ALL STAR JUMPER RENTALS, LLC. -2015

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TE _V6� ej CERTIFICATE OF LIABILITY INSURANCE 10/7f2015 ae.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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed, If SUBROGATION IS WAIVED. subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). l PRODUCER Contact Name: Larry Coaalo _ j Wa Cossio Insurance Agency Phone 864-688.0121 Fax 864.688-0138 PO Box 188 (NC No, Extp (A'C, No): - Simpsonville, SC 29681 E Mall tammy@ccsslolnsurance.com (864)688-0121 - ---- INSURER(S) AFFORDING COVERAGE NAIC# me At INSURER A: United States Fire Insurance Company INSURED �y SPORTS AND RECREATION PROVIDERS ASSOCIATION INSURER B: (PURCHASING GROUP) AND ITS PARTICIPATING MEMBERS: a - All Star Jumper Rentals, LLC INSURER C: 117 North Standard Avenue, Suite A Santa Ana, CA 92701 INSURER Dt INSURER E: COVERAGES CERTIFICATE NUMBER: USPT75026 REVISION NUMBER: Ve..a THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1 INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNIS. a EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NOR TYPE OF POLICY ADOL SUBW POLICY NUMBER POLICY EFF POUCYEXP LIMITS ITS INSR WVO (MM/OD/YYI (MMIDDIYY) X COMMERCIAL GENERAL LIABILITY CLAIMS MADE', OCCUR A GEN'L AGGREGATE LIMIT APPLIES PER '., X POLICY _PROJECT..'.. LOC OTHER: ._.. AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-0WNED AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CIAIMS-MADE DED I RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE YIN .. OFFICERIMEMBER EXCLUDED? (Mendetoryln NH) -� If yes, describe under DESCRIPTION OF OPERATIONS below SRPGP-101.0414 3/19/2015 'I. 3/19/2016 General Aggregate Limit -' $2,000,000 Products and Completed Operations $2.000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence Limit $1,000,000 '.. Fire Damage Limit -Any One Fire $300,000 Medical Expense Limit $5,000 Deductible Limit $0 COMBINED SINGLE LIMIT $ (Ea acril BODILY INJURY (Per Person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) PER OTH- STATUTE FIR Accidental Death & Dismemberment $10,000 i Maximum Benefit Amount $10000 A - Accident Medical AH-GA26932.002 3/19/2015 3/19/2016 Deductible $0 Cert#US446436 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Party Equipment Rentals Operations located at 117 North Standard Avenue, Ste A Santa Ana, CA 92701. Certificate Holder As Additional Insured Amusement devices on file with the company for special event(s) dated 11/6/2015 to 11/8/2015 located at 3006 W. Centennial Road, Santa Ana, CA 02704. CERTIFICATE HOLDER: CANCELLATION City Of Santa Ana, it's Officers, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Employees, Agents and Representative THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Plaza ACCORDANCE WITH THE POLICY PROVISIONS Santa Ana,a. CA CA 92701 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD