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PROOF OF INSURANCE (2013) CLOSEDAC ` CERTIFICATE OF LIABILITY INSURANCE MIDD /YYYY) 4i/25/212512012 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('lies) 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 CONTACT MHBT Inc. PHONE" 14X 8144 Walnut Hill Lane, 16th FI ac a eatt)a�a 2.774 .1� Q ......... lac., Np). 7, - 77(n -14 Dallas TX 75231 ADDRESS,, TNSURER(Sl AFFORDING OVERAGE NAIC # __._.._ ...... ......... _ _ ....... _ INSURER A QId Re ubliInsurance Qo ,. INSURED INSURER B "I I ,____________ ,,,, ,,,,,,,,, .ee, ,,,,,,,,, , ........ ...,, Los Angeles Area Council #33 INSURERC. Boy Scouts of America INSURER D : 2333 Scout Way .......,m... Los Angeles CA 90026 !N§PRER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 100848768 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rN$RR ..... TYPE OF INSU. _... JAODL SU -# ........... e POLICY RANCE WVD POLICY NUMBER MM/DD/YYW MPOLICY EXP M /DD(IiYYY LIMITS A GENERAL LIABILITY " iv1WZY59555 3/1/2012 /1/2013 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY A MWZX26709 3/1/2012 /1/2013 DAMAt,-F O R r `N'°Ir $ PREMISES (Ea Kyccaarre"(1cQ) CLAIMS MADE �X �! OCCUR MED,EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP /OP AGG $ X POLICY PRO - JECT (. i.C1C $ AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED _ ___., ....... . AUTOS AUTOS BODILY INJURY (Per accident) $ ,..e........... NON -OWNED PROPERTI' 17,4MAGE ,�, HIRED AUTOS AUTOS (Par accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION i WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TCR.Y la(MET.? . F„R.._. ANY PROPRIETOR /PARTNER/EXECUTIVE - OFFICER/MEMBER EXCLUDED ?... N/A E L EACH ACCIDENT $ (Mandatory in NH) E L DISEASE - EA EMPLOYEE $ If yes, describe under .- ....._. _ DESCRIPTION OF OPERATIONS below E,L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named as an additional insured by virtue of a written or oral contract or by the issuance /existence of a permit or certificate of insurance but only with respect to operations by or on behalf of the Insured, or to facilities of, or facilities used by the Insured and then only for the limits of liabilit specified in such contract for the event specified herein. Malcolm Au "s Eagle Scout.. Project, real <down and rebuifd a fire circle, install drainage system for a water spigot, and painting a mural wall at Camp Eucalyptus on May 19-20„ and June 2 -3, 2012, This certificate verifies that Troop 762 and registered BSA volunteers have primary coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF EL SEGUNDO ACCORDANCE WITH THE POLICY PROVISIONS. 350 MAIN STREET EL SEGUNDO CA 90245 AUTHORIZED REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD G ��) � \ \��� � \? ..� ����� ���� � %�� ���I�� �� \��2/ |. /