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ACORbr CERTIFICATE OF LIABILITY INSURANCE lla� DATE(MM/DD/YYYY) 1 04/18/2024 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 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 rights to the certificate t t( _old PRODUCER st Main Stree►Insurance ervices, Inc. Aeeve ls2yyy'e peeveoDate:2 Grass Valley CA 9cs, AME: II a d ONE FAX (530) 477-6521 1a No: R�'R"Es�l�nfb@theeventhelper.com 5 COVERAGE NAICF INSURERA; Evanston Insurance Company 35378 _ INSURED Christina Vo Christina Vo, dba: 4051 24th St San Francisco CA 94114 INSURER B : INSURER C : INSURER D : INSURER E: 1 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 LTA TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MIND YYI LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGERENrED PREMISESS (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 Host Liquor Liability Retail Liquor Liability PERSONAL S ADV INJURY $ 1,000,000 A Y N 3DS5475-M3648962 05/18/2024 05/19/2024 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PHLOC GENERALAGGREGATE $ 2,000,000 12:01 AM 12:01 AM PRODUCTS - COMP/OPAGG $ 2,000,000 Deductible $ 1,000 OTHER: AUTOMOBILE LIABILITY COMBINED BINEDSINGLE LIMIT OME. I $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY ident (Par Accident) ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ Is UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN I PER I OTH- STATUTE iER E.L. EACH ACCIDENT $ ANYPROPRIETORIPARTNEWEXECUTIVE ❑ OFFICERIMEMBEREXCLUDED9 N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS b01ow DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Addklonal Remarks Schedule, may Wattache! U more space is required) Certificate holder listed below is named as additional insured per attached MEGL 2217 01 19. Attendance: 40, Event Type: Performer at Event(No Heavy Metal, Punk, Rap, Hip Hop Or Hard Rock). Event Location: Santa Ana Public Library The City, its officers, officials, employees, and volunteers are covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed. SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC liWcRlnmganoLLD[viNdn City of Santa Ana AUTHORIZED REPRESENTATIVE REVIEWED & APPROVED Or. 20 Civic Center Plaza ��// P_.lUitlll➢'�L`:e A�ty4(u Santa Ana CA 92701 ®' Risk Management SpedNist ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD