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ACOROP CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMn10YYY11 <br />02/24/2020 <br />THIS CERTIFICATE IS 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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />H SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsements . <br />PRODUCER <br />Specialty Insurance, LTD. <br />P.O. Box 16901 <br />West Haven, CT 06516 <br />http://speciafyinsurancefd.com <br />CONTACT <br />NAME: Thomas Plouffe / Michael Plouffe <br />PHONE 203-931-7095 Hp; 203-931-0682 <br />ADDRESS: certificates@specialtyinsuranceltd.com <br />INSUFtER(SI AFFORDING COVERAGE <br />HAIC1 <br />waURERA: Certain Underwriters @Lio ds of London <br />15792 <br />INSURED <br />Christopher Gaudagno dba SO CAL Rides <br />15011 Genoa Circle <br />Huntington,CA 92647 <br />INSURERB: Scottsdale Insurance Company <br />41297 <br />INSURER C: Crum & Forster <br />31348 <br />INSURER D: <br />INSURERS: <br />_ <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCEADDLSUSR <br />PODCYNUMBER <br />POLICY EFF <br />MMIW <br />POLICY ExP <br />Lmn <br />A <br />X <br />COMMERCIALGENERALLIABILRY <br />CLAIMS -MADE OCCUR <br />x <br />CC/18-0177 <br />3/15/19 <br />/ <br />L/ <br />3/15/20 <br />✓ <br />EACH OCCURRENCE <br />S 1,000,000 <br />PREMISES Ea=unenca <br />S 300,000 <br />MED EXP (An oae ) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GEN. <br />AGGREGATE LIMIT APPLES PER <br />POLICY E] JET �x LOC <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />PRODUCTS-COMP/OP AGG <br />$ 3,000,000 <br />S <br />OTHER: <br />AUTOMOBREUMBILRY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY(Pw;Nnwo) <br />$ <br />ANY AUTO <br />OPINED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />BODILY INJURY tPar accMMA) <br />S <br />PROPERTY DAMAGE <br />nt <br />$ <br />S <br />A <br />uMBRELULAe <br />X <br />occuR <br />X <br />CFJ18 0126 <br />3/15/19 <br />3/15/20 <br />EACH OCCURRENCE <br />s 1,000,000 <br />X <br />AGGREGATE <br />S 1,DOO,000 <br />EXCESS LIAR <br />CLAIMS41ADE <br />DED <br />RETENTION S <br />$ <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LNBILITY YIN <br />ANYPROPRIETOR/PARTNEWEXECU'rIVE <br />OFFICEWMEMBEREXCLUDED? <br />(Mandatory In NH) <br />N yes tlac Wraker <br />DESCRIPTION OF OPERATIONS baksY <br />NIA <br />I <br />STATUTEPER <br />ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L DISEASE - EA EMPLOYEE <br />S <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />B <br />Excess Coverage <br />X <br />XLS0109340 <br />3/15/19 <br />3/15/20 <br />1 million occ - $1 <br />million agg <br />C <br />Excess Coverage <br />2019-SE-6910403 <br />3/15/19 <br />3/15/20 <br />2 million occ - $2 <br />million agg <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD IN, AddMomd Remarks Schedule, may In aaaclwd If more space B tW Word) <br />City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are added as an additional <br />insured per the attached endorsement CC-GL-BLAI (01 /17) as respects Santa Ana Street Festival, located at Comer of Flower and <br />Civic Center Dr., Santa Ana, CA 92702 from Sept. 7 -16, 2020 (inclued set up and tear down). WOS & PNC are endorsed onto this <br />policy per form CC — BL WOS PNC 05 17. <br />'UPON THE RENEWAL DATE ANEW CERTIFICATE WILL BE I,SUED WITH NEW POLICY NUMBERS AND <br />POLICY DATES" 30 DAYS NOTICE OF CANCELLATION • <br />City of Santa Ana IWIEMD & A %1W'kNY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />y RISk MAIVACGEM T LrYi^4ftSIP&RATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Dr., 4th Floor MAR 11120 <br />Santa Ana, CA 92702 �Un1ORUEDREPRESENTATAT <br />ANGIE ACE d0 Thomas Plouffe <br />U <br />l <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2018/03) The ACORD name and logo are registered marks of ACORD <br />