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<br /> SPECIALTY CERTIFICATE OF LIABILITY INSURANCE DATE
<br /> IMM/DDlYYY'/1
<br /> >i ;,, ; , r,, 1 06/20/2025
<br /> IMPORTANT:It the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL_INSURED provisions or be endorsed.If SUBROGATION IS
<br /> 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
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER Specialty Insurance Agency Contact Name: Heather Weiss Zenzen
<br /> Performers of the U.S. Phone: 715-246-8908 FAX: 715-246-8908
<br /> 3432 Denmark Ave#231 Email: cents@specialtyinsuranceagency.com
<br /> Eagan,MN 55123
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURED PERFORMERS OF THE U.S.AND ITS PARTICIPATING MEMBERS: INSURER A: Evanston Insurance Company 35378
<br /> Richard Ribuffo
<br /> INSURER B:
<br /> dba Magic Makers Entertainment, Inc
<br /> 352 South Center Street INSURER C:
<br /> Orange,CA 92866
<br /> INSURER O:
<br /> COVERAGES
<br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY
<br /> REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE
<br /> INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE
<br /> LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
<br /> iNSD wvD DATE{MM/DD/YY) DATE(MMIDDPfl)
<br /> X COMMERCIAL GENERAL EACH OCCUnRENCE $1,000,000
<br /> LIABILITY DAMAGETO RENTED $300,000
<br /> CLAIMS MADE XOCCUR PREMISES(Ea occurrence)
<br /> GEN'L AGGREGATE LIMIT MED EXP(Any one person} $5 OOD
<br /> A APPLIES PER: X X 2CN0180-13838 03/2612025 03/26/2026 12:01am PERSONAL&ADVINJURY $1,000,000
<br /> X POLICY❑PROJECT GENERAL AGGREGATE $2,000,000
<br /> LGC PRODUCTS-CCMPlOP
<br /> AGG $ ,OOD
<br /> A PERFORMER ASSISTANT(S) EACH OCCURRENCE $
<br /> AGGREGATE $
<br /> A BUSINESS PERSONAL AGGREGATE $
<br /> PROPERTY-INLAND MARINE
<br /> SEXUALABUSEAND EACH OCCURRENCE $1,000,OOD
<br /> A MOLESTATION 2CN0180-13839 03/26/2025 03/26/2026 12:01 am
<br /> X accuR AGGREGATE $2,000,400
<br /> A DATA BREACH AND CYBER AGGREGATE $
<br /> LIABILITY COVERAGE
<br /> A EQUIPMENT LEASED OR RENTED AGGREGATE $
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br /> PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.:
<br /> Richard Ribuffo dba Magic Makers Entertainment, Inc
<br /> Additional Insured:The City of Santa Ana, Risk Management,it's City Council,officers,employees,agents,representatives,and volunteers as additional inured.
<br /> Coverage is primary and not-contributory with respect to insurance or self-insurance maintained by the City. Waiver of Subrogation applies to general liability.
<br /> Thirty(30)day prior written notice of cancellation required.
<br /> Sexual abuse or molestation coverage is not excluded by endorsement.$1,000,000/$2,000,000 coverage limits apply to educational institutions only;otherwise
<br /> $100,000 each occurrencB/$300,000 aggregate limits apply to sexual abuse or molestation coverage.
<br /> Email:jhoang@santa-ana.arg Attn:,Julie Hoang Ongoing For Policy Period
<br /> Insured for:Balloon Twister,Childrens Entertainer, Magician,Public Speaker,Videographer,Rope Tricks Performer
<br /> oquny s.snm
<br /> Tu Tran APPROVED
<br /> Nguyen°:Ss'o:-0.a�a,
<br /> PTu T!O Nguyen at 2:55 pm,Jul 03,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
<br /> Attention:Parks,Recreation,and Community Services Agency BEFORE THE EXPIRATION DATE THEREOF,THE INSURER AFFORDING
<br /> COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
<br /> 20 Civic Center Plaza M-23 CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO
<br /> Santa Ana,CA 92702 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
<br /> INSURER,ITS AGENTS OR REPRESENTATIVES.
<br /> AUTHORIZED REPRESENTATIVE
<br />
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