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ACCO L10" CERTIFICATE OF LIABILITY INSURANCE2/4/15 <br />DATE 1DDIYYYY) <br />THIS CERTIFICATE IS ISSUED ASA 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 pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />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 />CONTACT <br />NAME:Nes! Brazl e <br />Thompson Insurance Enterprises LLC <br />3380Chastain Meadows Pkwy, Ste. 100 <br />PHONE Ext: (6%8)290-2197 AIC 21-- <br />)_3380 <br />nor <br />RIESS, Nesi.Brazile@thomcoins.coin <br />Kennesaw, GA 30144 <br />PRODUCER <br />CUSTOM <br />ER ID : <br />NSURER S AFFORDING COVERAGE NAIC # <br />INSURED <br />International Promotions, Inc DBA: Fiesta De Carnival <br />11278 Los Alamitos Blvd #101 <br />Los Alamitos, CA 90720 <br />INSURERA: Essex Insurance Company 39020 <br />INSURER B: <br />INSURER C : <br />INSURER D: <br />INSURER E : <br />FPG20011734-01 <br />INSURER F: <br />4/19/15 <br />COVERAGES CERTIFICATE NUMBER: 668315 REVISION NUMBER: <br />THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 MAYBE 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 />ifd$- <br />LTR <br />TYPE OF INSURANCE <br />A'DDL <br />POLICY NUMBER <br />POLICY EF <br />MMIDDIYYYY <br />D P <br />MMIDDIYYYV <br />-- <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />Eaocainence $ 100,000___ <br />COMMERCIAL GENERAL -(ABILITYPREMISES <br />_ CLAIMS -MADE E OCCUR <br />X <br />FPG20011734-01 <br />4/19/14 <br />4/19/15 <br />MED EXP (Any one person) $Exclu_ded <br />PERSONAL&ADV INJURY $ 1,0001000 <br />A <br />_ _._ <br />GENERAL AGGRFGATE $2000 000. <br />AGGREGATE LIMIT APPLIES PER'. <br />PRODUCT'S-COMP/OP AGO $2,000,000 <br />j'L <br />POLIry PRO- LOC <br />CT <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />Reviewed <br />{{..�� <br />by . <br />J <br />COMBINED SINGLE LIMIT $ <br />(EaaccMI <br />BODILY INJURY(Perperson) $ <br />AUTOS AUTOS <br />HIREDAUTOS ElNON-ONNED <br />AUTOS <br />El <br />c=_ <br />BODILY INJURY UGI.cIden[) $ <br />PRO PERT DAMAGE <br />(Per acddent) $ <br />-i--_ <br />UMBRELLA LIAB <br />EXCESS LIAB _ <br />_ <br />OCCUR <br />C_LAIMSMADE <br />/� <br />PR (CSA/ <br />vi <br />d11111,n , <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DED RETENTION$ <br />_ <br />.$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />AV PROPRIETOR/PARTNER/EXECUTI VE-1 <br />GE.L. <br />OFFICER/MEMBEREXCLUIDED9 <br />N/A <br />I WCSTATU- I IOTH- <br />TORI'LIMITS ER <br />EACH ACCIDENT $ <br />E.L. DISEASE-EAEMPL.OYEE $ <br />(Mandatory In NH) <br />Ifyos, describe under <br />fJESCRIPTION Of-'OPERATIONSbooW <br />-- --' <br />E.L DISEASE -POLICY LIMIT $ <br />A <br />Professional Liability <br />FPG20011734-01 <br />4/19/14 <br />4/19/15 <br />EACH OccuRRENCE $ $500,000 <br />AGGREGATE $ $500,000 <br />DESCR PTION OF 0PERATI DNS 1 LO CATI O NO I VEHICLES (Attach ACO RD 101, Acrid onal Remarks Schedule, M more space is required) <br />Certificate Halder is an Additional Insured per the attached CG 20 26 07/04 endorsement <br />City Of Santa Ana, Its Officers, Agents And Employees <br />Attn:PRCSA <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />@ 1580-2010 ACORD <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />