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S'f i"4" /� 2 j From: Marianne Hochmiath 9/1912014 4:14:17 PM (Page 4 of 4) AC"Rbr CERTIFICATE OF LIABILITY INSURANCE O�J/1Jc12014'YYrr' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONKERS 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 INSURERIB), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subjac4 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 certificato holder in Ilan of such endorsemon4 s . PRODUCER Allied Specialty Insurance, Inc. 85 N.E. Loop 410, Suite 600 San Antonio, TX 78216 CONTACT PHONE —.__......__ Fax -- E-h1A L ADDreeas._ _ INSURER(9) AFFOROINe COVERAGE NAIC N 210.341.1321 800.235.8774 _INSURERA:T.H.E.Insure nceCompany__.! 12866 INSURED Carnival Midway Attractions INPURERa: i---_ INSURERo: Linton Park Holdings, Inc. 2560 E. Chapman Ave. #245 Orange, CA 82869 INSURER O: _ 1 INSURER P: CERTIFICATE THIS IS TO CERTIFY THAT T4F POLICIES OF INSURANCE LISTED BELOW HAVF 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. INSRT TYPE OP INSURANCE ICY EJ(P POUGYi UMBER - UMII'S A cENEaAL uaaanr CPP01001016.04 �04/01/2014 0410112015 EACH OCCJRR�NCF $1,000,000 M CFJMMCRCIALGENETLU.1-ABIUTY ", 7 ER_n�EIJ� ESjEa cn c rcrr nce) $1 SO,0DO CLAIMS -MADE OCCUR NIEDEXP (Any nneLareon) $ PERSONAL NADVINJURY $1,000,000 GENERAL.ALIGNEGATE $SLOOD,ODO . GEN'LAGGRGGATE LIMITAPPLIES PER: ._ _ PRODUCTS-COMPlOPAGO $1,000,000 .._... PULIOV ,... PRO- LCC 'I, ISQT ----.—_..._..._-- 5 e AUTOMOBILE LIARILITY . CPP01001016.04 04/01/2014 0410112015 COMBINEDS L- Ear+-�e ��L. 1 OQOOOO r BOUILY INJORY(For poMan) $ ANYAUTO I ALL OWNED SCHEDULED AMTGB IX AUTOS I "— BODILY INJURY(Peracddeni) # j ' NON-ONNEI] HIRED AU-O3 Ii AUTOS PROPE10-rN, AGF - i (Fur a;r.IcnntL_.. ....._—__—.'� .__...._._ I A UMBRELLA LIAR X OCCUR cLP9610197•G4 04/0'112914 04101/2015 FACHOCCURRFNCF $4,000,000 )( F _ EXCESS UA9 GLAin�srnaoe —.—_—.__-. AGgaeGATt—.--- ..-- DED ! 1 4N _$4L000_,ODQ $ I I WORKERS COMPENSATION :' Ik WG STAIU- ;OTFF l-Y LINII_ ._.. ,;,..., AND EMPLOYERS' LIABILITY ANVf NOPWEYORIPAR'INEfUEXECUTIVE YlE yyryry //yy'(% 1 TT(('�i�%AbM `^ E.L, EACH ACCIDENT' $ OFFICER'UEMMER EXCLUDED'' NIA ..- J,'s ' EL. DISEASE $ (Myyantlntn,y In NWi r .. �t l �c(Y EL. DISEASE -POLICY grdiT ; 063LLJRIRTIONgFgPERATIONSEc. �Q C1 y At D Assistant rr DESCRIPTION OF OPERATIONS' LOCATIONS IV EHICLE$ (Attach AGORO 101, Addnlunal Rx,narke Schvd.]., 11,no,v space I, ♦nyulred) EFFECTIVE FROM 10/14114 THROUGH 10121114 ADDITIONAL INSURED: CITY OF SANTA ANA. ITS OFFICERS, AGENTS AND EMPLOYEES: ROBERT ACOSTA COVERAGE IS PRIMARY AND NOW -CONTRIBUTORY AS RESPECTS TO THE OPERATIONS OF THE NAMED INSURED ONLY p DAY CANCELLATION CLAUSE APPLIES y of Santa Ana In: PRCSA Civic Center Plaza - M-23 nta Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATS THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS, AUTHORIZED RLPRESENTAi1VE ©1988-2010 ACORO reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD