COSMOS EVENT RENTALS (ZAVALA, ROBERTO) (2)

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A� " CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01 /28/2025 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 endorsement(s). PRODUCER CONTACT ELIDA GARCIA CERVANTES NAME: StateFarm EDDIE QUILLARES JR. PHHCONN Ext : (714) 617-7150 FAX No): (714) 617-7158 STATE FARM AGENCY ADDRESS: ELIDA.GARCIACERVANTES.VAF5S3@STATEFARM.COM � � c INSURER(S) AFFORDING COVERAGE NAIC # 415 BROADWAY INSURERA: State Farm Fire and Casualty Company 25143 SANTA ANA CA 92701 INSURED INSURERB: State Farm Mutual Automobile Insurance Company 25178 INSURER C INSURERD: COSMOS EVENT RENTALS LLC INSURERE: 1773 W LINCOLN AVE STE S INSURERF: ANAHEIM CA 92801 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DA CLAIMS -MADE 1:1OCCUR PREM SESOEa occurrDence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ A GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY Y Y 698 1115-0O2-75A 03/02/2024 03/02/2025 COMBINEDccidentSINGLE LIMIT Ea a $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO 867 6798-F20-75 12/20/2024 06/20/2025 BODILY INJURY (Per accident) $ B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 195 7791-F12-75D 12/12/2024 12/12/2025 PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the permittee including materials, parts, equipment, and personnel furnished in connection with such work or operations. Library Services Agency Programming in the City of Santa Ana APPROVED By Tu Tran Nguyen at 10:39 am, Mar 17, 2025 CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA, ATT: DYLAN DARIO, LIBRARY SERVICES AGENCY,M-75 SANTA ANA , CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C%W-'a' ?�U� @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849.13 04-22-2020