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A` <br />CERTIFICATE i1PP11 G <br />CERTIFICATE ®F 1 LIABILITY <br />ITY INSURANCE <br />ACE DAT09/02/DI15 <br />., 1— L,M® L IYN7V R/1A\41G <br />�rrr' <br />09/02I2015 <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(1es) must be endorsed. If SUBROGATION IS WAIVED, subject to _ <br />the terms and conditions Of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the <br />certificate holder In lieu of such andorsoment(s). <br />_— ---.— <br />PRODUCER <br />Northeast insurance Center <br />AI �sEUO:_L239 L_9-7._7 .._._._.-._-._._._.._.._...1.1FaA% <br />P O Box 151886 <br />� ncmCglnainecontaccom _ <br />Cape Coral, FL 33915 <br />_ _INSURERIS_LAFFOROING COVERAGE <br />Phone (239) 244-9777 Fax (860) 627-8695 <br />INSURERA: UNITED STATES FIRE INSURANCE CO <br />_NAIOIi <br />21113 <br />INSURED <br />INSURERS: <br />jNLLLRER <br />EMERALD ISLE ENTERTAINMENT, INC DBA THE BUBBLE ROLLERS arid <br />INSURER o <br />1402 CLOYDEN ROAD <br />INSUfIE- <br />SANTA ANA CA 92705 <br />_ <br />INSURER F: <br />__ <br />COVERAGES ICATE N CERTIFUMBER USP173967 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 MAYBE 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 />---------------------�_- <br />--------------- <br />ADDL tlDk -' .__.. _..._. POLICY E F ppLICY E%P <br />VIA_ _TYPE OF INSURANCE _ H Wp .._._._... POLICY N MHER l pp yx�yi MMIDD/ EXP _ LIMITS <br />COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000, 00 <br />CLAIMS -MADE IV OCCUR DAMAGE TO RENTED <br />REMISES(Eaoccurrence S 300,000.00 <br />MED EL (Any one erep on $ 5.000.00 <br />A — "`-`" '"""_ — SRPGP-101-0414 03/0212015 03/02/2018 <br />PERSONAL snnv INJURY $ 1,000,000.00 <br />GEN'L AGGREGATE LI MIT APPLIES P E R: GENERAL AGGREGATE $ 2,000,000.00 <br />POLICY JECOT --- LOG PRODUCTS - COMPIOP ADD s 2,000,000, 00 <br />--- <br />OTHER ---- S — <br />AUTOMOBILELIABIUIFY <br />COMBINEDSINGLE LIMIT <br />Ee eccldenl <br />^� <br />S____ <br />BODILY INJURY IParpersan) <br />S <br />ANY AUTO <br />-- ALL OWNED — SCHEDULED <br />— AUTOS — AUTOS <br />BODILY IN (Pnr accident ) <br />S <br />— --. NONOWNED <br />hIIREDAUTOS _: AUTOS <br />PROPERTY DAMAGE <br />yPer ecclJonll__ <br />— <br />S <br />�1 <br />S <br />UMBRELLA LIAB OCCUR <br />EXCESS LIAB I CLAIMS.MADE <br />U` <br />�iJsJ�U <br />vie <br />\I <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />DEO_.i RETENTIONS <br />R_ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIASILITY YIN <br />_ <br />_______ <br />__ <br />a� <br />_ <br />""' PER -- <br />_IATUTE - <br />ANY PROPRIETOWPARTNERIEXECUTIV <br />�v <br />RIMEMBER EXCWDED4 <br />NIA <br />`I AA <br />W <br />rYY�"• <br />, <br />E.L, EACH ACCIDENTOFFIC <br />&L DIf <br />rwYTsE_ <br />ry in NH)c <br />yes, describe underDESCRIPTIONOFOPERAHONEanew <br />J,\V1G ��I <br />l?" <br />EL. DI3[ASC--POLICY <br />.. <br />{(�� <br />1.._._.�_�_ <br />A <br />DaSCRIPTIpN OF OPERATION8I LOCATIONSIVENICLSS (gileah RCORD tat, Additional Remarks 9Aledula, it more apeoe la required) <br />MOBILE BUBBLE ROLLERS, ZORB BALLS, SUMO SUITS, Inflalables, mobile laser tag, mobile Indoor almoft range <br />Certificate holder (landlord), It officers, employees, agents and representative are listed as additional insured In regards to general liability, within respects to the <br />named insured operation. Insurance is p1lmary and non-contributory. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />The City Of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: PRCSA <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />20 Civic Center plaza M 23 <br />gUTHtlftREO REPRESENTATIVE �J <br />Santa Ana, California 92701_'=-^^-- <br />----- <br />©1988.2014 ACORD CORPORATION, All rights reserved. <br />ACORD 25 (2014101) OF The ACORD name and logo are registered marks of ACORD <br />