PROOF OF INSURANCE (2012) CLOSEDI.+ CERTIFICATE F LIA I.ITY II
INSURANCE i ;' /2011
PRODUCER (562) 493 -3521 FAX: (562) 430 -5300
THIS, CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Alandale Insurance Agency
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
11022 Winners Circle, Ste. 100
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Los Alamitos CA 90720
INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURERA:Travelers Insurance ',25658
Legacy Long Distance International, Inc.
INSuPERB:Hartford Casualty 29424
Valley
10833 Valle View #150
INSLIP }ERC Twa.n_ City Fire Insurance 29459
294
IN'S'URER. M
Cypress CA 90630
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE fNSU'RED
NAMED ABOVE FOR THE POLICY PERIOD INDICATED, N01WITHSTANDIWd ANY
REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH I 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.
R A„j- ithENTS:SIt�N I - FD ICY PAID C LA
}6 ADD'L TYPE OF INSURANCE
INS" POLICY NUMBER
POLICY EFFECTIVE POLICY E.XF°IRATd00d,.
DATE 'MM)DD1YYI LIMITS
GENERAL LIABILITY
FACIiX 9m 14r- 1
X C+ 7blF .IE'f'tCIALG,ENERALLIA6U.IIr ,
_. --
300,000
A CLAIMS MADE E] OCCUR 6308468X727
7/10/2011 7/10/2012 D� E ane(9� s� _ 10, 000
PLRS I3AI A ADS @N.aaJR,Y _ $ 1,000,000
�1 8 IAA RF ACF 2, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER: i'
T. -, 'A s. 22,000,0()o
X P FH�,. L.
L@ Y
.....�...�_...�.,......._
AUTOMOBILE LIABILITY
X ANY AUTO
COMBINED SINGLE LIMIT 1,000,000
(Ea accident)
B ALL OWNED AUTOS 72UECJ04628
9/28/2010 9/28/2011 BODILY INJURY
SCHEDULED AUTOS
(Per person)
X HIRED AUTOS
I BODILY INJURY
X NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)T'
GARAGE LIABILITY
.AUTO ONIONI.Y,EAACCBCYIAN'F _
ANY AUTO"
OTHERTHAN EA &Z
AUTO ONLY:
EKCESSBUMBRELLALIABILITY
FJE �t
X tseGlJ'R 01 GLAtM'wMADE
RED 1, 0100, 000
A DEDUCTIBLE cUP3562R58A
7/10/2011 7/10/2012
X. R -r NT@ o N 10 , 000
C WORKERS COMPENSATION AND
Yd S,•IA },p. Og },I..
EMPLOYERS' LIABILITY
ice,
'ANYPROPRIETOWPARTNER/EXECUTIVE
E.I. „F@,C�pI•dk.C',.G1DE�htlT $ 1x,000,,000
OFFICER/MEMBER EXCLUDED? 72WEJW7079
Il yes, describe under
3/6/2011 3/6/2012 E.q IN EA 'SF EAEMP 1r000,000
SPECIAL PROVISIONS labxu
E.9 QIS_"ASE- POLICY9,ILeW'T 1 1,000,000
A OTHER Business Personal 6308468X727
7/10/2011 7/10/2012 Limit. $157,000
Property
Deductible $5,000 i
_.. 1�acrment C+�orN•a
DESCRIPTION OF OPERATIONS ILOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Certificate holder is named as additional insured per attached endorsement
*1,0 days notice of cancellation for nonpayment of premium
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of El Segundo
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL XAMYPXXX MAIL
Att : City Clerk
*30
350 Main St
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, X
E1 Segundo, CA 90245 -0989
Y`Yair+` @C iTVr kICIIX
”
AUTHORIZED REPRESENTATIVE
_.,
d COYSi/D I NA
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ACORD2 5(2-06-1/0-84-- _�_._
INS025 (oloe).osa
m ACORD CORPORATION 1988
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