ADRIAN W. MERRIT DBA BILLY BONKERS MAGIC 1

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ACCW?a III CERTIFICATE OF LIABILITY INSURANCE DATE 71212 DIVYVY) 7/2/zD1a 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(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 Specialty Insurance Agency Performers of the U.S. P.O. Box 24 N-2018-155 CONTACT Stephanie Weiss _ PHONE FAX (AID No,Ex6;_. 715-246-8908 IAIC No): 715-246-42.57 A MAIL certs s ecialt insurances enc .com DDRESS: p Y g Y New Richmond, WI 54017 INSURER(S) AFFORDING C_OVER_A_GE_ NAICN INSURERA: Evanston Insurance Company 35378 _ INSURED Adrian W. Merritt dba'Billy Bonkers 39 North Slope Lane INSURER B: --- "-" INSURER c:. Pomona, CA 91766 INSURER D: INSURER E : INSURER F : _ 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. ILTR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLIBYEFF MMIDD/YWY POLICY EXP MMIDDIYVW LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IXOCCUR EACH OCCURRENCE $ 1,0001000 Op G T0_FFNT Ea occurrence $ 300,000 _PREMISES MED EXP(Any one person) $ 5,000 PERSONAL aADV INJURY $ 1,000,000 A _ X X 2CN0155-17688 11113/2017- 11/12/2018 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _..$ 2,000,000 GEN'L X POLICY � PRO- LOCJECT PRODUCTS-COMPIOPAGG - $2,000,000 $ - OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _(Ea acclderm__ 1$ _ '.$ ANY AUTO - BODILY INJURY (Per person) OWNED SCHEDULED AUTOS ONLY AUTOS l) citl P BODILY INJURY eracen ( -- ',$ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY _ PROPERTY DAMAGE Per accident)_ _ $ $ UMBRELLALIAS OCCUR , EACH OCCURRENCE $ AGGREGATE _ -DED EXCESS LIAB�, CLAIMS -MADE _$ $ RETENTION$ I WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY YIN PER 1OTH- STATUTE ER E, L. EACH ACCIDENT _ $ ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? �I NIAI I — E_._L. DISEASE - EA EMPLOYEE - $ (Mandatory lnNH) If yes, describe Under - - - - DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ PRAL PROPERTY BUSINESS 11 PERSONAL INLAND MARINE AGGREGATE $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD fill, Additional Remarks Schedule, may be attached If more space is required) PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: Adrian W. Merritt Billy Bonkers Additional Insured:: The City of Santa Ana, 30 Day Written Notice Cancellation Required. P,� � U° Event Dates: Ongoing for policy period CERTIFICATE HOLDER CANCELLATION .00v _nl. J"' The City of Santa Ana 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana, CA 92701 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD