STAGE PLUS EVENT STAGING SERVICES - 2017

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A� " CERTIFICATE OF LIABILITY INSURANCE DA E(mMoor w) 08/22/2018 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(ies) must have ADDITIONAL INSURED provisions or 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 CONTACT Dori Jared-Fermnto NAME: Assistance Insurance Agency AIC NO E#: (714)245-2777 nlc, No: (714)245-2788 123 E. 9th Street E-MAIL ADDRESS: djared@assistanceins.com INSURER(S) AFFORDING COVERAGE NAIC# Unit 314 INSURERA: State Compensation Insurance Fund Upland CA 91786 INSURED INSURERS: Manuel Huante, DBA: Stage Plus, Inc. INSURERC: 2330 S. Susan St. INSURER D : INSURER E Santa Ana CA 92704 INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 WC 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 MAYBE 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. INSR I-M TYPE OF INSURANCE INSD MD POLICYNUMBER POLICYEFF MMIDDNWY POLICY EXP MMIDDM'YV LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ EO PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL B ADV INJURY $ GEN-L AGGREGATE LIMIT APPLIES PER: POLICY PRLOC GENERALAGGREGATE $ PRODUCTS - COMP/OPAGG $ $ OTHER' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANVAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Paramitlen0 $ PROPERTYDAMAGE Poraaitlent $ HIRED I NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN CUTIVE ❑ ANY CERIMEETOREXCL EXCLUDED' OFFICER/MEMBH) EXCLUOEO9 in NH) (fyes,d NIA 1786316-16 O$/Oi/2018 OS/01/2019 PER OTH- STATUTE ER EL EACH ACCIDENT $ 1,000,000 E.L. DISEASEEAEMPLOYEE g 1,000,000 describe Dyes, describe under DESCRIPTION OF OPERATIONS below OF O E.L. DISEASE - POLICY LIMIT 8 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) y� ' The City of Santa Ana, its officers, employees, agents, volunteers and representatives V e Proof of Insurance \a �a lel a:4111201 Li$OPIUM lial aJd;laJ9,rl_V Ul;-i%l SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 P&4'11 C)19RR-2n15 ACORO CORPORATION All rinhfa reenrvnd ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD