ALLEN R. OSHIRO DBA ILLUSIONS BY ALLEN 1

Home Browse Search

ACC>RO®'II CERTIFICATE OF LIABILITY INSURANCE DATE6/8/2 DIVYYV) �� MARI(EL° /BI2018 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 pollcy(les) 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 Stephanie Weiss Specialty Insurance Agency NAME,PHONE 715-246-8908 Fax 715-246-4257 Performers of the U.S. A/c No Eater_.__._._._.._ P.O. Box 24 N-2018-156 ADDRIESS: certs@specialtyinsuranceagency.com New Richmond, WI 54017 INSURER(5)AFFOROING COVERAGE NAICN INSURERA: Evanston Insurance Company 35378 INSURED Allen R. Oshiro INSURER dba. Illusions: By Allen -- — -_---- 12902 Correnti Street INSURER C: Pacoima, CA 91331 INSURER D: 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. INSR - _ ADDLSUBR POEICY POLICY ERP LTR TYPE OF INSURANCE POLICYNUMBER MM/ODM'YV MMIDDIWVY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE 1,000,000 '- CLAIMS -MADE 'KI OCCUR __ DAMAGE TO RENTED PRIEMI SESEa occ.Qencel is i$ 300,000 MED E_XP(Any one person) _ �I$ 5,000 $ 1,000,000 _ A J X X 2CN0162-5668 04/25/2018 04/24/2019 PERSONAL aADV INJURY _— AGGREGATE LIMIT APPLIES PER GENT - GENERAL AGGREGATE $ 2,000,000 IX PRO- PRO- P POLICY —J LOG PRODUCTS-COMPIOPAGG _$ 21000,000 '' OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT Ea accident $ — BODILY I NJURY(Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Peraccident) $ _ _ HIRED --I NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB �'I CLAIMS -MADE_ DIED RETENTION$ $ WORKERS COMPENSATION 'ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/ME M BEREXCLUDED4 NIA PER OTH- STATUTE ER E. L. EACH ACC) DENT $ - iE.L. DISEASE LMEAS PEEDISEA LMEAS PEE OYEEI$ ------ '(MantlatoryinNH) If yes, describe under _. -- DESCRIPTIONOFOPERATIONSbelow E. L. DIS EASE - POLICY LI M IT $ BUSINESS P ERSONAL P ROPERTY- A' INLAND MARINE III AGGREGATE $ DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES (ADDED 1e1, Additional Remarks Schedule, maybe attached If more space Is required) PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: Allen R. Oshiro dba Illusions By Allen �'a} Additional Insured: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701; its officers, employees, agents and represen ��yJ� s are named as additional insured's with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of. li ad il7sured. Cancellation is as stated in the Policy. c2 ` ` Email: mloera@santa-ana.org Attn: Michelle Loera K� Event Date: August 2, 2018 SOm-N UCK I IFIUA It KULUCK UANUCLLA I IVN '(y The City of Santa Ana G 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESC D POLICNC LL ELLED BEFORE Santa Ana, CA 92701 THE EXPIRATION DATE THERE , NOTI FCE BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,rr, ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD reserved.