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` CERTIFICATE OF LIABILITY INSURANCE <br />1 3/23/20117DYYYY) <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 INSUREII AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must 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 Ileu of such endorsement(s). <br />PRODUCER <br />A J INSURANCE <br />1000 Macarthur Blvd #66 <br />Santa Ana, CA 92707 <br />OF57419 <br />CONTACT <br />NAME <br />PHONE(714 673-5549 FAX <br />N. � <br />E- <br />ABFESS: aJ insurance@live . com <br />INSURERS AFFORDING COVERAGE MAIC# <br />INSURER A.. MESA UNDERWRITERS SPECIALTY INS. 36838 <br />INSURED GALAXY PARTY RENTAL <br />ZAVALA, ROBERTO-EUGENIO PEREZ <br />11787 CARDINAL, CIR <br />GARDEN GROVE, CA 92843 <br />714-569-1638 <br />INSURER B: <br />INSURER D: <br />INSURER 2 <br />F INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONSAND CONDITIONSOF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY EFF <br />MMIDDWYYYY <br />POLICY EXP <br />MMIDDIYYY <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 1 000 000 <br />CLAIMS -MADE El OCCUR <br />PREMISES <br />REMI E occurrence) $ 100 1000 <br />MED EXP (Any one arson $ 5 000 <br />X DED: $500 <br />MP000401000674 <br />09/26/1609/26/17 <br />PERSONAL dACV INJURY $ 1,000(000 <br />A <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERAL AGGREGATE $ 2,000,000 <br />X POLICY F1 PRC LOC <br />JECT <br />PRODUCTS - COMPIOPAGG S 2,000,000 <br />$ <br />OTHER, <br />AUTOMOBILE LIABILITY <br />COM BINEDSINGLELIMIT $ <br />Ea accident <br />BODILY INJURY(Per perscn) $ <br />ANYAUTO <br />ALLOWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) $ <br />NON -OWNED <br />pd� <br />Q <br />PROPERTY DAMAGE <br />$ <br />HIRBDAUTOS AUTOS <br />�1 <br />Q¢ <br />acct ant <br />$ <br />pi Y <br />UMBRELLA UAB <br />OCCUR <br />! <br />EACH OCCURRENCE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />C <br />�a-7 <br />AGGRFGATE $ <br />I I <br />DIED RETENTION <br />WORKERS COMPENSATION <br />4�;\ <br />STATUTE X OT' <br />AND EMPLOYERS' LIABILITY YIN <br />r+14 <br />EACH ACCIDENT $ <br />ANY PROPRIETORIPARTNERIEXECUTIVE =E.L. <br />CFFICERWEMBER EXCLUDED? <br />NIA <br />E.L. DISEASE - EA EMPLOYEE $ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTI N OF OPERATIONS below <br />D S SE - POLICY LIMIT <br />CONTENTS: <br />A <br />PROPERTY <br />MP000401000674 <br />09/26/1609/26/17$250,0000 <br />DED: $1,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule,may be attached if more space is required) <br />PARTY RENTAL STORE: <br />City of Santa Ana, its officers, agents and employees are named as additional insured. <br />City of Santa Ana Public Library <br />26 Civic Center Plaza <br />Santa Ana, CA 92701 <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 REPRESENTP <br />©1988 1„ — - ­. —, 'ights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />