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DATE(MM/DD/YYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <br /> 05/29/2025 <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 /> If SUBROGATION IS WAIVED,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 endorsement(s). <br /> PRODUCER NAME CT Tracy Lacheta <br /> Liberty United Insurance Services, Inc PHONE FAX <br /> 704 S VictoryBlvd Suite 204 AIC No Ext: 8187618888 A/c No: 8882666889 <br /> E-MAIL <br /> Burbank, CA 91502 ADDRESS: team@libertyunitedinsurance.com <br /> License#: OF89841 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA: Certain Underwriters at Lloyd's of London <br /> INSURED <br /> INSURER B <br /> Elite Special Events, Inc INSURER C7 <br /> 11278 Los Alamitos Boulevard #101 INSURER D7 <br /> Los Alamitos, CA 90720 INSURER E7 <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 00001977-270182 REVISION NUMBER: 476 <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 CONTRACTOR 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 TYPE OF INSURANCE ADDL SUBR <br /> POLICY EFF POLICY EXP <br /> LT R POLICY NUMBER MM DD YYYY MM/DD YYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY Y Y ZISM B1499 04 06/07/2026 06/07/2026 EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO RENTED <br /> X CLAIMS-MADE1:1 OCCUR PREMISES <br /> (Ea occurrence) $ 300,000 <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Santa Ana, its City Council, officers, officials, employees,agents, and volunteers are listed as additional insureds <br /> Tu Tran Digitally signed by <br /> Tu Tran Nguyen <br /> Nguyen Date:2025.05.30 APPROVED <br /> 14:32:42-07'00' <br /> By Tu Tran Nguyen at 2:32 pm,May 30,2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana, THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Attention: Parks,Recreation,and Community Services Agency ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza <br /> M-3 AUTHORIZED REPRESENTATIVE <br /> Santa Ana,CA 92701 <br /> • (TLL) <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by TLL on 05/29/2025 at 02:37PM <br />