PROOF OF INSURANCE (2019) CLOSED DNYY
CERTIFICATE OF LIABILITY INSURANCE °Aa�9/ao1B Y)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
f'FRTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
RESENTATIVE 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 Wigmore g more Insurance
Wigmore Insurance Agency Inc. PHONE taut) (714)979-6543 i
BUSINESSOWNERS
PB 60 04 04 11
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - SERVICES PERFORMED ON
PREMISES OF ADDITIONAL INSURED
This endorsement modifies insurance provided under the following;
PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM
A. The following is added to Section ll. WHO IS AN in the Schedule of this endorsement on
INSURED: premises owned, leased, maintained or used by
The person or organization designated in the such person or organization.
Schedule of this endorsement is also an B. ADDITIONAL EXCLUSION
insured, but only with respect to their liability for This insurance, including our duty to defend
"bodily injury"or"property damage"caused, in "suits", does not apply to"bodily injury",
whole or in part, by your acts or omissions or the "property damage"or"personal and advertising
acts or omissions of those acting on your behalf injury"arising out of any active negligence of the
in connection with acts or services normal and person or organization designated in the
usual to your business described in the Schedule of this endorsement.
Declarations, performed by you or on your
behalf for the person or organization designated
All terms and conditions of this policy apply unless modified by this endorsement.
SCHEDULE
Name of Person or Organization:
CITY OF EL SEGUNDO
350 MAIN ST
EL SEGUNDO CA 902453813
PB 60 04 04 11 Page 1 of 1
ACP BPW 7855932976 INSURED COPY 47 03886
BUSINESSOWNERS
PB 60 72 07 11
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT ENT TO OTHER INSURANCE CLAUSE FOR
ADDITIONAL INSUREDS - PRIMARY AND NOW
CONTRIBUTORY WHEN REQUIRED IN A WRITTEN
N
AGREEMENT OR CONTRACT WITH YOU
This endorsement modifies insurance provided under the following:
PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS
Only with respect to any additional insured, in the COMMON POLICY CONDITIONS, form PB 00 09, under
condition H. OTHER INSURANCE, paragraph 2.a. is replaced by the following:
H. OTHER INSURANCE
2. Under any liability coverage provided by this policy,
a. If for injury or loss we cover, there is other valid and collectible insurance available to any additional
insured under another policy, our obligations are limited as follows:
(1) Issued by another insurer, or if there is self insurance or similar risk retention that applies to a
loss covered by this policy, then this insurance provided by us shall be excess over such other
insurance, unless you have agreed in a written contract or written agreement signed prior to the
loss that this insurance shall be primary:
(a) Then this insurance is primary. If other insurance is also primary, we will share with all that
other insurance as described in d. below; and
(b) The coverage afforded by this insurance is non-contributory with the additional insured's own
insurance.
Paragraphs(a) and(b) do not apply to other insurance to which the additional insured has been
added as an additional insured to any other person or organization's policy.; or
(2) Issued by us or any of our affiliate companies,that applies to a loss covered by this policy, then
only the highest applicable Limit of Insurance shall apply to such loss.This condition does not
apply to any policy issued by us that is designed to provide Excess or Umbrella liability insurance.
All terms and conditions of this policy apply unless modified by this endorsement.
PB 60 72 07 11 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1
ACP BPW 7855932976 INSURED COPY 47 03892
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER
FROM OTHERS ENDORSEMENT
Policy Number: 72 WEC AA2RSY Endorsement Number:
Effective Date: 06/01/17 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: STEVEN ENTERPRISES, INC.
17952 SKY PARK CIR
IRVINE CA 92614
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
SCHEDULE
Any person or organization from whom you are required by contract or agreement to obtain this waiver from us.
Endorsement is not applicable in KY, NH, NJ or for any MO construction risk
Countersigned by
Authorized Representative
Form WC 00 0313 Printed in U.S.A.
Process Date: 05/03/17 Policy Expiration Date: 06/01/18