FIESTA DE CARNIVAL (A-2015-188-01)

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acraazc� CERTIFICATE OF LIABILITY INSURANCE °ATe(MM,°°IYYYYI 3/30/201 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($), 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 endorsement(s). PRODUCER HMR: Joanna Manion Arthur J. Gallagher Risk Management Services, Inc. P",�"u v.,,.d�F_ A -119A Pam ,,,.,.e')R_AA1_171A THIS IS TOCERTIFY 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, INSURER(S) AFFORDING COVERAGE RAICN INSURER A: American Slates Insurance Company .19704 INSURED CHRIAMU-01 INSURER 0: Christiansen Amusements. Ina INSURER C_ P. 0. Box 997 _ Escondido, CA 92033-0997 INSURER D -- -- ---------- PREMMEE(go asuganca) S INSURER E MED EXP(Any N.paraoni S INSURER F; COVERAGES CERTIFICATE NUMBER: 177753472 REVISION NUMBER: THIS IS TOCERTIFY 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. INSIR -S "GOLaBBR POII,,ICYEFFp POUCYEXP R TYPE OF INSURANCE INS POLICY NUMBER MIDC/YYYYI IMRAqb2V LIMITS GENERALLIAIPUTY EACH OCCURRENCE S DAMAGE TORENTED COMMERCIAL GENERAL LIABILITY PREMMEE(go asuganca) S CLAIMS -MADE OCCUR MED EXP(Any N.paraoni S _ PERSONALSADVINJURY j_. GENERALAGGREGATE $ OEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO S POLICY TPR LOCS A AUTOMOBILE LIABILITY ._._ 4/1/2015 4/1/2016 01CI562A6640 (Ea aacateg4 $1,000,000 X ANY AUTO BODILYINII/RY(P¢rgcersanl S AUTOS PO ._ _. SppiIX INJURY rPwacaltlglNl 5 .AUTOSULEO X AO Qs NED (Forr S HIRED AUTOS x_ _ aPoEkRT�Ytlf)JAMAGE UMBRELLA LIAR OCCUR fA'd r" EACH OCCURRENCE_ S SXCESSLIAS CLAIMS.MADE '"�r AGGREGATE 3 DED RLIENTIONS S Sri ANOEMP$COMPENSATION LIABILITYIN) �+ (� Cuevas _._...�,..,...... . TORY LIMr43__.. ANY PROPR MTORIPARTNEPo'EXECUTIVE Silvia OFFICERIMEMaER EXCLUOEO? �� "rA E L, EACH ACCIDENT S IManealary lR NH) _ pRIOSA/Admjn, EL CISEASE�EA EMPLOYEES Il ry1d dawre uMar i , RIPTiON EL. CISEASE,POU;Y S 0E3 OF OPERATIONS below LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AWgh ACORO 101, Addllloml Romuha Sohedule, if mow apaaa Is requlrad) The City of Santa Ana, Its officers, employees, agents and representatives and Fiesta de Carnival are included as additional Insureds but only as respects the operation of the named insured per policy terms and conditions per form CA7110 0307. For all Christiansen Amusement events during the period 4/112015.411/16 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Robert Carroll 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 USA A7 r ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD