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Francine R. Digitally signed by <br />Francine R. Villareal <br />Date:2022.01.20 <br />Villareal <br />10:27:34-08'00' <br />c vaeu CERTIFICATE OF LIABILITY INSURANCE 01/10/2022RANCE nnre(E+Mmnlwvv) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THY CERTIFICATE HOLDER. THIS <br />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 <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INBUREO, the pollCy(les) 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 rinhte to the OadlNoete hnldnr b, ne,...r.... ,.....,.._____„_. <br />PRODUCER <br />A J INSURANCE <br />1000 Maoarthur Blvd #60 <br />Santa Ana, CA 92707 <br />INSURED <br />COSMOS EVENT RENTALS <br />2AVALA,ROBERT0 <br />1773 W LINCOLN AVE #S <br />__._...._..._.._....._... KRVIO]UN NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED <br />ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT <br />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 />I R-- <br />TYFEOP IN;VPANCE <br />1'B <br />BR <br />POLICY U O8 <br />P01 aRF <br />M SI <br />P E <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />— <br />CLAIMS-FMDE ®OCCUR <br />EAOIIOCCURRENCE <br />Lro <br />$ 2,000 600 <br />DER:600 <br />P6EMI8E41Ea6 )___ <br />$ 100 000 <br />$ 5000 <br />A <br />MEOEXP ono a,,, <br />s. <br />MP0004014001196 <br />111412022 <br />1/14/2023 <br />PERSONALS, ADV INJURY <br />$ 1000000 <br />DEMP.041CYEOATE <br />UNIT M LIFE PER: <br />Loa <br />GENERAL AGGREGATE <br />$ _-.3,000000 <br />PRODUCT$-COMPIOPAGO <br />g 2000O O <br />JE <br />..._. <br />— <br />$ <br />AUTOMOBILE <br />LIABU.ITY <br />LI I <br />$ <br />ANY AUTO <br />OWNRD SC.IIEOULEO <br />FONI.Y <br />BODILY INJURY(Perpoman) <br />$ <br />SODILYINJURY(Parecaldenl) <br />$ <br />._.... <br />AtnT AUTOS <br />r11RED NON -OWNED <br />OPEE% 0 <br />-- <br />$ <br />AUTOS ONLY _ AUTOS ONLY <br />$ <br />UMBRELLA LIAO <br />OCCUR <br />EACLI OCCURRENCE <br />RXCESS LIAO <br />CLAIMS -MADE <br />A13OREGATE -.$ <br />-�-- <br />LED RETENTION11 <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNCRIEXSOUTIVE <br />OPrior;RIMMSER EXCLUDED? <br />NIA <br />RLEACHACCIOENT <br />$ <br />RL. DISEASE -PA EMPLOYe <br />— <br />Ifyyoa deoIXlae uMar <br />OWN,and <br />OF <br />EL. DISEASE. POLICY LIMIT <br />$ <br />DF.sCOlPrION OPERATIONSbolW, <br />PROPERTY <br />A <br />MPOOD4014001196 <br />1114/2021 <br />111412022 <br />CONTENTS: <br />100,000 <br />D880HIPTION OF OPERATION81 LOCATIONS IVEHICLEO (ACORD 141, AdI llloaal 101.03 Sdbgdolg, may Co nlmchod d mold goods drool <br />PARTY RENTALSTOREr <br />City of Santa Ann, Its of floors, amployaos, a0onts and roprosantathum are Additional In,urede WIDI re,poct to Gonadal Llablllty and Auto Liability PUT ads attaohad endorsement, or as <br />roqulrad by written Contraal, Insurance Is Prim ary nntl Non -Contributory, <br />{ y 30 Days' Notion of Canaoilatlan with 10 mry's NOMA for NOD-Paymeat of Pmmmm In accordance with the policy provisions. REVIL YYE APpI]R(wki✓ <br />By isk MA A EVENT DIVISION <br />Jf, <br />SHOULD ANY OF THE A5DVE I I at BE'C'" ORE <br />CITY OF SANTA ANA <br />THE EXPIRATION DATE THERI IN <br />ACCORDANCE WITH THE POLCY <br />20 CIAO Center Plaza <br />1=Z DNS. <br />Santa Ana, CA, 92702 <br />AUTHORIl REPRESENTATIVE --.....,,, <br />/ V <br />v TSOO-2U,b AOUKU CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD mmY)o and logo at's registered marks of ACORD <br />I <br />