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A� o® CERTIFICATE OF LIABILITY INSURANCE °"TE (MM 6/27/12' 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 S p ecialty Insurance 85 N.E. Loop 410 Suite 600 San Antonio, TX 78216 CONTACT NAME: PHONE FAX A/C. No.Ez A/C No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICtl INSURERA: T.H.E. Insurance Company 112866 INSURED Christiansen Amusements, Inc. and Southland Shows, Inc. P. 0. 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 ADDLS 111211 B WVDPOLICY NUMBER POLICY EFF MMR oryYYY) POLICY EXP (MWOMWyl LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1.000,000 ACOMMERCIALGENERAL LIABILITY CLAIMS -MADE 11OCCUR CPP0100507-02 04/01/12 04/01/I3 PREMISES Ea owurrance S 100,000 MED EXP (Any one perwn) $ PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 10, 000, 000 GEN'L AGGRLIMIT APPLIES PER: EGATE PRODUCTS-COMPfOP AGG $ 11000,000 PRO POLICY J CT LOC § AUTOMOBILE LIABILITY UMBI Eet SINGLE LIMITE. $ BODI LV I NJURY(Per Person) $ ANY AUTO ALLONMEDSCHEDULED AUTOS AUTOS INJURY ( BODILY INRY Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LAB OCCUR } 'L L%" EACH OCCURRENCE S IXCE55 LAB CLAIMS -MADE _ AGGREGATE $ DED RETENTIONS ""''"" WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE VIN OFRCERIMEMBER EXCLUDED? ElNIA "" "'"" 4..:10 y l iiCtt t l J A i r'-; `.L. STATU.TORY LIMITS OTH- E EACH ACCIDENT § E. L. DISEASE -EA EMPLOY S (Mandatory in NH) Ir yes, describe under DESCRIPTION OF OPERATIONS belov.• E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, R 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 CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA PARKS, RECREATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE AND COMMUNITY SERVICES AGENCY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: SILVIA CUEVAS ACCORDANCE WITH THE POLICY PROVISIONS. 26 CIVIC CENTER PLAZA SANTA ANA, CA 92701 AUTHORRE�PRESEN�T TIVE ©1988-2010 ACIDRD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD