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AnDigitally signed by Angie <br />geCERTIFICATE OF INSUR , 4c J�D�-O <br />SPECIAL EVENT LIABILITY GROUP INSURP JC.- TRUST, A RISK PURCHASING GROUP <br />_ <br />t <br />4 9*41 <br />FACI NE i a r : ( <br />ulti e, continued <br />� <br />PRC JUCER: 1 I <br />CA License #0757776 <br />on n rt pa e <br />rUB International Insurance Services Inc. <br />City of Santa Ana, its officers, officials, employees and volunteers, 20 Civic <br />3000 Executive Parkway, Suite 300 <br />Center Plaza, Santa Ana, CA 92701 <br />San Ramon, CA 94883 <br />PH: 925 609 6500 FX: 925 609 6550 specialeventala)hubinfemationalcom <br />EVENT HOLDER - Named Insured: (if multiple, continued on <br />next page) <br />EVENT INFORMATION <br />Chicano Heritage: Educational Celebration of <br />TYPE OF EVENT: <br />Vendors (8) <br />EVENT DATE(S): <br />8/29/2024 <br />Culture at the Library Vendors (8) <br />per the attached list <br />20 Civic Center Plaza, Santa Ana, CA 92701 <br />EVENT LOCATION(S): <br />City of Santa Ana City Hall, 20 Civic Center Plaza, Santa Ana, CA 92701 <br />This is to certify that the policies of insurance listed below have been issued to the insured named above for the event dates) 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: <br />COLONY INSURANCE COMPANY <br />INSR LTR <br />Type of Insurance <br />Policy Number <br />Effective <br />Expiration <br />Policy Limits <br />Each Occurrence <br />$1,000,000 <br />General Aggregate <br />$2,000,000 <br />Personal & Advertising Injury <br />$1,000,000 <br />Products/Com pleled Operations <br />$2,000,000 <br />Commercial <br />Aggregate <br />Damage to Premises Rented to You <br />$1,000,000 <br />A <br />General Liability <br />103 GL 0021111 <br />1/1/2024 <br />1/1/2025 <br />Medical Payments <br />$5,000 <br />Liquor Liability Each Occurrence <br />(Aggregate included in General <br />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. <br />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 <br />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 p <br />--Sexual Abuse 8 Molestation <br />RieleMraugemgttDiWfan <br />��/�� jam, j flEVIEWEp&APPROVm BY: <br />`3. <br />On behalf of the Risk Purchasing Group and each Member, the Trustee has <br />-- Terrorism <br />Insurance Act <br />Illialai'_L• A'r'fr`a AGa4'� <br />(TRIA). <br />41, <br />® Risk Management Specialist <br />—Additional Insureds, next page <br />