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ACORD, PAULMAUR CERTIFICATE OF LIABILITY INSURANCE DATE MMIDDIV zl Client#: 158 n nw IFIC I1E D It: IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS C0112018 ERTIFICATE DOES NCATE O RMATIVELY 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the po111 !, I es) 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), PRODUCER Haas & Wilkerson Insurance 4300 Shawnee Mission Parkway Fairway, KS 66205 913 9134324400 INSURERS) AFFORDING COVERAGE A NAICA INSURED INSURERA:ACE American Insurance Company 22667 Paul Maurer dba INSURERS: State National Insurance Compan 12831 Paul Maurer Shows INSURERC: 16081 Warren Lane INSURERD; Huntington Beach, CA 92649 INSURERS: COVERAGES INSURER II CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THEPOLICY INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTK TYPE OF INSURANCE ADOLSUBR R POLICY NUMBER POLICY EFF POLICY IXp A GENERAL LIABILITYMM/DD MM/OD/YY LIMITS G20496496 4/01/2018 04/01/201 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY RAMAGE TO RENTED CLAIMS -MADE DX OCCUR REMISSE8IEau an. $300,000 MED EXP(Any one pe�spn) $Exclud¢d _ PERSONAL & ADV INJURY $1 000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREOATE LIMIT APPLIES PER: POLICY PE� X LOC FIR ODUCTS -CCMP/OP AGO $2,000,000 A AUTOMOBILE LIABILITY $ Hu81332b'8 2/05/2018 02/051201 E.. usDISIN GLELIMIT 1,000,000 ANY AUTO AALL UTOS X SCHEDULED BODILY INJURY IPer person) $ AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X N AUTOS Per InF d tr AMAGE $ _ UMBRELLA LIAR _— $ OCCUR EXCESS LIAR EACH OCCURRENCE $ CLAIMS -MADE DEB RETENTION AGGREGATE IT B WORKERS COMPENSATION $ AND EMPLOYERS'=1'UTY NFA0568554 1/01/2018 01/01/201 X WC STATU- OTH- ANY PROPRIETOR/PARTNERIEXFCIXDVE Y / N OFFI MEMBER DED? N/A EL EACH ACCIDENT IMaodeeory In NH) $1 000 000 IF yes, deacons under E.L DISEASE - EA EMPLOYEE $1 000 000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICYLIMIT $1000,000 DESCRIPTION OF OPERATIONS LOCATIONS r VEHICLES (Aaach ACORD 101, Additional Remarks Schedule, If Mom space is required) Additional Insureds: City of Santa Ana, It's officers, agents, employees, representatives and volunteers, and Fiesta de Carnival. SEE ATTACHED ADDITIONAL INSURED AND NON-CONTRIBUTORY ENDORSEMENTS eye `1 Workers' Compensation coverage applies to the statutory requirements of the state of California.) e`�� '� l 5 CERTIFICATE HOLDER City of Santa Ana, Parks, Recreation & Community Services Agency 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE RIBED QLe1Y S BE CANCELLED BEFORE THE EXPIRATION DATE T EREOF, NdfICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORG:ED REPRESENTATIVE r=�2i ( ) 1 of 1 The ACORD name and logo are registered marks of A ORDB 2010 ACORD CORPORATION. All rights reserved. ACORD 25 2010/05 #S337819/M337818 SALAK