COSMOS EVENT RENTALS (ROBERTO ZAVALA) (2)

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ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03/18/2025 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(les) 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: StatelFarm EDDIE QUILLARES JR, PHONNE E (714)617 7150 FAX No): (714)617 7158 STATE FARM AGENCY n olEss: F LIDA.GARCI AC ERVANTES.VAF5S3@STATEFARM.COM WWI R 415 BROADWAY -INSURER($)AFFORDING COVERAGE NAIL# SANTA ANA CA 92701 INSURERA: State Farm Fire and Casualty Company 25143 INSURED INSURER B: State Farm Mutual Automobile Insurance Company 25178 INSURER C COSMOS EVENT RENTALS LLC INSURER D: 1773 W LINCOLN AVE STE S INSURERE: ANAGEIM CA 92801 INSURERF: 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 ADDL SUBR - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVn POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAWS-MADE 1A OCCUR PREMISES Ea occurrence- $ MED EXP(Any one person) $ A PERSONAL&ADV INJURY $ GEN'L AGGRFGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ X POLICY PRO JECT LOC PRODUCTS-COMPIOPAGG $ OTHER'. $ AUTOMOBILE LIABILITY Y Y 6981115-0O2-75A 03/02/2025 03/02/2026 COMB€NED SINGLE LIMIT $ 1,a00,000 Ea accident ANY AUTO 867 6798-F20-75 12/20/2024 06120/2025 BODILY INJURY(Per person) $ B OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED X NON-OWNED 195 7791-F12-75D 12/12/2024 12/12/2025 PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR_H CLAIMS-MADE AGGREGATE $ DEP RETENTION$ $. WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS`LIABILITY Y!N ANY PROPRIETOMPARTNERIEXECUTIVE OFFICERiMEMBER EXCLUDED? ElN/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 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 APPROVED By Tu Tran Nguyen at 11:30 am,Mar 20,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana-City Wide AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza ( i% L Santa Ana CA 92701 Q 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