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Alaii C RO CERTIFICATE OF LIABILITY INSURANCE DA4/2 e
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the
<br />PRODUCER
<br />Robert Harris Insurance Agency, Inc.
<br />Lic. #0216736
<br />3150 Bristol St., Suite 200
<br />Costa Mesa CA 92626
<br />u.N I�'I Adriana Lopez
<br />NAME.. __
<br />PHO
<br />IAIC,NNo Ext): (714) 619-4480 _ _ FAX
<br />IN T (714)619-4481
<br />E-MAIL
<br />ADDRESS: adriana@reharris. com
<br />INSURERS) AFFORDING COVERAGE NAIL
<br />INSURER A•Philadelphia Indemnity Ins Cc j18058
<br />INSURED
<br />nn _p4g INSURER B:Stdte Compensation Ing, Fund 135076
<br />Arrow Tag Entertainment LLC, N�io18
<br />INSURERC:
<br />DBA: AIIOw Tag OC INSURER D: '
<br />3400 W Warner Ave., Suite H INSURER E:
<br />Santa Alla CA 92704 INSURER F:
<br />COVERAGES CFRTIFICATF KHOWRFR•2018 RFt/14InM All IMPPO.
<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,
<br />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 —ADDL.SUBR.
<br />POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE WHO
<br />WVQ POLICY NUMBER MMIDDIYVVY MWDDIYYYY LIMITS
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE § 1,000,000
<br />X�
<br />A CLAIMSMADE OCCUR
<br />DAMAEMISGE I U RENTED
<br />PRES(Ea occurrences_ 100,000
<br />13/11/2018'0/29/20181
<br />-t$
<br />I PHP1785296 MED EXP (Any one person) '.$ 5,000
<br />PERSONAL B ADV INJURY 'I$ 1,000,000
<br />GEVL AGGREGATE LIMIT APPLIES PER',,
<br />GENERAL AGGREGATE ,$_ 2,000,000
<br />XPOLICY JECT _ LOU
<br />—,
<br />PRODUCTS - COMPIOP AGO $ 2,000,000
<br />-$
<br />OTHER:
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT $
<br />(Eaaccdent)_
<br />ANY AUTO !
<br />BODILY INJURY (Per person) $
<br />_
<br />. ALL OWNED !. SCHEDULED
<br />AUTOS AUTOS
<br />(Y INJURY Per acc i $
<br />BOY tlent )
<br />-- -- -. NON -OWNED
<br />—HIRED AUTOS —gUT05
<br />_
<br />PROPERTY DAMAGE $ -- _-- --
<br />Perapcitlent)
<br />$
<br />UMBRELLA LIAa OCCUR
<br />- EACH OCCURRENCE $$
<br />EXCESS LIAB CLAIMS -MADE,
<br />�', AGGREGATE $ —,
<br />DED !RETENTION$''
<br />§
<br />WORKERS COMPENSATION
<br />'�. X PER ' 0TH -
<br />AND EMPLOYERS' LIABILITY YIN
<br />.STATUTE I I ER
<br />ANY PROPRIETOWPARTNERIEXECUTIVE
<br />I '.NIA
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />B OFFICERIMEM HER EXCLUDED?
<br />(MandatorylnNH)
<br />—
<br />9216909-2017 8/29/2017 8/29/2018 EL DISEASE- EA EMPLOYEE 1,000,000
<br />If yes, describe under
<br />DESCRIPTIONOFOPERATIONSbe.
<br />! - -- -
<br />E.L. DISEASE -POLICY LIMIT I�$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Rama rks Schedule, may be attached If more space Is maul red)
<br />The City of Santa Ana, officers,
<br />employees, agents and representatives are named as additional insured
<br />per the attached PIAS009 04/04
<br />pxQ�'
<br />e
<br />� r 5
<br />The City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DE;
<br />THE EXPIRATION DATE THEA
<br />ACCORDANCE WITH THE POLICY
<br />AUTHORIZED REPRESENTATIVE
<br />c3`BE CANCELLED BEFORE
<br />WILL BE DELIVERED IN
<br />Lauren Atkinson/ALO °S `-""-"�'a^-- '•+avwx..-......s„„-,
<br />All riehts reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />INS025 (201401)
<br />
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