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

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ACC>R ' CERTIFICATE OF LIABILITY INSURANCE DA2/05/15 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: If 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 certificate holder in lieu of such endorsements). PRODUCERAllied Specialty Insurance,Inc 10451 Gulf Blvd Treasure Island, FL 33706 8002373355 CONTACT NAME:-_ PHONE A'��°€�=MAIL ADDRE FAX—' --------- A� ""°1 -------------- ADDRESS: AUTHORIZED RESENTATIVE INSURERL8 AFFORDING COVERAGE NAIC# _ INSURERA__-_T.H..E. EACH OCCURRENCE INSURED Christiansen Amusements, Inc. ri and Southland Shows, Inc. P. 0. BOX 997 P. Escondido, CA 92033 _Insuranceompany-12866 -.0 INSURERa XCOMMERCIAL GENERAL LIABILITY ........ ---------- ------ ---- INSURER C:_ --- _ —_ INSURER D: 04/01/14 INSURER E _ pREM�Ea owgre0ce) _ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER' 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, INSft .._.,._... _....._.-.._ ADD BUSK P(SCib TFF POIICV E%P -.. -__.—._.._—__-_. - LTR TYPE OF INSURANCE INSR VD POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS SANTA ANA, CA 92701 - GENERAL. LIABILI'rV AUTHORIZED RESENTATIVE EACH OCCURRENCE 1.000.000 A XCOMMERCIAL GENERAL LIABILITY CPP0100507-04 04/01/14 04/01/15 _ pREM�Ea owgre0ce) _$__ $ 100,000 JCLAIMS -MADE FA OCCUR MED EX_P(Any one person)— $_ PERSONAL S ADV INJURY $ 1,000.000 - GENERAL AGGREGATE .._..—.._._---_—_.._._._ $ 10,000,00 0 GEN'LAGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMP/OPAGG $ 1,0001000 POLICY PRG LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -j,Eeacadentl ----- $ ANY AUTO BODILY INJURY (Per person) —_........ _-_. $ ALL OWNED SCHEDULED AUTOS AUTOS INJURY Per accident BODILY ( ) $ �HIREDAUTOS_ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) "'--'--- $ UMBRELLA LIAR XOCCUR EACH OCCURRENCE_ $ 4,000,000 AX EXCESS LIAB CLAIMS -MADE ELP0010135-04 04/01/14 04/01/15 AGGREGATE $ 4,000,000 DED RETENTION.$ $ WORKERS COMPENSATION wC STATU- OTIi- ANDEMPLOVEft3'LIABILITY YIN _ER_____ _-._..-..._._.._ ANY PROPRIETORIPAR'rNERIEXECUTIVE E.LEACHACCIDFNT $ OFFICERIMEMBER CXCLUDCD'f NIA (Mandatary In NH)DISEASE-EA EMPLOYE $ If Ves dascriba under _ U SSRIP'I'ION OF OPERATIONS belowµ=RCGS E.L. DI SEASE_ POLICY LIMIT 5T DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Small did, If more space Is Dan Ined) 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 CERTIFICATE HOLDER CANCELLATION 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 PRQMISIONS. SANTA ANA, CA 92701 AUTHORIZED RESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 28 (2010/08) The ACORD name and logo are registered marks of ACORD