PROOF OF INSURANCE (2011) CLOSEDACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE
- 2aJ
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TECHINSURANCE GROUP LLC /PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
505301 P:(866)467-8730 F:(877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO BOX 33015
SAN ANTONIO TX 78265
INSURED
PROGRESSIVE SOLUTIONS
PO BOX 783
BREA CA 92822
............................... ............................... ................. ................. _. .... .........................
COVERAGES
INSURER A: Hart
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
INSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURERS AFFORDING COVERAGE
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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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.............. ._ ............ .
I AUTO ONLY - EA ACCIDENT I S
OTHER THAN EA ACC
INSRI p POLICY EFFECTIVE
LTR ........................ .....................TYPE,OF... INSURANCE................----------- - -.5 -. POLICY NUMBER ....... DATE (MMfDD R ..-
POLICY EXPIRATION
.�.......DATE MMfD�b R7`
II LIMITS
LIABILITY
S
EAC1 -li OCCURRENCE
$10000e000
,GENERAL
A
1 COMMERCIAL GENERAL LIABILITY 4 6 SBA R 19 3 9 9 04/10/10
04/10/11
I FIRE DAMAGE IA., one fire)
CLAIMS MADE I X l OCCUR
L MED EXP (Any one person)_
$10 , 0 0 a
X9
General Llab
E.I.., MSEASE - EA EMN.GVEE
I PERSONAL & ADV INJURY
$1 , 0 0 0, 0 0 0
.................
I GENERAL AGGREGATE
l S2 , 0 0 0, 0 0 0
GEN'L AGGREGATE LIMIT APPLIES PER:
I PRODUCTS - COMPIOP AGG
s2, 0 O 0, O 0 0
PRO-
POLICY I —LX--1 LOC
.IEI:T
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$1,000,000
A
ANY AUTO 46 SBA RI9399 04/10/10
04/10/11
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
X
HIRED AUTOS
BODILY INJURY
$
X
NON-OWNED AUTOS
Per accident)
GARAGE LIABILITY
I ANY AUTO
EXCESS LIABILITY
........ ....................
I OCCUR [__I CLAIMS MADE.
DEDUCTIBLE
AETEN "P`IDN S
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER
PROPERTY DAMAGE
$
IPer accident)
.............. ._ ............ .
I AUTO ONLY - EA ACCIDENT I S
OTHER THAN EA ACC
$
AUTO ONLY: AGG...
$
EACH OCCURRENCE
S
I... A G G R E G A T E ......................................................................
I.... 5.............................................. ..................,,,,,,,,,,,,,
I.....
I$
..
B
lC S'Sp,.- '°0..
AT 0 10
"1 f
f ..Y IM E
E . EACH ACCIDEN "F
$
E.I.., MSEASE - EA EMN.GVEE
S
E.L. D0SEASE - POI.. CY L1M0 "0
$
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Those usual to Insured's operations. Certificate holder is named as Additional
Insured.
ADDITIONAL INSURED; INSURER LETTER::
Office of The City Clerk
Patti Adlen
350 Main Street
El Segundo, CA 90245 -3895
ACORD 25 -S (797)
OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE 00 DAYS FOR NON-PAYMENT► TO THE CERTIFICATE
ILDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
'LIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PRESENTATIVE&
t' °" ACORD CORPORATION 1988
CERTHOLDER COPY
P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 12 -31 -2008
CITY OF EL SEGUNDO
BUILDING & SAFETY DEPARTMENT
350 MAIN STREET
EL SEGUNDO CA 90245
GROUP: 000625
POLICY NUMBER: 0000187 -2009
CERTIFICATE ID: 2
CERTIFICATE EXPIRES: 12-31 -2010
12- 31- 2008/12 -31 -2010
SP JOB:ALL CALIFORNIA OPERATIONS
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
IgK�,
THORIZED REPRESENTATI PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #1600 - GLENN R. VODHANEL, PRESIDENT - EXCLUDED.
ENDORSEMENT #1600 - YOLANDE C VODHANEL, SEC - EXCLUDED.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12 -31 -2001 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
PROGRESSIVE SOLUTIONS, INC.
PO BOX 783
BREA CA 92822
$P
M0408
{REV.2 -051 PRINTED : 11 -17 -2008
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