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<br />iru CERTIFICATE OF LIABILITY INSURANCE
<br />DATE /2D/YYYY)
<br />02/28
<br />02/28/2018
<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 CERTIFICATE
<br />THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE R(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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.
<br />10451 Gulf Blvd
<br />Treasure Island, FL 33706-4814
<br />NAMPC' Stephanie Moore
<br />PHONE 727-547-3121 FAX
<br />E A/C, N 1
<br />MAIL smoore allleds ecialt com
<br />ADDRESS: Q P y
<br />INSURERS AFFORDING COVERAGE
<br />NAICp
<br />msuRERa: T. H.E. Insurance Company
<br />12866
<br />INSURED
<br />ROCK BOUNCE, LLC
<br />211 Orange St. Unit B N-2018-054
<br />Newport Beach, CA 92663.
<br />INSURERS:
<br />INSURER C:
<br />INSURER D :
<br />INSURERS:
<br />INSURER F
<br />-- ------ "-"'- navIO1v1Y IVUIYIumm:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED
<br />NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT
<br />WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />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'SUSR
<br />LTR TYPE OFINSURANCE DI POLICY NUMBER MMIDOYN MMIDD LIMITS
<br />A X, COMMERCIAL GENERAL LIABILITY CPP0101967-07 09/14/2017 9/14/2018 EACH OCCURRENCE $ 1,000,000
<br />0
<br />CLAIMS-MADE X OCCUR
<br />PREMISES Ea occurrence It 100,000
<br />MED EXP (Any one person) $
<br />- PERSONAL &ADV INJURY $ 1,000,000
<br />GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br />X 1 POLICY PRO-
<br />LOC
<br />JECT J PRODUCTS - COMP/OP AGO $
<br />OTHER'
<br />AUTOMOBILE
<br />LIABILITYCOMBINED
<br />SINGLE LIMIT
<br />ANY O
<br />So accident l
<br />$
<br />BODILY INJURY (Per person)
<br />$
<br />OWNED
<br />OWNEDSCHEDULED
<br />POOP INJURY (Per accident)
<br />$
<br />AUTOS ONLY AUTOS
<br />HIRED NON-OAUTOS ONLY
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />_—
<br />$
<br />Per accidentl
<br />g —
<br />I
<br />UMBRELLAUAB
<br />OCCUR
<br />an�°
<br />EACH OCCURRENCE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$
<br />DED RETENTION$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'UABILITY
<br />'*
<br />..
<br />PER_
<br />AERH
<br />$
<br />YIN
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />as
<br />E,L, EACH ACCIDENT
<br />It
<br />OFFICER/MEMBER EXCLUDED4
<br />NIA
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<br />,Q`�0
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />(Mandatary In NH)
<br />If yes, describe under^y..
<br />E.L. DISEASE- POLICY LIMIT
<br />_
<br />$
<br />DESCRIPTION OF OPERATIONS below
<br />a",
<br />V "
<br />I
<br />a
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more apace Is requled)
<br />Event Date: 04/21/2018 Event Location: Santa Ana Public Library/Central - 26 Civic Center Plaza, Santa Ana, CA 92701
<br />Additional Insured: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and representatives as respects
<br />to the negligence of the named insured only. This insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written
<br />notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. Further this insurance will be deemed to be primary and
<br />non-contributory with respect to the insurance of such additional insured if you agreed to such a condition in the written contract with such additional insured.
<br />n verlv,n a Te+ ,,.., ,.,-.,
<br />CITY OF SANTA ANA
<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 />AUTHORIZE REPRESENTATTIIVVEE
<br />C� V
<br />©1
<br />........ 1 rlr.,ww name ano logo are registered marks of ACORD
<br />reserved.
<br />
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