FIESTA DE CARNIVAL 6A - Laserfiche WebLink

Home Browse Search

�oRcr CERTIFICATE OF LIABILITY INSURANCE � °A3/26/14 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 CONTACT Allied Specialty Insurance, IRC NAME P.O. BOX 67008 PHONE ._... FAX Treasure Island, FL 337367008 Wc.E-MEXth w/c "Pl:.. 8002373355 ADDRESS. ....... ..... _.... _ ....... .._._............... .......... .. 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. (NSR, IADDL SUER POLICVEFF POUCYEXP - -- -- LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYYI fMMiDDIYYYY)LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X �� CPP0100507-04 II 04/01/14 i 04/01/15 DAMAGETORENT15 ��' 100 000 OOMMERGIAL GENERAL LIABILITY __. PREMISES (Es occur el ce) $ Iilt CLAIMS MADE X OCCUR I MED EXP (Any one person) $ {{ Alt PERSO $ 1 000 000 T^� A V y' GENERAL AGGREGATERY g 10 000 000 _ ... .... GEN L AGGREGATE 4TE LI IT A PLIES PER L - PRODUCTS�COMP/OP AGG g 11000,000 _ PRO POLICY JECT LOG .•'• _. ._ $ AUTOMOBILE LIABILITY - a ' COMBINED SINGLE LIMIT $ ANY AUTO D .�,( 1�t'[�ffle'l 1 t itV C BODILY INJURY (Per person) i$ SCHEDULED P'SsIst nY BOYDII VdINJ RY P raccdent $ AUTOSNED AUTOS '4y NON OWNED .I r�/' PROPERTY AMAmF $ HIRED AUTOS i AUTOS J (Pe accid.nt)_ ..; _ $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE 'I. $ 4,000,000 A X EXCESS LIAR CLAIMS -MADE ELP0010135'04 04/01/14 04/Ol/151AGGREGATE Is 4,000r 000 DEO RETENTION $ I'. $ WORKERS COMPENSATION j M/CSTATU OTN-'. AND EMPLOYERS' LIABILITY YIN L, ..: TOftV.AAMITS 1 -S .................. ......... ANY PROPRIETORiPARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED^ �I,NIA ---- -(Mandatory In NH) ) ELDISEASE EA EMPLOYEE$ If describe under 1 Dyes, DESCRIPTION OF OPERATIONSbelow I E.L. DISEASE POLICY LIMIT $ 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 ANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVE AND VOLUNTEERS. EVENT: FOR ALL OF CHRISTIANSEN AMUSEMENTS EVENTS FROM 4/1/14 TO 4/1/15 CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: RISK MANAGEMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA ACCORDAN9E WITH THE POLICY PRQMISIONS. SANTA ANA, CA 92701 AUTHORIZED ftRESENTATIPIE © 1988-2010 ACORD CORPORATION. All rights reserve ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD