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AR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYY)
<br />0312912017
<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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Allied Specialty Insurance, Inc.
<br />10451 Gulf Blvd
<br />CONTACT Sherrie Calhoun
<br />NAME: —_--
<br />Svc°,No, Ext): 210-201-7315 FAX Not: _ —
<br />Treasure Island, FL 33706-4814
<br />E-MAIL y'
<br />ADDRESS: p scalhoun allieds ecialt cam
<br />INSURERS AFFORDING COVERAGE NAICq
<br />CPP0100507-07
<br />INSURER A: T.H.E. Insurance Company 12866
<br />04/01/2018
<br />INSURED
<br />Christiansen Amusements, Inc.
<br />INSURER B
<br />—
<br />INSURERC:
<br />and Southland Shows, Inc.
<br />INSURER D:
<br />P.O. Box 997
<br />Escondido, CA 92033
<br />INSURER E
<br />INSURER F:
<br />I PAM111 TO 11111I!5__
<br />REMISES E...urr nce $ 100,000
<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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />p
<br />SUBR
<br />D
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMJDDNYYY
<br />POLICY EXP
<br />MMIDDIYYYY I LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CPP0100507-07
<br />04101120171
<br />04/01/2018
<br />EACH OCCURRENCE $ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />I PAM111 TO 11111I!5__
<br />REMISES E...urr nce $ 100,000
<br />MED EXP (Any one person) $
<br />PERSONALBADVINJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 10,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />PRODUCTS - COMP70P AGG $ 1,000,000
<br />-PRO-DUCTS
<br />—
<br />OTHER:
<br />AUTOMOBILELIABILITY
<br />COMBINED SINGLE LIMIT $
<br />Ea accident
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Peraccidant) $
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE $
<br />_(Per,accident)T__-
<br />$
<br />i
<br />A uMBRELLAUAB
<br />x
<br />OCCUR
<br />ELP001 0 135-07
<br />04/01/2017
<br />04101/2018
<br />EACH OCCURRENCE $ 4,000,000
<br />', X I EXCESS LIAB
<br />CLAIMS -MADE
<br />— - — ---
<br />AGGREGATE $ 4,000,000
<br />DED RETENTION $
<br />WORKERS COMPENSATION
<br />�ANDEMPLOYERS'LIABILITY YIN
<br />iANYPROPRIETCRJPARTNERIEXECUTIVE
<br />I PER OTH-
<br />;STATUTE ER__.
<br />E.L,EACH ACCIDENT
<br />-`_-
<br />$
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />�(Mandatory In NH)
<br />MIA
<br />E,L. DISEASE - EA EMPLOYEE
<br />$
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />_
<br />I E.L. DISEASE -POLICY LIMIT
<br />$
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />EFFECTIVE FROM 5101117 THROUGH 5110117
<br />ADDITIONAL INSURED: CITY OF SANTAANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVES
<br />AND VOLUNTEERS, FIESTA DE:, CARNIVAL AS RESPECTS TO THE OPERATIONS OF THE NAMED INSURED ONLY
<br />CERTIFICATE HOLDER CANCELLATION
<br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES,
<br />REPRESENTATIVES AND VOLUNTEERS, FIESTA DE CARNIVAL
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLAZA
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTA ANA, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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