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Al �® CERTIFICATE OF LIABILITY INSURANCEF3/13/2012 DATE (MMIDD/YYYY ' 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 POE -$. NOT CQNSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCEAjij O'Tk IbORTI I�AtE DER. 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 Kaliff Insurance P.O. BOX 171225 San Antonio TX 78217-8225 CONTACT Lisa Grant NAME: PHONE (210)829-7634 FAX (210)829-7636 AIC No): E-MAIL ADDRESS: lisaa@kaliff.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:General Star Indemnity Company INSURED Paul Maurer Shows P.O. BOX 3211 Huntington Beach CA 92605 INSURERB:First Mercury Insurance CO. INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CFRTIFICATF NIIMRFR-CL122809477 RFVI--SIf)N NI IMRFP- 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 ADDL SUBR POLICY NUMBER POLICY EFF /Y MM/DDYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE ElOCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC_ $ AUTOMOBILE LIABILITY-�- '- COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS , .: r,-, BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB X OCCUR IXG356995M (4X1) 4/1/2011 4/1/2012 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A X EXCESS LIAB CLAIMS -MADE XCESS OVER AUTO S GL DED I I RETENTION$ $ RENEWAL 4/1/2012 4/1/2013 WORKERS COMPENSATION I WC STATU- OTH- AND EMPLOYERS' LIABILITY Y I NI ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F7 N I A ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below B SECOND LAYER EXCESS EXCA000672 (5X5) 4/1/2011 4/1/2012 EACH OCCURENCE $5,000,000 OVER AUTO & GL RENEWPiL rm 4/1/2012 4/1/2013 AGGREGATE $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ADDITIONAL INSURED AS RESPECTS TO INSURED'S OPERATIONS: City of Santa Ana, its officers, employees, agents, representatives and volunteers, Fiesta de Carnival, Hinds Investments LP, and Daytom Enterprises. Event Dates: Cesar Chavez Park, April 6-8, 2012 (On Site: April 1-9, 2012) UtK I IFIUA I L HULUtK CANCELLATION City of Santa Ana Attn: Silvia Cuevas 20 Civic Center Plaza Santa Ana, CA 92701 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 tchell Kaliff/LAG All AUUKU LS (LU) U/Ub) (D1988-2010 ACORD CORPORATION. All rights reserved. INS025 /7mnns� ni Tho Af:r)Rr1 namc and Innn arc rcniefarnel mar4c of Ar- )Rr)