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- - CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDNYYY) <br />_ 07/30/2013 <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 air ADDITIONAL INSURED, the policy(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 on this certificate does not confer rights to the <br />PRODUCER <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WI'liCll THIS <br />NA'Aim 1 Craig Hutt <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Wraith, Scarlett & Randolph <br />Ins. Serv., Inc OB48084 <br />- - POLICYEFF - POUCYEXP <br />IMWDDIYYYYII IMMIDDIYYYYI: LIMITS <br />PHONE FAX <br />(AIC, No, Ex0; 630-662.9181 INC. Np)p <br />530.662.6462 <br />622 Main Street <br />DAMARENTED <br />EMAIL crei h^ wsrins.com <br />ADDRESS: g 4 <br />'., PREMISESEa ocemeNes) S <br />Woodland, CA 95695 <br />',. MED EXP (Any one person)_ _ $ <br />PERSONAL&ADV INJURY ! S <br />Craig Hutt <br />! GENERAL AGGREGATE S <br />INSURERS) AFFORDING COVERAGE <br />NAICM <br />.OTHER' <br />$ <br />INSURERA:StataCompensation Insurance <br />,35076 <br />INSURED Christiansen Amusements <br />(Ea accuard) <br />INSURER D: <br />BODILY INJURY (Par Person) $ <br />Stacy Brown <br />BODILY INJURY(Pefaccident)S <br />NON -OWNED <br />PROPERTY DAMAGE $ <br />P.O. Box 997 <br />(Paraccident) <br />INSURER C: <br />Escondido, CA 92033 <br />F:ACH OCCURRENCE S <br />INSURER D: <br />'.. AGGREGATE S <br />DEO RETENTIONS <br />" S <br />INSURER E <br />I,.. X PER: <br />AND EMPLOYERS' LIABILITY <br />STATUTE ER <br />INSURER F : <br />0810112016'.06101/2016 Et EACH ACCIDENT 5 1,600,609 <br />COVFRA(;FR CFRTiFICATF NIIMRFR- <br />RFVISIr1NNI1MRER- <br />(Mandatory in NH) : <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TIME POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WI'liCll 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 />INSR'. ;ADDLSUBR' <br />LTRTYPE OP INSURANCE '- INSD WVD POLICY NUMBER <br />- - POLICYEFF - POUCYEXP <br />IMWDDIYYYYII IMMIDDIYYYYI: LIMITS <br />COMMERCIAL GENERAL LIABILITY - <br />EACH OCCURRENCE S <br />City Of Santa Ana <br />DAMARENTED <br />CLAIMS -MADE OCCUR <br />'., PREMISESEa ocemeNes) S <br />Santa Ana, CA 92701.4050 <br />',. MED EXP (Any one person)_ _ $ <br />PERSONAL&ADV INJURY ! S <br />GENT AGGREGATE LIMrI APPLIES PER. - <br />! GENERAL AGGREGATE S <br />POLICY PRO <br />JECT LOC _ <br />PRODUCTS - GOMPiOP AGO $ <br />.OTHER' <br />$ <br />_ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT I.$ <br />(Ea accuard) <br />ANY AUTO <br />BODILY INJURY (Par Person) $ <br />ALL OWNED SCHEDULED <br />AUTOS ! AUTOS <br />BODILY INJURY(Pefaccident)S <br />NON -OWNED <br />PROPERTY DAMAGE $ <br />HIRED AUTOS AUTOS <br />(Paraccident) <br />UMBRELLA LIAR OCCUR - <br />F:ACH OCCURRENCE S <br />EXCESS LIAR CLAIMS -MADE <br />'.. AGGREGATE S <br />DEO RETENTIONS <br />" S <br />- WORKERS COMPENSATIONYIN <br />I,.. X PER: <br />AND EMPLOYERS' LIABILITY <br />STATUTE ER <br />A ANY PROPRIE'I'CRIPARTNERIF.XECUTNE I .90680352016 <br />'., <br />0810112016'.06101/2016 Et EACH ACCIDENT 5 1,600,609 <br />AFFIC'ERWEMBER EXCLUDEWCI NIA <br />(Mandatory in NH) : <br />EL DISEASE - EA EMPLOYEE S 1,000,000 <br />Ityee, descilbeundor <br />DESCRIPTION OF OPERATIONS below <br />EL. DISEASE -POLICY LIMITS 1,606,060 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is comeredNQr <br />Evidence insurance to Christiansen Amusements between <br />of related all events <br />811/15.8/119 6 <br />t <br />0. <br />r9QTIVIr ATF Pint nPO rAMrFI I ATInM <br />CITYSA3 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOl'ICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City Of Santa Ana <br />20 Civic Center Plaza <br />AUTHORIZEDREPRAE�S�ENTATIVE <br />Santa Ana, CA 92701.4050 <br />(01988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD <br />