Laserfiche WebLink
AcoROr CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM)DDIYYY'Y) <br />�-� <br />11/15/2017 <br />11/1s/zol7 <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(ies) 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 lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME: Nancy Smith <br />Governor Insurance Agency, Inc. <br />A"CNNEo (330)539-9999 qIC Is:(330)539-9998 <br />972 Youngstown -Kingsville Rd. <br />E-MAIL ADDRESS: N3mith@Govexnor2ns. cam <br />P.O. BOX 770 <br />INSURERS AFFORDING COVERAGE <br />NAICIf <br />INSURERA:R-T Specialty LLC <br />Vienna OR 44473 <br />INSURED <br />INSURER B: <br />International Promotions, Inc. <br />INSURERC: <br />DBA: Fiesta de Carnival <br />INSURER D: <br />11278 Los Alamitos Blvd <br />INSURER E: <br />Los Alamitos CA 90720 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER-CL1762209695 RPVLCInN NI IMRPp- <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 />SUBR <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDIYYYV) <br />POLICY EXP <br />IMMIDDIfTffl <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X�OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMA ETO RENTED <br />PREMISES Ea occurrence <br />$ 100,000 <br />MED EXP(Any one person) <br />$ 5,000 <br />X <br />VBA539518 <br />5/27/2017 <br />5/27/201B <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY JECTPRO- <br />LOG <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENT <br />g <br />PRODUCTS - COMPIOP AGO <br />$ 2,000,000 <br />$ <br />OTHER <br />I <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />S <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY Per accitlenl <br />( ) <br />$ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTYDAMAGE <br />Per accitlenl <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED RETENTION$ <br />S <br />WORKERS COMPENSATION <br />ANO EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? ❑N/A <br />PER OTH- <br />STATUTE ER <br />E. L. EACH ACCIDENT ,. <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />(Mandatory, in NH) <br />f yes. describe under <br />DESCRIPTION OF OPERATIONS below <br />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) e1 <br />Certificate holder is named as additional insured per the attached CG 2026 form .s. NQ 1 <br />V <br />e <br />�e J `` <br />City of Santa Ana <br />20 Civic Center Dr. <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLTICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />& <br />R Thompson, Jr/NANCY -7[,-(- <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />AUURU 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />INS025 (201401) <br />