COSMOS EVENT RENTALS (ZAVALA, ROBERTO)

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ACOREY CERTIFICATE OF LIABILITY INSURANCE `� DATE (MM DDIYYYV) 1 3111/2020 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 endorsements . PRODUCER CONTACT NAME: PHONEEstl 714 673-5549 FAX klol A J INSURANCE 1000 Macarthur Blvd #66 ADDRESS. a'insurance@live.com INSURERS AFFORDING COVERAGE NAIC N Santa Ana, CA 92707 INSURER A: MESA UNDERWRITERS SPECIALTY INS. 36838 INSURED COSMOS EVENT RENTALS INSURER B INSURER C INSURER D ZAVALA, ROBERTO INSURER E: 1773 W LINCOLN AVE #S INSURERF: ANAHEIM CA 92801 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 NBR TYPE OF INSURANCE ADOL SUER wyn POLICY NUMBER EFF MM DDPOLICYY/YY MM DY VYYJ EXP LIMIT X COMMERCIAL GENERAL LLABILITY CLAIMS -MADE OCCUR / / EACH OCCURRENCE $ 1,000,000 DAMAGE PREMISES E RENTED n n $ 100,000 MEDEXP(My wepemon $ 5000 DED:500 PERSONAL aADVINJURY $ 1000000 A MP0004014001102 1/1412020 1/14/2021 GENL AGGREGATE LIMIT APPLIES PER: POLICY Ea �LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2000000 $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per acudeni 8 PROPERTY DAMAGE (Per accidentl E HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOWPARTNEWEXECUTIVE ❑ OFRCERIMEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ EL DISEASE - FA EMPLOYEE $ (Mandatory In NH) If yes describe antler DESCRIPTION OF OPERATIONS below EL DISEASE-POUCYLIMR E A PROPERTY `/ MP0004014001102 vial zo vlazozl CONTENTS: 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached if more space Is rep PARTY RENTAL STORE: By Risk MANAQEMENT DIVISION City of Santa Ana, Its officers, employees, agents and representatives are Additional Insureds with respect to General Liability and Auto LIapIII (, the a faehed endorsements or as required by written Contract. Insurance is Primary and Non -Contributory. ✓ AP 2020 30 Days' Notice of Cancellation with 10 D`a_y's Notice for Non-Paym snt of Premium In accordance with the policy provisions. ANGIE ACEVEdO CITY OF SANTA ANA Risk Management Division, 4th floor 20 Civic Center Plaza Santa Ana, CA, 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. M 11 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD