HAYNES, FRANKLIN, DBA: FRANKLIN HAYNES MARIONETTES

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acoRO® ifI CERTIFICATE OF LIABILITY INSURANCE DAT5/16/2 11'VYYI 5I16I2019 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). PRODUCER CONTACT Stephanie Weiss Specialty Insurance Agency NAME,PHONE Extp__715-246-8908 FAX 715-246-4257 _ Performers of the U.S. _LA& No _ _ (A/C 1 RO. Box 24 E'MAIL l s eciat Incs nc ADDRESS: certs @ p Y _suranee.com _ 9_ Y New Richmond, WI 54017 -- ___ INSURER1S)AFFOROING COVERAGE NAIC # _. INSURER A: Evanston Insurance Company 35378 INSURED Franklin Delano Haynes dba Franklin Haynes Marionettes 1234 Muirfeld Road Riverside, CA 92506 C COVERAGES CERTIFICATE NUMBER- RFvISIn N1 w Ifirli 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 - - 'AC )L.8UBR POLICY EFF LTR TYPE OF INSURANCE p yy p POLICYNUMBER MMIDDnIYYY POLICY EXP MWDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 ._ CLAIMS -MADE X OCCUR DAMAGE TO REN ED—300,000 PREMISES (Ea occurrence) '$ —� VIED EXP(Any one person) '$ 51000 A X X 2CN0165-7335 '.. 04/18/2019 04/17/2020 PERSONAL S ADV INJURY '.$ 1,000,000 . GEN'L AGGREGATE LIMIT APPLIES PER: ' '. GENERAL AGGREGATE '. $ 2,000,000 'X POLICY'_ JEC '',J LOC PRODUCTS COMP/OP AGG $ 21000,000 OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO '', BODILY INJURY (Per person) $ OWNED '. SCHEDULED _ AUTOS ONLY AUTOS Per accltlent BODILY INJURY ( ) 5 HIRED NON -OWNED ',� PROPERTY DAMAGE _ --' "— $ _ _AUTOS ONLY AUTOS ONLY per accident) S UMBRELLA LIAR OCCUR EACH OCCURRENCE 5 EXCESS LIAR.. CLAIMS MADE AGGREGATE - S _ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE "� ,DER__ ANYPROPRIETOR/PARTNER/EXECUTIVE - E.L. EACH ACCIDENTOFFICE EXCLUDED? NIA' ❑ —--EMPLOYEE— — (MandaR/MEMBER (Mandatory In NH ( I E.L. DISEASE - EA S if yyee describe -- — — - OFunder O -0ESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A BUSINESS PERSONAL PROPERTY- INLAND MARINE AGGREGATE $ DESCRIPTION OF OPERATIONS 1 LOCATION SI VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U,S.: Franklin Delano Haynes dba Franklin Haynes Marionettes rad� Additional Insured: The City of Santa Ana, its officers, agents and employees as additional insured Email: mloera@santa-ana.org Attn: Michelle Loera p� Event Date: July 15, 2019 G. �\�Grt,�(y:�' �\ City of Santa Ana 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD