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PROOF OF INSURANCE (2013) CLOSEDOP ID: AR CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDIYYYY) 07/03/12 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 pol)cy(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 76071 -7116 C N A 'T NAME. Alliance Mgt. & Insurance Sery 760 71 P44ONE FAX 355 Via Vera Cruz #7 -9378 .. N% I�4): ............ ..... �iac- -- �AflL CA Agent/Broker Lic# 0737966 $ 1,000,00 San Marcos, CA 92078 ADDRESS •- ---- ----- - - -- WilliamR. West ...................................... ............................... — ..........__. SE -CGL- 0000007013 -01 INSURERS AFFORDING COVERAGE NAIC INSURED y enn $r Associates -- ° -- - -- - - - - -- ....... __... INSURER A: First MercU Insurance Co. 81 5 S Central Ave #20 Glendale, CA 91204 INSURER B: INSURER C : INSURER D MED EXP (Any one p erson) 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 6'LTR._�.—____ ..................... ..., DDL .......... PL:G � �F1 P�SLIdY E %F" _ TYPE OF INSURANCE POLICY N.... LTR UMBER tMMIDD/YYYY MMIDDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY SE -CGL- 0000007013 -01 03/06/12 03/06/13 DAMAGE TO GFNTE10 PREMISES (Ea cunt9pe) $ 100,00 CLAIMS -MADE X OCCUR MED EXP (Any one p erson) ............... $ 5,00 .... ........ X Errors & Omission PERSONAL & ADV INJURY $ 1,000,00 XJ Owners & Contract GENERALAGGREG ATE $ 5,000,00. _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Inc / in Agg X POLICY PICt LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ ............................... ....................w HIRED AUTOS (Per accident) NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE ATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- ANDEMPLOYERS' LIABILITY YIN - .._._.._.....,TORL.IJMjTS_ W......... ,_ER ,- .................... ANY PROPRIETOR /PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? F—] NIA . .•.... (Mandatory in NH) E L. DISEASE - EA EMPLOYEE $ yes, describe under DESCRIPTION OF OPERATIONS below E L OISC'ASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Proof of insurance only. This certificate is void if altered. Certificate holder may be added upon request. Investigation, CA -- Unique Sports,.-----. . c jj dba: Wyenn & Associates, ,. S 815 S Central Ave #20 Glendale, CA 91204,, 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 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:SE-CGL-0000007013-02 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons)Or O an¢atio s 01ity of El Segundo 50 Main St -I Segundo CA 90245 Information Muired to com lete this Schedule if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or missions or the acts or omissions of those acting on your behalf A In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDINGIDELETING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART In consideration of a $50 flat,fully earned additional premium, the following endorsement(s)are either added to, or deleted from, the policy, the effective date as of the date shown below: AD TED MB CG 20 26(07/04)-ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION City of El Segundo 350 Main St El Segundo CA 90245 6 Am g .°° ...... .,.....���, ....... ......., :a"s ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. This endorsement forms a part of the Policy to which attached, effective on the inception date of the Policy unless otherwise stated herein. (The following information is required only when this endorsement is issued subsequent to preparation of the Policy.) Endorsement effective 08/15/2013 Policy No. SE-CGL-0000007013-02 Change No. 1 Named Insured Unique Sports Accessories Inc(DBA)Wyenn&Associates e , Countersigned by ....... .... , _ --- --� (Authorized Representative) FMIC-GL-2200{11!2011) Page 1 of 1 CALIFORNIA ALLSTATE PROOF OF AUTO INSURANCE CARD You' re in good hands. ALLSTATE INDEMNITY COMPANY NAIC 19240mmmIT .._ __ ,. ._ 1819 ELECTRIC ROAD, SW, ROANOKE, VA 24018 THOUSAND OAKS CA 91362 This policy meets the requirements of the applicable California financial responsibility law(s) . POLICY NUMBER YEAR MAKE MODEL 934083194 2010 ELANTRA EFFECTIVE DATE VEHICLE ID NUMBER 0312012012 EXPIRATION DATE 09/20/2012 If you have an accident or loss: - Get medical attention if needed. - Notify the police immediately. - Obtain names, addresses, phone numbers (work & home) and license plate numbers of all persons involved including passengers and witnesses. - Call 1-800-ALLSTATE (1-800-255-7828) , logon to allstate.com or contact your Allstate agent or broker. Mike Krupka BUS: (818) 407-1672 22024 Lassen St Chatsworth CA 91311 U96884