FIESTA DE CARNIVAL (A-2015-019)-2015

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Av CERTIFICATE OF LIABILITY INSURANCE DA/0 25/15) 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: It the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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 PRODUCER y � A 1e eCla t Insurance Inc NAME_._, --_—___--_-_-_-__- 10451 Gulf Blvd �PHONE -- AH Treasure Island, FL 33706 E/j�MC1, No Ex, .--_-_ --- . _-- Lac No_ 8002373355 ADDRESS --_ —__T __ _ INSURER(S)AFFORDING COVERAGE NAIL# _ INSURERA_ T.H.E. Insurance Com a 1in2866 �misuaeo�� Christiansen Amusements, Inc. INSURER B: and Southland Shows, Inc. NsuREgc'_ P. 0. Box 997 - -- -- -- -- -- Escondido, CA 92033 INSURERD.: INSURER F: COVERAGES CERTIFICATE NUMBER- RRVL410N NIIMRFR- 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 LTR TYPE OFINSURANCE Ali-eL INs u�tTB POLICYNUMBER POLIG EFV MNIIDDIYYYY ICV EXP MMODIVYV --- LIMITS GENERAL LIABILITY EACH OCCURRENCE A X7 COMMERCIAL GENERAL LIABILITY CPP0100507-04 04/01/14 04/01/15 __$1,000.000 DAMAGETtS`MRTED 100,000 —..._.._-_. J CLAIMS -MADE OCCUR PREMISESEa oc currence __ i _S person MED EXP (Any one ) $ _..-.- PERSONAL &ADV INJURY $ 1,000,000 Review ) • —______.._.-__._-__......_—__—_ GENERAL AGGREGATE $ 10, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $ 1,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITYC SINGLE LIMIT OMBII 7 ANY AUTO �`.I Silvia Cuevas II INDEED en $ BODILY INJURY (Per person) $ ._.- ALLOWNEU SCHEDULED AUTOS —' AUI [� / j PRC.SA/ ,..I ,\,rm)n. �' - -- $ — BODILY INJURY(Poraaidend PROPERTY DAMA('E 1Per accldontl _ $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRE_NC_E $ 4,000,000 A XI EXCESS LIAB CLAIMGMADE ELP0010135-04 04/01/14 04/01/15 AGGREGATE $ 4,000,000 DED RETENTION $ ----- .------ .__— $ WORKERS COMPENSATION WCSTAiU- O(H- ANDEMPLOYERS'UASIUTY YIN —TORY LIMILT.S.— ER E. L. EACHACCIDENT —____._ $ ANY PROPRIETORIPARTNFRIEXEC'UTIVF. OFPICERIMEMSER EXCLUDED4 E NIA ----------------__.._.-- — (Mandatory In NH) E. L. DISEASE, EA EMPLOYEE $ describe under --"--—'—'--"-----'- '— ' —' E,L.DISEASE POLICYLIMIT $ ws, SCRIMONOFOPERATIONSbelow DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks schedule, if more space is required) ADDITIONAL INSURED WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED ONLY: CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVE AND VOLUNTEERS, FIESTA DE CARNIVAL. EVENT: FOR ALL OF CHRISTIANSEN AMUSEMENTS EVENTS FROM 4/1/14 TO 4/1/15 [N�iYla[N!11i�:GTB47�t _ L ! • , CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: RISK MANAGEMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA ACCORDAN E WITH THE POLICY PR ISIONS. SANTA ANA, CA 92701 AUTHORIZED RESENTATIVE T O 1055-2010 ACORD CORPORATION. All rights reserved. AC ORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD