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.�acoizo'� CERTIFICATE OF LIABILITY INSURANCE
<br />��
<br />DATE (MM /DD /YYW)
<br />8/29/2012
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTA T Jt11ie Vitt:O
<br />NAME:
<br />PHONE (805)579 -1900 FAX .(805)5'19 -1916
<br />Tnsurance Waat Corp.
<br />2450 Tapo $treat
<br />-MAIL vitto @inaurancewest.com
<br />ADDRE J
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />Simi Valley CA 93063
<br />INSURERA:Hart£ord Casualt =nsurance
<br />29424
<br />INSURED
<br />INSURER B
<br />INSURERC 3- iart£ord Fira Snsurance Com an
<br />19682
<br />Artistic Entertainment Services LLC, DHA:
<br />12 0 N Aapan Ave
<br />INSURER D
<br />$ 300 , 000
<br />INSURER E
<br />S 10 , 000
<br />PERSONAL S ADV INJURY
<br />INSURERF:
<br />Azusa CA 91702
<br />COVERAGES CERTIFICATE NUMBER:12 -13 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />A DL
<br />B
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/1'YYY
<br />POLICY EXP
<br />M/DD /YYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />S 1 , 000 , 000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />72 VCNJ09284
<br />1/21/2012
<br />1/21/2013
<br />PREMI E a occurrence
<br />$ 300 , 000
<br />MED EXP (Any one person)
<br />S 10 , 000
<br />PERSONAL S ADV INJURY
<br />$ 1 , 000 , 000
<br />GENERAL AGGREGATE
<br />S 2 , 000 , 000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP /OP AGG
<br />$ 2 , 000 , 000
<br />X POLICY PRO LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />72UCNJ092B4
<br />Ea acBCltleDt IN LE LIMIT
<br />1 000 000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />ix�ad Auto Phya Dmga -
<br />$100,000 ACV /Coat o£
<br />1/21/2012
<br />1/21/2013
<br />BODILY INJURY (Per eecitlent)
<br />3
<br />NON -0WNED
<br />HIRED AUTOS AUTOS
<br />apais, phichavas is lase
<br />PROPERTY DAMAGE
<br />Per accitlenl
<br />$
<br />Metlical a manta
<br />$ 5 000
<br />omp fi Coll dad: $1,000
<br />X
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />S 1 , 000 , 000
<br />AGGREGATE
<br />S 1 , 000 , 000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$ 10,00
<br />$
<br />72RHVJ09300
<br />1/21/2012
<br />1/21/2013
<br />$
<br />WORKERS COMPENSATON
<br />WC STATU- GTH-
<br />AND EMPLOYERS- LIABILITY Y / N
<br />ANY PROPRIETOR /PARTNER /EXECUTIVE
<br />OFFICER /MEMBER EXCLUDED-T �
<br />N / A
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L_ DISEASE - EA EMPLOYE
<br />S
<br />(Mandatory In NH)
<br />IT yes, tlescnbe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />S
<br />C
<br />Owned 6 R ®ntad ECjuipmant
<br />72MSVJ09111
<br />1/21/2012
<br />1/21/2013
<br />Limit $120,000
<br />Special Form - R/C
<br />Detluc[ibie $2,500
<br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD tOt, AGliltlonal Remarks Schedule, H more apace Is requlretl)
<br />The City o£ Santa Ana, 20 Civic Center Plaza, Santa Ana, Ca1i£ornia 92701,
<br />o££icers, �mploy�ea, agents and representatives era included as additional insured par attached Form
<br />CG20100704. Primary Wording is included r attached Form HG00010605.
<br />�,� � Zis ; v�:� as -��o �� aP�ivi
<br />s�...,. .�,.y n�...,....Y
<br />SCuevas @santa- ana.org
<br />City o£ Santa Ana
<br />Parks, Recreation and Community Services
<br />Attention: Silvia Cuevas
<br />26 Civic Cantor Plaza
<br />Santa Ana, CA 92701
<br />ACORD 25 (20'I O /OS)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATVE
<br />Tucker /CHER2 �'� �_�"��- -.
<br />©'1988 -200 ACORD CORPORATION. All rights resen
<br />INS025 r�nT nnsi nt Tha A(`(1Rrl name anr✓I Innn �ru ronrc�o ruri mar4c r.f A('_ARrI
<br />
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