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PROOF OF INSURANCE (2019) CLOSED
►!►°' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmYY) 08/15/2018 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(les) 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 CONTACT John Hunt — 8 Supreme Choice Insurance Solutions PHONE Est). (909)„5 7-,4223 (888)236 -6993 (aGe Mp). 10700 Jersey Blvd EI A116.. mDnky( supreme-choice.com INSURERIS) AFFORDING COVERAGE Rancho Cucamonga CA 91730-5130 INSURERA: United Specialty Ins Co INSURED INSURER B : Lloyd's of London Edward Professional Advisors, LLC INSURER C 10700 Jersey Blvd Ste 160 INSURER D NAIC # 12537 INSURER FNSURER E I..... ....................................„,, . ........... Rancho Cucamonga CA 91730-5127 1 . 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, ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER !MM/D D/Y� EFF POLICY EUPyyy1,,,,.(KM/00,,,„,/x,,, yl LIMITS Ali X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CCURRENCE $ 2,000,000 00 CLAIMS -MADE X OCCUR prA$MISE�iEL,1 $ 100,000 B DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 10700 Jersey Blvd Ste 160, Rancho Cucamonga CA 91730 CERTIFICATE HOLDER CANCELLATION City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EI Segundo CA 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John Hunt I � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MED EXP (Any one PB.�.P�".).............. $5,000� A X X USA4232194 08/15/2018 08/15/2019 PERSONAL a ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 FOLIC PRO' �FOT LOC Include DUCTS-COMP/OPAGG $ d .X..^ AUTOMOBILE LIABILITY COi MISIF0 SINGLE LEWT p�Cc $ 2,000,000 Per person) $ A OH X X USA4232194 08/15/2018 08/15/2019 BODILY JURY (Per ccidenl) ..PRO/�'EWvTY $ . To REDS ONLY X — NONAUT�OWNED f9AkFhkea $ AUTOS ONLY -XI AUTOS ONLY "f,,pfgl 4.0.01:m) �. Y OCCURRENCE $ CDESS LI LAIMS-MADE AGGREGATE i $ C RETENTION $ WORKERS COMPENSATION PER OTH- ER AND EMPLOYERS' LIABILITY Y/N --- -- -LIT ----- OFFCERPRIETO REXC UDE/EXECUTIVE F --1N / A EL, EACH ACCIDENT $,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under ( DESCRIPTION OF OPERATIONS below E . DISEASE - POLICY LIMIT $ PL Aggregate Limit 1,000,000 Professional Liability MPL2334113 18 08/15/2018 08/15/2019 Each Claim Limit 1,000,000 B DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 10700 Jersey Blvd Ste 160, Rancho Cucamonga CA 91730 CERTIFICATE HOLDER CANCELLATION City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EI Segundo CA 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John Hunt I � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE dame of Person or Organization: Any person or organization for whom you are required to waive your right of recovery on this Coverage Part under a written contract or agreement. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 DATE (MMIDD � CC> CERTIFICATE OF LIABILITY INSURANCE 06/11/2019IYYYY) 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(les) 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 "ONTACT NAME: AP INTEGO INS GROUP LLC PHONE AX 375 WOODCLIFF DR FL 1 STE 102 IA+c, No, Exl): (666) 990-9965 AIC, No): (866) 733.5112 FAIRPORT, NY 14450 ADDRL AODRESS, frau'atlerasol'eclpayrollserviceslraaalors,com INSURER(S) AFFORDING COVERAGE NAIC # INSURED EDWARD PROFESSIONAL ADVISORS 10700 JERSEY BLVD RANCHO CUCAMONGA, CA 91730 COVERAGES CERTIFICATE NUMBER: =INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURER B: iINSURER C r. INSURER D IINSURER E: !INSURER F I 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. INSTR TYPE OF INSURANCE LTR COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Q OCCUR GE 'L AUGHLUA'tb. LIMIT APPLIES PER: POLICY PRO' LOC ECT OTHER: ....................._ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED iAUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBR'ELLALIABOCCUR '— EXCESS UAS CLAIMS -MADE DED 1� IIETEI J $ WORKERS COMPENSATION NIA AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YM OFFICER/MEMBER EXCLUDED? A (Mandatory in NH) Nf yes, describe under DESCRIPTION OF OPERATIONS below ADDL SUBR POLICY NUMBER INSD WVD POLICY EFF POLICY EXP (MMIDD/YYYY) (MMIDD/YYYY) LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one persori)...... -- PERSONAL & ADV INJURY GENERAL AGGREGATE I PRODUCTS . COMP/OP AGG COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY' (Per parson) BCD tlNJURYIP'ararcrdenl) PROPERTY' DAMAGE (Per accident) r II EACH OCCURRENCE AGGREGATE UB -3N547603-19-42 03/09/2019 03/09/2020 X I PER I N DTH STATUTE ER E,L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) r . CERTIFICATE HOLDER CANCELLATION EDWARD PROFESSIONAL ADVISORS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 10700 JERSEY BLVD BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RANCHO CUCAMONGA, CA 91730 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1968.2015 ACORD C'O'RPORATION. Ail rights resarved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD �E��i�WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: (UB -3N547603-19-42) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2 .0 % of the California workers' compensation pre- mium. Schedule Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Job Description BUSINESS CONSULTANTS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 03-09-19 ST ASSIGN: Page 1 of 1