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Sadler Sports: Entertainers / Performers Insurance Plan <br />IDATE (MMI ODI YYYY) <br />'$*CVRO- CERTIFICATE OF LIABILITY INSURANCE 0510312018 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR <br />NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN <br />THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the eartt0ced holder Is an ADDITIONAL INSURED, the pollcydep must be entlmeetl. If SUBROGATION IS WAIVED, subject to the farms and conditions of the policy, certain pDllclas may <br />require an endorsement A statement on this contiguous does not confer rights to the cedigcate holder In Her of such endomementhap <br />PRODUCER <br />SADLER & COMPANY, INC. <br />P.O. BOX 5866 <br />COLUMBIA, SOUTH CAROLINA 29250-5866 <br />CONTACT NAME: Sports Dept <br />PHONE (A/C, No. Exth 600-622-7370 1 FAX (Al C, Not eo3.256-4017 <br />E� MAIL ADDRESS: evenls@sloVerepons.cem <br />PRODUCER CUSTOMER to#: <br />INSURED <br />Joseph Peck <br />IDEA Panhead Music <br />DO BOX 4323 <br />MALIBU, CA 90264 N-2018-12 <br />MA <br />Application ID: 218984 <br />A Memberof the Sports, Leisure & Entertainment RPG <br />INSURER(S) AFFORDING COVERAGE <br />NAIL <br />INS LINES ltle ER A: Nations Mutual Insurance Company <br />INSURER B: <br />INSURER C: <br />INSUREa D: <br />COVERAGES CERTIFICATE NUMBER REVISION NUMBER <br />THIS 19 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN <br />MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INBR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />POLICYEXP <br />LIMITS <br />LTR <br />INSR <br />WVD <br />(MMI DOI YYYY) <br />(MMI DW YYYY) <br />A <br />GENERALLIABILITY <br />X <br />- <br />®COMMERCIAL GENERAL <br />EACH OCCURRENCE <br />$1,E0111000 <br />DAMAGE TO PREMISES RENTED <br />$1.000,000 <br />LIABILITY <br />TO YOU (Fire Legal Llablllly) <br />El CLAIMS MADE 2 <br />MEDICAL EXPENSE (other than <br />g5p0D <br />Participants) <br />OCCUR <br />12:01AM ET <br />12:01AM ET <br />PERSONALBADVERTISING <br />PERRY <br />exmadab <br />RPGOOOOOO6071100 <br />03/31/2018 <br />03/31/2019 <br />GENERAL AGGREGATE (other than <br />Products- Completed Operations) <br />$5,000,000 <br />GEN'L AGGREGATE LIMIT <br />PRODUCTCOMPLETED <br />APPLIES PER'. <br />OPERATIONS <br />S <br />$1,000,000 <br />PROFESSIONAL LIABILITY <br />$1,000 Goo <br />POLICY PROJECT <br />LEGAL LIABILITY TO <br />$5000 <br />LOG <br />PARTICIPANTS <br />MEDICAL <br />PAYMENTSTO <br />$5,000 <br />PARTICIPANTS <br />AUTOMOBILE LIABILITY <br />❑ANY AUTO <br />CCOMbBINED SINGLE LIMIT (Es <br />ALL OWNED AUTOS <br />BODILY INJURY (Per person) <br />SCHEDULED AUTOS <br />BODILY INJURY (Per sceldenQ <br />HIRED AUTOS <br />❑ NON OWNED AUTOS <br />PROPERTY DAMAGE (Per accident) <br />NOT PROVIDED WHILE IN <br />HAWAII <br />[-]UMBRELLALIASOCCUR <br />EACH OCCURRENCE <br />E]EXCESSLIAB CLAIMS- <br />MADE <br />AGGREGATE <br />DEDUCTIBLE <br />❑ RETENTION <br />WORKERS <br />COMPENSATION AND <br />WC STATUTORY LIMITS <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR <br />❑OTHER <br />PARTNER/ Y/N <br />EXECUTIVE OFFICER/ <br />N/A <br />E.L.EACH ACCIDENT <br />MEMBER EXCLUDED' <br />E.L. DISEASE - EA EOMPLOYEE <br />(Mandatory in NH) <br />If yes, despdbe under <br />DESCRIPTION OF OPERATIONS <br />below <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED 101, AdUutonal Remarks Schedule. if more speed is required) <br />RE: Type of Entertainer I Performer - Musician, Singer or Vocalist, <br />PROFESSIONAL LIABILITY $1,000,000 <br />The certll1cate holder Is added as or add Iflonal Insured, but only wlth respect 10 Pie Ilablllly, arising out of the operations of ma barred above. <br />CERTIFICATE HOLDER CANCELLATION <br />RELATIONSHIP: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPI <br />Property Owner? Lessor <br />DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PjflR NS. <br />�j� <br />City of Santa Ana, its officers, agents, and <br />AUTHORIZED REPRESENTATIVE <br />employees <br />20 Civic Center Plaza <br />`ram <br />4 <br />Santa Ana, CA 92701 <br />`✓ '�J <br />_ n <br />rived is �,nr ex,enne„rn �.o. av ® l?l;- <br />"NOTICE TO TEXAS INSUREDS: The Insurer for tire purchasing group may not be subject to all the Insurance laws and reguloltons of the Stale of Texas. <br />ACORD 25 (2014101) O 1988-2114 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />