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PROOF OF INSURANCE (2014) CLOSED VIEWINC-01 DMEANEY DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1 2/24/2014 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 TACT NAME: Judy Yeary Mason&Mason Technology Insurance Services, Inc. PHONE' ... ......... „ .... 'I hSh ) 787_ 531 (781)447-7230 t . , o Whitman,MA 02382 AaD Essa �masoninsure.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A:Sentinel Insurance Company 11000 INSURED INSURER B:Hartford Underwriters Ins Co 30104 Viewflrlity,Inc. INSURER C� 400 Totten Pond Road INSURER D Suite 301 Waltham,MA 02451 INSURER E INSURER 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 'OLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR� TYPE OF INSURANCE POOL SUBR POLi-CY-EFF Poul-eq FxP LTR I IN%R WVO POLICY NUMBER (MM/DDIYYYY),_(MMIDDIYYYY)I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ccrADAMAGE TO I .. ,. COGENERAL (ABILITY 08SBATZ9080 12/15/2013 12/15/2014PREMSE((Ea occurrence) $ 10 , CLAIMS-MADEXOCCUR MED EXP(Any $ 0,000 PERSONAL&ADV INJURY $ 1,000,000 j GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X „ I ......,�PRO y,POLICY IFCT ....I LOC $ 000 UTOMOBILE LIABILITY COMBINED tiINGLE LIMIt n.... (Ea accident) $ 1,000,0001 A ANY AUTO OBSBATZ9080 12/15/2013 12/15/2014 BODILY INJURY(Per person) $ u ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ V AUTOS I AUTOS _ X HIRED AUTOS X +:NON-OWNED f`sfSY� Fd°°('',`CJflftiAfi,rr'"xF AUTOS (PER ACCIDENT) $ UMBRELLA EACH OCCURRENCE $ 4,000,000; A X EXCESS LIAe� X l oLAIMs-MADE 08SBATZ9080 12/15/2013 12/15/2014 AGGREGATE $ 4,000,000; DED I X I RETENTION$ 10,000 ( $ WORKERS COMPENSATION X I TORY LIMITS I(J(T'� TH (Mandatory in NH) I 08WECCP3279 12/15/2013 12/15/2014 ( EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED?AND EMPLOYERS'LIABILITY Y/N N/A 1'000'000' B ANY PROPRIETOR/PARTNER/EXECUTIVE """"""""""' E L DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000' DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLE (Attach ACORD 101,Additional Remarks Schedule,if more space is required) It is understood and agreed that The City of EI Segundo is included as an additional insured as respects general liability as required by written contract per the terms and conditions of the policy. Cancellation notice is 10 days in the event of non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of EI Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y 9 ACCORDANCE WITH THE POLICY PROVISIONS. Attn.: City Clerk 350 Main Street EI Segundo,CA 90245-0989 AUTHORIZED REPRESENTATIVE I , ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD