FIESTA DE CARNIVAL (3)-2018 - Laserfiche WebLink

Home Browse Search

ACORbP CERTIFICATE OF LIABILITY INSURANCE 111 DATE(MM/DDIYYYY) 11/15/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY 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 poiicy(ies) 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 endorsement(s). PRODUCER CONTACT Nancy Smith NAME: Y Governor Insurance Agency, Inc. 972 Youngstown -Kingsville Rd. PHONE t, (330)539-9999 AIC No: (330)539-9998 E-MAIL ADDRESS: NSmi th@GovernorIna. com P.O. BOX 770 INSURERS AFFORDING COVERAGE NAIC# INSURERA:R-T Specialty LLC Vienna OH 44473 INSURED INSURER B : International Promotions, Inc. INSURER C: DBA: Fiesta de Carnival INSURERD: 1127E Los Alamitos Blvd INSURER E: INSURER F: Loa Alamitos CA 90720 COVERAGES CERTIFICATE NUMBER-CL1762209695 RFVIRION NUMBER• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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. INSR LTR rypE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDDIYVW POLICY EXP MMIDDIWYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $ 1,000,000 PREMI PREMISES ES( Ea RENTEDoccunence $ 100,000 MED EXP(Any one person) $ 5,000 X VRM34518 5/27/2017 5/27/2018 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LI MIT APPLIES PER: POLICY PRO- LOC GENERAL AGGREGATE $ 2,000,000 GEHL X PRODUCTS-COMPIOPAGG$ 2,000,000 $ OTHER'. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ee accitlent $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Peraccident) ( ) $ NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE Per accitlent $ $ LIAR OCCUR EACH OCCURRENCE $ _ $ __DED EXCESS LIAB CLAIMS -MADE RETENTION$ _AGGREGATE $ _JUMBRELLA WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? NIA PER OTH- STATUTE ER E,L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory In Ni If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below 1 1 11 7_7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aHached if more space is Mail red) Certificate holder is named as additional insured per the attached CG 2026 form6 �`I CERTIFICATE HOLDER CANCELLATION '100� "" n`E;nv r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Dr. ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE R Thompson, Jr/NANCY-9[ © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) 1 NS025 (201401) The ACORD name and logo are registered marks of ACORD