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Ac �®1!I 5/10/2019 CERTIFICATE OF LIABILITY INSURANCE DAT <br />5/10/2 <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 <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, 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 CONTACT Stephanie Weiss <br />Specially Insurance Agency PHONE FAX <br />Performers of the U.S. lac L,�,q. 715-246-8908 _ - _ (AIc No): 715-246-4257 _ <br />P.O. Box 24 E-MAIL ADDRESS: @p y g y carts s ecialt inrances enc .com <br />_su_ _ <br />New Richmond, WI 54017 _.. --- _ <br />INSURER(S)AFFORDING COVERAGE NAICM <br />INSURER A: Evanston Insurance Company 35378 <br />INSURED Shannon Lovley <br />dba Best Bubble Parties, Best Bubble Learning <br />13654 Victory Blvd., #545 <br />Van Nuys, CA 91401 <br />D: <br />COVFRAIMPR CRRTIPICATR KIIIMRRR- RF\/ICIr1N MI IMRRR• <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IN SR - LSUBRi POLICY EFF POLICY EXP <br />LTR ADD <br />TYPE OF INSURANCE N D POLICY NUMBER MMIOOM/YY MMIDDM/YY LIMITS <br />X COMMERCIAL GENERALLIABILITV <br />III <br />EACH OCCURRENCE $ 1,000,000 <br />MADE X OCCUR <br />j DAMAGE TO AEN ED <br />30Q000 <br />I�CLAIMS <br />PRE EXP( Any one person) $ 5,000 <br />PMEDREMEES (Ed(Any occurrence) $ <br />A <br />X <br />X 2CN0162-19097 OB/02/2018 <br />08/01I201g <br />PERSONAL &ADV INJURY $ 1,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />__. <br />G ENERALAGGREGATE $ 2,000,000 <br />PRO- <br />X POLICY J JECT LOC <br />h I- <br />PRODUCTS-COMP/OP AGG $ 2,000,000 <br />11 OTHER: <br />$ <br />AUTOMOBILE LIABILITY <br />11 COMBINED SINGLE LIMIT $ <br />I (Ea accident_ _ <br />ANY AUTO <br />BODILY INJURY (Perperson) I $ <br />OWNED SCHEDULED <br />�I AUTOS ONLY AUTOS <br />----- --- <br />BODILY INJURY (Per accident) $ <br />—� <br />HIRED NON -OWNED <br />I ' PROPERTY DAMAGE - -- <br />�I <br />' AUTOS ONLY AUTOS ONLY <br />(Per accident) <br />III, <br />UMBRELLA LIAB�� OCCUR <br />EACH OCCURRENCE I S <br />I EXCESS LIAB CLAIMS -MADE. <br />I .AGGREGATE I $ <br />_ -_.. <br />DED ''.. I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />STAPERTUTE OTH- <br />ER <br />i� -- -- <br />AND EMPLOYERS' LIABILITY YIN <br />E. L. EACH ACCIDENT $ <br />_ - - - <br />IANYPROPRIETOR/PARTNER/EXECUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED? N/A <br />(MandaiinNH) <br />1 E.L. DISEASE - EA EMPLOYEE $ <br />If yes, describe under <br />-- <br />DESCRIPTIONOFOPERATIONSbelow <br />IiI LIMIT $ <br />A <br />BUSINESS PERSONAL PROPERTY- <br />(?f`a� <br />�L`,DI `p1-POLICY <br />GREGATFI $ <br />INLAND MARINE I <br />y\" <br />444 <br />PJ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more spas is require) n1 <br />PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: <br />Shannon Lovley dba Best Bubble Parties, Best Bubble Learning (� <br />Insured: Santa <br />Additional Ana Public Library, City of Santa Ana, it's officers, agents and employees <br />Email: mloera@santa-ana.org Attn: Michelle Loera Event Dates: July 2, 2019 <br />Santa Ana Public Library <br />26 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Santa Ana, CA 92701 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />@ 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />