uses y one 1� Clltlrras I T e rail Adv,telrllu�' Made tic;t�raae General Aggregate in-kit AppiMez., Per Location PrudXomp. Op.. A r.1 Per Project _ Auto r 60172309b 12/14/12 02127!13 C tiSill Lima � 1,Q�I,000 - X mobile liability I Any Auto Bodily Inju All Owned Autos (Per persaara Scheduled Autos otiily Ira as Kited Autos Nr aecia rat X Non-Owned Autos � idaen; .. ge, 11-- _L­ "-- �. ._ ._ .......................... .._.._.._ .. _... X G 02/27/13 Only-Ea, lAabluty 601723096 1211411'2 Auto )ra. Accident i 41a�6y Fach Accident Any Auto 7 Ae.te 2.000.000 I W w Compensation and Statutory Ernploy rs" Liability Each Accident n Disease - Ea. Employee i Disease ! y 'poi Limit Description of Operations /Vehicles /Restrictions /Special items: 11659 RIVERSIDE DR. #171, LAKESIDE, CA 92040 Certificate Holder Name PROOF OF C GE & Address 66.24t}Y 10.11 REPLACES CERTIFICATE DATED 12 -14 -2012 ,, - ...�.._..� _ ........ Cancellation Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance v4sfi the jpollcy, provisions. ;w7z�i•i "�;�IIi:1Fj Commercial Certificate of Liability Insurance FARM E R5 Agency Scot Adams Name 13794 Highway 8 Business & El Cajon, CA 92421 Address St. 99 -- Dist. 11 IT mmITIT_„ Agent 303 Insured AMERICAN OUTFITTERS, INC. Name 11659 RIVERSIDE DR #171 & LAKESIDE, CA 92040 Address Issue Date (NIi' /DD /'ifs") 121i4i12 TW ewtifiafe is issued as a matter Of mfornlatioo only and aafas ■o rights upon the w tificrrte holder. nis eerfdicate does at aftsWMy or aegW" atoerrd, extend or alter the coverage afforded by &e pull= shmm below. ills aert"d'iate of ia%-- — ,1 does not eanstilute a contrail between the nlsareft awthorned represextatnre or prodwer, aad the ,, tifitxte holder. tmpaeies Providing Coverage MW #). Company Letter A Truck Insurance Exchange 21709 Company Letter B Farmers Insurance Exchange 21652 Company Letter C Mid- Century Insurance Company 21687 Comtaarly Letter D -- Coverages 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 p2hcies. Limits shown May have been reduced b paid claims. Ltr. Ins d. Type of Insurance Policy Number 0 Policy Limits ral Liability Commercial General Lia $usmessowners Liability Claims Made Occurrence General Aggregate Limit A Per Location Per Protect X Automobile Liability Any Auto Ali Owned Autos Scheduled Autos Hired Autos X__ Non -Owned Autos Garage i iabnity Any "Auto Umbrella Liability Retention $ Workers' Compenntlen and Employers' Liability 601723096 112/14112 102/27/13 Each Occurrence Damage Rented Premises ea, Occur.) Medical Expenses (Any one person) Personal & Adv. Injury General Aggregate Prod. /Comp. Ops. Aggr. Ca iyftried Sl e Limit 1,000,000 (Each aeddenit tidily lrulur �r i:�e!r5on odt y lryjury Per acc�[1,it Only -Fa. Accident Than Each Accident Limit Each Accident Disease - Ea. Employee Disease - Policv Limit Description of I per,atlo / +ehit ies/ esbictiotta /Special items: 11659 RIVERSIDE DR. #171, LAKESIDE, CA 92040 Certificate Holder Cancellation Should any of the Name PROOF OF COVERAGE before the elalra or & accordance lyyi the Address 56.2492 10.11 2,000,000 above described policies be cancelled date thereof, notice will be delivered in pllcy provisions. 02492201 PIS 1 OF 2 AMEROUT -01 ORMI ,ac CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12114/2012 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). PRODUCER Automatic Data Processing Insurance Agency, Inc 1 ADP Boulevard Roseland, NJ 07068 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. INSR . ......... AbbL U ........ -------------- PCSLIC,CtF" ,...06crty E)fP .. ------ LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD/ fJIMIDD9YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY — c+�^urr..�rr�cel $ m „fl�REMg�F$,Q1va CLAIMS -MADE [ � OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ .,,.......... ..., GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP /OP AGG $ fwR47- POLICY r LOC $ AUTOMOBILE LIABILITY OM9iFgR5 NGLE UMI Laacc4de17N ...$... ..... ., ANY AUTO BODILY INJURY (Per person) $ ALL OWNED _...... SCHEDULED AUTOS AUTOS ( .� BODILY INJURY Per accident . $ AUTO-SWNED PRCVPIERC' t $ HIREDAUTOS QPar ecc�p iGl UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS X � AND EMPLOYE RS' LIABILITY YIN ..,,X,..., TORY ,IMTT$ __ A ANY PROPRIETOR/PARTNER /EXECUTIVE IJUB486MS30612 11/112012 11/112013 E L EACH $ 1,000,00 - OFFICER /MEMBER EXCLUDED NIA (Mandatory in NH) EL DISEASE ASE -EA EMPLOYE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below ................. .............. E L, DISEASE POLICY LIMIT ......--- ,,,,. $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) I.Cr% 1 Iris m 1 C r1ULL0CR EL SEGUNDO POLICE DEPT. ATTN: SARGENT REX FOWLER 348 MAIN STREET El Segundo, CA 90245- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Shillin , Mona From: Garcia, Angelina Sent: Tuesday, December 18, 2012 12:42 PM To: Shilling, Mona Subject: FW: Service Agreement for work on PD vehicles Angelina Garcia From: Garcia, Angelina Sent: Tuesday, December 18, 2012 9:41 AM To: 'Michael Kaddatz' Cc: David Luke Subject: RE: Service Agreement for work on PD vehicles Thanks so much Michael. Have a great day. Angelina Garcia From: Michael Kaddatz [mailto:mkaddatz @bickmore.net] Sent: Monday, December 17, 2012 2:38 PM To: Garcia, Angelina Cc: David Luke Subject: Service Agreement for work on PD vehicles V�i �e Hi Angle, David asked me to take a look at your emails, while he tries to focus on another issue. First, garagekeepers is the "CGL" for organizations that are in the business of selling, repairing or modifying vehicles. So it seems appropriate for this contract. If you're talking on your second question about a waiver of subrogation on WC, yes you should still try to get it. I could see one of the contractor's workers getting injured in a City vehicle and claiming it was from hazard in the vehicle that the City should have warned the contractor about. Let me know if you have questions. Michael Kaddatz, CPCU, ARM Director, Risk Consulting Solutions Bickmore 1100 W. Town and Country Road, Suite 1550 Orange, CA 92868 714.426.8511 mkaddatz@bickmore.net Bickmore Follow us on 0 1 ��:o aarrre,n , ti c,a Ip ai+:aus e irr�� I ini ,� ,r,;0+�^. afl acIie 1 h) / , l.ar���'P„ aarr a °a�:infiu,l+�r7N a.9 �m�wMwrfrrr�a�wri��u����Ilu���V" �r. rWnnw�����:. 1' laa. r, �- a�7rti!' �apgYr�¢ i��r .ria,,.�a��ni,,!�uar�1��a�a} a�C,ria,a 1,10onrr ation ttl a'l i:w Id^sb,!Oy jmr vilo dpa! d If You ,,air- nIA the intor' cl cl l dyuerrl I iirrrrMclfi,ahca y n'loUty nuo by ii7plylarrr to 9 dig :5 a-aia 7H o, I Ialephorie wd ,ii drrw, ;lr.iad Yr,rbr,ryrirsa,aa. +r7,:!rrr +.I i1s „at'I.cr. ^0irrrr&,r9,. rn+ul.hOa.rB rr7;arlurrr.