ACORD® DATE (IM/DOMYYY)
CERTIFICATE OF LIABILITY INSURANCE 0412212022
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(8), AUTHORIZEI
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITONAL INSURED provisions or be endorsed.
I SUBROGATION IS WAIVED, subjeot to the terms and conditions of the policy, certain polioies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lleu of such endorsements).
PRODUCER CONTACT
HAME:
Lockton Affinity, LLC PHONE (A/C, No, Ext):
PO Box 410679 E-MAIL ADDRESS:
Kansas City, MO 64141-0679
INSURERS) AFFORDING COVERAGE NAICE
37540
INSURERA: Beazley Insurance Company Inc.
INSURED INSURER B:
Kristy Ibarra-Armas
INSURER C:
2647 HILL ST
INSURER D:
WALNUT PARK, CA 90256-6331
INSURER E:
INSURERE:
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.
LIMITS
EACH OCCURRENCE Is N/A
CLAIMS MADE OCCUR V1595R22PD00 12/20/2022 12/20/2023
X
X Professional Liability MED EXP (Any one person) $2,000 $50,0000 aggregate
PERSONAL & ADV INJURY s Included
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1.000.000 X POLICY PRODUCTS - COMPIOP AGG s Excluded
OTHER: EACH CLAIM $1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
a accident
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) s
AUTOS ONLY LUTOS PROPERTY DAMAGE
VON-OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAB AGGREGATE
CLAIMS MADE
DED RETENTION S
YIN
GET MEMBER EXCLUDED CUTIVE NIA EL EACH ACCIDENT
(Mandatory in NH) EL. DISEASE - EA EMPLOYEE S
DYSCRIPTION OF OPERATONS below
8100,000
A Fire Legal Liabitty GENERAL GREATES
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached i'more space is required)
CERTIFICATE HOLDER CANCELLATON
2957093
The City of Redondo Beach
1922 Artesia Bivd ICCORDANCE WITH THE POLICY PROVISION:
Redondo Beach, CA 90278 AUTHORIZEO REPRESENTATIVE
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 42722636 Effective date of this Endorsement: 12/20/2022
This Endorsement is attached to and forms a part of
Policy Number: V1595R22PD00
Beazley Insurance Company Inc. referred to in this
endorsement as either the "Insurer" or the
"Underwriters"
ADD/DELETE ENDORSEMENT WITHOUT ADDITIONAL/RETURN PREMIUM This endorsement modifies insurance provided under the
following:
HEALTH AND FITNESS PROFESSIONALS PROFESSIONAL LIABILITY AND GENERAL LIABILITY
CLAIMS MADE AND REPORTED INSURANCE
It is hereby understood and agreed that the following endorsements) is Added to the Policy.
The City of Redondo Beach
1922 Artesia Blvd
Redondo Beach, CA 90278
All other terms and conditions of this Policy remain
unchanged.
Authorized Representative
E00303 Page 1 of 1
022008 ed.