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OP ID: <br />$•�+� + _ <br />CERTIFICATE OF LIABILITY INSURANCE DA HE IMMIDOIYYYYI. <br />----- 07/30/20/3 <br />ThIIS CERTIFICATE IS ISSUED AS <br />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 />IIVIPORTAN T: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) roust 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 endorsomentaH. <br />PRODUCER <br />Wraith, Scarlett & Randolph <br />CONTACT <br />Nnm . Craig Huft <br />Ins. Be"., inc QBaaaaa <br />PHONE <br />IANC No E 0 530.662 9181 ��°;� Noy.530 662-6452 <br />- <br />622 dl1T tree[ <br />Woodland, CA 95695 <br />L- MAIL ___ _ --. - — -._ <br />ApulPEss craighp_wsrins.com <br />Craig Huft <br />INSURER(S)AFFORDING COVERAGE NAICN <br />--- ----------- <br />_—_ <br />INS URER A State Compensation Insurance 35076 <br />INSURED Christiansen Amusements <br />r.�-C,ZC1iLI�.. y <br />-- - -- -'---- <br />INSURER B. <br />Stacy <br />Stac Brown <br />0.0 <br />B <br />- -- - <br />P.O. Box 997d\ <br />Escondido, CA 92033 <br />!`Y—LX "'(aa <br />INSURER C <br />IN5ORE Ro------- <br />MED EYP (Any one <br />__ <br />6-3-014 <br />INSURER E <br />INSURER <br />COVERAGES CFRTIRICATR <br />MI IMRRR• <br />.. _. .._._.. ...... ..___ <br />wtf <br />-----""'-- IcYta POIN NUIVILSCK: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 1-0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERN] 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 10 ALL THE 'PERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSLTR _ __-__—__-_____.—_.. __ <br />LTR 'TYPE OF INSURANCE ADOL SUER POLICY EFF POLICY ENP <br />juall mll POLICY NUMtlER- <br />MMIDDIYVVY MMIODIY`/YY LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />---- <br />_.� CLAIMS -MADE �] OCCUR <br />-"'- <br />OCCURRENCE— <br />'_ <br />$ <br />-EACH <br />Aiv10E70 R5NTE— — <br />PREMISES Eaoccurrancat <br />__ L_—_._—_.__ <br />------"-- <br />8 <br />MED EYP (Any one <br />__ <br />__—_.... _.._—._ <br />"" <br />wtf <br />-------- <br />PERSONAL 3 ADV INJURY <br />_.._—.._ <br />$ <br />C'ENL <br />f <br />p�, <br />� <br />AGGREGATE LIMIT APPLIES PER <br />PGLIGY C� JRCT [] LOC <br />- <br />GENERAL AGGREGATE <br />- <br />5 <br />PRODUt TS COMP/OP AUG <br />-_. <br />$ <br />OTHER <br />8 <br />$ <br />AUTOMOBILE <br />-i <br />LIHBILITY <br />ALL OWNOCDANY - <br />SCHEDULED <br />AUTOS _ AUTOS <br />HIRED AUTOS NOTLWNED <br />C ��CJ'N <br />�� <br />erns\sta <br />rv' <br />b- n <br />5��r tt \ <br />WNIBINED SINGLE LIMIT <br />C <br />BODILYINJURY (Per person) <br />$ <br />BODILY INJURY (Pers Idem) <br />$ <br />PROPERLY DAMAGE <br />1Pe acunei1 <br />'- <br />b_ <br />- _—_ <br />8 <br />UMBRELLA UAB <br />EXCESS LIFE <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />b <br />FOCREGA HE _ <br />A <br />DED RF.TEN'rION$ <br />WORKERS COMPENSAAEILI <br />NND EMPLOYERS' LIABILrrY <br />ANVETOR;PARTNER/E%EcuTVE YIN <br />OFHULRIMECLR/MEMBER EXCW DEp9 <br />f me doryin NH) <br />yea Runbar <br />NIA <br />90680352014 <br />0810112014 <br />0810112015 <br />PER 0TH- <br />i. LS fATUT t_ ER <br />_ <br />8 <br />EL EACH ACCIDENT <br />-- ._ <br />g 1,000,000 <br />E.L. DISEASE -EA EMPLOYEE 11000,000 <br />. _. .8 <br />D <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $ 11000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 10 1. Additional Reemrke Schedule, Ilmy be b1sehed it more specels require.1) <br />Evidence of Insurance related to all Christiansen Amusements events between <br />8/1/14 - 8/1/15. <br />CRRTICIr` n Tc Lint nco <br />CITYSA3 <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701.4058 <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 REPRESENTATIVE <br />soo-<u1w H�urcu GUKI'OKA T ION. All rights reserved, <br />ACORD 25 (2014!01) The ACORD name and logo are registered marks of ACORD <br />