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FIESTA DE CARNIVAL (A-2015-188-01)
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FIESTA DE CARNIVAL (A-2015-188-01)
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Last modified
3/27/2020 9:30:34 AM
Creation date
3/8/2016 10:19:24 AM
Metadata
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Template:
Contracts
Company Name
FIESTA DE CARNIVAL
Contract #
A-2015-188-01
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
2/2/2017
Insurance Exp Date
5/27/2017
Destruction Year
2022
Notes
A-2015-019; A-2015-188
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AIII ICC)RDF CERTIFICATE OF LIABILITY INSURANCEDA3%31/15 <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) 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 Ilea of such ondorsement(s). <br />PRODuceaAllied S ecialty Insurance,Ine <br />M <br />10451 GA E S1Vd E: <br />AX----_--___ <br />Treasure Island, FL 33706 <br />6002373355 <br />INSURER A: T H.E Insurance Con <br />INSURED Christiansen Amusements, Inc. INSURER 0; <br />and Southland shows, Inc. - ----- <br />P. Q. Box 997 INSUR0RO _ <br />Escondido, CA 92033 gvaen <br />P99TIRPArR MI lnnnco. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERMD <br />INDICATED. NOT`MTHSTANDINO 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 />TR <br />TYPE OF INSUflANCE <br />__—. — <br />POLICYNUMBER <br />V M <br />Mf VVYY IjkLM�pfNYYYYL <br />LIMITS <br />A <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIADJU Y <br />CLAIMS (� OCCUR <br />CPP0100507-05 <br />04/01/15 - p4/Ol{14 <br />EACH OCCURRENCE <br />s 11000,040 <br />PREMISES is. occyugnouj_- <br />MEUIXPIAnY ene Pmeenl <br />S 150, 46 <br />S <br />aa,,..11 <br />4lA Y. <br />Reviewed <br />'r ( '. <br />✓ <br />PERSONAL& 0.pY INJURY <br />_.-_....._....._..--- <br />GENERAL AGGREGATE . <br />PRODUCTS. COMPIOP AGO <br />_. <br />S 1,000.440 <br />__...0 00 <br />—...._..._..—_._ <br />S 11000,000 <br />GEML AGGREGATE LIMIT APPLIES PER: <br />1 POLICY pNO. --]Loc <br />$ <br />AUTOMOBILE <br />...'.ALLOMMF..D <br />I <br />LIABILITY <br />ANY AUTO <br />- S'CHEpOLED <br />AUTOS AUTOS <br />FIIREU AUTOS AUTUS EO <br />1(E;gNQnt) <br />Silvia Cuevas <br />p �+/� q�4Mr�, <br />Ft'\CJA'V/r-1Ut1 ��11. <br />C A'V A <br />I <br />C E 1 <br />BODILY INJURY (Par persen) <br />S - <br />'.0_.— <br />eO01LY IDiJURY IN, w1deral <br />S <br />(PROPERTY—DAMAGEcl <br />S <br />A <br />�{-IIIj'EXOEBSLIAO <br />UMBRELLA LIAR <br />X <br />OCCUR <br />CLAIMS•MAGE <br />ELP0010135.05 <br />04/01/15 <br />04/01/16 <br />F.ACH OCCURRENCE <br />$ <br />AGGREGATE <br />_4,_0400000 <br />$ 4,60b,000 <br />— RErENTION 5..— <br />1 OCR <br />WORKERSCOMPENSAVON <br />ANO EMPLOYBRV LIABILITY Y1 <br />ANYPROPRIETORIPARTNEWE%ECUTIVE❑ <br />OPPiGBflIMIiMSER EXCLUDED? <br />IMandalmyinNIN <br />I yyeY dwribe and., <br />I'm <br />OGSCRIPTIONOFOPERA.TIONSbelft <br />NIA <br />Vvt 9TATU. OM. <br />— <br />EL. EACN ACCInENY <br />EL. DISEASE • EA EMPLOY <br />(S <br />— ----- <br />S <br />— <br />E, L, UNEA$E- POLICY LINO <br />---- <br />S <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (AAI ACORD 101, AddleRgW Remarks Schedule, IT mare space is rNulred( <br />ADDITIONAL INSURED WITH REPSECTS 110 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 SHOULD ANY OF THE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />FRANK CHAVES THE EXPIRATION DATE THEREOF, NOTICE WILL SE OELIVERED IN <br />P.O. BOX 11412 ACCOROAN E WITH THE POLICYPR ISIONS, <br />SANTA ANA, CA 92711 <br />aurnoRl¢Bo flaeENTAnvE <br />4y W11-- <br />01988-2010 ACORD CORPORATION, All rights reserve <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />
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