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PROOF OF INSURANCE (2012) CLOSEDL �11 CERTIFICATE 0% LIABILITY INSURANCE ( DATE M4' °zoii 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. u IMPORTANTy If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to — the Ip 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 ondorsornentfs). PRODUCER RANSOL FINANCIAL & MARKETING INSURANCE 3598 BEVERLY BLVD LOS ANGELES INSURED .... �.....�.........�......... CITY OF SANTA CLARITA CA 90004 D: 213 - 487 -4900 PROGRESSIVE CASUALTY COMPANY - 487 -65 23920 VALENCIA BLVD. INSURER E SANTA CLARITA, CA 91355 lj�SURER F, 'I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S 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. INspS(M ..�...._��.,,__. ......,.�.. ..._._._ I�!d EF'F PC6LICY E91P T ., TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABIUTY CiA1MS•W4dA0E [_�] OCCUR I MEP .EP (Ar),ony arson $ PERSONAL 8 ADV INJURY S _ GENERALAGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S POLICY P'R LOC AUTOMOBILE UAeILm 04317391 -7 04 -14 -11 04 -14 -12 1 L LIMI ti- ANY AUTO BODILY INJURY (Per person) $ B '.. ALL OWNED SCHEDULED BODILY INJURY (Per ecclden() AUTOS NON -OWNED PROPERTY pwM1MADE HIRED AUTOS AUTOS ?�LIRR{4 r.W $ -.... ...... a UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _ EXCESS LIAa CLAIMS-MADE AGGREGATE $ D I anewjom S COMPENSATION WORKERS STATU- 0TH- ANDEMPLOYERS'LIA LIABILITY Y!N YET ��... .. ANYPROPRIETOWPARTNERlEXECUTIVE E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? ❑ NIA (Mendatory In NH) E L DISEASE EA EMPLOYE S If yes, describe under .. DESCRIPTION OF OPERATIONS below ESL. DISEASE • POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more spars Is required) CITY OF EL SEGUNDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WrTH THE POLICY PROVISIONS. 150 IILINOIS ST. AUTHORIZED REPRESE' 'TATNE EL SEGUNDO. CA 90245 ✓ i Q 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD OP ID: HF CERTIFICATE OF LIABILITY INSURANCE DATE {? 05/103/:1 03111 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 WANED, 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 a . PRODUCER 951- 676.3365 A E. United Agencies, Inc. (M) 951 X76 -3020 CA License #0252838 PHONE 27403 Ynez Rd., Ste. 110 Temecula, CA 92591 EACH OCCURRENCE Ryan E. Hollander , IOpILBELLB -1 _.__.., X COMMERCIAL 11 SURER. )AF'FORDINGCOVERAOE NAIC* .........m.. INSURED Chan Hoe Yang INSURER A: Landmark American Insurance Bell Building Maintenance Co. INSURER a Preserver Insurance Com n 5170 Sepulveda Blvd., #180 _ —' °° ' - " " " "_ Sherman Oaks, CA 91403 NSURE R C INSURER D : INSURER E : _ INIURER F; COVERAGE'S CERTIFICATE NUMBER: REVISION NUMBER: 1 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. __ _ &N' TYPE OF INSURANCE POLICY NUMSER MIA LIMITS . ......�. GENERAL LIABILITY '. EACH OCCURRENCE S 1,000.00 A X COMMERCIAL X X LBA100$8900 01/10/11 01/10112 PREMISESW a owulren. ®....._.. .. 10I 0 CLAIMS-MADE � OCCUR �IIAS MED F,CP (Any one person) S T.� _ PERSONAL 8 ADV INJURY S 1.00 ... . ........................ .... ......._ ..... _..�_i�_........w......,...�.._ GENERAL AGGREGATE .�,.. $ 2,00 G AGGREGATE LIMIT APPLIES PER: EN' LA PRODUCTS - COMPIOP AGG � 1,00 X POLICY N .PICT LOI:. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Es accident) „ ANY AUTO BODILY INJURY (Per person) S ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AU 70S PROPERTY DAMAGE .............. HIRED AUTOS (Peracadent) S NON -OWNED AUTOS .�......._.....g.,_..._._.... S UMBRELLA LWB I L I OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ �.� , ...... RETENTION $- $ WORKERS COMPENSATION X TH- AND EMPLOYERS' LIABILITY YIN B ANY PROPRETORIPARTNERIEXECUTIVE CC 0004991 '.... 05102111 05/02/12 E.L. EACH ACCIDENT S 1,000 00 OFFIC'ER(MEMBE'FR EXCLUDED? ❑ N/A (MwAslory to NH) E.L. DISEASE -EA EMPLOYE $ 1,000,00 UD SCRIPTIO rOF OPERATIONS Uolow E.L. DISEASE -POLIC Y LINT uMIr $ 1,000,00 i I ESCRIPT*N � TIO1�ISI LOCATIONa EHMLESjorji tC)Or IR13 1. A401 r"ky Sch#d l*, H moro spate Is required) IVhe CI of�I�a undo an Its ic�'als m o t� � insure Iwt a an ems are a r ttlGrounder In rotation to those operations uses occupations, acts and lactivities dmscribed generally above with rogardf to operations performed by or on behalf of the named Insured. Coverage, is primary & non-contributory; waiver of sub o atlon Irpplies. ELSEGUN 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. PUBLIC WORKS 150 ILLINOIS ST AUTHORIZED REPRESENTATIVE EL SEGUNDO, CA 90245 ©1"988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: LBA100289 COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES O CONTRACTORS S _ SCHEDULED PERSON OIL ORGANIZATION This endorsement modifies insurance provided under the following.. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF EL SEGUNDO ITS OFFICIALS, OFFICE , MPLOYEES, AGENTS AND VOLUNTEERS 350 MAIN STREET EL SEGUNDO CA 90295 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured 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 ongoing operations performed for that insured. B. With respect to the additional insureds, added: 2. Exclusions insurance afforded to these the following exclusion is This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional insureds) at the site of the cov- ered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 © ISO Properties, Inc., 2000 Page 1 of 1 0