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

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AR Y CERTIFICATE OF LIABILITY INSURANCE °A3/31/155' 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. it 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). PRODucERAllied Specialty Insurance,Inc 10451 Gulf Blvd Treasure Island, FL 33706 NAME: PHONE tA-'O,_a�x) - - r1AX - p _ TP -Ax No). 8002373355 ADDRESS. INSURER��FFORDINO COVERgGE NAICM CPP0100507-OS ., INSURERA: T.H.E. Insurance Company 12866 _ INSURED Christiansen Amusements, Inc. and Southland Shows, Inc. P. O. BOX 997 INSURER 8:_— _ — _- - INSURER C: INSURER D: Escondido, CA 92033 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 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. INS R LTR TYPEOFINSURANCE .ADSL eebR- -------"""""'_ "—PoUOY PDLICYNUMBEft ERR- fMMIDDNyyYL LOY-ET( (MMIDDYYYYTLIMITS A' GENERAL LIABILITY -X COMM12RCIALGENER�AyL�UABILITY CLAIMS MADE LJ OCCUR CPP0100507-OS 09/01/15 09/O1 J16 EACH OCCURRENCE $ 1,000,000 PORFM�S Ee mance--i .EX Ar 1 MED EXP (Any ona porsnrp 100'000 _._. $ PERK ADV INJURV _ $ 1,000,000 --1 GENERAL AGGREGATE $ 10,000+000 PRODUCTS_COMP/OP AGG S 11000,000 CENT AGGREGATE LIMIT APPLIES PER: POLICY PRP LOC $ AUTOMOBILE LIABILITY! ANY AUTO GO INV SIN LELMIT Ea accident s BODILY INJURY (Per Forrsm0 ALLOWIJED SCHEDULED 'AUTOS AUTOS NONAWNED C HIRED AUTOS AUTOS BODILY INJURY (Par cadm,Q S $ S Per acyid, eni)___ UMBRELLA LIAR X OCCUR EAGH OCCURRE14CE S 4,000,000 A XI EXCESS LIAR CLAIMSMADE ELPOOI0135-05 'x1/15 04/01/16 _ AGGREGATE x,000,000 DED RETENTION$ •t $ WORKERS COMPENSATION•�� AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes describe under DESLIRIPTIONOFOPERATIONSbelow NIA Qac yEL. �` 1 / "� �N�, WGSTATU- IOIH TORY i IMITg, _ EACH ACCIDENT$ E. L. DISEASE - EA EMPLOYEE --- S S —_-- "'---- E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attack ACORD 101. Additional Remarks SoeodUlo If more 61mco Is required) ADDITIONAL INSURED WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED ONLY: CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVE AND VOLUNTEERS, FIESTA DE CARNIVAL. EVENT: FOR ALL OF CHRISTIANSEN AMUSEMENTS EVENTS FROM: 4/1/15 TO 4/1/16 CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PARKS, RECREATION AND COMMUNITY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SERVICES AGENCY ACCO RDAN E WITH THE POLICY PR ISIONS. 26 CIVIC CENTER PLAZA SANTA ANA, CA 92701 AUTHORIZED RESENTATIVE T— m 1950.2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD