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F`� "' CERTIFICATE OF LIABILITY INSURANCE DAT j I jYYY) <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, the pohcy(fes( must be endorsed. if SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require ark endorsement. A statement on this certificate does not center rights to the <br />certificate holder In lieu Of such endorsererd s . <br />PRODUCERAllied Specialty Insurance,Inc CONTAC _ r _ <br />109:51 Gulf Blvd PHONNe FAA <br />Treasure Island, FL 33706 E.mAa <br />8002373355 gonRESS __. <br />INSURER(JAFFORDING COVERAGE NAIC# <br />INBORERq T H.E Insurance Company 112866 <br />INSURno Christiansen Amusements, Inc. INSURERS <br />and Southland Shows, Inc. INSURER C: <br />P. 0. Box 997 <br />Escondido, CA 92033 gsuReRO __ <br />INSURER U:. <br />INSURER <br />COVERAGES CERTIFICATE NUMBER- RP \ /IRIMI MIIMpFR. <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 WHICH THIS <br />CERTIFICATE MAY BE 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 />iLSRr -- -�IML�S,'A�^' POLICVEFF POLIC�,P. <br />TR iYPE OF INSURANCE ++ca+c _ POLICY NUMBER �IMMIOtUYYVYf�f,MWDD)YYYY LIMITS <br />GENERAL LIABILITY <br />s 1,000,000 <br />A ICOMMERCIALGENERALLIABILII'Y <br />CPP0100507 05 04/01/15 04/01/16 <br />IACHOOCURREIvCE <br />hRE'MISCS(EacEianee) <br />�3 100,E <br />CLAIMS -MADE }{..00CUR <br />MED EXP(Any one nenon) <br />PERSDNALA AD_V .I_P._ LRV <br />5 ,000, OOD <br />ReV. 2W8d by <br />GEry <br />s 11O 00010 6 0 <br />GEN'L AGGREGATE LIMIT APPLES PER. <br />PRO- <br />,��- yyy/'' ! ��,. -f! <br />iCROpUCTS COMPMIP AGG <br />5 1,000,000 <br />POLICY f7 ! LOC <br />AUTUMOBI(ELIpaiLITV <br />I <br />cuqq <br />KEMOINEDSINGLELIMN <br />L l . <br />S. <br />ANYAUTO <br />Silvia vCU <br />BODILY HI JURY (Pere non? <br />3 <br />A ONJEp -..OULED <br />AU TOS AUTOS <br />PRCSA /Admjn. <br />BODILY INJURY (PeI amldoni) <br />_. <br />5 <br />NON ED <br />�IIIREC>AUTOS AUTOS AU'I'OS <br />PRt1PERTf DPMtiGF <br />S _- <br />.._. -iXj <br />f <br />— <br />S <br />..0. —..00._ <br />-A LIAR <br />UMBRELLA LIAS $'i, ocouR <br />DO <br />EACIIOCCIIRREIJCE <br />3 Ar ODD, DDD <br />V <br />A XI i EXCEH9 LIgB ICLAIMSMADEI <br />L:L,P0010135 -05 !, o4 /olns 04/01/16 <br />_. _ _ <br />AGGREGATE <br />_ _ <br />S 4,000,000 <br />�I DED RETENTION <br />i <br />WORKERS COMPHNSgTION <br />WE,TATU., 10TH- <br />AND EMPLOYERS' LIABILITY YIN <br />1 <br />AIIYPROPRIETOR IPARTNERIEXECUTIVE <br />El. FACHACCIDENT <br />3 <br />orr CERIMEMBER EXCLUDCIY NIA <br />-- <br />ELDISEASE EA EMPLOYEE <br />(Mandatory lnAN) <br />s <br />If Yax, u <br />dun. <br />" <br />�� <br />1— <br />_ <br />0 SCRIPNON Of OPERATIONS below I <br />EL DISEASE POLICY LIMIT <br />TS <br />jjj <br />DESCRIPTION OF UPEPAI' IONS I LOCATIONS I VEHICLES (plYdch ACORD 101. Addltlannl RemuBa Schetlnle, IT more apace Is rngWretl) <br />ADDITIONAL INSURED WITH REPS &CTS TO THE OPERATIONS OF THE NAMED INSURED ONLY: <br />PAJARITO, LLC, MR. FRANK CHAVES, CITY OF SANTA ANA. <br />FOR THE DATES: 4/29/15 THROUGH 5/04/15 ' <br />PAJARITO, LLP <br />FRANK CRAVES <br />P.O. BOX 11412 <br />SANTA ANA, CA 92711. <br />ACORD 20 (2010105) <br />SHOULD ANY OF THE ABOVE <br />THE EXPIRATION DATE T <br />ACCORDANCE WITH THE POI <br />The ACORD name and logo are registered marks of ACORD <br />CANCELLED BEFORE <br />BE DELIVERED IN <br />rinhrc rncn n,nH <br />