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SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST <br />DATE <br />CERTIFICATE OF INSURANCE ENDORSEMENT <br />8/14/2024 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE ENDORSEMENT DOES NOT CONSTITUTE A CONTRACT <br />BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />PRODUCER: <br />CONTACTNAME: JOYCUMMINGS <br />HUB International Insurance Services Inc. <br />PHONE 9256096500 <br />FAX 9256096550 <br />3000 Executive Parkway, Suite 300 <br />EMAIL soecialeventna hubinternational.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />San Ramon, CA 94583 <br />INSURER A: <br />Colony Insurance Company <br />39993 <br />CA License #0757776 <br />NAMED INSURED: <br />Chicano Heritage: Educational Celebration of <br />Culture at the Library Vendors (8) <br />per the attached list <br />20 Civic Center Plaza, Santa Ana, CA 92701 <br />COVERAGES <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 below. Notwithstanding any requirement, ten o <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 <br />terms, exclusions and Conditions of such policies. <br />INSR <br />INSURED MEMBER <br />COVERAGE EFFECTIVE/ <br />TYPE OF INSURANCE <br />ENDORSEMENT <br />LIMITS <br />LTR <br />NUMBER <br />EXPIRATION DATE <br />A <br />GENERAL LIABILITY <br />EACHOCCURRENCE <br />$1,000,00 <br />X COMMERCIAL GENERAL LIABILITY <br />41528 <br />08/29/2024 <br />DAMAGE TO RENTED PREMISES <br />$1.000,000 <br />(En accurtencel <br />MED ENP(Any ene perme) <br />$5,000 <br />CLAIMS -MADE FxOCCURRENCE <br />PERSONAL 6 AW INJURY <br />$1,000,000 <br />GENERAL AGGREGATE <br />$2,000.0 0 <br />PROOUCTSCOMPIDPAGG <br />$2,000,000 <br />LIQUOR LIABILITY PER <br />OCCURRENCE(AGGREGATE <br />INCLUDED IN GENERAL LIABILITY <br />n/a <br />AGGREGATE) <br />MASTER POLICY #103 GL 0021111 - EFFECTIVE DATE 111I2024; EXPIRATION 1/112025 <br />DESCRIPTION OF OPERATIONS I LOCATIONS <br />City of Santa Ana, its officers, officials, employees and volunteers, 20 Civic Center Plaza, Santa Ana, CA 92701 <br />islare Included as an additional Insured(s) per attached endorsement T5409-0118. Policy is Primary and Non-contributing per attached endorsement T1095-0108; Waiver of <br />Subrogation applies per attached endorsement CG 24 04 05 09. <br />Event Type: Vendors (8) <br />Event date(s): 8/29/2024 <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE <br />BEFORE THE EXPIRATION DATE RiskAtamagarredDhis[on <br />ACCORDANCE WITH THE POLICY REVIEWED&APPROJ®BY: <br />City of Santa Ana <br />of>°ec' <br />Attention: Ella Sepulveda <br />,1 <br />AUTHORIZED REPRESENTATIVE A-r.&.�C )•fay(I(p - <br />20 Civic Center Plaza M-75®' <br />Risk Management Spedalist <br />Santa Ana, CA 92701. <br />