ANY PROPRIETOR/PARTNER/ EXECUTIVEOFFICER/ MEMBER EXCLUDED?
INSR SUBRLTRADDL
INSD WVD
PRODUCER CONTACTNAME:
FAXPHONE(
A/C, No, Ext): A/C, No):(
E- MAILADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER EXPTYPEPOLICY EFF POLICY OF INSURANCE MM/DD/YYYY) ( MM/DD/YYYY) LIMITS(
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
RENTEDCLAIMS- DAMAGE TO MADE OCCUR $ PREMISES (Ea occurrence) MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO- POLICY AGGJECT LOC PRODUCTS - COMP/OP
OTHER: $
COMBINED SINGLE LIMIT $(
Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident)
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTHSTATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
LIMITDESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORD
9/13/2023
License # 0L48969
23434
NC Communications, Inc.
14519 W Western Ave
Gardena, CA 90249
16691
A 1,000,000
X X A0197342004 6/1/2023 6/1/2024 500,000
15,000
1,000,000
3,000,000
2,000,000
000A1,000,
X X A0197342001 6/1/2023 6/1/2024
000B6,000,
TUU 3415471 03 6/1/2023 6/1/2024 6,000,000
A
X A0197342 1/25/2023 1/25/2024 1,000,000
1,000,000
1,000,000
30 days notice of cancellation; 10 days notice for non-payment per standard guidelines.
The Certificate Holder is included as an Additional Insured, as respects to General Liability, regarding operations of the Named Insured, as required by written contract, per the attached endorsements.
City of Redondo Beach
415 Diamond St.
Redondo Beach, CA 90277
WIRICON-01 SCHVA1
C3 Risk & Insurance Services404 Camino Del Rio S. STE 410 San Diego, CA 92108
Vanessa Schaub
[email protected]
Middlesex Insurance Company
GREAT AMERICAN INSURANCE COMPANY
X
X
X
X
X
X X