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Client#: 158 PAULMAUR ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 3/05/2020 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 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). Haas & Wilkerson Insurance 4300 Shawnee Mission Parkway Fairway, KS 66205 913 432-4400 INSURED Paul Maurer dba Paul Maurer Shows 16081 Warren Ln Huntington Beach, CA 92649 _. _— 432-4400 FAX No): Ace Anencan Insurance Company(CHUBB) ZZ667 SI.Y NE lan.l I .... no. Compan, Ins. 12831 COVERAGES CERTIFICATE NUMBER: REVISION NIIMRFR- 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 CONTRACTOR 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 TYPE OF INSURANCE _.INSR SUBR MD, POLICYNUMBER POLICY EFF (MMIEKINYYY) POLICY UP LFDDr ). LIMITS 2/05/2020 02/05/2021 $1,000,000 -- • GENERAL LIABILITY '�. G20496496 EACH OCCURRENCE X COMMERCIAL GENERALLIABILITY DpMpGE TORENTED PREMI$ES�occunence)_. s300,000 CLAIMS -MADE LXJOCCUR MED EXP (Anyone Person) _.. $Excluded _ PERSONALBADVINJURY $1,000,000 _ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO -_ $2,000,000 POUCV JECT 1 XI LOC_,.,,._. $ A AUTOMOBILE UASIUTY H08133268 2/06/2020 02/05/2021 Ea acci En SINGLE LIMIT Ea cddamL-- §1,000,000 BODILY INJURY (Per person) ANY AUTO $ ALL OWNED X-SCHEDULED A AUTOS AUTOS BODILY INJURY (Per accitlenq $ _........-.._.... X X NON -OWNED -PROPERTY DAMAGE S HIRED AUTOS AUTOS(Par accitlent 5 UMBRELLA LIAR OCCUR _ EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS�MADE DED RETENTIONS $ WORKERS COMPENSATION B NFA0568564 1/01/2020 01/01/2021 OTH- X LIMIT'Eft AND EMPLOYERS' LU,BILITY YIN TO p RY ANY PROPRIETORIPARTNERIEXECUTIVE-- OFFICERIMEMBER EXCLUDED? Y N/A EL EACH ACCIDENT ---- --- $1,000,000 (Mandatory in NH) E.L.DISEASE EA EMPLOYEE:1,000,000 Ify.%descrlbeunder DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT - __. $1000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) & APPROVED Additional Insureds: City of Santa Ana, it's officers, agents, employees, representatives and REVIEWED DivisiON volunteers, and Fiesta de Carnival. By Risk MANAGEMENT SEE ATTACHED ADDITIONAL INSURED, NON-CONTRIBUTORY AND 30 DAY NOC ENDORSEMENTS uA i O Workers' Compensation coverage applies to the statutory requirements of the state of California. MA 11 City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE A,iAL B_AhAr..,=- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S413051/M406720 SALAK