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AC'C)R" CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MWODNVYY) <br />03/1012017 <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 BELOW. <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the golicy((les) must have ADDITIONAL INSURED provislons or be endorsed. <br />it SUBROGATION IS WAIVED, subject to the terms and conditions of the poticy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />K&K Insurance Group, Inc. <br />1712 Magnavox Way <br />Fort Wayne IN 46804 <br />CONTACT NAME: MESS MBIChand!sing <br />Aano Exl: i-II 328-2317 qIO Na; 1-260-459-5502 <br />E-MAIL {nfoC�oventinsurance-kk.com <br />ADDRESS: <br />PRODUCER <br />CUSTOMER 10: <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED 2000648858 CP# 1581 <br />Kevin Christian Noonchester <br />DBA: NOTEWORTHY PUPPETS INC <br />MONROV A, CA 91016 �11 _32C If U lc.` <br />A Member of the Sports, Leisure & Entertainment RPG <br />INSURER A: Nationwide Mutual Insurance Company <br />23787 <br />INSURER a: <br />INSURER C: �^ <br />INSURER INSURER o: <br />NSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 2000294117 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR <br />LTA <br />TYPE OF INSURANCE <br />AODL <br />HIED <br />SUBR <br />VIVO <br />POLICY NUMBER <br />POUCYEFF <br />M6VDDIYYY <br />POLICY EXP <br />MMIDD/YYV <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />68RPG000G005895300 <br />04I16/17 <br />G4116/18 <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMSMADE7 OCCUR <br />12:01 AM <br />12.01 AM <br />DAMAGE TO -NY2f <br />PREMISES Ea Occurrence <br />_ <br />$300,000 <br />MED EXP(Any am person) <br />— <br />$5,000 <br />PERSONAL &ADV INJU RY <br />u Excluded <br />GEN'L AGGREGATE LIMIT APPLIES PER' <br />GENERAL AGGREGATE <br />$5,000,000 <br />POLICY ❑ PROJECT ❑ LOC <br />PRODUCTS-COMPIOP AGO <br />$2,000,000 <br />PROFESSIONAL LIABILITY <br />OTHER: <br />LEGAL LIAR TO PARTICIPANTS <br />$2,000,000 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED <br />amident <br />SINGLE UMIi Ice <br />BODILY INJURY (Per person) <br />AUTO <br />IANY <br />X <br />OWNED SCHEDULED <br />AUTOSONLY eAUTOS. <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />Not provided while in Hawaii <br />''`` <br />��}j'j. ) <br />13 \ <br />BODILY INJURY (PeracGtlenp <br />PROPERTY DAAIA E <br />Perea;idenl <br />RELLA <br />LAB OCCUR <br />EXCESSLIAB CLAIM&MADE <br />�Qu <br />0-pi <br />�l <br />EACHOCCURRENCE <br />AGGREGATE <br />DEO M RETENTION <br />WORKERS COMPENSATION <br />N/A <br />PER STATUTE OTHER <br />ANYY PROPRIETORIPARTNERI YIN <br />❑ EXECUTIVE OFFICERIMEMBER <br />EXCLUDED? (Mandatary In NH) <br />+a0 (_� <br />\` (`'LJ <br />{}.il <br />E.L. EACH ACCIDENT <br />EL DISEASE -EA EMPLOYEE <br />It yes, deacrllue under <br />DESCRIPTION OF OPERATIONS below <br />G' <br />E.L. DISEASE -POLICY LIMIT <br />A <br />MEDICAL PAYMENTS FOR PARTICIPANTS <br />68RPG0000005895300 <br />04/16/17 <br />12:01 AM <br />04/16/18 <br />12:01 AM <br />PRIMARY MEDICAL <br />$5,000 <br />EXCESS MEDICAL <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEH CLES CO O10,Adduanal Remarks Schedule, maye aaached R more space is required) <br />Performing as Puppeteer <br />Event Date: 07/25/2017-07/30/2017 <br />City Of Long Beach, its officials, employees and agents are added as an additional Insured, but only for liability caused, in whole or in part, by the acts or <br />omissions of the named insured. <br />CERTIFICATE HOLDER CANCELLATION <br />City Of Long Beach <br />333 West Ocean Boulevard <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH <br />Long Beach, CA 90802 <br />THE POLICY PROVISIONS. <br />Owner/Manager/Lessor of Premises <br />AUTHORIZED REPRESENTATIVE <br />/?'�r/b..�i/( <br />01908.2015 ACORD CORPORATION. All rights reserved. <br />Coverage is only extended to U.S. events and activities. <br />'" NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the Insurance laws and regulations of the State of Texas. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />