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CERTIFICATE OF INSURANCE ENDORSEMENT <br /> SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST,A RISK PURCHASING GROUP <br /> Certificate# <br /> FACILITY OWNER-Additional Insured: (if multiple,continued <br /> PRODUCER: CA License#0757776 <br /> on next page) <br /> HUB International Insurance Services Inc. <br /> City of Santa Ana,its officers,officials,employees and volunteers,20 Civic 3000 Executive Parkway,Suite 300 <br /> Center Plaza,Santa Ana,CA 92701 <br /> San Ramon,CA 94583 <br /> PH:925 609 6500 FX:925 609 6550 specialevent(o�hubinternational.com <br /> EVENT HOLDER-Named Insured: (if multiple,continued on EVENT INFORMATION <br /> next page) <br /> City of Santa Ana TYPE OF EVENT: Festival/3vs3 Basketball <br /> 20 Civic Center EVENT DATE(S): 8/11/2024 <br /> Santa Ana, CA 92701 <br /> EVENT LOCATION(S): Centennial park,3000 W.Edinger Ave.,and Diamond Elementary,1450 S. <br /> Center St.,Santa Ana,CA <br /> This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated above. Notwithstanding any requirement,term or <br /> 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, <br /> exclusions and conditions of such policies. <br /> INSURER A: COLONY INSURANCE COMPANY <br /> INSR LTR Type of Insurance Policy Number Effective Expiration Policy Limits <br /> Each Occurrence $1,000,000 <br /> General Aggregate $2,000,000 <br /> Personal&Advertising Injury $1,000,000 <br /> Products/Completed Operations $2,000,000 <br /> Commercial Aggregate <br /> A 103 GL 0021111 1/1/2024 1/1/2025 <br /> General Liability Damage to Premises Rented to You $1,000,000 <br /> Medical Payments $5 000 <br /> Liquor Liability Each Occurrence <br /> (Aggregate included in General n/a <br /> Liability Aggregate) <br /> COVERAGE TERMS: <br /> Occurrence Form(CG 0001) <br /> The coverage afforded by this insurance is primary and non-contributing with any <br /> Host Liquor Liability Included. insurance held by the "Additional Insured" as Named Insured,when the "Additional <br /> Insured" is shown on this Certificate of Insurance Endorsement as "Additional Insured" <br /> Full Liquor Liability Included when a or WHEN REQUIRED BY WRITTEN CONTRACT. <br /> separate premium has been charged. <br /> COVERAGE EXCLUSIONS:(REFER TO POLICY FOR COMPLETE LISTING OF EXCLUSIONS) <br /> --Communicable Diseases <br /> Specific Events are excluded from coverage. Please see second page for list of excluded events. <br /> --Sexual Abuse&Molestation <br /> --Terrorism On behalf of the Risk Purchasing Group and each Member,the Trustee has declined coverage for the Terrorism Risk <br /> Insurance Act(TRIA). <br /> Additional Insureds,next page— <br />