ZAVALA, ROBERTO dba COSMOS EVENT RENTALS

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Digitally signed by Francine R. Francine R. Villareal Villareal Date: 2022.01.20 10:27:34-08'00' � �"M" CERTIFICATE OF LIABILITY INSURANCE DATE(MMdDDIYYYY) 0111912022 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(les) 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 Gonferrjabts to the certificate holder In lieu of such endorsements . PRODUCER I CONTACT - A U INSURANCE 1000 Macarthur Blvd #66 Santa Arta, CA 92707 INSURED COSMOS EVENT RENTALS 2AVALA, ROBERTO 17731M LINCOL.N AVE #S MESA UNDERWRITERS SPECIALTY INS. COVERAGES CERTIFICATE NUMBER: REVISION NUMB ER. 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, EXCLUSION'S AND CONDITIONS OF SUCH POLICIES, LIMITS' SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR I3EO 500 ADDL S BR POLIO NUMBER MP0004014001196 POLICY EFF M'M bDt1°YYY 1114/2022 POLICY EXP M IDD 111412023 LIMITS EACFI IJCCURRENCE $ 2,000 000 CAMAGET RENTED EMISES 'Ea carurrone .." $ 10 QQQ MED EXP Any ono arson's $ 51000 PERSONAL $ ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER! POLICY 0 PRO- JECT LOG GFNFRALAGGREGATE $ 2,000000 GEN'L PRODUCTS -COMPIOPAGG $ 2,000,000 OTHER: $ AUTOPMSOBIlLE LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED f— NUTOS N L AUTOS ONLY AUTOS ONLY COMa IrEO SINGLE LIMI $, BODILY INJURY (Per person) $ BODILY INJURY(Paraccldont) $ P eOr ac da CYAMAUE $ i $ I I UMBRELLA.LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOPJPARTNEPJEXECU'nVE E IN...7A OF�FICFRIMEMMDER EXCLUDED? (Mandatory In NH) Dyes, describe undar DESCRIPTION OF OPERATIONS below ST T T OE E,L,k~AOHACOIDENT F.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT A PROPERTY MP0004014001196 111412021 1114/2022 CONTENTS: 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACM 101, Additional Remarks Schedule, may.. be attached If more space IS required) PARTY RENTAL STORE: City of Santa Ana, Its officers, employees, agents and representatives are Additional Insureds with respect to General Liability and Auto Liabillty par the attached endorsements or as required by written Contract. Insurance is Primary and Non-Contrlbutory. to g PROVED 3e Days' Notice of Cancellation w1th "le Day's Notice for Non -Payment of Premium In accordance with the policy provisions. HAM" B�fisk W A "41FV wi W I N CERTIFICATE HOLIER CANCELLATION ' CITY t:lF enter lazy 2Q� Civic Center Plaza SHOULD ANY OF THE A13OVE DEJra of BL"" ORE THE EXPIRATION DATE THEIR ACCORDANCE WITH THE POLICY P IN Santa Ana, CA, 92702 AUTHORIZED REPRESENYA-rivE V II SU-20115 AGORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACO'RD name and logo are registered marks of ACORD