COSMOS EVENT RENTALS (ROBERTO ZAVALA)

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® 7211/2025 (MM/DD/YYYY) ACC OR" � CERTIFICATE OF LIABILITY INSURANCE 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 holder in lieu of such endorsement(s). PRODUCER NAME CT Adrian J Robles A J INSURANCE IC N Ext: 714 673-5549 A/c No: 3843 S Bristol Street, #130 AODRess: a'insurance live.com Santa Ana, CA 92704 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: MESA UNDERWRITERS SPECIALTY INS. 36838 INSURED INSURER B: COSMOS EVENT RENTALS INSURER C 7 ZAVALA, ROBERTO INSURER D 7 1773 W LINCOLN AVE#S INSURER E: ANAHElM CA92801 INSURERF: 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 ADDTYPE OF INSURANCE INSD WVDSUBR POLICY NUMBER POLICY EFF POLICY EXP LTR MM DD YYYY MM DD YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE � OCCUR PREMISES (Ea occurrence) ccurrrence) $ 100,000 DED: 500 MED EXP(Any one person) $ 5,000 A x x MP000401410006200 1/14/2025 1/14/2026 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ EXCLUDED?OFFICER/MEMBER N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ PROPERTY A MP000401410006200 1/14/2025 1/14/2026 CONTENTS: 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) PARTY RENTAL STORE: City of Santa Ana,its officers,employees,agents and representatives are Additional Insureds with respect to General Liability and Auto Liability per the attached endorsements or as required by written Contract.Insurance is Primary and Non-Contributory.LIBRARY SERVICES AGENCY PROGRAMMING IN THE CIYT OF SANTA ANA. 30 Days'Notice of Cancellation with 10 Day's Notice for Non-Payment of Premium in accordance with the policy provisions. signeby Tu Tran TDugTralnNguyen APPROVED Date:2025.03.20 Nguyen 11:3039-07'00' By Tu Train Nguyen at 11:29 am,Mar 20,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF SANTA ANA-CITY WIDE 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA,92702 x<_ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD