SING E DANCE MUSIC
JOANNE BRADFORD
ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/03/2021
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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(es) 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 endorsements).
Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA
(NG. No. Ext): (888) 202-3007
520 Madison Avenue
32nd Floor ADDRESS: [email protected]
New York, NY 10022 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hiscox Insurance Company Inc 10200
INSURED
INSURER B:
Sing and Dance Music
2510 Curtis Ave Apt A INSURER C:
Redondo Beach CA 90278 INSURER D:
INSURER E:
INSURER F:
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
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.
TYPE OF INSURANCE POLICY EFF POLICY EXP
LTR INSOWYD POLICY NUMBER
(MM/DD/YYYY)(MM/0D/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
CLAIMS MADE X ¡ OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence) $ 100.000
MED EXP (Any one person) $ 5,000
A UDC-2197121-CGL-21 03/09/2021 03/09/2022 PERSONAL & ADV INJURY $ 1,000,000 GENI AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 PRO
X POLICY JECT I LOC PRODUCTS • COMP/OP AGG s S/T Gen. Agg OTHER
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO
BODILY INJURY (Per person)
OWNED SCHEDULED
AUTOS ONLY BODILY INJURY (Per accident)
HIRED NON OWNED
AUTOS ONLY PROPERTY DAMAGE
AUTOS ONLY
Per accident)
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
EXCESS LIAB
CLAIMS MADE AGGREGATE
DED RETENTIONS
WORKERS COMPENSATION
PER OTH
AND EMPLOYERS LIABILITY STATUTE I ER
ANYPROPRIETOR/PARTNER EXECUTIVE
OFFICER MEMBEREXCLUDED: N/ A EL EACH ACCIDENT
Mandatory in NH)
yes. desonbe und EL DISEASE - EA EMPLOYEE S
ESCRIPTION OF OPERATIONS beic EL DISEASE • POLICY LIMIT / S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ACCORDANCE WITH THE POLICE PROVISIONSO THE EXPIRATION DATE NOTICE WILL BE DELIVERED IN
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD HISCOX Hiscox Insurance Company Inc.
Policy Number: UDC-2197121-CGL-21
Named Insured: Sing and Dance Music
Endorsement Number. 11
Endorsement Effective: August 2, 202
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - 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) 192 Ayes Blond Beach, is oficers, elected and appointed ficials, employees, and volunteers Redondo Beach, CA 90278
[Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section I - Who Is An Insured is amended to in-
clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect
to liability for "bodily injury". "property damage" or
'personal and advertising injury" caused, in whole o
n part, by your acts or omissions or the acts or omis
sions 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