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CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE
JECT LOC PRO- POLICY GEN'L AGGREGATE LIMIT APPLIES PER:
CLAIMS-MADE OCCUR
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $ DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ DED RETENTION $ CLAIMS-MADE OCCUR
$ AGGREGATE $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY) POLICY EXP(MM/DD/YYYY) LIMITS
PER
STATUTE OTH- ER
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under DESCRIPTION OF OPERATIONS below
(Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT BODILY INJURY (Per person)
BODILY INJURY (Per accident) PROPERTY DAMAGE $$
$
$
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.
INSD
ADDL WVDSUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
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.
INSURED
PHONE
(A/C, No, Ext): PRODUCER
ADDRESS: E-MAIL
FAX
(A/C, No): CONTACT NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
Certificate Of Insurance
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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).
TechInsurance, Division of Specialty Program Group LLC
203 N. LaSalle St., 20th Floor, Chicago, IL 60601
(800) 688-1984 312-690-4123
Peregrine Technologies
130 Bush St Fl 8 , San Francisco, CA, 94104-3819
Hartford Multi-State 00914 Underwriters at Lloyd's 99998 Hartford Underwriters Insurance Company 30104 C 46SBABF4FW2 ✔
✔
2,000,000 10,000
3/29/2025
1,000,000
3/29/2024 2,000,000 4,000,000 4,000,000 C
2,000,000 ✔ ✔
46SBABF4FW2 3/29/2024 3/29/2025
C
✔ ✔
10,000
46SBABF4FW2 3/29/2024 3/29/2025
3,000,000 3,000,000 ✔
A
No 46WECAC3TVE 12/4/2023 12/4/2024
✔
1,000,000 1,000,000 1,000,000 B Professional Liability (Errors and Omissions) WG00004746AD 3/8/2024 3/8/2025 Occurrence/Aggregate $2,000,000 / $2,000,000 Redondo Beach Police Department
401 Diamond St. Redondo Beach, CA 90277
6/7/2024 ✔
10671185 Peregrine Technologies 6/7/2024 9:22:24 PM