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Clierf#; 158 PAULMAUR ' <br />ACORM CERTIFICATE OF LIABILITY INSURANCE DATE!MMI°D/YVYYJ <br />zr0vz01s <br />THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER <br />IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be entlorsed. if SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsemengs). <br />PRODUCER <br />Haas $ Wilkerson InsuranceN NNE <br />4300 Shawnee Mission Parkwa a "N 1:913 432-4400 NO <br />i1 EMAIL <br />Fairway, KS 66205 A RE$E <br />9134324400 INSURERS) AFFORDING COVERAGE �.,,.. <br />Paul Maurer dba <br />Paul Maurer Shows <br />16081 Warren Lane <br />Huntington Beach, CA 92649 <br />THIS <br />-----''"-"""""' <br />IS TO CERTIFY iHAi TPOLICIES <br />HE <br />OF <br />INSURANCE <br />REVISION NUMBER: <br />INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, <br />LISTED BELOW HAVE BEEN <br />TERM OR CONDITION OF ANY <br />ISSUED TO <br />THE INSURED <br />BOVE <br />NAMED AFORTHE POLICY PERIOD <br />CERTIFICATE <br />EXCLUSIONS <br />MAY BE ISSUED OR MAY <br />PERTAIN, <br />THE INSURANCE AFFORDED BY <br />CONTRACTOR <br />THE POLICIES <br />OTHER DOCUMENT <br />DESCRIBED <br />WITH RESPECT TO WHICH THIS <br />AND CONDITIONS OF SUCH <br />POLICIES. <br />LIMITS SHOWN MAY HAVE BEEN <br />REDUCED <br />BY PAID CLAIMS. <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />!N SR <br />LTR <br />TYPE OF INSURANCE <br />IA OLSUB <br />POLICY NVMBER <br />YEF <br />MWD <br />M <br />A <br />GENERALLU181uTV <br />620486496 <br />4/0112018 <br />A�CWYYP <br />04/01/201 <br />LIMITS <br />EACH <br />X COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE$1000000 <br />ECCURRENCE <br />,REMISE am"TEiD S3000O0 <br />CLAIMS -MADE OCCUR <br />MED EXP (Anywepareon $EXCluded <br />PERSONAL B ADV INJURY $1,000000 <br />GEN'LAGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE $2,000,000 <br />PRODUCTS-DDMPAJPpGG s2,000,000 <br />POLICY PEQ X LOC <br />JET <br />$ <br />SOaccidDISINGLE LiMR 1000000 <br />A <br />AUTOMOBILE <br />H08133268 <br />2105/201802/05!201! <br />NYAUTO <br />AALL <br />X AUTOSULED <br />BODILY INJURY (Per parson) $ <br />AUTOSMED <br />NON- <br />X HIREDAUTOS X <br />BODILY INJURY (Pear accident) 18 <br />AUT09W"ED <br />accidenten°AMAGE $ <br />UMBRELLA LIAR OCCUR <br />EXCESS DAB CLAIMS-MADE <br />EACH OCCURRENCE § <br />OED R NTION§ <br />AGGREGATE $ <br />§ <br />X �sTATU- OTH- <br />B <br />WORKER$ COMPENSATION <br />AND ERRMppPLOYYETEER&pLLgqIABTIINNLEnEppY��FF��(( <br />NFA0568554 <br />1/01/2018 <br />01/01/201 <br />AOFFICEWMEIMBOREJ(WLUOEf]?ECt1TIVEa <br />NIA <br />(Mande" in Ni <br />EL EACH ACCIDENT $1 OOO Ogg <br />E.L. DISEASE- EA EMPLOYEE Et OOO OOO <br />SYes, dencrbe ehdM <br />DESCRIPTION OF OPERATIONS 001. <br />E.L. DISEASE -POLICY LIMIT 1 $1000000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atatch ACORD 101, Add1UOru1 Romare, Schedule, N more apace is ne Wrad) <br />Additional Insureds: City of Santa Ana, It's officers, agents, employees, representatives and <br />volunteers, and Fiesta de Carnival <br />SEE ATTACHED ADDITIONAL INSURED AND NON-CONTRIBUTORY ENDORSEMENTS <br />Workers' Compensation coverage applies to the statutory requirements of the state of Californi 5 a �i 5 <br />'x <br />CERTIFICATE HOLDER <br />City of Santa Ana, Parks, <br />Recreation 8: Community <br />Services Agency <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DLrSrCRiBEO PKICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />(01988-2010 <br />#3337819/M33781$ yr 1 ...m r,.urcu name ano logo are registered marks of ACORD <br />SALAK <br />All r:..11 a <br />