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DocuSign Envelope ID: 2117C8A0-DE59-4584-A333-CF93B10B6E45 <br />Page 2 <br />events: car jumping contests/demonstrations of hydraulic modifications to <br />automobiles; $2,000,000 per occurrence for Interim Carnival Rides, Fairtime <br />Kiddie Carnival Rides of up to 6 rides, Concerts with over 5,000 attendees, Rave <br />Type Events All Types, Cannabis Festivals/Trade Shows, Mechanical Bulls, <br />Extreme Attractions All Types that require a DOSH permit to operate, and <br />Simulators; $1,000,000 per occurrence for Rodeo Events All Types without <br />any Rough Stock Events; $1,000,000 per occurrence for all other contracts for <br />which liability insurance (and liquor liability, if applicable) is required. <br />The Certificate of Insurance shall list the applicable policy forms, including <br />endorsements. Any exclusions or coverage limitations, including sub -limits, that <br />apply to the contractor/renter's activities, or business to be conducted under the <br />contract or rental agreement/lease, must be listed in the Certificate of Insurance. <br />If there is a self -insured retention or deductible in the contractor/renter's coverage <br />equal to or in excess of $100,000, the self -insured retention/deductible amount <br />shall be included as part of the Certificate of Insurance. A copy of the <br />contractor/renter's policy declaration page containing this information as an <br />attachment/exbibit to the Certificate of Insurance will be acceptable, provided it <br />contains all the aforementioned information. <br />b. Automobile Liability - Commercial Automobile Liability coverage, on a per <br />accident basis, at least as broad as the current ISO policy form # CA 00-01, <br />Symbol #1 (Any Auto) with limits of not less than $1,000,000 combined single <br />limits per accident for contracts involving use of contractor vehicles (autos, trucks or <br />other licensed vehicles) on fairgrounds. <br />c. Workers' Compensation - Workers' Compensation coverage shall be <br />maintained covering contractor/renter's employees, as required bylaw. <br />d. Medical Malpractice - Medical Malpractice coverage with limits of not less <br />than $1,000,000 per occurrence shall be maintained for contracts involving medical <br />services. <br />e. Liquor Liability - Liquor Liability coverage with limits of not less than <br />$1,000,000 per occurrence shall be maintained for contracts involving the sale of <br />alcoholic beverages. <br />4. Cancellation Notice: Notice of cancellation of the listed policy or policies shall be <br />sent to the Certificate Holder in accordance with policy provisions. <br />5. Certificate Holder: <br />• For Individual Events Only - Fair, along with fair's address, is listed as the <br />certificate holder. <br />For Master Insurance Certificates Only - California Fair Services Authority, <br />Attn: Risk Management, 1776 Tribute Road, Suite 100, Sacramento, <br />CA 95815 is listed as the certificate holder. <br />Revised Eft. January 3, 2020 <br />