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Aboil <br />SPECIALTY <br />* a suUNCE Agm <br />i of w , ycur cxwmrc d <br />Digitally signed <br />Angie by Angie <br />Aceved DATE <br />CERTIFICATE OF LIABILITY INWMf fP(1 n natP. 2(t)40122 <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADD111ONALMMD prove Ion. or b endorsed. If SUBROGATION IS <br />WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on +:Iis ;ertificate 0,9n44nf�r0gb,0gA00' <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Contact Name: Heather Weiss Zenzen <br />Specialty Insurance Agency <br />Performers of the U.S. <br />Phone: 715-246-8908 FAX: 715-246-8908 <br />3432 Denmark Ave #231 <br />Email: certs@specialtyinsuranceagency.com <br />Eagan, MN 55123 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURERA: Evanston Insurance Company <br />35378 <br />Terry Conci <br />INSURER B: <br />dba Franklin Haynes Marionettes <br />INSURERC: <br />1234 Muirfield Road <br />Riverside, CA 92506 <br />INSURER D: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE <br />INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS <br />AND CONDITIONS OF SUCH POLICIES. AGGREGATE <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />INSD <br />WVD <br />DATE (MM/DD/YY) <br />DATE (MM/DD/YY) <br />X COMMERCIAL GENERAL <br />EACH OCCURRENCE <br />$ 1 000 000 <br />DAMAGE TO RENTED <br />LIABILITY <br />CLAIMS MADE�CCUR <br />PREMISES (Ea occurrence) <br />$ 300'000 <br />MED EXP (Any one person) <br />$ 5 000 <br />A <br />GEN'LAGGREGATELIMIT <br />X <br />X <br />2CN0171-7334 <br />09/08/2021 <br />09/07/2022 <br />PERSONAL &ADV INJURY <br />$ 1 000 000 <br />APPLIES PER: <br />GENERAL AGGREGATE <br />$2000 000 <br />POLICY❑PROJECT <br />PRODUCTS - COMP/OPAGG <br />$ 2,000,000 <br />HLOC <br />PERFORMER ASSISTANT(S) <br />EACH OCCURRENCE <br />$ <br />A <br />AGGREGATE <br />$ <br />A <br />BUSINESS PERSONAL <br />AGGREGATE <br />$ <br />PROPERTY- INLAND MARINE <br />SEXUAL ABUSE AND <br />EACH OCCURRENCE <br />$ <br />A <br />MOLESTATION <br />$ <br />OCCUR <br />AGGREGATE <br />A <br />DATA BREACH AND CYBER <br />AGGREGATE <br />$ <br />LIABILITY COVERAGE <br />A <br />EQUIPMENT LEASED OR <br />AGGREGATE <br />$ <br />RENTED <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: <br />Terry Conci dba Franklin Haynes Marionettes <br />Additional Insured: The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers as additional inured. Coverage is <br />primary and not -contributory with respect to insurance or self-insurance maintained by the City. Thirty <br />(30) day prior written notice of cancellation required. <br />Email: msepulveda@santa-ana.org Event Dates: 04/08/2022 - 06/29/2022 <br />%&ManagernadEl iaian <br />+� \@ REVIEWED & APPROVED BY: <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABO AT <br />BEFORE THE EXPIRATIOICOVERAGE <br />City of Santa Ana Risk Management Division <br />Specialist <br />20 Civic Center Plaza, 4th floor <br />WILL ENDEARManagement <br />CERTIFICATE HOLDER N, , <br />Santa Ana, CA 92702 <br />SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE "V <br />