COSMOS EVENT RENTALS (ROBERTO ZAVALA)

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A� of CERTIFICATE OF LIABILITY INSURANCE DAM(MMMD/YYYY) 1/11/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 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. 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 endorsements . PRODUCER CONTACT NAME: A J INSURANCE 1000 Macarthur Blvd #66 PHONN EAU. E 714 673-5549 FAX No): E- o less: a'insurance live.com INSURERS AFFORDING COVERAGE NAIC # Santa Ana, CA 92707 INSURERA: MESA UNDERWRITERS SPECIALTY INS. 36838 INSURED COSMOS EVENT RENTALS INSURER B : INSURER C INSURER D: ZAVALA, ROBERTO INSURER E: 1773 W LINCOLN AVE #S INSURER F. ANAHEIM CA 92801 f �'illy[Nv\i= 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. INTSRR TYPE OF INSURANCE ADDLSUBR POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL ABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1000 0QQ DAMAGE TO RENTED PREMISES Eaoccunence IS 100000 MED EXP (Any one Person) $ 5,000 DED: 500 PERSONAL BADVINJURY 000000 A X x MP0004014001366 1/14/2024 1114/2025 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑PRODUCTS-COMP/OPAGG LOCOTHER: GENERAL AGGREGATE GEN'L 000 000JECT R$2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaac6dentANY AUTO BODILY INJURY Perperso) OWNED SCHEDULED AUTOS BODILY INJURY Per accidentAUTOSONLY ( )HIRED NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGEAUTOS Peraccident UMBRELLA LIA OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIM' -MADE DED I I RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABIDTY YIN ANY PROPRIETOR/PARTNERIEXECUTWE OFFICER/MEMBER EXCLUDED? N/A PER OTH- STATUTE ER E. L. EACH ACCIDENT § E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS belay A PROPERTY TMP0004014001366 1114/2024 1114/2024 CONTENTS: 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be etteched if more space is required) APPROVED By Cynthia Mora at 7:49 am, Dec 03, 2024 City of Santa Ana Attn: PWA Water Resource 215 S Center Street Santa Ana, CA 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 01988-2015 ACORD CORPORATIr1N All Hl hfo •nacn,cA ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD