PROOF OF INSURANCE (2013) CLOSEDALOVD- CERTIFICATE OF LIABILITY INSURANCE
DATE (MM,IDDiYYYY)
T
100111,10 ON
TO ilw a'
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INSUR -1- Unit at s Labili t 95
258
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at _ e_ i- , , � " , Y" I'll, � I
.TNS�U��R B State Comip Ins Fund 35076
INSURER R C
N_.� _ __ . ....... . . ........ . . . . . ......
SURER D . ......
'_LR
... ....... ..... --- - ---------
INSURER E
COVERAGES
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 AGGRE".GATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
— -------- - - - - -------
':""I 'C', E 11
40�VYV� DA LIMITS
01 Al U � M
GENERAL LIABILITY EACH OCCURRENCE S
�'PMMERCIAL GENERAL LIABILITY
ti V;
CLAINISMADE L&I OCCUR MED EXP�A y one q
A Y MTK1000527C 05-01-12 05-01-13 PERSONAL &ADVINJURY
GENERAL AGGREGATE 000;
2 0
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOPAGG S
POLICY
AUTOMOBILE L IABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-O"'NEDAUTOS
COMBINED SINGLE LIMIT
(Ea acc dent)
BODILYlNJURY
(Per person) S
_ ............ ..
PROPERTY DAMAGE
(Peracciclentl
_GARAGE LIABILITY
AUTO ONLY- EAACCIDENT $
ANYAUTO
OTHER THAN . . . . ......
AUTOONLY
'EX I CESSIUMBRELL I A LIABILITY
EACH OCCURRENCE
OCCUR CLIVNIS r4ADE
AGGREGATE
. . ......
DEDUCTIBLE
RETENTION
V NIP I '!'c F Iq S L flr,llli „r 1949056
01-01-12 01-01-13 "E,L EACHACCIDENT $ 000_'
B
'1"
LL DISEASE EAEMPLO EMPLOYEE S
. . .........
E L DISEASE POLICY HM
Occ:urence
AjProfessional MTKI000527C
$1,000,000 Aggregate
Liability-_____
:05-01-12 05-01-13 Claims Made
UESC411 , 7 ON iLd o W^ pllkN :)Ns' p AC'PTR)hK: "/FK� Fs: I W1 M)Nll o'u MNMT) W " W W i GIAL PROVISIONS
Consulting, programming and hosted software services.
Coverage (C) Company "All Business Personal Property and General Liability Incl
Bus Pers Prop added by endorsement @ $50,000
POLICY NUMBER: MTKI000527C COMMERCIAl.., GENE Al., LIABI1..,ITY
THIS ENDORSEMENT CHANGES T14E POLICY, PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - OWNERS, LESSEES 01
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENEF l- LIABILITY COVERAGE PART.
WHO IS AN INSURED (Section 11) is amended to include as an Insured the person or
organization shown in the Schedule, but only with respect to liability arising out of
-your work" for that insured by you.
CG 20 10 11 85 Copyright, Insurance Services Office, Inc. 1984
Endorsement
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - PRIMARY COVERAGE
This endorsement modifies insurance provided under the following:
C K� )ului�:Z�1�1[e7�►1�1,7�11if1:: l LK�I� /�1:7:te7�7,1�7M
It is agreed that any person or organization described below is an additional insured, but
only with respect to liability arising out of operations performed for the additional
insured by or on behalf of the named insured.
The insurance afforded to such additional insured is primary and shall not contribute in
any way with any other insurance which such additional insured may have.
All other endorsements, provisions, conditions, and exclusions of this insurance shall
remain unchanged and apply to the additional insured described below.
ADDITIONAL INSURED TYPE OF OPERATION PROJECT LOCATION
"The City of El Segundo, its officers, officials, agents and volunteers"
PER CERTIFICATE ATTACHED
AGENT: Wright Insurance Services/Signature:
POLICY NO.: MTK 1000527C
CG 76 0106 87 Copyright, Insurance Services Office, Inc. 1984