FIESTA DE CARNIVAL 6A - Laserfiche WebLink

Home Browse Search

A �R CERTIFICATE OF LIABILITY INSURANCE 3/11 MMIDOM/YY) 1112 /2014 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(les) 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 C NTACT NAME: Joanne Manion Arthur J. Gallagher Risk Management Services, Inc. 777 108th Ave NE, #200 Bellevue VVA 98004 PHONE _454-3386 aIc No' - 1 Sol EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICX INSURER A INSURED C H RIAM U-01 INSURER 8: INSURER C: Christiansen Amusements, Inc. P. 0. Box 997 Escondido, CA 92033-0997 INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1426321791 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. IN.Tq I TYPE OF INSURANCE ADD L INSR SUB R WVD, POLICYNUMBER POLICY EFF MMIODIYVYY POLICY EXP MMIDDIVYVY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LI ABILITYAMA E RENTED PREMISES Ea occurrence $ CLAIMS -MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 17 POLICY PRO- lErT LOC I $ A AUTOMOBILE LIABILITY I I I0IC15624863 /1/2014 :4/1/2015 N N L 1 000,000 (Ea aLY INJURY BODILY INJURY (Per person) $ X ANY AUTO i ALL OWNED SCHEDULED AUTOS AUTOS BODI LY INJURY acids,,)I$ X X NON -OWNED HIRED AUTOS AUTOS j PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS-MADE-/�t y+,wp, 5r L EACH OCCURRENCE $ AGGREGATE Is DED RETENTION$"`{''�� $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOMPARTNEWEXECUTIVE❑ OFFICERIMEMBER EXCLUDED' (Mandatory In NH) f yes describe under DESCRIPTION OF OPERATIONS below NIA �.-'" yIL` },. .'�.S •- 'te n+�'•- -(,Z(_,,fN STAUOTH- CV M EL EACH ACCIDENT § E.L. DISEASE - EA EMPLOYEE $ EL DISEASE � POLICY LIMIT $ ; s1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required The City of Santa Ana, its officers, employees, agents and representatives are included as additional insureds but only as respects the operation of the named insured per policy terms and conditions per form CA7110 0307. For all Christiansen Amusement events during the period 4/1/2014 - 4/1/15 City of Santa Ana Attm Robert Carroll 20 Civic Center Plaza Santa Ana CA 92701 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE z�1'CA.UaL� © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD