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PROOF OF INSURANCE (2018) CLOSED _­00"N OP ID:SMP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/25/2017 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 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 CONTACT , ll .Nowell Allance Mgt.&Insurance Sery PHONE .... Fl Aw X 760-471-9378 Via Vera Cruz#7 A.N.EA( .– CA Agent/Broker Lic#0737966 nowellmis rp.com San Marcos,CA 92078 OCR j Michelle A.Nowell I En ID,,;MESSI-1 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Messina&Associates Inc INSURER A:Acceptance Casualty Ins Comp 10349 814 Forbes Drive I INSURER B: Brea,CA 92821 INSURER C: INSURER D: .. ... - INSURER E: ...... „, LMWMR F„ COVERAGES CERTIFICATE NUMBER: REVISION 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 POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ,0 NN—SR AWSUSH POLICY EFF POLICY EXP LTR TYPE OF INSURANCE lN POLICY NUMBER IMMIDDIYYYYI (MM/DDIYYYYI I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 L LIABIL111'°Y X CP00961045 06/0112017 06/01/2018 D EX ae eoerre�nc i $ 100,00 A X COMMERCIAL GENERAL E �_ CLAIMS MADE I " d OCCUR ( y person) $ 5,00 X Errors&Omission PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE I$ 5,000,000 G;EN'L AGGREGATE LIMIT APPLIES IIUk : PRODUCTS-COMP/OP AGG I$ 1,000,000 .X, I.POLICY II tlr,' „��.a�(w' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -- (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ... ............................. ALL OWNED AUTOS ................ I BODILY INJURY(Per accident)�$ SCHEOULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (PER ACCIDENT) NON-OWNEDAUTOS I $ UMBRELLA LIAB OCCUR ^— EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE I$ DEDUCTIBLE $ RETENTION '",,, .. .m WORKERS COMPENSATION TORY I ATU- I IOT AN D EMPLOYERS'LIABILITY EP ANY PROPRIETOR/PARTNER/EXECUTIVE Y IN E L EACH ACCIDENT $ ❑ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under m W �'�'�'""""''"'"' "� DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT,$ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(Attach ACORD 101,Addillona1 Remarks Schedule,if more space is required) City of El Se undo its officers,volunteers,emplo ees and re resentatives are named as a ditional insured with r7sTect t5�wort,perfornte by the named insured with,and 30 Days Notice o ancelation. .Investigation,CA-- canderson(a)elsequndo.org CERTIFICATE HOLDER CANC'EL'LATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Attn Christopher Donovan 314 Main Street AUTHORIZED REPRESENTATIVE EI Segundo, CA IN&W% 04W.I.&M I' ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP00961045 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSPIRED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s) Automatic Status Included Where Required by Written Contract. All Where Required by Written Contract. "It is agreed, as respects the Policy, thirty (30) days notice of cancellation, except as respects non- payment of premium,for which ten (10)days notice will apply, or other regulatory requirements that may apply,will be given as respects the indicated certificate holder." Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organ- ization(s) shown in the Schedule, but only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ c. You and any other involved insured must: b. Excess Insurance (1) Immediately send us copies of any de- This insurance is excess over any of the other mands, notices, summonses or legal pa- insurance, whether primary, excess, contingent pers received in connection with the claim or on any other basis: or"suit"; (1) That is Fire, Extended Coverage, Builder's (2) Authorize us to obtain records and other Risk, Installation Risk or similar coverage information; for"your work"; (3) Cooperate with us in the investigation or (2) That is Fire insurance for premises rented settlement of the claim or defense against to you or temporarily occupied by you with the"suit"; and permission of the owner; or (4) Assist us, upon our request, in the en- (3) If the loss arises out of the maintenance or forcement of any right against any person or use of aircraft, "autos" or watercraft to the organization which may be liable to the in- extent not subject to Exclusion g. of Cover- sured because of injury or damage to which age A(Section 1). this insurance may also apply. When this insurance is excess, we will have no d. No insured will, except at that insured's own duty under Coverages A or B to defend the in- cost, voluntarily make a payment, assume any sured against any"suit" if any other insurer has obligation, or incur any expense, other than for a duty to defend the insured against that"suit". first aid, without our consent. If no other insurer defends, we will undertake to 3. Legal Action Against Us do so, but we will be entitled to the insured's No person or organization has a right under this rights against all those other insurers. Coverage Part: When this insurance is excess over other in- surance, we will pay only our share of the a. To join us as a party or otherwise bring us into amount of the loss, if any, that exceeds the a"suit"asking for damages from an insured; or sum of: b. To sue us on this Coverage Part unless all of (1) The total amount that all such other insur- its terms have been fully complied with. ance would pay for the loss in the absence A person or organization may sue us to recover on of this insurance; and an agreed settlement or on a final judgment (2) The total of all deductible and self-insured against an insured obtained after an actual trial; amounts under all that other insurance. but we will not be liable for damages that are not payable under the terms of this Coverage Part or will share the remaining loss, if any, with an that are in excess of the applicable limit of insur- any other insurance that is not described in this ance. An agreed settlement means a settlement Excess Insurance provision and was not and release of liability signed by us, the insured bought specifically to apply in excess of the and the claimant or the claimant's legal repre- Limits of Insurance shown in the Declarations sentative. of this Coverage Part. 4. Other Insurance c. Method of Sharing If other valid and collectible insurance is available If all of the other insurance permits contribution to the insured for a loss we cover under Coverag- by equal shares, we will follow this method al- es A or B of this Coverage Part, our obligations are so. Under this approach each insurer contrib- limited as follows: utes equal amounts until it has paid its applica- ble limit of insurance or none of the loss a. Primary Insurance remains, whichever comes first. This insurance is primary except when b. below If any of the other insurance does not permit applies. If this insurance is primary, our obliga- contribution by equal shares, we will contribute tions are not affected unless any of the other by limits. Under this method, each insurer's insurance is also primary. Then, we will share share is based on the ratio of its applicable limit with all that other insurance by the method de- of insurance to the total applicable limits of in- scribed in c. below. surance of all insurers. Messina&Associates,Inc CP00961045 Acceptance Casualty Insurance Company 06-01-2017 to 06-01-2018 CG 00 01 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 9 of 13 13 lnterinsurance Exchange of the Automobile Club Automobile Insurance Policy Coverages and Limits Renewal Declarations 'hlU'e are pleased to offer you a renewal for your automobile insurance policy, To renew your policy, send at least the minimum payment on or before the due date. Insurance is in effect only for the vehicles, coverages, and limits of liability shown on this declarations page and as set forth in the insurance policy and endorsements, These declarations,together with the contract and the endorsements in effect,complete your s policy, If any change to your policy or to the information we have on file results in a premium decrease during the policy period,the Interinsurance Exchange reserves the right to apply any refund due to your outstanding balance. NAMED irJS1.IRED(ttern 1.) o AUTO POLICY NUMBER:CAA 065044011 MESSINA, MICHAEL AND CAROLYNA POLICY PERIOD(PACIFIC STANDARD TIME) 814 FORBES OR POLICY EFFECTIVE DATE: 03-25-17 12:01 A.M. BREA CA 92821-7306 POLICY EXPIRATION DATE: 03-25-18 12:01 A.M. VEHICLES VIEH' YEAR MAKE MODEL IDENTIFICATION VEHICLE GARAGE ANNUAL" VERIFIED SALVAGE NO, NUMBER USE ZIP CODE MILES MILEAGE 2 2005 AMGL HUMMER H2 5GRGN23U55H108695 COMMUTE 92821 5,501 - 7,500 VERIFIED NO 5 2012 KIA SOUL SW/I/SPORT KNDJT2A65C7474113 PLEASURE 92821 3,501 - 4,500 VERIFIED NO 7 2009 JEEP WRANGLER UNLIMITED 1J4GA391591-745955 PLEASURE 92821 10,001-12,500 VERIFIED NO 8 2016 MBNZ E CLASS 550 WODKJ7DBOGF314383 PLEASURE 92821 5,501 - 7,500 VERIFIED NO 9 2016 CHEV SLVRDO 1500 CR NEW 3GCUKSEC3GG285230 PLEASURE 92821 10,001 -12,500 VERIFIED NO COVERAGES AND LIMITS ANNUAL PREMIUMS Coverage Is not in effect unless a premium or the word"included"is shown. COVERAGES LIMITS OF LIABILITY Vehicle 2 Vehicle 5 Vehicle 7 Vehicle 8 Vehicle 9 Liability, I' Bodily Injury $100,000 each person/ $300,000 each occurrence $219 $298 $420 $164 t $269 Properly Damage $50,000 each occurrence $143 $191 $264 $98 $198 Medical !No Coverage i No Coverage 3 No Coverage It No Coverage J'No Coverage I l � Physical Damage (Actual Cash Value unless othermse stated,less deductible) Vehicle 2 Vehicle 5 Vehicle 7 Vehicle 8 Vehicle 9 i kE 81 ii Comprehensive ACV ACV ACV ACV ACV $73 $65 $S6 $136 ' $60 (Less Deductible) $250 $250 $250 $250 $250 i Collision ACV ACV ACV ACV ACV i $306 $674 $386 $941 ) $644 (Less Deductible) $250 $250 $250 $250 $250 T 6 Car Rental Expense er Day) $35 $35 $35 $35 SM $27 $64 1 $58 $31 $28 hinsured Motorist i t Bodily Injury- $30,000 each person/ $60,000 each accident $41 $42 ; $48 $34 : $27 Uninsured&Underinsured Vehicles s i Uninsured Deductible Waiver Included Included Included p Included Included Uninsured Collision No Coverage No Coverage';No Coverage I No Coverage No Coverage Total Premium $809 $1324 $1231 $1304 $1226 PREMIUM DISCOUNTS "No Coverage"indicates coverage not purchased, Ch a to a unt pp y„ Total Annual Premium" $5894 If at an Please refer to the enclosed document entitled'Premium Discounts Applied to Your Automobile Po is 1 11 finance charges tirrleof a t.... outstanding uwtandlm k (I I er Savinis, barges f piton % per month of t are part of these declarations,py "Net Prelm uhold le discounts.) Dividend $5100 as explained In your billing p . r To see the annual mileage for your expiring policy, please refer to the eaq,+ .�. your renewal e, Notice of Annual„pill t1~ III a contained in , PROCESS DATE 02-14.17 PLEASE ATTACH TO YOUR POLICY (SEE REVERSE) 021517