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PROOF OF INSURANCE (2017 - 2018) CLOSED Id DATE(MMIDD/YYYY) c"R CERTIFICATE OF LIABILITY INSURANCE �,,,,,,,..•-�' MARKEL- 3/30/2017 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 have ADDITIONAL INSURED provisions or 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 715-246-8908 C Specialty Insurance Agency 4 Stephanie Weiss 71 CONTACT NAnm :., P Y 9 Y �PI1oNrW FAX Performers of the U.S. to/P,Nor Fit); tArc,No): 5 246-4257 P.O.Box 24 A"aDRE,SS, certs @specialtyinsuranceagency.com New Richmond,WI 54017 INSURER(S)AFFORDING COVERAGE NAICN INSURERA: Evanston Insurance Company 35378 INSURED Eric R.Greenberg INSURER B: dba Liberty City 18560 Vanowen St,Unit 14 INSURER C: Reseda, CA 91335 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVI'SI'ON 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 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 'OLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY SAID CLAIMS INSR ...., ..,,,„ .,,...'""aibbC ........PO POL{CYE_FF^--POLICY EXP. ,.... ....,,,,, LTR TYPE OF INSURANCE POLICY NUMBER I'MMIDDIYYYYI� IMMIDO/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY �OCCURRENCE $ 1,000,000 CLAIMS-MADE KI OCCUR MI ES,(E@ Nir=D 300,000 PREH�SE,S,(Ea,apcunenoe) $ MED EXP(Any one person) $ 5,000 A X X 2CN0155-2490 04/25/2017 04/24/2018 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PR'O ❑ JEOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 _ IVY OTHER �i$ AUTOMOBILE LIABILITY COM81NEDSINGI.E LIMO I ^$ (Ea,.aec:dpnij ANY AUTO BODILY INJURY(Per person) ( $ OWNED SCHEDULED BODILY INJURY Per accident AUTOS ONLY AUTOS ( ) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY {P?prc;1t'�,(8ftya8}„ $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB (CLAIMS-MADE AGGREGATE $ QED O RETENTION$ $ STATUTE ., ER WORKERS COMPENSATION PER OT OF (Mandatory In NH)AIR L EIR EXECUTIVE YIN EL DISEASE CIDEEMPLOYEE OFFICER/MEMBEREXCLUDED? N/A DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY-LIMIT if Y $ BUSINESS PERSONAL PROPERTY- li A INLAND MARINE AGGREGATE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: Eric R.Greenberg dba Liberty City Additional Insured:The City of El Segundo,its officers,officials,employees,agents and certified volunteers are named as additional insured,but only insofar as the operations under this contract are concerned. Fax:818-344-6108 Email:libertycityeric @aol.com Event Date:2017-06-11 CERTIFICATE HOLDER CANCELLATION City of El Segundo 350 Main St,Room 5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE El Segundo,CA 90245-3813 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY III POLICY NUMBER: 2CN0155-2490 � IRKE EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM PROFESSIONAL LIABILITY COVERAGE FORM Please refer to each coverage form to determine which terms are defined. Words shown in quotations on this endorse- ment may or may not be defined in all coverage forms. SCHEDULE Person or Entity: Any person or organization to whom you are obligated by valid written contract to provide such coverage. Additional Premium: $ (Check box if fully earned.®) Included WHO IS AN INSURED is amended to include the person or entity shown in the Schedule above as an Additional Insured under this insurance, but only as respects negligent acts or omissions of the Named Insured and only as respects any coverage not otherwise excluded in the policy. Our agreement to accept an Additional Insured provision in a contract is not an acceptance of any other provisions of the contract or the contract in total. When coverage does not apply for the Named Insured, no coverage or defense shall be afforded to the Additional In- sured. No coverage shall be afforded to the Additional Insured for injury or damage of any type to any"employee" of the Named Insured or to any obligation of the Additional Insured to indemnify another because of damages arising out of such injury or damage. All other terms and conditions remain unchanged. MEGL 0009-01 04 11 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 with its permission. COMMERCIAL GENERAL LIABILITY gig POLICY NUMBER: 2CN0155-2490 MARKEr EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Additional Premium: $ 0 Name of Person or Organization: Any person(s)or organization(s)to whom the Named Insured agrees to waive rights of recovery in a written contract. 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 as respects written contracts that exist between you and such person or entity, provided you have agreed in writing to furnish this waiver. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain unchanged. MEGL 0241-01 04 11 Includes copyrighted material of Insurance Services Office, Inc. with its Page 1 of 1 permission. POLICY NUMBER: 2CN0155-2490 COMMERCIAL GENERAL LIABILITY CG 20 0104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2CN0155-2490 COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMIT'S OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of El Segundo City Clerk Attn: Recreation & Parks Director 350 Main Street, Room 5 El Segundo, CA 90245-3813 The City of El Segundo, its officers, officials, employees, agents and certified. 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 2. This insurance does not apply to: include as an additional insured any state or a. "Bodily injury", "property damage" or governmental agency or subdivision or political "personal and advertising injury" arising out subdivision shown in the Schedule, subject to the of operations performed for the federal following provisions: government, state or municipality; or 1. This insurance applies only with respect to b. "Bodily injury" or "property damage" operations performed by you or on your behalf included within the "products-completed for which the state or governmental agency or operations hazard". subdivision or political subdivision has issued a permit or authorization. B. With respect to the insurance afforded to these additional insureds, the following is added to However: Section III—Limits Of Insurance: a. The insurance afforded to such additional If coverage provided to the additional insured is insured only applies to the extent permitted required by a contract or agreement, the most we by law; and will pay on behalf of the additional insured is the b. If coverage provided to the additional amount of insurance: insured is required by a contract or 1. Required by the contract or agreement; or agreement, the insurance afforded to such additional insured will not be broader than 2• Available under the applicable Limits of that which you are required by the contract Insurance shown in the Declarations; or agreement to provide for such additional whichever is less. insured. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 P000000671/C000 0 3 01 5 6-00 5/0 48•'VIP•A00071 /SEL/3 � ��4wrr PERSONAL OFFER O RENEW COVER COVER PAGE ADDRESS NAMED INSURED AND ERIC GREENBERG WAWANESA INSURANCE 18560 VANOWEN ST#14 9050 FRIARS RD STE 101 RESEDA CA 91335 SAN DIEGO CA 92108-5865 Telephone: 1-800.640-2920 Policy Number Account Number Policy Period 12:01 A.M.standard time at the address of the 11345100 2174251-1 From Nov 5,2016 to May 5,2017 Named Insured as stated herein Thank you for your continued business with Wawanesa General Insurance Company("Wawanesa Insurance"). We appreciate the opportunity to provide you with quality coverage and peace of mind knowing that we strive to provide the most dependable coverage at the lowest price possible. For information regarding Wawanesa Insurance including products and services, please visit our website at wawanesa.com. Please review your Renewal Declaration.This Declaration is an offer only. Payment of the premium renews your policy for the period shown. If your payment is not received by Nov 05, 2016,this Offer to Renew becomes null and void. Your coverage expires Nov 05,2016 at 12:01 A.M. By accepting this Policy and the Declaration pages you consent to be legally bound by the provisions of the policy. Including the coverage limits, options and endorsements. Important Information (This page is part of your Policy Declaration): If you are responsible for the payments due on this policy,please refer to the invoice statement(enclosed or mailed separately).The invoice statement also includes additional payment information,such as our flexible new payment options. g and approved by the.California Department of Insurance .......................... . Recent changes reviewed a lif De f Insurance may have affected your premium. Although your premium may have changed,we believe you will find Wawanesa remains very competitive for your insurance needs. 1. As of October 1,2016,Wawanesa will renew all 12 month auto policies into six month policies. This allows easier quote comparison, better financial planning and flexibility ensuring your coverage needs. 2. Changes have also been made to your estimated annual mileage. Please review the estimated annual mileage form enclosed with this renewal offer and provide your response prior to the renewal effective date. 3. Roadside Assistance Coverage has been discontinued on vehicles aged 15 years or older,effective at renewal. 4. Policies that carried a discontinued Medical Payment limit,Comprehensive deductible or Collision deductible have been renewed with the next available limit or deductible. These discontinued limits include the following: • $500 Medical Payment Coverage limit • $25&$50 Deductible options for Comprehensive Coverage 0 $50 Deductible option for Collision Coverage Please review your policy declaration for coverage changes that may have affected your policy. We are pleased to offer new and enhanced limits for Rental Expense Coverage and higher Comprehensive and Collision deductible options. The following are now available: • Rental Expense Coverage o $25 per day to a maximum of$750 per covered loss Wawanesa welcomes referrals from satisfied policyholders as an important means of developing new business. Earning Your Trust Since 1896 Got 05,201800:13 CT "Wawanesa Insurance"Is a trademark of Wawanesa General Insurance Company P000000671/0000030157-0061046•-VIP•A00071 BEL/3 PERSONAL POLICY OFFER O RENEW 111SIM717Ce COVER PAGE ADDRESS NAMED INSURED AND ERIC GREENBERG WAWANESA INSURANCE 18560 VANOWEN ST#14 9050 FRIARS RD STE 101 RESEDA CA 91335 SAN DIEGO CA 92108-5885 Telephone: 1-800-640-2920 Policy Number Account Number Policy Period 12:01 A.M.standard time at the address of the 11345100 2174251-1 From Nov 5,2016 to May 5,2017 Named Insured as stated herein o $30 per day to a maximum of$900 per covered loss o $40 per day to a maximum of$1,200 per covered loss o $50 per day to a maximum of$1,500 per covered loss • Comprehensive and Collision Deductibles o $100, $200,$300,$500,$1,000, $1,500 and$2,500 Questions? If you'd like to make change to your policy, please contact us at renewals.0 (ccDw,a'wanesa.com and provide your name and policy number,or call our office and our knowledgeable Customer Service Representatives will be happy to assist you. Did you know?We're available online 24/7! Visit wawanesa.com to submit changes to your policy,report a claim, or receive a free insurance quote in minutes. Wawanesa welcomes referrals from satisfied policyholders as an important means of developing new business. Earning Your Trust Since 9896 Oct 05.2016 00:13 CT "Wawanesa Insurance"Is a trademark of Wawanesa General Insurance Company