CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
INSURER(S) AFFORDING COVERAGE NAIC #
PRODUCER
INSURED
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
COVERAGES
TYPE OF INSURANCE POLICY NUMBER LIMITS
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: POLICY LOC OTHER:
EACH OCCURRENCE
MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
$
$
$
$
$
$
AUTOMOBILE LIABILITY
ANY AUTO
$
$
$
$
OCCUR
CLAIMS-MADE DED RETENTION $
EACH OCCURRENCE
AGGREGATE
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
$
$
$
$
$
Y/N
CONTACT NAME: PHONE
(A/C, No, Ext): E-MAIL ADDRESS:
FAX
(A/C, No):
CERTIFICATE NUMBER: REVISION NUMBER:
$
UMBRELLA LIAB
EXCESS LIAB
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD $
INSURER F :
$
N/A
SCHEDULED AUTOS NON-OWNED AUTOS ONLY
OWNED
AUTOS ONLY HIRED
AUTOS ONLY
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.
INSR
LTR
ADDL
INSD
POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)
PRO- JECT
DAMAGE TO RENTED PREMISES (Ea occurrence)
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident) PROPERTY DAMAGE
(Per accident)
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH)
If yes, describe under DESCRIPTION OF OPERATIONS below
PER STATUTE OTH- ER
SUBR WVD
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).
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
07/02/2024
WM F BUELL INC
621 E PARK AVE
LIBERTYVILLE, IL 60048
(888) 661-3938
(888) 661-3938 (877) 872-7604
[email protected]
PEGASUS STUDIOS
5760 LINDERO CANYON RD
# 1151
WESTLAKE VILLAGE, CA 91362
TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
097502747571481
B X
X
X HIRED AUTO X NON OWNED AUTO X
X 680-4X180440-24 04/29/2024 04/29/2025 2,000,000
300,000
5,000
2,000,000
4,000,000
4,000,000
A
X
X BA-4X180280-24 08/12/2024 08/12/2025 1,000,000
B X X
X 0
CUP-4X18065A-24 04/29/2024 04/29/2025 1,000,000
1,000,000
B UB-4X180519-24 04/29/2024 04/29/2025 X
1,000,000
1,000,000
1,000,000
AS RESPECTS TO GENERAL LIABILITY, CITY OF REDONDO BEACH, ITS OFFICERS AND EMPLOYEES ARE ADDITIONAL INSURED - BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS, CG D1 05, BUT ONLY AS RESPECTS TO VIDEO PRODUCTION. AS RESPECTS TO GENERAL LIABILITY, COVERAGE IS AFFORDED ON A PRIMARY AND NON-CONTRIBUTORY BASIS AS PER CG T1 00. AS RESPECTS TO AUTOMOBILE LIABILITY, CITY OF REDONDO BEACH, ITS OFFICERS AND EMPLOYEES ARE ADDITIONAL INSURED - CA T4 42 ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE. AN ENDORSEMENT HAS BEEN ADDED TO THE POLICY (OR POLICIES) THAT PROVIDES 30 DAY EARLIER NOTICE OF CANCELLATION, SUBJECT TO THE TERMS OF THAT ENDORSEMENT
CITY OF REDONDO BEACH
415 DIAMOND STREET
REDONDO BEACH, CA 90277