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PROOF OF INSURANCE (2014) CLOSEDCERTIFICATE OF LIABILITY INSURANCE DATE(MrMI° °"""' 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 endorsement(s). PRODUCER ­Iylant Group Inc - Toledo 311 Madison Ave Foledo OH 43604 INSURED M &JKI -1 INSURER B: M &J Kids Scientific Inc dba INSUR Mad Science of Los Angeles ____ 15815 Monte St, Ste 101 INSURER D: Sylmar CA 91342 INSURER E: /1/2014 INSURER F: COVERAGES CERTIFICATE NUMBER: 196564352 REVISION NUMBER: NAIC # 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 CCRTiFICATE 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. S ADDLa(1'il.',m ..e..... POLICY EFF POLICY EXP._ _. ..._. , ,- — ,,,,- -,m,_, . ­_­- .iN R..... — .....-- .......--- TYPE OF INSURANCE LIMITS .... LTR POLICY NUMBER MMI DIYYYY MMIDD.. A GENERAL Y PHPK1034372 /112013 /1/2014 EACH OCCURRENCE 0 $$310,00 0 00,0.0.. X I U EN C _ COMMERCIAL GENERAL LIABILITY' pAM 0..0 CLAIMS -MADE OCCUR MED EXP An one person) $15 000 I Abuse/ Mo. lestst ..� ........ ....._......,w..,.�LLw-.. PERSONAL ADV INJURY & $1,000,000 GENERAL AGGREGATE $2,000,000 N'L AGORFOATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $2,000,000 POLICY LOC A &M $500,000 A AUTOMOBILE LIABILITY PHPK1034372 7/1/2013 /1/2014 �aacr,da�U .._ $1,0 0,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS _ -„ . ...._- ...._ -. BODILY INJURY (Per accident) $ X X NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS P r c L4�4I1 UMBRELLA LIAB OCCUR EACH OCCURRENCE ...e ........................... $ ,-.,........._...... ............................... EXCESS LIAB CLAIMS -MADE AGGREG. ATE $ DED RETENTION $ $ B WORKERS COMPENSATION EIG1419699 11/1/2013 11/1/2014 X WCSTATU- 0TH -' AND EMPLOYERS' LIABILITY Y / N SJ,F,.33,Y_LJM�T R....,........ ANY T VE E,1,__ CH, NT $1,000,000 OFFICER/MEMBER EXCLUDED' F NIA N Mandato m NH ( ry 1 ) E.L. DISE _ EA ASEC P LOYE $1,000,000 If yes, describe under .._ ......... ..�.�������� ..................� DESORIPTION OF OPERATIONS below E,. L. DISEASE - POLICY LIMIT $1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City, its officers, officials, employees, agents and volunteers are included as an Additional Insured perform CG2010. TE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo Parks & Rec ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ms. Vina Ramos 350 Main St AUTHORIZED REPRESENTATIVE El Segundo CA 90245 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:PHPK1034372 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES O CONTRACTORS ACTORS - SCHEDULED PERSON O ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations City of E1 Segundo Parks & Rec The City, its officers, officials, Attn: Ms. Vina Ramos employees, agents and volunteers are 350 Main St included as an Additional Insured E1 Segundo CA 90245 per form CG2010. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1