CHRISTIANSEN AMUSEMENT, INC. 3 - 2015

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CERTIFICATE OF LIABILITY INSURANCE 1 DATE 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 endorsementfsl. PRODUCERAllied Specialty Insurance,Inc NAME"l _ _ 10451 Gulf Blvd PHONE FAX Treasure Island, FL 33706(AICNo, Ext: (AC Nm: E-MAIL 8002373355 ADDRESS, INSURER(S) AFFORDING COVERAGE NAI WSURERA. T.H.E. Insurance Company 1286 - — - INSURED Christiansen Amusements, Inc. INSURERS: and Southland Shows, Inc. NsuRERc: P. 0. Sox 997 Escondido, CA 92033 INSURERS: COVERAGES CERTIFICATE NUMBER: T REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LID 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. INSRTypE LTR OF INSURANCE iADDLSUBR WVD POLICV NUMBER POLICY EFF MM/DDIYYY POLICY EXP MMIODIYYYY LIMITS `n' GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY �y� CLAIM&MADE "I OCCUR CPP0100507-05 04/01/15 04/01/16 EACH OCCURRENCE $ 11000,000 DA ORENTED 100 000 PREMISES occgrrance $,. .. _ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ 1,000,000 _ GENERALAGGREGATE $ 10, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT (PRODUCTS-COMPIOP AGO $ 1,000,000 Reviewed Reviewed I+ lJ)I. ! $ AUTOMOBILE LIABILITY r COMBINED BIGED SINGLE LIMIT g BODILY INJURY (Per person) $ ANY AUTO_ J^c _ AU OWNED SCHEDULED O AUTOS AUTOS NON -OWNED AUTOS S'IV1e Cue j PO BODILY INJURY (Per accin.rt) $ gMAGE PROPERTY-DAUTOS $fRCSAIAdMIn. 1 — $ A X UMBRELLA LIAB EXCESS L11 X -OCCUR CLAIMS -MADE ELP0010135'05 04/01/15 04/01/16 EACH OCCURRENCE �$ 4,000,000 AGGREGATE g 4,000,000 • DED7 RETENTION$ $ WORKERS COMPENSATION V STATU-OTH- ANDEMPLOYERS'LIABIUTY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? j NIA TORY LIMITS, ER E L EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYE $ (Mandatary in NH) If yes, describe under — E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (Attach ACORD 701, 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, FIESTA DE CARNIVAL. EVENT: FOR ALL OF CHRISTIANSEN AMUSEMENTS EVENTS FROM: 4/1/15 TO 4/1/16 CITY OF SANTA ANA PARKS, RECREATION AND COMMUNITY SERVICES AGENCY 26 CIVIC CENTER PLAZA SANTA ANA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROMISIONS. n 1gRA_9n1n ArnAn rn Aon CATlnM All do F1e nen. -A ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD