ZAVALA, ROBERTO DBA COSMOS EVENT RENTALS (2)

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DATE (MM/DD/YYYY) Ejhjubmmz!tjhofe! CERTIFICATE OF LIABILITY INSURANCE 1/11/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS cz!Bohjf! Bohjf! 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 Bdfwfep! 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. Ebuf;!3135/14/16! Bdfwfep 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 endorsement(s). 25;61;25!.19(11( CONTACT PRODUCER NAME: FAX PHONE A J INSURANCE(714)673-5549 (A/C, No): (A/C, No, Ext): E-MAIL 1000 Macarthur Blvd #66ajinsurance@live.com ADDRESS: Santa Ana, CA 92707 INSURER(S) AFFORDING COVERAGENAIC # MESA UNDERWRITERS SPECIALTY INS. INSURER A :36838 INSURED INSURER B : COSMOS EVENT RENTALS INSURER C : ZAVALA, ROBERTO INSURER D : 1773 W LINCOLN AVE #S INSURER E : ANAHEIM, CA 92801 INSURER F : COVERAGESCERTIFICATE 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ 1,000,000 DAMAGE TO RENTED CLAIMS-MADEOCCUR$ 100,000 PREMISES (Ea occurrence) MED EXP (Any one person)$ DED: 5005,000 1/14/20241/14/2025 PERSONAL & ADV INJURY$ AxxMP00040140013661,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ 2,000,000 PRO- POLICYLOCPRODUCTS - COMP/OP AGG$ 2,000,000 JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below PROPERTY CONTENTS:100,000 1/14/20241/14/2024 AMP0004014001366 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 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 Liability per the attached endorsements or as required by written Contract. Insurance is Primary and Non-Contributory. 30 Days' Notice of Cancellation with 10 Day's Notice for Non-Payment of Premium in accordance with the policy provisions. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF SANTA ANA Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana, CA, 92702 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD