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SUSY PARTY RENTAL, INC.
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SUSY PARTY RENTAL, INC.
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Last modified
6/15/2022 3:25:15 PM
Creation date
6/26/2019 1:13:35 PM
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Contracts
Company Name
SUSY PARTY RENTAL, INC.
Contract #
N-2019-114
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
7/5/2019
Destruction Year
2024
Notes
Property liability refelcts 6/5/2019
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ACC)RhP CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD/YYYY) <br />06/21 /2019 <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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 <br />NON <br />AMEA T Ray Mclure <br />r_ <br />P6lCItONE <br />t31n.0211I (714) 664 8911 I FAixc No ; (714) 664 0011 <br />McLure Insurance Brokerage, Inc. <br />EApo 'IutAILESS, service®mclureins.com <br />17731 Irvine Blvd. Suite 104 <br />INS, URER(S AFFORDING COVERAGE <br />NAIC N <br />INSURERA: COLONY INSURANCE COMPANY <br />39993 <br />Tustin CA 92780 <br />INSURED <br />INSURER : SECURITY NATIONAL INSURANCE COMPANY <br />INSURER C <br />INSURER D : <br />SUSY PARTY RENTALS <br />INSURER E : <br />1517 S. SYCAMORE STREET <br />INSURER F <br />SANTA ANA CA 92707 <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 />ILTR <br />TYPE OF INSURANCE <br />INSOADD <br />U9R <br />POLICY NUMBER <br />POLICY EF'F <br />OfotCY E P <br />LIMITS <br />x <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />f <br />CLAIMS -MADE " I OCCUR <br />PA�ILI amuq@ <br />$ 100,000 <br />MED EXP (Any oneperson) <br />$ 5,000 <br />PERSONAL BACV INJURY <br />$ 1,000,000 <br />A <br />Y <br />101 PKG0044107-04 <br />0610512019 <br />06/05/2020 <br />GEN'LAGORFWe LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />X POLICY❑JECOT �LOC <br />PRODUCTS-COMP/OPAGG <br />$ INCLUDED <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />CO let➢BINED SINGLE LIMrr <br />$ <br />ANYAUTO <br />BODILY INJURY (Per person) <br />$ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />LPerawdenll <br />$ <br />$ <br />UMBRELLA LIAR <br />HOCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED RETENTLONS <br />$ <br />WORKERS COMPENSATION <br />X PER dTH- <br />B <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN <br />OFFICER/MEMBER EXCLUDED? O <br />(Mandatory In NH) <br />N I <br />Y <br />TWC3805782 <br />06/0712019 <br />06/07/2020 <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L, DISEASE - EA -EMPLOYEE <br />$ 1,000,000 <br />If yyes, describe under <br />nFsCRIPTION OF OPERATIONS below <br />r l DISEASE- POLICY UMI r <br />$ 1,000,000 <br />PROPERTY <br />LIMITS <br />$450,000 <br />A <br />101 PKG 0044107-04 <br />06/06/2019 <br />06/05/2019 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701; ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS <br />ARE NAMED AS ADDITIONAL INSUREDS ("ADDITIONAL INSUREDS") WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE <br />OPERATIONS AND USES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. <br />REVIEWED B <br />CERTIFICATE HOLDER CANCELLATION <br />KISR Iviancigemenf UIV1510 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City Of Santa Ana Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />20 CIVIC CENTER PLAZA c <br />SANTA ANA CA 92701 <br />r, Annn n r+ conrihn A'.12%_12 <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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