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r <br /> DATE <br /> SPECIALTY CERTIFICATE OF LIABILITY INSURANCE (MMIDD/YYYY) <br /> INSURANCE AGENCY 0211212026 <br /> IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS <br /> 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 <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER <br /> Specialty Insurance Agency Contact Name: Heather Weiss Zenzen <br /> Performers of the U.S. Phone: 715-246-8908 FAX: 715-246-8908 <br /> 3432 Denmark Ave#231 Email: certs@specialtyinsuranceagency.com <br /> Eagan,MN 55123 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED PERFORMERS OF THE U.S.AND ITS PARTICIPATING MEMBERS: INSURER A: Evanston Insurance Company 35378 <br /> Richard Ribuffo <br /> INSURER B: <br /> dba Richard Ribuffo of Magic Makers Entertainment <br /> 352 South Center Street INSURER C: <br /> Orange,CA 92866 INSURER D: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY <br /> REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE <br /> INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE <br /> LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ADDS SUaa - POLICY EFFECTIVE POLICY EXPIRATION <br /> TYPE OF INSURANCE INSD WVD POLICY NUMBER DATE(MM/DD/Y1fI DATE IMM/DD/YY) LIMITS <br /> XCOMMERCIAL GENERAL EACH OCCURRENCE $1 000 000 <br /> (ABILITY DAMAGE T RENTED .,,....0 <br /> CLAIMS MADE X�OCCUR PREMISES(Ea ocwrrence) $300,000 <br /> GENT AGGREGATE LIMIT MED EXP(Any are person) $5,000 <br /> A APPLIES PER: X X 2CN0183-13838 03/2612026 03/26/2027 12:01am PERSCNAL&AOV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> X POLICY PROJECT PRODUCTS-COMP/03' <br /> LOC AGG $2,000,000 <br /> A PERFORMER ASSISTANT(S) EACH OCCURRENCE $ <br /> AGGREGATE $ <br /> BUSINESS PERSONAL <br /> A AGGREGATE <br /> PROPERTY-INLAND MARINE <br /> SEXUAL ABUSE AND EACH OCCURRENCE $1,000,000 <br /> A MOLESTATION 2CN0183-13838 03/26/2026 03/26/202712;01am <br /> ElOCCUR AGGREGATE $2,000,000 <br /> A DATA BREACH AND CYBER AGGREGATE $ <br /> LIABILITY COVERAGE <br /> A EQUIPMENT LEASED OR AGGREGATE $ <br /> RENTED <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: <br /> Richard Ribuffo dba Richard Ribuffo of Magic Makers Entertainment <br /> Additional Insured; City of Santa Ana,its City Council,Officers,officials,employees,agents,and volunteers. Waiver of Subrogation applies to general liability. <br /> Sexual abuse or molestation coverage is not excluded by endorsement.$1,000,000/$2,000,000 coverage limits apply to educational institutions only;otherwise <br /> $100,000 each Occurrence/$300,000 aggregate limits apply to sexual abuse or molestation coverage. <br /> Email:bgarcia-diaz@Santa-ana.org Attn:Beatriz Garcia-Diaz Ongoing For Policy Period <br /> Insured for:Balloon Twister,Childrens Entertainer, Magician,Public Speaker,Rape Tricks Performer,Videographer.Note:Athletic audience participation <br /> exclusion applies. <br /> APPROVED <br /> 8y 7u Tran Nguyen a�May <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCEMEB <br /> City of Santa Ana BEFORE THE EXPIRATION DATE THEREOF,THE INSURER AFFORDING <br /> Attention;Library Services, COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE <br /> Dylan Dario CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO <br /> SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> 20 Civic Center Plaza,M-42 INSURER,ITS AGENTS OR REPRESENTATIVES, <br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE - � �� <br /> d!MA'�l <br />