PROOF OF INSURANCE (2016) CLOSEDTHIS CERTIFICATE IS ISSUED AS A 1A
CERTIFICATE DOES NOT AFFfRMATIV
BELOW. THIS CERTIFICATE OF 14SU
REPRESENTATIVE OR PRODUCER, A NI
IMPORTANTr, R the coroncate bcq&r j
We tornm and concliflans of the policy,,
cordficato holder in Hot) 01SUCh endorse
vaooucttar
L RICHARDSON INSLIF
17715 CRENSHAW 80
JV, TORRANCE, CA 90504
VISION k-rip, Wp:mr-
DBA PARTY POSIES
1311 SARTORI AVENU� TORRANCE, CA 90501
,State Farm SS3 KICIFAX4 at:1511-20-12:05 'Doc:807 Page:004
p TIFICATE OF LIABILITY 1 SURANCE
... .......
TIER OF INFORMATION ONLY AND CONE EI 3 NO R1134ITS UPON THE CERTIFICATE HOLDER. THIS
Y OR KeATIVELY AMEND, EXTEND OR pLTER THE COVERAGE AFFORDED BY THE POLICIES
NCE DOES "OT CONSTITUTE A CONTRA T BETWEEN THE ISSUING INSURER(Sh AUTHORED
THE CERTIFICATE HOLDER
n'AODITION A INSURED, tho IAOJd1 i(I ms) mug Fit, _ondamd. it
SUBROGATION IS WAIVED, subject to
iorwo Policies fogy require an endomerneft A slatomnt on this certificate does spot corder rights to the
qu Aft
I O'TANIA �11CWDSON
NCE AGEN Y, INC &3239$71 j� EKLJF �X. YIO-372.8171
THM 13 3 TO CERTIFY THAT THE POVCIE;
INDICATED NOTIA01'rKSTANDOING ANY At
CERTIFICATE MAY BE trAuED OR MAY
EXCLUSIONS AND CONDITIONS OF SUCH
rte! of XW1VN/ iii
F
A XiCOMMERCIALGEMMALLLABILMY
"Lolm.""km OCCUR
ESS
APFLR5 PER:
010 El LOC
0110ER
A A'J-- WOULP useury
ANY AUTO
Woos ill ore!
AUTOS moo$
REDAUM No"4A Im
f�i AWO6
ureaEILA Lme
MFSSLtAO
'(1
THE IN
UIATS
92-1117•1"115" G
92-137-P154-9 G
UILLN 1bW41 IV Imt: cart. MKD ABOVE FOR THE POLICY PEA*0
ANY CONT 9 OR OTHER DOCUMENT WITH RESPECT TO WHICH THS
BY THE X x
otIr
'I
IFS UI�SC$MO HERON IS SUBJECT TO ALL THE TERMS,
ve
07)(1 201E
crs-to. - Aurh S 2.000.000
. . . . ...... ..........
Is 1.000.000
i BOOLYNiArRY(Pe
ACGREGAr.
ELEACHArODFUr
AUTOMATIC RENEWAL ShMA ft 12 RiOnIhS, lhl$ poi MI be (011ZIM41 UkogrrWiCW SW49d to the protniurrm, rules, and farms in prfmd
for each succeeding pokey period. If Luis wa, �s we VAI 9" yore the Mop 194geo wthit m notice In cam mHance with the portly provisions or as req uked
by law. 10 days before the effective date of IrApIce4a horl Owe raw.41 fm 11 vnpaynnelfl o(luemium; 0 days before the effective date of cancellation rf we cancel
for any other reason.
350 MAIN STREET, EL SEGUNDO, CA WU�
I
ADDITIONAL INSURED
CITY OF EL SEGUNDO
350 MAIN STREET
EL SEGUNDO, CA $0245
ACORO 26 (2014101)
SHOULD ANY qF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRAT411111 DATE THEREOF, NOTICE WfLL BE DELIVERED IN
ACCORDANCE WH THE POLICY PROVISION&
ACORDnaine and logo ari-jegistorad nm bzs ofAdDRD ID0IA96 132849.9 024I42014
PMTP Policy No.: 92- 137- P154 -9
SECTION II ADDITIONAL INSURED ENDORSEMENT
Policy No.: 92- 1217- P154 -9
Named Insured: VISION ADELANTE
DBA PARTY POSIES
Additional Insured (include address):
THE CITY OF EL SEGUNDO ITS OFFICERS, OFFICIALS, 'e "
EMPLOYEES, AGENTS & VOLUNTEERS
ATTN CITY CLERK
350 MAIN ST
EL SEGUNDO CA 90245 -3895
FE-6609
WHO IS AN INSURED, under SECTION II DESIGNATION OF INSURED, is amended to include as
an insured the Additional Insured shown above, but only to the extent that liability is .imposed on that
Additional Insured solely because of your work performed for that Additional Insured shown above.
Any insurance provided to the Additional Insured shall only apply with respect to a claim made or a
suit brought for damages for which you are provided coverage.
The Primary Insurance coverage below applies only when there is an "X" in the box.
® Primary Insurance. The insurance provided to the Additional Insured shown above shall be
primary insurance. Any insurance carried by the Additional Insured shall be noncontributory
with respect to coverage provided to you.
All other policy provisions apply.
FE4;609 Printed In U.S A.
Party Posies Floral
Floral & Event Planning
November 20, 2015
Monse Palacios
350 Man Street
El Segundo, Ca. 90245
Dear Monse,
This letter is to inform you that Party Posies /Vision Adelante will be hiring °
Independent contractors fur the Christmas installation on December 1,
2015.
Please fill free to contact one should you have any question.
Thank yo't;
Rosa a Torres
1311 Sartori A ve., CA 90501
Phone: (310) 378 -1018 Fax: (310) 320 -3450