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

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CERTIFICATE OF LIABILITY INSURANCE MIDDIYYY ) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 3!330/20012015 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 endorsoment s . PRODUCER CONTACT NAME: Joanne. Manion Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX 777 108th Ave NE, #200 E-MAIL Bellevue WA 98004 _Ao0REse: GENT AGGREGATE LIMIT APPLIES PER: INSURERIS) AFFORDING COVERAGE NAIC4 POLICY'. PR0- LOC INSURER A:American States Insurance Company 19704 INSURED CHRIAMU-01 INSURER 8: Christiansen Amusements, Inc. INSURER c: P. O. Box 997 BODILY INJURY (Per.rddent)' S - Escondido, CA 92033-0997 INSURER D: -- - -- HIREDAUTOS INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 177753479 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 CONTRACTOR 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. !NSR TYPE OF INSURANCE 'ADDUSUBR'. _ POLICYEFF POLICY E%P L INWVO "'. POLICY NUMBER MMIDOIYYYYI IMMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ',. ''. DAMAGE TO RENTED P EEMGeS.(Eaecounence) ; S :. CLAIMS -MADE OCCUR : MED EXP (Any one person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE S GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGE $ POLICY'. PR0- LOC S A ", AUTOMOBILE LIABILITY OICIBB248640 41112015 4/1/2016 (Ea aocident) '', $1,000,000 X ANY AUTO_ BODILY INJURY(Per person) L5 ALL OWNEDSCHEDULED AUTS BODILY INJURY (Per.rddent)' S - X X NON -OWNED '., ,.AUTOS OPER nDAMAGE �$ HIREDAUTOS (PROPERTY UMBRELLA LIAR OCCUR EACHOCCURRENCE 4 EXCESS LIAR CLAIMS -MADE AGGREGATE $ DEC RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYnn/� N t WC STATU. OTH- TORY LIMITS. ER ANY PROPRIETORlpAR'rNEftIE%ECUTIVE YIN ry,.y� -L EACH ACCIDENT $ nC/ . OFFICERIMEMBER EXCLUDED9 N IA ,p y+' } I (MendaWry In NH) 1 If desrsibe under EL DISEASE - EA EMPLOYEE ffi Yee, Com' DESCRIPTION OF OPERATIONS below 'E. L. DISEASE -POLICY LIMIT $ egc- DESCRIPTION OF OPERATIONS I LOCAtIONS I VEHICLES (Attach ACORD 101, AddiftnetAg.rks Sch$�4,�, $Neta Is requiredl The City of Santa Ana, its officers, employees, agents and representatives n 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 4/1/2015 - 4/1/16 City of Santa Ana Attn: Robert Carroll 20 Civic Center Plaza Santa Ana CA 92701 USA ACORD 26 (2010/06) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 0 1958-2010 ACORD CORPORATION. All riamn The ACORD name and logo are registered marks of ACORD