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.alco/20 CERTIFICATE OF LIABILITY INSURANCE `� GATE IYYYV) 3/2/2022/2020 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 policy(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 CONTACT NAME: Brian Roberts Blue Lion Insurance, LLC PHONE 800-665-5154 A/C Ext : (AIC, No : 888-221-9537 IN. ADDRESS: Brian@bluelioninsurance.com 10224 Airport Way, Ste C INSURER(S) AFFORDING COVERAGE NAIC# Snohomish WA 98296 INSURER A: Mesa underwriters Specialty INSURED INSURER B Darrell Wagner ribs Professional Entertainment INSURERC: PO BOX 78593 INSURER D : INSURER E : Seattle WA 98178 INSURER F: CERTIFICATE NUMRFR: 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. MIER LTR TYPE OF INSURANCE DO INSD WVD POLICY NUMBER (MMIDDNYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ©OCCUR EACH OCCURRENCE $ 2,000,000 PREMISES (Ea occurrence) $ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y MP0046001003112 12/05/2019 12/05/2020 GSEEN'L AGGREGATE LIM IT APPLIES PER: I^ POLICY �JECOT Lac GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY o (Ea accident) $ BODILY INJURY Per person) S ANY AUTO OWNED 5CHEOULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Per accitlent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ ORKERS COMPENSATION _ ND EMPLOYERS' LIABILITY YIN NY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? ❑ NIA STATUTE I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ Mandatory in NH) If yes, describe under E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space is required) City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are listed as additional insured. Coverage is primary and non-contributory. Certificate of Insurance provides thirty (30) day prior written notice of cancellation. REVIEWED & APPROVED at, Biel; MAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza, 4th Floor (3 0j Rlrircrf$ I Santa Ana, CA 92702 V 1S66-ZU15 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD