FIESTA DE CARNIVAL 5 - Laserfiche WebLink

Home Browse Search

ACCORD `./ CERTIFICATE OF LIABILITY INSURANCE TE (MM /DD/ DATE 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 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 85 N.E. Loop 410 Suite 600 San Antonio, TX 78216 CONTACT NAME: PHONE FAX , jA/C, No): -- E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC X INSURERA: T.H.E. Insurance Company 12866 INSURED Christiansen Amusements, Inc. and Southland Shows, Inc. P. O. BOX 997 Escondido, CA 92033 INSURER B: INSURER C 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 DD (INSR S WVD POLICYNUMBER POLICY EFF MWDD/YYY POLICY EXP MWDDIYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE_ $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY ''. CLAIMS -MADE XOCCUR CPP0100507-02 04/01/12 04/01/13 AMAGTED 10REMISESEaocc�.� renr$ 100,000 MED EXP (Any one person) $ PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY JC7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN'. ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? ❑ '�. N /A I WC STATU- -. —70TH - T RY LIMITS ''. I ER EACH ACCIDENT $ -- E.L. DISEASE - EA EMPLOY $ (Mandatory in NH) If yes, describe under, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ 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: THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVES AND VOLUNTEERS. EVENT: CARNIVAL AT MADISON PARK FOR THE DATES: 8/27/12 THROUGH 9/05/12 < &F%1 IrIVM I G Mil-uCR 1.Kr1R.CLLH I IUIN CITY OF SANTA ANA ATTN: RISK MANAGEMENT 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. AUTHORI REPRESENT TIVE f�/I © 1988-2010 ACISRD CORPORATION- All rlahts reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD