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ACC>RV CERTIFICATE OF LIABILITY INSURANCE lk.� DATE (MMIDD/YYYY) 07/24/2012 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 endorsement(s). PRODUCER Allied Specialty Insurance, Inc. 85 N.E. Loop 410, Suite 600 CONT NAMEACT PHONE FAX AC No: E-MAIL ADDRESS: San Antonio, TX 78216 INSURERS AFFORDING COVERAGE NAIC # 210-341-1321 800-235-8774 INSURERA: T.H.E. Insurance Company 12866 INSURED Christiansen Amusements, Inc. INSURERB: and Southland Shows, Inc. INSURER C: P.O. Box 997 INSURER D : INSURER E INSURER F : Escondido, CA 92033 CnVCDAr_CC CERTIFICATE NIIMRFR- 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. IR' LTR LT TYPE OF INSURANCE INSR SUER POLICY NUMBER Y EFF MM DI D POLICY EXP MMDDIYYYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CPP0100507-02 04/01/2012 04/01/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence S 100,000 MED EXP (Any one person) - $ n CLAIMS -MADE J OCCUR I PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 10,000,000 �GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $1,000,000 $ POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)$ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ! ( PROPERTY DAMAGE Per accident $ $ A )C UMBRELLA LIAB EXCESS LIAB X OCCUR -MADE ELP0010135-02 104101/2012 04/01/2013 EACH OCCURRENCE $ 4,000,000 AGGREGATE $4,000,000 _CLAIMS DED RETENTION $ $ WORKERS COMPENSATION OTH- WC STATU- ER T.9gY.11MLT AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT S If yes, describe under DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional insured with respects to the operations of the named insured only: City of Santa Ana, its officers, agents, employees, representative and volunteers. Event: Carnival at Jerome Park For the Dates: 03/04/13 through 03/13/13 CFRTIFICATF Hni nFR CANCFI I ATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Parks, Recreation and Community Services Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE, DEL!YE IN Attn: Silva Cuevas ACCORDANCE WITH THE POLICY PROVISIONS. 26 Civic Center Plaza AUTH 12ED PRESE ATIVE Santa Ana, CA 92701 411' , V _ ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD .APPROVED AS TO FORK! _____"C1SA E. STORCK (� / Assistant Pity Attornev (/41