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AC) �® ViRLJ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDI 6/27/1212 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 pol(cy(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 85 N.E. Loop 410 Suite 600 San Antonio, TX 78216 CONTACT NAME: (PA ",c°NN Ext): AIC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC tt INSURERA: T.H.E. Insurance Company 12866 INSURED Christiansen Amusements, Inc. and Southland Shows, Inc. P. 0. Box 997 Escondido, CA 92033 INSURER B: 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 INSURANCEADDL INSR WVD POLICY NUMBER POLICY EFF MM/DDfYYY POLICY EXP MWDDIYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7X OCCUR CPP0100507-02 04/01/12 04/01/13 DAMAGEToRE ED urrence $ 100'000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 1,000,000 POLICY F7 PRO- LOC JEC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ��. a x .. ,,BOgILY INJURY (Per accident) $ +. . NON -OWNED HIRED AUTOS AUTOS DAMAGE $ (Per accident $ UMBRELLA LIAB OCCUR... EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATIONWC H- 'ETR AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N f A T RY I ISTATU- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT 1 $ 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, ITS OFFICERS, AGENTS, EMPLOYEES, FIESTA DE CARNIVAL. EVENT: CARNIVAL AT MADISON PARK. FOR THE DATES: 8/27/12 THROUGH 9/05/12 CITY OF SANTA ANA PARKS, RECREATION AND COMMUNITY SERVICES AGENCY ATTN: SILVIA CUEVAS 26 CIVIC CENTER PLAZA SANTA ANA, CA 92701 ACORD 25 (2010/05) IJ"_1W TJ 9 -qWLR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI REPRESENT TIVEE� 9 f/�//'� W. �r' © 1988-2010 AC19Rn CnRPnRATIAN_ All rinhts rPSPrvPd The ACORD name and logo are registered marks of ACORD