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CERTIFICATE OF LIABILITYINSURANCE : i Ga4/12/Dom
<br />- 04/12I2017
<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 COVERAGEAFFORDEDBY 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(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 Allied Specialty Insurance, Inc. NAMEpCT
<br />85 N.E. Loop 410, Suite 600 PHONE
<br />San Antonio, TX 78216 EA/coo' E1`pp
<br />MAIL --_--
<br />210-341-1321 800-235-8774 nooREs$;
<br />INSURED - -- _ INSURERA: T.H.E. Insurance Company _ 12866
<br />Christiansen Amusements, Inc. INSURERB__ _
<br />and Southland Shows, Inc. INSURERC:
<br />P.O. Box 997 - --- -- - _-
<br />Escondido, CA 92033 INSURER D:
<br />INSURER E:
<br />INSURERF: '
<br />COVFRnriFs rcor, r,rarr �
<br />- -- -- --- RC V IQKont rvuiviocm:
<br />THIS IS TO CERTIFY THAT THE POLICIES INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM
<br />UI CONDITION
<br />FOR THE POLICY PERIOD
<br />ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
<br />CERTIFICATE MAY TO WHICH THIS
<br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
<br />A D THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />O
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />-- N
<br />INSNN R'
<br />LTR
<br />ADOLsuaR
<br />TYPE OF INSURANCE 'WV
<br />POLICYNUMBER
<br />MMIDIO YEVYFY' MMIIOD�
<br />—
<br />LIMITS
<br />A X;
<br />COMMERCIAL GENERAL LIABILITY
<br />ll
<br />CPP0100507-07
<br />04/01/2017 04/01/2018!
<br />EACH OCCURRENCE $ 1,000,000
<br />J CLAIMS -MADE/ OCCUR -
<br />PREMISES rEa occurrence $ 100,000
<br />IMED EXP (Any one person) $
<br />r—
<br />J—
<br />—
<br />I I
<br />PERSONAL&ADVINJURV '$ 1000,000
<br />GEN
<br />LAGGREGATE LRO-APPLIES PER:
<br />G AL AGGREGATE S 10000,000
<br />POLICY I� 7 li
<br />.PRODUCTS-COMPIOP AGG $ 1,000,000
<br />_— JECT LOD
<br />OTHER'
<br />$ ..
<br />AUTOMOBILE LIABILITY
<br />-
<br />COMINEDSINGLELI MIT $
<br />(Ea accident)__ _ ----
<br />INJURY (Per person)
<br />OWNED
<br />�- OWNED I SCHEDULED
<br />IeODILY
<br />---- ._
<br />AUTOS ONLY I AUTOS
<br />HIRED
<br />Imo-
<br />BODILV INJURV (Per accident) $
<br />I AUTOS
<br />AUTOS ONLY . AUTOS ONLY
<br />—,
<br />PROPERTY DAMAGE
<br />I Per ecoidant _ I $$
<br />A
<br />J UMBRELLA uaB X OCCUR i ELP0010135-07
<br />'. 04/01/2017 04/01/2018 1EACH DOD RRENCE I $ 4,000,000
<br />LX:EXCESS LIAB CLAIMS-MADEAGGREGATE
<br />—I
<br />- $ 4,000,000
<br />DED RETENTION$
<br />$
<br />WORKERS COMPENSATION !
<br />ANDEMPLOYERS'LIABILITY YIN -
<br />PER ORTH-
<br />!STATUTE � iE
<br />IANYPROPRIETORIPARTNER/EXECUTIVE
<br />OFFICER/MEMER EXCLUDE09 ❑,N/AI
<br />_..
<br />!, - E1. EACH ACCIDENT IS
<br />(Mandatory In NH)
<br />If yes, tleso [be u,der
<br />- EL OISEASE_ EA EMPLOYEE! $
<br />_
<br />DESCRIPTION OF OPERATIONS below
<br />�—
<br />I E, L, DISEASE - POLICY LIMIT $
<br />ILEB
<br />-
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHIC AICOR 101 Addidonal Remar s
<br />( k Schedule, me be attached if mores ace is e Y p r gmretl)
<br />pa
<br />Additional Insured: City of Santa Ana, its officers, agents, employees, representatives and volunteers; Fiesta De Carnival area al insy[e� ' h re cis to
<br />the negligence
<br />of the named insured.
<br />��� !Eq
<br />RR
<br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES,
<br />REPRESENTATIVES AND VOLUNTEERS, FIESTA DE CARNIVAL
<br />20 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 REPRESENTATIVE
<br />AUUKU ZD (2U16/03)
<br />6ACORD
<br />The ACORD name and logo are registered marks of ACORD
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