PROOF OF INSURANCE (2015) CLOSEDs CERTIFICATE OF LIABILITY INSURANCE
DATE (VAMWYYYY)
8!812015
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(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 Risk Strete6les Corn any �IQNTACI —
01 N. Brand Blvd » �uite 650 � �g>�l .. _� sis ash 3o1oW� � l��a�. � saw -274 -0325
Glendale, CA 912'p
INSURED
Coastal Window TTreatrnents Inc.
21926 L adeene Ave
Torrance CA 90503
COVERAGES CERTIFICATE NUMBER: 1 _ 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
INDICATr:6). 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.
LTR TYPE Of&SURANC4 S •� PbLIGY!�VWR Imm uma$
A COIU"RCIAL a9WRAL LIAORM 5094493955 8130/2014 8/3012015 EACH OCCURRENCE 5 1,000,000
CLAIMS -MADE a OCCUR rd MO
S 3001000
a� M£DEkPlAtevane]Iaryan aril S
PERSONAL & ADV INJURY S 1:0m,0m
G£r1 AGGREGATE LIMIT APPLIES PER;
GENERAL AGGREGATE S 2,0000
POLICY RO LOC PRODUCTS j. 2,lQO,JECi ..
S
AUTOMOB" LFASUM a arx paarO ! 5
ANY AUTO BODILY INJURY (Pe( person) S
AUTOS SCHEDULED BODILY INJURY (Per acdgenl) S
HIRED AUTOS AUTOS NED $
A
S
UMBRBLLALI" OCCUR... EACH OCCURRENCE S
EXCE>sBLU18
AGGREGATE S
CLAJMSMA.bE
ED RETENTION s t
YrORKIR$ COMPENSATION
A00 EMKOYIRX IJASIUTY YIN �S . A UTe PR
ANY PROPRIETOMPARTNEWEXECUTIVE E.L. EACH ACCIDENT y S
f PICERPi«r MSER 9KCLUDEO? NIA
IMar,rlaary In NH) E.L. DISEASE. EA EMPLOYE S
E,L DISEASE - POLICY UM T S
MCRI
Prdoay OF flPERATIflitB r LOCATIONS) VEHICLES (ACORD tor, AtlaNdonal Rernorka Sahadula, may ua eltaahatl If rlwne apaCa Is nqulratll
RE: Covered CA Operations Performed By or On Behalf of Named Insured
The City of Ei Segundo, Its officers„ officials, employees, agents and volunteers ere Included as additional Insured as respects to General Liability
where required by written contract, General Liability extends !primary and non - contributory With any other Insurance of the aforementioned additional
insured Where required by written contract..
Citj1 of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
350 Main El eg THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
El Segundo CA 90245 ACCORDANCE WITH THE POLICY PROVISIONS.
AUrHaaalzEa RsdnNTAtnr+£
Mike Christian
1988 -2014 ACORD CORPORATION, All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
25002701 l 2013 -2015 General Liability I areann Hoberman i 6/8/2015 11:15:02 AM (PDY) I Page 2 of 6
CMA5094493955 SB- 146932 -E
Coastal Window Treatments Inc. (Ed. 06111)
6/8/2015
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered
as an additional insured on any other endorsement now or hereafter attached to this Policy.
1. ADDITIONAL INSURED — BLANKET VENDORS
WHO IS AN INSURED is amended to include as an
additional insured any person or organization (referred
to below as vendor) with whom you agreed, because
of a written contract or agreement to provide
insurance, but only with respect to "bodily injury" or
"property damage" arising out of "your products" which
are distributed or sold in the regular course of the
vendor's business, subject to the following additional
exclusions:
1. The insurance afforded the vendor does not apply
to:
a. -"Bodily injury" or "property damage" for which
the vendor is obligated to pay damages by
reason of the assumption of liability In a
contract or agreement. This exclusion does
not apply to liability for damages that the
vendor would have in the absence of the
contract or agreement;
b. Any express warranty unauthorized by you;
c. Any physical or chemical change in the
product made intentionally by the vendor;
d. Repackaging, except when unpacked solely
for the purpose of inspection, demonstration,
testing, or the substitution of parts under
instructions from the manufacturer, and then
repackaged in the original container;
e. Any failure to make such inspections,
adjustments, tests or servicing as the vendor
has agreed to make or normally undertakes to
make in the usual course of business, in
connection with the distribution or sale of the
products;
f. Demonstration, installation, servicing or repair
operations, except such operations performed
at the vendor's premises in connection with
the sale of the product;
g. Products which, after distribution or sale by
you, have been labeled or relabeled or used
as a container, part or ingredient of any other
thing or substance by or for the vendor; or
h. "Bodily injury' or "property damage" arising
out of the sole negligence of the vendor for its
SB- 146932 -E
(Ed. 06/11)
own acts or omission or those of its
employees or anyone else acting on its
behalf. However, this exclusion does not
apply to:
(1) The exceptions contained in
Subparagraphs d. or f.; or
(2) Such inspections, adjustments, tests or
servicing as the vendor has agreed to
make or normally undertakes to make in
the usual course of business, in
connection with the distribution or sale of
the products.
2. This insurance does not apply to any insured
person or organization, from whom you have
acquired such products, or any ingredient, part or
container, entering into, accompanying or
containing such products.
S. This provision 2. does not apply to any vendor
included as an insured by an endorsement Issued
by us and made a part of this Policy.
4. This provision 2, does not apply if "bodily injury" or
"property damage" included within the "products -
completed operations hazard" is excluded either
by the provisions of the Policy or by endorsement.
2. MISCELLANEOUS ADDITIONAL INSUREDS
WHO IS AN INSURED is amended to include as an
insured any person or organization (called additional
insured) described in paragraphs 2.a. through 2.h.
below whom you are required to add as an additional
insured on this policy under a written contract or
agreement but the written contract or agreement must
be:
1. Currently in effector becoming effective during the
term of this policy; and
2. Executed prior to the "bodily injury," "property
damage" or "personal and advertising injury," but
Only the foilowing persons or organizations are
additional insureds under this endorsement and
coverage provided to such additional insureds is
limited as provided herein:
a. Additional Insured — Your Work
That person or organization for whom you do
work is an additional insured solely for liability
25002701 1 20I4 -2015 General Liability j Breann Hoberman I o /e /2oi5 ll:ls:o2 Am /Pars 1 Page 2 of 6
Page 1 of 5
due to your negligence specifically resulting
from your work for the additional insured
which is the subject of the written contract or
written agreement. No coverage applies to
liability resulting from the sole negligence of
the additional insured.
The insurance provided to the additional
insured is limited as follows:
(1) The Limits of Insurance applicable to the
additional insured are those specified in
the written contract or written agreement
or in the Declarations of this policy,
whichever is less. These Limits of
Insurance are inclusive of, and not in
addition to, the Limits of Insurance shown
in the Declarations.
(2) The coverage provided to the additional
Insured by this endorsement and
paragraph F.S. of the definition of "insured
contract" under Liability and Medical
Expenses Definitions do not apply to
"bodily injury " or "property damage"
arising out of the "products - completed
operations hazard" unless required by the
written contract or written agreement.
(3) The insurance provided to the additional
insured does not apply to "bodily injury,"
"property damage," or "personal and
advertising injury" arising out of the
rendering or failure to render any
professional services.
b. State or Political Subdivisions
A state or political subdivision subject to the
following provisions:
(1) This insurance applies only with respect
to the following hazards for which the
state or political subdivision has issued a
permit in connection with premises you
own, rent, or control and to which this
insurance applies:
(a) The existence, maintenance, repair,
construction, erection, or removal of
advertising signs, awnings, canopies,
cellar entrances, coal holes,
driveways, manholes, marquees,
hoistaway openings, sidewalk vaults,
street banners, or decorations and
similar exposures; or
(b) The construction, erection, or
removaE of elevators; or
(2) This insurance applies only with respect
... to operations performed by you or on your
behalf for which the state or political
subdivision has issued a permit.
SB- 146932 -E
(Ed. 06111)
This insurance does not apply to "bodily
injury," "property damage" or "personal and
advertising injury' arising out of operations
performed for the state or municipality.
c. Controlling interest
Any persons or organizations with a
controlling interest in you but only with respect
to their liability arising out of:
(1) Their financial control of you; or
(2) Premises they own, maintain or control
while you lease or occupy these
premises.
This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for such additional
insured.
d, Managers or Lessors of Premises
A manager or lessor of premises but only with
respect to liability arising out of the ownership,
maintenance or use of that specific part of the
premises leased to you and subject to the
following additional exclusions:
This insurance does not apply to:
(1) Any "occurrence" which takes place after
you cease to be a tenant in that premises;
or
(2) Structural alterations, new construction or
demolition operations performed by or on
behalf of such additional insured.
a. Mortgages, Assignee or Receiver
A mortgagee, assignee or receiver but only
with respect to their liability as mortgagee,
assignee, or receiver and arising out of the
ownership, maintenance, or use of a premises
by you.
This insurance does not apply to structural
alterations, new construction or demolition
operations performed by or for such additional
insured.
f. Owners/Other Interests — Land is Leased
An owner or other interest from whom land
has been leased by you but only with respect
to liability arising out of the ownership,
maintenance or use of that specific part of the
land leased to you and subject to the following
additional exclusions:
This insurance does not apply to:
(1) Any "occurrence" which takes place
after you cease to lease that land; or
S8- 146932 -E Page 2 of 5
(Ed. 06111)
25002701 1 2014 -2025 General LiabiLlq. i Bream Fioberman 1 5/8/2015 11:15:02 AM (PDT) I Page 3 of a
CNA SB- 146932 -E
(Ed. 05111)
(2) Structural alterations, new
Damage To Property, is replaced by the
construction or demolition operations
following:
performed by or on behalf of such
additional insured.
k. Damage 7o Property
9 P rty
g. Co -owner of Insured Premises
"Property damage" to:
A co -owner of a premises co -awned by you
1. Property You own, rent or occupy,
and covered under this insurance but only
including any costs or expenses
with respect to the co- owners liability as co-
incurred by you, or any other person,
owner of such premises.
organization or entity, for repair,
replacement, enhancement,
h. Lessor of Equipment
restoration or maintenance of such
Any person or organization from whom you
property for any reason, including
lease equipment. Such person or organization
prevention of injury to a person or
are insureds only with respect to their liability
damage to another's property;
arising out of the maintenance, operation or
2. Premises you sell, give away or
use by you of equipment leased to you by
abandon, if the "property damage"
such person or organization. A person's or
arises out of any part of those
organization's status as an insured under this
premises;
endorsement ends when their written contract
or agreement with you for such leased
3, Property loaned to ou
p Y you;
equipment ends.
4. Personal property in the care,
With respect to the insurance afforded these
custody or control of the insured;
additional insureds, the following additional
S. That particular part of any real
exclusions apply:
property on which you or any
This insurance does not apply:
contractors or subcontractors working
directly or indirectly in your behalf are
(1) To any "'occurrence " which takes place
performing operations, if the "property
after the equipment lease expires; or
damage" arises out of those
(2) To "bodily injury," "property damage" or
operations; or
"personal and advertising injury" arising
S. That particular part of any property
out of the sole negligence of such
that must be restored, repaired or
additional insured.
replaced because "your work" was
Any insurance provided to an additional insured
incorrectly performed on it.
designated under paragraphs b. through h, above
Paragraph 2 of this exclusion does not
does not apply to "bodily injury" or "'property
apply if the premises are "your work" and
damage" included within the "products- completed
were never occupied, rented or held for
operations hazard."
rental by you.
3. The following is added to Paragraph H. of the
Paragraphs 1, 3, and 4, of this exclusion
BUSINESSOWNERS COMMON POLICY
do not apply to "property damage" (other
CONDITIONS:
than damage by fire or explosion) to
H. Other Insurance
premises:
4. This insurance is excess over any other
(•f) rented to you:
insurance naming the additional) insured
(2) temporarily occupied by you with the
as an insured whether primary, excess,
permission of the owner, or
contingent or on any other basis unless a
(3) to the contents of premises rented to
written contract or written agreement
you for a period of 7 or fewer
specifically requires that this insurance be
consecutive days.
either primary or primary and
noncontributing.
A separate limit of insurance applies to
Damage To Premises Rented To You as
4. LEGAL LIABILITY — DAMAGE TO PREMISES
described in Section D — Liability and
A. Under B. Exclusions, 1. Applicable to
Medical Expenses Limits of Insurance.
Business Liability Coverage, Exclusion k.
SS- 146932 -E Page 3 of 5
(Ed. 06111)
25002701 1 2019 -3015 General Liability j Bream. Hobermatt I 6/e /201= 11;15:02 Al {p17r) 1 page 4 of 6
Paragraphs 3, 4, 5, and 6 of this
exclusion do not apply to liability
assumed under a sidetrack agreement.
Paragraph 6 of this exclusion does not
apply to "property damage" included in
the "products - completed operations
hazard."
8. Under B. Exclusions, 1. Applicable to
Business Liability Coverage, the last
paragraph of 2. Exclusions is deleted and
replaced by the following;
Exclusions c, d, e, f, g, h, i, k, I, m, n, and o,
do not apply to damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner or to the
contents of premises rented to you for a
period of 7 or fewer consecutive days. A
separate limit of insurance applies to this
coverage as described In Section D. Liability
And Medical Expenses Limits Of
Insurance.
C. The first Paragraph under item S. Damage To
Premises Rented To You Limit of Section
D. Liability And Medical Expenses Limits
Of Insurance is replaced by the following:
The most we will pay under Business Liability
for damages because of "property damage"
to any one premises, while rented to you, or
temporarily occupied by you, with the
permission of the owner, including contents of
such premises rented to you for a period of 7
or fewer consecutive days, is the Damage to
Premises Rented to You limit shown in the
Declaration.
6. Blanket Waiver of Subrogation
We waive any right of recovery we may have
against:
a. Any person or organization with whom you
have a written contract that requires such a
waiver.
G. Broad Knowledge of Occurrence
The following items are added to E.
Businessowners General Liability Conditions
in the Businessowners Liability Coverage
Form:
e. Paragraphs a. and b. apply to you or to any
additional insured only when such
.occurrence," offense, claim or "suit" is known
to:
(1) You or any additional insured that is an
individual;
SB- 146932 -E
(Ed. 06111)
(2) Any partner, if you or an additional
insured is a partnership;
(3) Any manager, if you or an additional
insured is a limited liability company;
(4) Any "executive officer" or insurance
manager, if you or an additional insured is
a corporation;
(6) Any trustee, if you or an additional
insured is a trust; or
(G) Any elected or appointed official, if you or
an additional insured is a political
subdivision or public entity.
This paragraph a. applies separately to you
and any additional insured.
7. Bodily Injury
Section F. Liability and Medical Expenses
Definitions, item 3. "Bodily Injury" is deleted and
replaced with the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by a person, including death,
humiliation, shock, mental anguish or mental
injury by that person at any time which results as
a consequence of the bodily injury, sickness or
disease.
8, Expanded Personal and Advertising Injury
Definition
a. The following is added to Section F. Liability
and Medical Expenses Definitions, item 14,
Personal and Advertising Injury, in the
Businessowners General Liability
Coverage Form:
h. Discrimination or humiliation that results in
injury to the feelings or reputation of a natural
person, but only if such discrimination or
humiliation is:
1. Not done intentionally by or at the
direction of:
a. The insured; or
b. Any "executive officer," director,
stockholder, partner, member or
manager (if you are a limited liability
company) of the insured; and
2. Not directly or indirectly related to the
employment, prospective employment,
past employment or termination of
employment of any person or person by
any insured.
b. The following is added to Exclusions, Section
B.:
SB- 146932 -E Page 4 of 5
(d. 06111)
25002701 1 2014 -2015 General Liability ! 9 NAnU Hoa+ecmaR j G /0/ 015 11 :15:02 AM Mr) I Page 5 of 6
t T
(16) Discrimination Relating to Room,
Dwelling or Premises
Caused by discrimination directly or
indirectly related to the sale, rental„ lease
or sub -lease or prospective sale, rental,
lease or sub -lease of any room, dwelling
or premises by or at the direction of any
insured.
(IS) Fines or Penalties
Fines or penalties levied or Imposed by a
governmental entity because of
discrimination,
c. This provision (Expanded Personal and
Advertising Injury) does not apply if
SB- 146932 -E
(Ed. 06/11)
Personal and Advertising Injury Liability is
excluded either by the provisions of the Policy
or by endorsement.
S. Personal and Advertising Injury Redefined
Section F. Liability and Medical Expenses
Definitions, item 14, Personal Advertlsing injury,
Paragraph c. is replaced by the following:
e. The wrongful eviction from, wrongful entry
inter, or invasion of the right of private
occupancy of a room dwelling or premises
that a person or organization occupies
committed by or on behalf of it's owner,
landlord or lessor.
25002761 1 2014 -2015 Genera? Liability ! Brea= HotCernwn j 6/8/2615 11:15:02 AN ;PCT) I page 6 of 6
Page 5 of 5
DATE (MWDD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 8/27/2015
.... .�... ........................._ _......................_...._ �..�.
THIS CERTIFICATEIS 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 SUBROGATIONIS 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).
UNITED AGENCIES INC /VIII /PHS
255656 P :(866) 467 -8730 F :(888)
PO BOX 33015
SAN ANTONIO TX 78265
INSURED
467-8730___.. ): ( 888) 443 -6112
(A^iC, Nru. Est): (8 6 6) i(Aa N °...
4 4 3 - 6112 A DRESS:
COASTAL WINDOW TREATMENTS, INC INC.
21926 LADEENE AVE
TORRANCE CA 90503
COVERAGES CERTIFICATE NUMBER:
INSURER(S) AFFORDING COVERAGE
INSURERA: Hartford Accident & Indemnity Co
INSURER B.....,.,...�... ......�. ......... .._.
INSURER
INSURER D..� ................. .. ............................._.
INSURER E:
INSURER F ; ... �.,....., ��. � .......... ........�.�.......�.�...�,�....
REVISION NUMBER:
NAIC*
THIS IS TO CERTIFY THAT THE POLICIES mmmOFmm INSURANCE mmmPOLICY
LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE P
..... 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,
...... .... ........ __ ............. ..........................._...
INSR TYPEOFLNSURANCE ADDL SUBR POLICYNUMBER POLICYEFF POLICYEXP LIMITS
ro i,NngmnivyyYi iMnsmnrvvvvi
. . ....... .. ..............
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE ,, ITITmm
ry DAMAGEmmTO RENTEDmm
CLAIMS -MADE (OCCUR mm
PREMISES (Ea occurrence) ')
MED EXP (Any one person)
PERSONAL &ADV INJURY _.... ..�.� ..........................
r%Ntl. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
POLICY PRO- ❑ LOC PRODUCTS - COMP /OP AGG
.... JECT
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
A AUTOS X 72 UE;C ZN7938 02/03/2015 02/03/2016 BODILY INJURY ( Per accident )
UTOS
X HIRED AUTOS' X NON -OWNED PROPERTY DAMAGE$
AUTOS (Per accident)
........ _........... _ ................. ..........._u..... ......., ��....._. ..............._...............
UMBRELLA LIAB OCCUR EACH OCCURRENCE ..
_..... _ ..................... ..................... .... ...... .......
.�
EXCESS LIAB CLAIMS -MADE AGGREGATE
DE RETENTION $
WORKERS COMPENSA T /ON PER OTR-
AND EMPLOYERS'L/ABIl /TY STATUTEERW.....
ANY PROPRIETOR/PARTNER /EXECUTIVE YIN E EACH ACCIDENT
OFFICER /MEMBER EXCLUDED? N/A
(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 (ACORD 909, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insured's Operations. Certificate holder is an Additional
Insured per the Commercial Auto Broad Form Endorsement HA99160312 attached to
this policy.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
City of El Segundo AUTHORIZED REPRESENTATIVE ITITITmmmmmmmmmmm
350 MAIN ST
EL SEGUNDO, CA 90245 /
.....
. _ .... _ _ ._ ._.—. _.
1988 -2'014 ACORD CORPORATION, All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
Coastal
01n.,
June 5, 2015
Attn: City of El Segundo
Re: Business Automobile friability Insurance and Worker's Comp
1, Josh Flink, President of Coastal Window Treatments, certify that all my
Installers are independent contractors.
Coastal Window Treatments is Incorporated, and does not carry Business
Workers Comp Insurance.
Thank you,
Joshua Flink
MIMEM