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PROOF OF INSURANCE (2016) CLOSED
Client#: 32476 TRAIN3 DATE { ACORD,., CERTIFICATE OF LIABILITY INSURANCE 9!25!2095 MMIODlYY(Y) 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 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 endorsrxment(s), PRODUCER NA;; -- L auren Castellanos Arroyo Insurance Services PHONE F rr 626 799 9532 F � 626 294 -9072 Albert C. Simonds &Cam an EMAIL _.. m iArcNr, Company opw�� IaurenG�arroyoins.c'orTt 440 E. Huntington Dr. #100 E . µ ..NAICN Arcadia CA 99006 iNSURER(S)AFFORDINGCO VfRAGE AIC Western World insurance Co. INSURED INSURER 8: Bruce Sherman dba: Trains on the Move, "�'� INSURER C A Plus Promotions & Collectibles INSURER D 17120 Ermanita Avenue INSU E Torrance, CA 90504 ___R_._. ER 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 CONTRACTOR 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. Lyn IADD I"^!D POLICY_w % lc _... � Lyn ?ADOL U 'R _ .mi°0 I Y EFy� PO 1�CY EkP LIMITS TYPE OF INSURANCE 4 NUMBER m�0g0Yy_YY !6t0G #YYY A X COMMERCIAL GENERAL LIABILITY NPP8214724 0611012015 061101201 EACH OCCURRENCE S1.000.000 AMAGEF,TORENf6 -D m_. ..m,___,.....,.m... -.� CLAIMS -MADE X OCCUR OO.00O ..... ,u RFMISS IEa ecC4r7e�....cel T�...,.., ME_p EXP fAnV one person! SrJ.O_OO PERSONAL6ADVINJURY'S9 OOO.00O. ~ AGGREGATE A _LIES _..R: GENERAL AGGREGATE s2µ.000'0. N GEN L AGGREGATE LIMIT APPLIES PER: OO PRO. POLICY FI JECT LOC PRODUCTS- COMPIOPAGO slnciuded OTHER: AUTOMOBILE ._.._....�,W_...,..._.m. �.',. 11 S OMOBILELIABILITY Or.7B'VNEG� IN L,.,Ma' F""iia arrralert.)_ A ANY AUTO BODILY INJURY (Per person) S _ ALL OWNED SCHEDULED - AUTOS AUTOS BODILY INJURY (Peracpdenl) S HIREDAUTOS r'eraccadeW._ b -, °�- _.....,m.... NON-OWNED i{ROPEri"I'Y DAMAGk AUTOS.R..°'Ci_--- _...�., ..... ..............a..�.....,,.W,... S ......_ ... RiiLL. g UMBRELLA LEAB � C�IUR �_w_ EACH OCCURRENCE S OCCUR EXCESS LIAR ,... MS MADE -AGGREGATE..-----,,-- i3Fl] RFTENTION S ......,a.. w_. .,..,.._..._,.....,.,. .......- .- .._.....w. . .._..m.. - ...,.. -.... ..,....�..._...__ ........... ... WORKERS COMPENSATION _ YIN .� AND EMPLOYERS' LIABILITY � - - -�� � �R ANY ' PROPi�tllr.' r0'1"WARTN'I:R/I"sXEG..CY'rWVE" E.L. EACH ACCIDENT S OFFICEIIMFMBEREXCI.UDEOY iNJA (Mandatory ) . DISEASE - EA EMPLOYEE S Mandalo y IO NH t=,_L, m , Irrys, describe under DESCPIPTION OF OPERATIONS below E.L. _ _ LIMIT 5 .� .. _.. _m DISEASE -POLICY DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES {ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Additional Insured and Waiver of Subrogation in favor of Certificate Holder per policy provisions. City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 Main Street 1,4 ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S914791M90884 LMC This Endorsement Modifies Your Policy (Effective At Inception Unless Another Date Shown Below) ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The Insurance afforded by this policy for "bodily injury," "property damage" and /or "personal and advertising injury" shall also apply to the "additional insured" listed below for claims, suits, and /or damages made against the "additional Insured," but only to the extent the "additional insured" is being held responsible for the acts, omissions and /or negligence of the "named insured," This insurance afforded shall not apply to claims, suits and /or damages arising out of the acts, omissions and /or negligence of the "additional insured(s)." The inclusion of the "additional insured(s)" shall not operate to increase the Limits of Insurance. To the extent, if any, that this policy affords coverage to an "additional insured." the "additional Insured" is subject to all of the terms of the policy. Our obligation to provide coverage to an "additional insured" is further limited by the interest of the "additional insured" as defined below. Interest of the Additional Insured(s) Defined: The insured Is operating his train at their location For the purpose of this endorsement, the "named Insured" is the person(s) and /or party(les) designated on the Declarations Page of the policy or on any endorsement. The "additional insured" is the person(s) and /or party(les) identified below: Identity of Additional Insured(s): Clly of El Segundo inn Main Street El Segundo. CA 90245 (Complete this section It endorsement is added after policy Is issued,) NPPS214724 1 10/05/2015 Policy Number Endorsement Number Endorsement Effective Date 00514 Signature of Authorized Representative Producer Number Page 1 of 1 INSURED WWI 80 (03/10) This Endorsement Modifies Your Policy (Effective At Incoption Unions Another Date Shown Below) ADDITIONAL INSURED ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The insurance afforded by this policy for "bodily injury," "property damage" and /or "personal and advertising injury" shall also apply to the "additional insured" fisted below for claims, suits, and /or damages made against the "additional Insured," but only to the extent the "additional insured" is being held responsible for the acts, omissions and /or negligence of the "named insured." This Insurance afforded shall not apply to claims, suits and/or damages arising out of the acts, omissions and /or negligence of the "additional insured(s)." The inclusion of the "additional insured(s)" shall not operate to increase the Limits of Insurance. To the extent, if any, that this policy affords coverage to an "additional insured," the "additional insured" Is subject to all of the terms of the policy. Our obligation to provide coverage to an "additional insured" is further limited by the interest of the "additional insured" as defined below. Interest of the Additional Insured(s) Defined: Owner or customer as required by written contract, for work performed for the Additional Insured by our Named Insured For the purpose of this endorsement, the "named Insured" Is the person(s) andlor party(les) designated on the Declarations Page of the policy or on any endorsement. The "additional insured" is the person(s) and /or party(les) identified below. Identity of Additional Insured(s): C)wngra nr rustomerrx as r rep by wr,ttwn cnntraat, namino such oersonfs) or otnaniz »tion(s) as Additional Inswe( a (Complete this section if endorsement Is added after policy Is issuod.) Policy Number Endorsement Number Endorsement Effective Date Signature of Authorized Representative Producer Number Page 2 of 2 INSURED Wwi80 (03110) This Endorsement Modifies Your Policy. Please Read it Carefully. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Owners or customers, where required by written contract, naming such person(s) or organization(s) as additional insured(z) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV - COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above bpc use of payments-we make for injury or damage arising out of 0,00,1 elo .pf "ywr- -' done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above and only as respects to the sole negligence of the Named Insured. This waiver afforded shall not apply to claims, "suits" and /or damages arising in whole or in part out of the acts, omissions, and /or negligence of the person or organization shown in the Schedule above. Includes copyrighted material or ISO Properiles, Inc., WW421 (11113) with its permission. INFINITY_ Infinity Commercial Auto 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Customer Service: 800-722-3391 � Claims Service: 800- 334 -1661 CERTIFICATE OF INSURANCE Named insured Sherman, Bruce DBA A Plus Promotions 17120 Ermanita Ave Torrance, CA 90504 -2508 Producer Auto Club Services, Llc 2601 S. Figueroa Blvd # H302 Los Angeles, CA 90007 Phone: 888 -416 -2402 Agency #: 33361 Certificate Holder City of El Segundo 350 Main Street El Segundo, CA 90245 This certificate of insurance is issued for informational purposes only and confers no rights upon the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policy listed below. The insurance coverages afforded by the policy listed below are subject to all the terms, exclusions, provisions, limitations, conditions, and endorsements of the policy. Policy Effective Date: 04/01/2015 Policy Expiration Date: 04/01/2016 Insurer: Infinity Select Insurance Company Policy #: 504 - 61003- 3573 -001 NAIC: 20260 combined single Limit Bodily Injury Bodily Injury Prop" barrage (each accident) (per person) (per accident) (per accident) .� $1,000.000 !. Scheduled Autos Only _.. Hired Autos Included Non -Owned Autos Included - Any Auto Cancellation In the event of cancellation of the policy described in this certificate, notice will be delivered in accordance with policy provisions. Ant[ onzead Representative 50000CE101 Date: 1 011 91201 5 A PLUS Promotion DBA: Trains on the Move �A -ro whom it fnay Concern, I air, a sole proprietor and tic', required to cam/ workers comip in the state of California: therefore, I take responsibflity for any injuries that 1 may incur while providing a service to Thile City of is Segundo, Signatum. Printed Name 2 11 r