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PROOF OF INSURANCE (2013) CLOSED
DRMAU -1 OP ID: T5 ,4coR0 CERTIFICATE OF LIABILITY INSURANCE DATE(M 04/113/13/1YYY) 2 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 EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. APORTANT: 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). License #0428915 PHONE kr., !.. E�1310�2444�1357 „ .. F( 310 524 -1 100 PRODUCER 800 -464 -3606 _ Carole S. Mitchell Brakke Schafnitz West - D No .— 358 Santa Wilshire Monica, Blvd. CA 90 07 E-MAIL s eIN sb .us Darla Gray ADDRE carol """,INSURER(S) _._...... _ y S) AFFORDING COVERAGE 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 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„ ..... ._ ..... . ... ............ Db'L' IC,..Y , .E .. P ... ,..� ,..._._ .. i LIMITS LTR TYPE OF INS URANCE POLICY NUMBER AaaYwv Mh)0"YY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X, COMMERC GENERAL LIABILITY X 624270427001 05101112 05/01/13 __OAMF 'G'E" 0 RENTED � X � OCCUR MED EIXP (Any one person) $ �55,00( - --- ........f _ ._w ... ,.... „. „.,. ... PERSONAL & ADV INJURY $ X Prof & Pollut -CLM GENERAL AGGREGATE „1,000,00, -. $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,00 POLICY PRL'3; ............ LOC E Ben. ..$.........,,.... ............. N/ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY (Per person) $ _ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ -� „- AUTOS AUTOS NON -OWNED 'PROPERTY DAMAGE .m$ HIRED AUTOS AUTOS , „,),,,Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE --- ----------- $ - DED RETENTION $ $ WORKERS COMPENSATION C STATU- TH- WaY AND EMPLOYERS' LIABILITY YIN . .... 5 FIR JJY1 ANY PROP RI ETORIPARTN - ECUTIVE A ACCIDENT OFFICERIMEMBER EXCLUDED? NIA J —- in NH) El. DISEASE - EA $ If yes, describe under -.. M .. ,,,.,.,v.. „ .. _...---- _ --- ..._....._.... DESCRIPTION OF OPERATIONS below E L DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) *Except 10 days IF cancelled for nonpayment of premium. The Certificate Holder is recognized as Additional Insured per endorsement (ENV -3100) attached. C -ELSEG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City g ACCORDANCE WITH THE POLICY PROVISIONS. Attn City Clerks Office 530 Main Street 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 . ... . ....... ......... .. S r-'4 n ow woods M"--t Was Insuranewcoinvany VHM ENDORSEMENT CHANGES THE POLKY, PLA, fUEA1)1 V[,'1(,,;AM INStIRED OWNER& LEBST 1 5 OR (,`.'0'P)'VRAC TOM - SCHEDL)k-ED PE11,1130N 110N 11my andursemart rnadlhes 11suFave provkkad LaWar Ina 10MYK)' COMMERCAL G8,4U,�A1,, UA&LFIFY 2LL Any Pe son w Omni$ Zola n I nal i, aoa ,vnfv cA I f","W pfinjsq',,,flta c'1 " on vvhch iNm PVC t"R, "'v oal ckv jo'i4v",Jsu Ism haH y arm parlomRng upozWom =1 onj At V ymcK 6 nn rnq ,ea a,'3 in� Wnn Poson Or mv=wmn K yu, nomwn mah fecuu; is mact", UD 111 r4( entry tO,u'ey, �5n thti, tcla A, St:"CT10?4 h - 1, , 1a01,,I INS1,JRED i, to ockjoe as a unwed to t:m.o,sc rI or ir'l ayd ,tt'y 1.',ct%eckOf , ou c rfly IPN+0'y W &WRY abog out Q Yom anwnng opeawbns PeHormed sw that msumd, me as namn a Mxdsa wANw a aMAhr W us" m wk Pe ks knong nxchsor is ado nd: 2. rc,.,v16A-i(%kwrvi "nos hsumnco 600!� nol, tc,", or V�aga r ing ai lokh... � 40 "Pvt)'dt�, "Welows, pans 0; eqIWUMA f"jo1w V cavWw" *Hh amp woo, my Me Pyaled, WU or Han swvku, V, f & ou pa ho wed by w on hwuP of Me nAMWnM Omw of ,4� the sibe c)i thra' Cow n'r?'d VWS N,,,'4,f" ()F'il J)l Wo ,A , 0� 1' "at polar Work o1,,ovh4,,9,t lrywri,, cn da"Inge Kses =s too, Int to di lowndyl Uss bl"", nny poem, of ovam2avul OMM Mar anaver cxWhndnr or OWKWINIcto" npmakms ko a jwhcjW as as pad ad Ma same PMjcl, r No A WO W10C nrl""Juelk (AUne, �nc, wwsm h Its p,,anr? i,%Ick of I