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I► 4+.kill SPECIALTY CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1,,SU Rny:t nc;>+c-r 02/22/2024 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 c kLT1IIII cate holder iy lieu of such endorsement(s). _ Digitally signed by Angie erance Agency Contact Name: Heather Weiss Zenzen Pers of the U.S. Acevedo Phone: 715-246-8908 FAX: 715-246-8908 3432 Denmark Ave#231 certs@specialtyinsuranceagency.com pcer\7eldDate. 2024.03.18 14.3lRS AFFORDING COVERAGE NAIC# INSURED PERFORMERTHE U.S.AND ITS PART;CI''ATING ME14$EVS:001 INSURER A: Evanston Insurance Company Terry Conci P Y 35378 INSURER B: dba Franklin Haynes Marionettes 1234 Muirfield Road INSURER C: Riverside,CA 92506 INSURER D: I COVERAGES 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 CONTRACTOR 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS INSD WVD DATE(MM/DD/YY) DATE(MM/DD/YY) COMMERCIAL GENERAL EACH OCCURRENCE $1,000,000 LIABILITY DAMAGE TO RENTED CLAIMS MADEnOCCUR PREMISES(Ea occurrence) $300,000 MED EXP(Any one person) $5,000 GEN'L AGGREGATE LIMIT A X X 2CN0177-7334 09/08/2023 09/07/2024 PERSONAL&ADV INJURY $1,000,000 APPLIES PER: _ nPOLICY❑PROJECT GENERAL AGGREGATE $2,000,000 LOC PRODUCTS-COMP/OP AGG $2,000,000 EACH OCCURRENCE $ A PERFORMER ASSISTANTISI AGGREGATE $ A BUSINESS PERSONAL AGGREGATE $ PROPERTY-INLAND MARINE SEXUAL ABUSE AND EACH OCCURRENCE $1,000,000 A MOLESTATION 2CN0177-7334 09/08/2023 09/07/2024 ElOCCUR AGGREGATE $2,000,000 A DATA BREACH AND CYBER AGGREGATE $ LIABILITY COVERAGE A EQUIPMENT LEASED OR AGGREGATE $ RENTED DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.: Terry Conci dba Franklin Haynes Marionettes Additional Insured:The City of Santa Ana,Risk Management,it's officers,employees,agents,representatives,and volunteers as additional inured.Coverage is primary and not-contributory with respect to insurance or self-insurance maintained by the City. Waiver of Subrogation applies to general liability.Thirty(30)day prior written notice of cancellation required. Sexual abuse or molestation coverage is not excluded by endorsement.$1,000,000/$2,000,000 coverage limits apply to educational institutions only;otherwise $100,000 each occurrence/$300,000 aggregate limits apply to sexual abuse or molestation coverage. Email:jhoang@santa-ana.org Event Dates:05/04/2024-07/15/2024 Insured for:Puppeteer CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division ) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED \ /ORE THE EXPIRATION DATE THEREOF,THE INSURER AFFORDING RA 20 Civic Center Plaza,4th floor JERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE Santa Ana,CA 92702 "` °`_ �Dnd9[Dn 1TIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO REVIEWED&APPROVED ALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE ��'c. A ALeU_J_ URER,ITS AGENTS OR REPRESENTATIVES. ®', IORIZED REPRESENTATIVE /)I j n / Risk Management Specialist �il/{Ifj/t ) ,