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SHINE HWANG, DBA: SUNSHINE MUSIC
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SHINE HWANG, DBA: SUNSHINE MUSIC
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Last modified
8/24/2022 10:01:19 AM
Creation date
10/10/2019 4:26:29 PM
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Contracts
Company Name
SHINE HWANG, DBA: SUNSHINE MUSIC
Contract #
N-2019-201
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Destruction Year
2025
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CRUM&FORSTER' NAMED INSURED MEMBER <br />CERTIFICATE OF COVERAGE <br />This Certificate of Coverage evidences your coverage as a Named Insured Member under the Master Policy <br />described herein. <br />United States Fire Insurance Company certifies that the Named Insured Member as shown herein is insured <br />under the Sports & Recreation Providers Association Purchasing Group Master Policy. The Limits of <br />Insurance, Premium and Effective Date of coverage applicable to the Named Insured Member are as specified <br />above. This Certificate of Coverage, together with the Common Policy Conditions, Coverage Part(s), <br />Coverage Form(s) and Endorsements attached to the Master Policy, complete the above numbered insurance <br />contract. <br />The Master Policy, containing the terms and conditions of coverage, has been furnished to the Policyholder <br />and a copy of that policy accompanies this Certificate of Coverage. All claims are paid according to the terms <br />and conditions of the Master Policy. <br />Schedule of Additional Insureds <br />The entities shown below are added as Additional Insureds, but only In respect to liability caused by operations of the <br />Named Insured Member during the certificate policy period. <br />Form Number <br />Description <br />FSPG 101.0.0007 <br />Name Of Additional Insured Person(s) Or Organization(; <br />Designated Person/Org <br />FSPG 101.0.0008 <br />Name Of Additional Insured Governmental Entity(ies) <br />Designated Person/Org <br />(CA Govt) <br />FSPG 101.0,0009 <br />Name of Additional Insured State Or Governmental Agency Or Subdivision or <br />State/Govt Agency/ Subdivision <br />Political Subdivision: <br />FSPG 101.0,0010 <br />Name Of Additional insured Person(§) Or Organization(s): <br />Vendors_ <br />FSPG 101.0.0011 <br />Name Of Additional Insured Person( ) Or Omanization(s): <br />Managers or Lessors of <br />Premises <br />FSPG 101.0.0012 <br />Name Of Additional Insured Person(s) Or Organization(s); <br />Lessor of Leased Equipment <br />Endorsement Schedule <br />Form Number <br />Description <br />CG 2144 <br />Premises: <br />Limitation To Designated <br />Protect Or Operation: <br />Premises, Projects, Operations <br />CG 21 53 <br />Description of Dosignated Ongoing Opera i : In addition, scheduled activities <br />Exclusion — Designated <br />exclusion endorsement applies: Inflatable Amusement Devices, Carnival Rides, <br />Ongoing Operations <br />Knockerball/Bubble Soccer, Bungee Devices, Fireworks, Mechanical Bucking <br />Devices: including Multi Ride Attachments, Permanent & Mobile Rock Wall <br />Structures, Security Services Other Than Contracted Law Enforcement Officers, <br />Trampolines, and Zip Lines. <br />Specified Location (if Ap Ip i99b—li <br />Crum & Forster is part of Fairfax Financial Holdings Limited. C&F and Crum & Forster are registered trademarks of United <br />States Fire Insurance Company. <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DlvisiON <br />MG 05 009 07 17 , 0t9 Page 2 of 2 <br />FRANCINE R. VILLAREAL <br />
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