DRAYTON INSURANCE; BROKERS, INC.
<br />2500 CENTER POINT ROAD, Si7ITE 301 P051 OFFICE 130X 9 W7
<br />BIRMINGHAM, ALABAMA 35215 BIRMINGLiAM, ALABAMA 35220
<br />PIION'E: (205) 854-5806 EMAIL: dibf?draytauius.com
<br />FAX; (205) 8545899
<br />CERTIFICATE OF INSURANCE
<br />It is certified that, if named below, this policy includes as Additional Insureds 1) the sponsor(s), promoter(s), organi7vrfs) (inoluding other
<br />entities leaving. similar interests), of insured pyrotechnic events and/or 2) the ownerls) of real property (or ba)ges) at which insured pyrotechnic
<br />events ate held and/or 3) the owner(s), manager(s), tenant(s), mortgagee(s) (including other entities having similar interests), of buildings, stadiums.
<br />areims and similar facilities at which inamed pyroteehn is events are held and/or 4 the licensing or permitting authority, or other authority having
<br />iurisdidion, issoing licenses/permits for insured pyrotechnic event; and/or 5) fifty other entity for which life it is required to be afforded
<br />under written coo nact, Coverage applies only as; respects the legal liability of such Additional InSmed(s) for bodily injury and property damage
<br />causal by the operations of the Named Insured. The insurance afforded any Additional Insured does not include covefagc for ttny bodily injury or
<br />property damage arising from the fhilure ofsuch Additional insured to fulfill its obligations specified in its coiltrao with the Named hiswed.
<br />NAME & ADDRESS OF INSURED SPONSORS,
<br />PROPER] Y OWNERS, LICENSORS
<br />City of Santa Ana, It's Officers, Employees, Agents, Volunteers and Representatives
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />ADDITIONAL INSURED(S) City of Santa Ana, County of Orange, Orange County Fire Authority, and their officers,
<br />agents, employees and volunteers when acting in their official capacity as suell.
<br />The Coverage afforded the additional insureds as set forth in this certificate shall be primary,a l-L-ibutory with
<br />respecl to any insurance carried by such additional insureds.
<br />DISPLAY LOCATION DISPLAY DATE(S)
<br />Centennial Regional Park Soccer Field July 4, 2015
<br />Santa And, CA
<br />Q
<br />It is ceftified that this policy requires a 30 day 11I notice oreance Cation between the hisurn find the Named In,swed, [it the event of such
<br />cancellation we will endeavor to mail In (lays written notice Io the Additional Insw-ed(s), whose name and address is shown hereon, but failure
<br />to mail such police Shall IMI)Csc no obligation or liability of any kind upon the insurer andior the undersigned.
<br />DRAYTON INSURANCE BROKERS, INC.
<br />ALr(I 23, 2015 ls::; ''
<br />DATE Oh ISSUE Artl. STRINGER, PRESIDE,N"
<br />No. 510035 Revised
<br />Wo ceitity that inswnnce Is afforded
<br />as stated below, "this Certificate does not tffnmaIively or Ifegaovcly amend. extend m' alcor the cove;ug,c
<br />attoIkIcd by the imsuranee policy
<br />fail I.lie inswancc affooded is subject to ell the teens, esehtsions and conditions o the policy.
<br />INSURER
<br />Adariral hostance Company POLICY NO, CA000002771-29
<br />NAMED ENSURED
<br />Pyre spectaculars, Inc. PyrD Spectacular, by Souza
<br />Pyro Lvenls, Lm. Pyro Spectrwular I1111a5tr105, life
<br />Pyru spectaculars Productions, enc North Americmt Piw"orls CD , Inc (NAI -CO)
<br />R0. Box 2329 Sun Diego Firewoks
<br />stain), California 92377
<br />POLICY TERM
<br />January 13, 2015 to lamlaty 13, 2016; Both Days 12:01 A.M. Standard Tiwe
<br />COVERAGE.
<br />Commercial General Liability: Z Occurrence Basis ❑ Claims Made Basis
<br />LIMIT OF LIABILITY
<br />$1,000,000 each occurrence, $2,000,000 general aggregate, $2,000,000 products/completed operations aggregate
<br />7'he limitof liability ,shall not he. i nercwsed by the inchlsion or al0re than one inswed or additional insured.
<br />INSURED OPERATIONS
<br />Public firewo'ks display and special effects contractor
<br />It is certified that, if named below, this policy includes as Additional Insureds 1) the sponsor(s), promoter(s), organi7vrfs) (inoluding other
<br />entities leaving. similar interests), of insured pyrotechnic events and/or 2) the ownerls) of real property (or ba)ges) at which insured pyrotechnic
<br />events ate held and/or 3) the owner(s), manager(s), tenant(s), mortgagee(s) (including other entities having similar interests), of buildings, stadiums.
<br />areims and similar facilities at which inamed pyroteehn is events are held and/or 4 the licensing or permitting authority, or other authority having
<br />iurisdidion, issoing licenses/permits for insured pyrotechnic event; and/or 5) fifty other entity for which life it is required to be afforded
<br />under written coo nact, Coverage applies only as; respects the legal liability of such Additional InSmed(s) for bodily injury and property damage
<br />causal by the operations of the Named Insured. The insurance afforded any Additional Insured does not include covefagc for ttny bodily injury or
<br />property damage arising from the fhilure ofsuch Additional insured to fulfill its obligations specified in its coiltrao with the Named hiswed.
<br />NAME & ADDRESS OF INSURED SPONSORS,
<br />PROPER] Y OWNERS, LICENSORS
<br />City of Santa Ana, It's Officers, Employees, Agents, Volunteers and Representatives
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />ADDITIONAL INSURED(S) City of Santa Ana, County of Orange, Orange County Fire Authority, and their officers,
<br />agents, employees and volunteers when acting in their official capacity as suell.
<br />The Coverage afforded the additional insureds as set forth in this certificate shall be primary,a l-L-ibutory with
<br />respecl to any insurance carried by such additional insureds.
<br />DISPLAY LOCATION DISPLAY DATE(S)
<br />Centennial Regional Park Soccer Field July 4, 2015
<br />Santa And, CA
<br />Q
<br />It is ceftified that this policy requires a 30 day 11I notice oreance Cation between the hisurn find the Named In,swed, [it the event of such
<br />cancellation we will endeavor to mail In (lays written notice Io the Additional Insw-ed(s), whose name and address is shown hereon, but failure
<br />to mail such police Shall IMI)Csc no obligation or liability of any kind upon the insurer andior the undersigned.
<br />DRAYTON INSURANCE BROKERS, INC.
<br />ALr(I 23, 2015 ls::; ''
<br />DATE Oh ISSUE Artl. STRINGER, PRESIDE,N"
<br />
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