Laserfiche WebLink
A CERTIFICATE OF LIABILITY INSURANCE DATE <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 />PRODUCERAllled Specialty Insurance,Inc <br />P.O. Box 67008 <br />Treasure Island, FL 337367008 <br />8002373355 <br />INSURED Christiansen Amusements, Inc. <br />and Southland Shows, Inc. <br />P. 0. Box 997 <br />Escondido, CA 92033 <br />INSURER(S) AFFORDING COVERAGE NAZCA <br />NSURFRA T.H.E. Insurance Comnanv 1286.6 <br />COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE INSR UDKIR _-- POLICY NUMBER MMDDYYYY MMDFF DYYYY <br />LTR LIMITS <br />ACCORDANCE WITH THE POLICY PRO -VISIONS. <br />GENERAL LIABILITY <br />—/— <br />AUTHORIZED RESENTATIVE i4 t <br />EACH OCCURRENCE <br />§ 1,000, 006 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CPP0100507-04 04/01/14 <br />Ofl/01/15 <br />DAMACEI6F ocurrenoel <br />PREMISES a00CUFr <br />$ 100,000 <br />. - J CLAIMS MADE Xj OCCUR <br />4 <br />_ <br />MED EXP (Any o re per h). <br />S <br />PERSONAL ADV INJURY <br />$1 000 000 <br />S <br />GFNERALAGGREGATF <br />__ <br />S 10,00D DDD <br />-1,000, <br />GEN'L.4GGREGATE LIMIT APPLIES PER <br />ryyyy R9OVl.a% <br />�T"L" <br />PRODUCTS 4GG- <br />S DDD <br />POLICY PRO- LOC <br />,...-i,.-------..-- <br />_-COMP/OP <br />S <br />AUTOMOBILE LIABILITY <br />z <br />-t��t�+` <br />y <br />CCMGINEDSINGLELIMIT <br />IES acmdenl)_ <br />3 <br />ANY AUTO <br />"L(SA At{QV ne'd <br />C'1 y <br />1 _ <br />11-11 I NJLIRY (Perp m,,r) <br />$ <br />.4LLONMED r SCHEDULED <br />ASSIStan1 <br />1 <br />BODILY INJURY (P cldenq� <br />$ <br />AUTOS ` AUTOS <br />NON OWNED <br />pr <br />PROPERTYOAMA,F <br />$ <br />HIRED AUTOS AUTOS <br />J <br />(Pe acclden4 <br />I <br />$ <br />UMBRELLA LIAR X OCCUR <br />EACH OCCURRENCE <br />$ 4 000 ,000 <br />A <br />�X EXCESS NAB -I <br />MAUEI <br />ELP0010135-04 04/01/14 <br />04/01/15 <br />A GREGATE <br />$ 4 000 660 <br />DED , RETENTION $ <br />Is <br />WORKERS COMPENSATION <br />WC STATU- IOTH- <br />ANDEMPLOVERS'LIABIIITY YIN <br />',., <br />TOIRY_._L_IMIT '_gg,,, <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />EL EACH ACCIDENT <br />$ <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />------- <br />(Mandatory in NH) <br />j <br />E L DISEASE - EA EMPLOYEE <br />$ <br />If,.,, describe under <br />DESCRIPTION OFOPERATIONS belcw <br />EL DISEASE POLICY LIMIT <br />5 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, k more space is required) <br />ADDITIONAL INSURED WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED ONLY: <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVE AND <br />VOLUNTEERS. <br />EVENT: FOR ALL OF CHRISTIANSEN AMUSEMENTS EVENTS FROM 4/1/14 TO 4/1/15 <br />CERTIFICATF NO[ nFR CANCFI I ATION <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />ATTN: RISK MANAGEMENT <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA <br />ACCORDANCE WITH THE POLICY PRO -VISIONS. <br />SANTA ANA, CA 92701 <br />—/— <br />AUTHORIZED RESENTATIVE i4 t <br />7 © 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />