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OP ID: JU _ --= CERTIFICATE OF LIABILITY INSURANCE DATE02/010/YYYY) 1 2/01/12 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, Scarleft & Randolph Ins. Serv., Inc OB48084 530-662-6452 622 Main Street Woodland, CA 95695 Craig Huft CONTACT PHONE FAX aC No.Ext : AIc No): &MAIL ADDRESS: PRODUCER CUSTOMER ID #: CHRIS23 INSURERS AFFORDING COVERAGE NAIC I/ INSURED Christiansen Amusements Stacy Brown P.O. Box 997 INSURER A:Companion Property & Casualty 12157 INSURER B INSURER C : Escondido, CA 92033 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE Nt1MRFR• oovrcrnkr ui Isa000. 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 A L POLICY NUMBER POLICY EFF MMlDD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE OCCUR PERSONAL $ ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JFCT LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO f !-" COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ HIRED AUTOS $ NON -OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICEPJMEMEXCLUDED? ❑ N/A CPCA13469 08/01/11 08/01/12 WC STATU- OTH- X T Y I IT 1 ER E.L. EACH ACCIDENT $ 1,000,00 (MandatoryH)ER (Mandatory in and If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Jerome Park Carnival/ Event dates: March 5 - 14, 2012 CITYSA3 City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701.4058 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 Cf W 7988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD