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STRADI5-01
<br />KIMM
<br />DAT51412017rYI
<br />51412017
<br />CERTIFICATE OF LIABILITY INSURANCE
<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 an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsements .
<br />PRODUCER License # 0252636
<br />Risk &insurance Services, Inc.
<br />4160 Temescal Canyon Rd., #402
<br />Corona, CA 92883
<br />CONTACT
<br />-NAMGallant
<br />Falco, No, Extl: (951 ) 368-0700 FAX, Nol:(957 )368-0707
<br />ai ;
<br />AFFORDING COVERAGE
<br />NAICN
<br />_
<br />INSURER A: United Fire & Casualty Company
<br />13021
<br />INSURED
<br />INSURERB:IrISUrance Company ofthe West
<br />27847
<br />INSURER0:
<br />Straub Distributing Co. LTD
<br />INSURER D :
<br />4633 La Palma Ave.
<br />Anaheim, CA 92807
<br />INSURER E
<br />-
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER -
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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
<br />LTR
<br />IADDL'SUBR
<br />TYPE OF INSURANCE IN )IJ
<br />POLICY NUMBER
<br />- POLICY EFF I POLICYEXP
<br />I MMIDDlYYYY MMIDD
<br />_
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />E
<br />X
<br />60486242
<br />02101l2017; 02101/2018
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />5 300,000
<br />MED EXP (Any one ersonl
<br />$ 5,000
<br />PERSONAL& ADV INJURY 1
<br />$ 1,000,000
<br />k
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY U JEGT1:1 LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />-
<br />$ 2,000,000
<br />GEN'L
<br />f
<br />_PRODUCTS= COMP/OP AGG 1
<br />5
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY Auro
<br />OWNED SCHEDULEL)
<br />AUTOS ONLY AUTOS
<br />X
<br />60486242
<br />02/01/2017
<br />I
<br />02101/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY Per arson
<br />5
<br />BODILY INJURY Per accident)
<br />$
<br />r a'.I n DAMAGE
<br />PeJ
<br />$
<br />AU7 5 ONLY AiJ705 ONLY
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />__
<br />OCCUR
<br />EACH OCCURRENCE
<br />2,000,000
<br />$
<br />AGGREGATE
<br />_
<br />$ 2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />60486242
<br />0210112017
<br />02/01/2018
<br />pE❑ X i RETENTION $ 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />AA�NppY PROPRIETOeeW�PARTNERIEXECUTIVE YIN
<br />(MandER(MEn B EXCLUDE1
<br />If yes, descrlbe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />WSD602056505
<br />02/0112017
<br />02/01/2018
<br />X STATUTE 1ORTH-
<br />-
<br />_E, L. EACH ACCIDENT
<br />1,000,000
<br />$ ---
<br />11000,000
<br />$
<br />E,L. DISEASE - EA EMPLOYEE
<br />E.L. DISEASE - POLICY LIMIT
<br />_
<br />1,000,000
<br />$
<br />\\K
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more N19 requlred) F.,
<br />RE: Anheuser Busch Fiestas 2017 KK�I rr��
<br />The City of Santa Ana, its officers, employees, agents and representatives are listed as additional ins red in regards fdl ll\pqQity and auto liability per
<br />the attached blanket policy forms. Coverage is primary and non-contributory per the attached blanket policy for
<br />30 day notice of cancellation.
<br />���
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Cityof Santa Ana, Parks, Recreation & Community Services
<br />Y
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Agency-M23
<br />Attn: Silvia Cuevas
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />PO Box
<br />Santa Anaa,, CA 92702
<br />�.-�
<br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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