SUPER BIRTHDAY, INC dba MINI EXPRESS

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Tori Pierson Digitallysigned Pierson Date: 2022.03.09 1010:23 23:21-08'00' l oizo�,4` CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 10 22 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). PRODUCER CONTACT NAME: Thomas Plouffe n/c°Na Ext: 203 931 7095 FAX No: 203-931-0682 Specialty Insurance, LTD. ADMDRESS: Certificates@specialtyinsuranceltd.com P.O. Box 16901 INSURER(S) AFFORDING COVERAGE NAIC # West Haven, CT 06516 INSURERA: Mesa Underwriters Specialty Insurance Coma 36838 INSURED INSURER B Super Birthday, Inc INSURERC: 1941 California Ave # 77591 INSURER D : Corona, CA 92881 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 LTR TYPE OF INSURANCE ADDL I SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A �( COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR x M P0020002002094 11 /20/21 11 /20/22 EACH OCCURRENCE $ 1 ,000,000 PREM SESDAMAGEOEa oocur ence $ 100,000 MED EXP (Any one person) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO - El JECT1:1 LOC PRODUCTS- COMP/OPAGG $ Included $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE F—FDED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and representative are added as an additional insured but only with respects to the operations of the named insured during the policy period. 30 days written notice of cancellation will be provided. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana 20 Civic Center Plaza Santa Ana, California 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 v tertl: 'D"b'V%8q11,ye�M�,1,. ... / RED& APPRaVEO fir F47fif, pW^CC^zt4aa © 1988-2014 ACORD C( i<csurvoanagen� rn iencalr ae ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD