O ENTERTAINMENT, INC. 4B - Laserfiche WebLink

Home Browse Search

OP ID: JU CERTIFICATE OF LIABILITY INSURANCE DAT F 08/04 OS/04/11 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 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 530-662-9181 Wraith, Scarlett & Randolph Ins. Serv_, Inc OB48084 530-662-6452 622 Main Street Woodland, CA 95695 Craig Huft CONTACT ME PHONE FAX C ac Nu: AODREss: PRODUCER C STONER ID : CHRIS23 INSURERS AFFORDING COVERAGE NAIC # INSURED Christiansen Amusements INSURER A: COm anion PropertyPr.perty & Casualty 12157 Stacy Brown P.O. Box 997 INSURER B Escondido,, CA 92033 INSURERC INSURER D INSURER E INSURER F : 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 L POLICY NUMBER POLICY EFF MM/OD POLICY EXP MM/DD/Y LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE = OCCUR EACH OCCURRENCE $ PREMISES Ee oeeu El rrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F I PRO LOG PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS `` a I L t l�PPR0 v L 1� --�� ) �yUCa Ay�i�ian (. i A 4 t �'-y __ — :�iy , --- COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Par person) $ BODILY INJURY (Per arcident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICEWMEMBER EXCLUDED? (Mandatory in NH) If- describe under DESCRIPTION OF OPERATIONS below N / A CPCA13469 08/01/11 08/01/12 X WC SLIMI OTH- E.L. EACH ACCIDENT $ 1.000,00 E.L. DISEASE- EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1-000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Rema SohedYle. U more apaoe la required) RE: Madison Park Carnival August 26, 2011 - September 7, 2011 a.crc1 Ir1l..ia1 c "-cm CANCELLATION CITYSA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Management 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701-4058 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD