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A� " CERTIFICATE OF LIABILITY INSURANCE <br />DA3%31/1Y51 <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE <br />THIS CERTIFICATE IS ISSUED AS A 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, tine 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 oil this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Allied Specialty Insurance,InO <br />CONTACT <br />NAME_. <br />10451 Gulf Blvd <br />PHONE 1 FAx <br />Treasure Island, FL 33706 <br />.ltll� 2�X1L -- _(AGC No);._.__. <br />E.maa - <br />8002373355 <br />ABDrsBSs <br />100,800 <br />INSURERS) AFFORDING COVERAGE_ NNCp <br />INSURER A' T.A.E. Insurance Company 12866 <br />INSURED Christiansen Amusements, Inc. <br />INSU Sea: <br />and Southland Shows, Inc. <br />— <br />P. O, Sox 997 <br />INSURERC <br />Escondido, CA 92033 <br />INSURERD <br />.A « —Ck.IV 1111. �r „Cj <br />INSURER E _ <br />i"'Y 25 Cf <br />INSURER F: 'r <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE <br />AFFORDED BY THE POLICIES DESCRIBED HERFIN IS SUBJECT TO ALL <br />THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS <br />SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INr S R I <br />ABOLTB IID' _ <br />TYPE OR INSURANCE <br />"`} VE %P <br />POLICY NUMBER IMMID iY Y LIMITS <br />GENERAL LIABILITY <br />i EACH OCCURRENCE S <br />11000, 000 <br />A XI COMMERCIAL GENERAL LIABILITY <br />CPP0100507-05 <br />_ <br />1. 04/01/15 ' 04/01116 PRMI�FTOJleee)I,tDe�nce) S <br />100,800 <br />I <br />CLAIMSMAbE X DCGUR <br />MEU FOP (Any onP Pesan) S <br />_ <br />_ <br />PERSGNALAADVINJURV IS <br />1,080,000 <br />OFNERAL AGGREGATE S <br />10 000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />Reviewed <br />rrti <br />by. PftODIICt SCOMPIOP AGG �S <br />iJ <br />1,000,000 <br />POLICY PRO LUC <br />J 5 <br />.. <br />AUTOMOBILE LIABILITY <br />�-^ <br />.COMBINED SINGLE <br />((E91ii <br />atC89...__.... <br />ANY AUTO <br />nG01LY INJURY (Per Veansurd 5 <br />A MED i --- SCHEDULED <br />AVTC,$ AU ME <br />NON-OWNED <br />Cuevas <br />ITNmJyU (APGm a 5 <br />drnSilvia <br />j P EGDIPLEY <br />HIRED Al705 AUTOS <br />PRCSA /m <br />PnO cR DRAY M S <br />actlY t___~ <br />UMafte"LIAR xI OCCUR - <br />s <br />EACH OCCURRENCE $ <br />41000,000 <br />A I� E%CES6 UA0 CLAIMS MgIrE` ( <br />ELP0010135 05 <br />04/01/15 1 04/03/16 AGGREGATE <br />4 000,000 <br />OED RETENTIONS <br />S <br />WORKERS COMPENSATION <br />0TH <br />' <br />AND EMPLOYERS' YIN <br />UT„T �— <br />— Ei l <br />__.. <br />ANY PIOPRIEORIPARTNE/WXFtU1TYE <br />OF J,NIA <br />E L EACH ACCIDENT S <br />(Mandate ryI.. —1, <br />1 EL OIEEASE - EA EMPLOYEE S <br />— <br />ECknPNO iON5 Um� aw <br />E.L DIS6A9F POLICY LIMIT 5 <br />l <br />DESCRIPTION Of OPERATIONS i LOCAiiONS 1 VEHICLES (Attach ACORD 101. AtltllOCnal Remarks 9ohetlule, If Moro space 1s requiYeq) <br />ADDITIONAL INSURED WITH RESPECTS <br />TO THE OPERATIONS OF THE NAMED INSURED ONLY: <br />CITY OF SANTA ANA, PI'S OFFICERS, <br />AGENTS, EMPLOYEES, REPRESENTATIVE AND <br />VOLUNTEERS, FIESTA DE CARNIVAL. <br />EVENT: FOR ALL OF CHRISTIANSEN AMUSEMENTS EVENTS FROM: 4/1/15 TO 4/1/16 <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />PARKS, RECREATION AND COMMUNITY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />SERVICES AGENCY ACOOROAN911 WITH THE POLICY PRQ9iV� <br />_ ISIONS. <br />26 CIVIC CENTER PLAZA 1% // <br />SANTA ANA, CA 92701 AUTHORIZED RESENTATIVE / I „ ) <br />All <br />ACORD 25 (2070705) The ACORD name and logo are registered marks of ACORD <br />