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HomeMy WebLinkAboutAI, ELIZABETH (2) INSURANCE NOT ON FILE N-2025-130 WORK MAY NO7 PROCEED CITY CLERK DATE: MAY 2-2 2925 April 22,2025 Elizabeth Ai("Speaker/Performer") 192 Casuda Canyon Dr., Unit G Monterey Park, CA 91754 Re: Speaker/Performer Engagement Agreement 0:Ll7(0) This Ietter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagement described below: 1. Event Description: Author presentation and reading of her book,"NewWave". Author will do a Q&A and book signing after conclusion of presentation, as detailed in the Scope of Services listed as Exhibit A,attached hereto and incorporated by reference. 2. Date(s): May 24,2025 3. Event Time(s): 2:00 p.m.—6:00 p.m. 4. Location: The Frida Cinema, 305 E. 0' St., Santa Ana,CA 92701. 5. Compensation: not to exceed $2,200.00 (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS form W-9 before payment can be made 6. Equipment provided by City: City will provide staging and audio equipment as may be required by Speaker/Performer. 7. Equipment provided by Speaker/Perfonner: Speaker/Performer will be responsible for providing all equipment, materials, supplies and personnel necessary to perform the act. S. City Contact Person (for coordinating purposes only): Dylan Dario. 9. Independent Contractor: Speaker/Performer shall,during the entire term of this Agreement,be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship,or to allow the City to exercise discretion or control over the professional manner in which Speaker/Performer perfonns the services that are the subject matter of this Agreement; however, the services to be provided by Speaker/Performer shall be provided in a manner consistent with all applicable standards and regulations. Speaker/Performer shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 10. Indemnification: Speaker/Performer,his or her agents, or employees(if applicable) agrees to and shall indemnify, defend,and hold harmless the City,its officers,agents,employees,consultants,special counsel,and representatives from and against all loss, expenses, or liability (including costs and attorney's fees) arising from the negligence or willful misconduct of Speaker/Performer, his or her agents,or employees. 11. Release: Speaker/Performer accepts the Property and any City-provided equipment used in connection with the performance in their "as-is" condition, with all faults. Speaker/Performer fully releases, waives and discharges forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not to sue,City,its elected officials,officers,employees,agents and volunteers,and all persons acting on behalf of,by, Letter Agreement—Elizabeth Ai Page 2 through or under each of them, under any present or future laws, statutes, or regulations for any claim or event relating to the condition of the Property or City-provided equipment or Speaker/Performer's use thereof. 12. Insurance: Insurance shall be procured and maintained by the Speaker/Performer as required by the City and as further detailed in Exhibit B,attached hereto and incorporated herein. 13. Worker's Compensation Insurance. In accordance with the California Labor Code, Speaker/Performer, if Speaker/Performer has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. 14, The City shall have the right and royalty-free license to simulcast or produce and show a tape-delayed broadcast of Speaker/Performer's presentation to the City community or general public, through webcast or any other means. This license shall be non-exclusive and the copyright shall remain with the Speaker/Performer. Copies of Speaker/Performer's presentation may be maintained by the City, and Speaker/Performer consents to use of such recordings. 15. Speaker/Performer is solely responsible for payment of royalty fees, performance fees, or similar fees that may be required by unions or similar organizations. Speaker/Performer shall indemnify the City against any liability or damages, including attorney's fees,that may arise as a result of violation by Speaker/Performer of copyright laws. 16. Speaker/Perfonner shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, disability, or any other basis protected by applicable law in connection with any activities related to this Agreement. 17. This Agreement shall in all respects shall be interpreted,enforced, and governed exclusively by and under the laws of the state of California. Both parties agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of,in connection with or by reason of this Agreement. is. This Agreement represents the complete and exclusive statement between the City and Speaker/Performer regarding the subject matter herein and supersedes any and all other agreements, oral or written, between the parties. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Speaker/Performer. CITY O S A ANA SPEAKER/PERFORMER �GizabE�l� fir' �u Elizabeth Ai(Apr29,262511:28 PDT) Alvaro Nunez Elizabeth Ai City Manager r ATTEST: APPROVED AS TO FORM: Y= ennifer L. all onathan Martinez Assistant City Attorney RECOMMENDED FOR APPROVAL: Brian Sternberg, Executive Director,Library Services Department Letter Agreement—Elizabeth Ai Page 3 Exhibit A SCOPE OF SERVICES SPEAKER/PERFORMER INFORMATION: Name: Elizabeth Ai Address: 192 Casuda Canyon Dr.Unit G Monterey park, CA 91754 Phone Number: 626.676.9217 Email Address: Elizabeth.Ai@gmail.com EVENT: Reading and Screening Presentation, Q&A Session&Book Signing for Elizabeth Ai,Filmmaker and Author of"NewWave". LOCATION: The Frida Cinema, 305 E. 0 St. 9100, Santa Ana, CA 92701 TERM: One-time event: Saturday, May 24,2025 COMPENSATION: not to exceed $2,200.00 DESCRIPTION: Author and filmmaker Elizabeth Ai and co-writers will provide a presentation, reading, and screening of her book,NewWave. Ms. Ai will engage a Q&A and a book signing once the presentation concludes. The presentation will be conducted in-person at The Frida Cinema in Santa Ana. The event will be hosted by Tony Lam, Senior Librarian, and Patty Lopez, Principal Librarian. The presentation is free and the public may attend.The event will take place one time on Saturday, May 24, 2025 from 2:00 p.m. - 6:00 p,m. at The Frida Cinema, located at 305 E. 4a'St., Santa Ana, CA 92701. Letter Agreement—Elizabeth Ai Page 4 Exhibit B INSURANCE REQUIREMENTS Speaker/Performer shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with products and materials supplied to City. Total cost of such insurance shall be borne by Speaker/Performer. MINIMUM SCOPE AND LIMIT OF INSURANCE: Commercial General Liability: coverage shall be at least as broad as Insurance Services Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain,the following provisions: I. City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Instructor including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: (Name of Department Staff Responsible for Agreement), Address of Department Responsible for Agreement, M-XX, Santa Ana, CA 92701. Verification of Coverage Speaker/Performer shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Speaker/Performer's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Special Events Coverage Special events coverage is available and can be purchased by Contractor. Use this link to learn more: hl!ps:H2sparta.com/selip application.php. Special Risks or Circumstances City reserves the right to modify these requirements at any time, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. City reserves the right to modify or waive insurance requirements for certain low risk recreational activities. Elizabeth Ai- Speaker-Performer Agreement (May 2025) APPVD AS TO FORM Final Audit Report 2025-04-29 Created: 2025-04-23 By: Dylan Dario(ddario@santa-ana.org) Status: Signed Transaction ID: CBJGHBCAABAAT411zNjZPVK8TN3SiTspP_umo5vrUwA "Elizabeth Ai- Speaker_Performer Agreement (May 2025) APPV D AS To FORM" History -) Document created by Dylan Dario (ddario@santa-ana.org) 2025-04-23-10:15:21 PM GMT C-� Document emailed to Brian Sternberg (bsternberg@santa-ana.org)for signature 2025-04-23-10:15:26 PM GMT ,-I Email viewed by Brian Sternberg (bsternberg@santa-ana.org) 2025-04-28-8:14:47 PM GMT Email viewed by Brian Sternberg (bsternberg@santa-ana.org) 2025-04-29-2:38:35 PM GMT Caa Document e-signed by Brian Sternberg (bsternberg@santa-ana.org) Signature Date:2025-04-29-6:12:55 PM GMT-Time Source:server Document emailed to Elizabeth Ai (elizabeth.ai@gmail.com)for signature 2025-04-29-6:12:57 PM GMT Email viewed by Elizabeth Ai (elizabeth.ai@gmail.com) 2025-04-29-6:27:47 PM GMT 6� Document e-signed by Elizabeth Ai (elizabeth.ai@gmail.com) Signature Date:2025-04-29-6:28:13 PM GMT-Time Source:server 4 Agreement completed. 2025-04-29-6:28:13 PM GMT Adobe Acrobat Sign THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY POLICY CHANGES Endorsement: 2 Policy Number Policy Changes Effective Company 25014354 5/24/2025 Colony Insurance Company Name Insured Authorized Representative The Post Gen Inc. Amwins Insurance Brokerage, LLC e - O Changes Policy Effective Date: 5/24/2025 Agent: HUB International Insurance SE In consideration of no change in premium, it is understood and agreed that the policy is hereby amended as follows: Named Insured is amended to read: Elizabeth Ai 192 Casuda Canyon Dr. G Monterey Park, CA 91754 APPROVED By Tu Tran Nguyen at 11:18 am,May 20,2025 Tu Trdn TuTralnysigned Nguyenby Date:2025.05.20 Nguyen,,:18:31- All other terms and conditions remain the same. 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY POLICY CHANGES Endorsement: 1 Policy Number Policy Changes Effective Company 25014354 5/24/2025 Colony Insurance Company Name Insured Authorized Representative The Post Gen Inc. Amwins Insurance Brokerage, LLC 8 - O Changes Policy Effective Date: 5/24/2025 Agent: HUB International Insurance SE In consideration of no change in premium, it is understood and agreed that the policy is hereby amended as follows: The following Additional Insureds are added with form T5409-01 18: SANTA ANA PUBLIC LIBRARY 26 Civic Center Plaza, Santa Ana, CA 92701 FRIDA CINEMA 305 E 4th St#100, Santa Ana, CA 92701 All other terms and conditions remain the same. 1 of 1 Liability Insurance Policy-Member Endorsement Special Event Liability Group Insurance Trust eventinsure.com This is to certify that the policy of insurance listed below has been issued and this endorsement adds the Named Insureds as Members for the event and dates indicated on this Member Endorsement. Notwithstanding any requirement,term or condition of any contract or other document with respect to which this endorsement may be issued or may pertain,the insurance afforded by the policy described herein is subject to all the terms,exclusions and conditions of such master policy. Producer Name:Hub International Insurance Services, Inc Mail Address:3000 Executive Parkway,#300 City:San Ramon State:CA Zip Code:94583 PHONE(925)609-6547 Fax#:(925)609-6550 Email:specialevent@hubinternational.com Website:Hub International Insurance Services, Inc License State:CA License Number:0757776 First Named Insured/Member Name:The Post Gen Inc Mail Address:192 Casuda Canyon Drive, Unit:G City:Monterey Park State:California Zip Code:91754 Member Endorsement Number 25014354 Member Endorsement Effective Date 05/24/2025 Member Endorsement Expiration Date 05/25/2025 12:01 A.M.Standard Time at your Mailing Address. Event Description Arts&Crafts Insurance Company Colony Insurance Company Master Policy Number 103 GL 0212472 02 Master Policy Effective Date 2025-01-01 Master Policy Expiration Date 2026-01-01 Endorsement Premium $ 40.00 State Tax 1.20 Stamping Fee 0.07 Total Premium $ 41.27 Member Endorsement Limits: Each Occurrence $ $1,000,000 Personal&Advertising Injury $1,000,000 General Aggregate $2,000,000 Products&Completed Operations $2,000,000 Damage to Premises Rented to You 1,000,000 Medical Payments 5,000 Liquor Liability Each Occurrence N/A If a Liquor Liability Each Occurrence limit is displayed,then Liquor Liability is subject to the General Aggregate Limit shown above. Liability Deductible $ 0 Master Policy Number 103 GL 0212472 02 Member Endorsement Number 25014354 Date 04/17/2025 Authorized Representative r Type of Insurance Commercial General Liability Occurrence Form Forms and Endorsements: Number Title CAPRNOTICE-0911 California Notice-Premium Refunds D2-0120 Important Notice(CA) ILP001-0104 US Treasury Department's Office of Foreign Assets Control("OFAC")Advisory Notice PRIVACYNOTICE-0820 Notice of Insurance Information Practices U094-0415 Service of Suit SIGCIC-0817 Signature Page DCJ6550-0117 Common Policy Declarations 0001-1004 Schedule of Forms and Endorsements DCJ6553-0702 Commercial General Liability Coverage Part Declarations U411-0615 Liquor Liability Coverage Supplemental Declarations CG0001-0413 Commercial General Liability Coverage Form CG0033-0413 Liquor Liability Coverage Form CG2412-1185 Boats UCG2175-0121 Terrorism Exclusion CG2001-1219 Primary and Noncontributory-Other Insurance Condition CG2010-0413 Additional Insured-Owners, Lessees or Contractors-Scheduled Person or Organization CG2037-0413 Additional Insured-Owners, Lessees or Contractors-Completed Operations CG2109-0615 Exclusion-Unmanned Aircraft CG2116-0413 Exclusion-Designated Professional Services CG2149-0999 Total Pollution Exclusion Endorsement CG2153-0196 Exclusion-Designated Ongoing Operations CG2167-1204 Fungi or Bacteria Exclusion CG2196-0305 Silica or Silica-Related Dust Exclusion CG2244-0413 Exclusion-Services Furnished by Health Care Providers CG2404-1219 Waiver of Transfer of Rights of Recovery Against Others to Us IL0021-0908 Nuclear Energy Liability Exclusion Endorsement(Broad Form) T1007-0507 Exclusion-Concert Liability T1065-0408 Common Policy Conditions T1523-0111 Separation of Insureds-Insured Members and Reporting Endorsement T1944-0124 Additional Insured-Volunteers T4326-0113 Conditional Liquor Liability Endorsement T5152-0117 Exclusion-Designated Operations T5153-0117 Exclusion-Rides T5380-0817 Additional Insured-State or Governmental Agency or Subdivision or Political Subdivision-Permits or Authorizations T5407-0118 Limits of Insurance-Designated Project or Premises T5408-0118 Cross Suits Exclusion T5409-0118 Additional Insured-Designated Person or Organization (LIST CONTINUED ON FOLLOWING PAGE) Master Policy Number 103 GL 0212472 02 Member Endorsement Number 25014354 Date 04/17/2025 Forms and Endorsements(Continued): Number Title T5531-0119 Exclusion-Designated Activities T5532-0119 Additional Insured-Designated Person or Organization T5533-0119 Additional Insured-Managers or Lessors of Premises T8022-0820 Alaska Policyholder Notice 0002A-0916 Minimum Earned Premium 0009-0310 Aircraft Products and Grounding Exclusion U016-0621 Athletic or Sports Participants Exclusion U018-0520 Exclusion-Communicable Disease,Virus or Bacteria U048-0310 Employment-Related Practices Exclusion U1010-0923 Exclusion-Cyber Incident, Electronic Data,Confidential or Personal Material or Information,And Violation of Law Addressing Data U1338-1221 Privacy Exclusion-Poly-and Perfluoroalkyl Substances U1396-0223 (PFAS) Exclusion-Hired Auto(s) Liability U173AS-1023 Cancellation-Number of Days Cancellation:30 Days U175-0608 Multiple Coverages Limitation U232-0104 Exclusion-Punitive, Exemplary or Multiple Damages U266-0510 Exclusion-USL&H,Jones Act or Other Maritime Laws U276-0310 Exclusion-Breach of Contract U466-0212 Exclusion-Lead U467-0212 Exclusion-Asbestos U684-0511 Exclusion-Abuse or Molestation U1407-0723 Economic and Trade Sanctions Endorsement State Surplus Lines Notification CALIFORNIA DISCLOSURE Amwins Insurance Brokerage LLC may be charging you a brokerage fee for providing the basic services set forth herein.The amount of the mutually agreed upon brokerage fee,if any,is the amount included on our invoice.The general brokerage services we perform include,but are not limited to,searching our relevant market(s)for appropriate combination(s)of price,coverage and security for a particular risk.Amwins may also be entitled to receive compensation,directly or indirectly,from the insurer that accepted and bound your business,even when you have been charged a brokerage fee. The above disclosures are required by Section 1623 of the Insurance Code of the State of California when a wholesale intermediary broker transacts insurance with,but not on behalf of,an admitted insurer.Amwins,in the interest of transparency, includes this disclosure on transactions with both admitted and non-admitted carriers where brokerage fees are involved. Please review the above quotation/binder carefully;terms and/or conditions may differ from those requested in your submission. In addition to the above mentioned exclusions,the policy contains other standard exclusions;specimen policies are available upon request. Terms herein are summarized for use by a licensed broker and should not be submitted in this format to the applicant. Please call with any questions. This quotation/binder is subject to all terms and conditions of the policy to be issued.The quotation/binder shall be terminated and voided by delivery of a policy to either the insured,his agent or representative.The coverage will remain in effect for the term indicated unless cancelled by the insured,Amwins or the Company,via written notice. This quotation/binder is a privileged document and shall not be released or assigned in whole or in part to any other person or entity without the written consent of Amwins,endorsed hereon. Master Policy Number 103 GL 0212472 02 Member Endorsement Number 25014354 Date 04/17/2025 Full Named Insured Schedule First Named Insured: The Post Gen Inc Master Policy Number 103 GL 0212472 02 Member Endorsement Number 25014354 Date 04/17/2025 Full Location Schedule 305 E 4th St#100 Santa Ana California 92701 103 GL 0212472-02 IWORTANT NOTICE: 1. The insurance policy that you have purchased is being issued by an insurer that is not licensed by the State of California. These companies are called "nonadmitted" or "surplus line" insurers. 2. The insurer is not subject to the financial solvency regulation and enforcement that apply to California licensed insurers. 3. The insurer does not participate in any of the insurance guarantee funds created by California law. Therefore, these funds will not pay your claims or protect your assets if the insurer becomes insolvent and is unable to make payments as promised. 4. The insurer should be licensed either as a foreign insurer in another state in the United States or as a non-United States (alien) insurer. You should ask questions of your insurance agent, broker, or "surplus line" broker or contact the California Department of Insurance at the toll-free number 1-800-927-4357 or internet website www.insurance.ca.gov. Ask whether or not the insurer is licensed as a foreign or non-United States (alien) insurer and for additional information about the insurer. You may also visit the NAIC's internet website at www.naic.org. The NAIL—the National Association of Insurance Commissioners—is the regulatory support organization created and governed by the chief insurance regulators in the United States. 5. Foreign insurers should be licensed by a state in the United States and you may contact that state's department of insurance to obtain more information about that insurer. You can find a link to each state from this NAIL internet website: https:Hnaic.org/state_web_map.htm. 6. For non-United States (alien) insurers, the insurer should be licensed by a country outside of the United States and should be on D-2-0120 Page 1 of 2 103 GL 0212472-02 the NAIC's International Insurers Department (IID) listing of approved nonadmitted non-United States insurers. Ask your agent, broker, or "surplus line" broker to obtain more information about that insurer. 7. California maintains a "List of Approved Surplus Line Insurers (LASLI)." Ask your agent or broker if the insurer is on that list, or view that list at the internet website of the California Department of Insurance: www.insurance.ca.gov/01-consumers/120-company/07- lasli/lasli.cfm. 8. If you, as the applicant, required that the insurance policy you have purchased be effective immediately, either because existing coverage was going to lapse within two business days or because you were required to have coverage within two business days, and you did not receive this disclosure form and a request for your signature until after coverage became effective, you have the right to cancel this policy within five days of receiving this disclosure. If you cancel coverage, the premium will be prorated and any broker's fee charged for this insurance will be returned to you. D-2-0120 Page 2 of 2 DATE CERTIFICATE OF LIABILITY INSURANCE 5/14/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE ENDORSEMENT 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 policy(ies)must have ADDITIONAL INSURED provisions or 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: SPECIAL EVENT DEPARTMENT CONTACT INFORMATION HUB International Insurance Services Inc. PHONE 925 609 6547 FAX 925 609 6550 3000 Executive Parkway, Suite 300 EMAIL specialevent cahubinternational.com San Ramon, CA 94583 INSURER(S)AFFORDING COVERAGE NAIC# CA License#0757776 INSURER A: Colony Insurance Company 39993 NAMED INSURED: The Post Gen Inc., 192 Casuda Canyon Dr., Unit G, Monterey Park, CA 91754 COVERAGES This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated below. 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. INSURED MEMBER INSR COVERAGE EFFECTIVE TYPE OF INSURANCE ENDORSEMENT / LIMITS LTR NUMBER EXPIRATION DATE A GENERAL LIABILITY 25014354 5/24/2025-5/25/2025 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea (Ea occurrence) CLAIMS-MADE ❑X OCCURRENCE MED EXP(Any one person) $5,000 PERSONAL&ADV INJU RY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG $2,000,000 LIQUOR LIABILITY PER OCCURRENCE(AGGREGATE INCLUDED IN GENERAL LIABILITY n/a AGGREGATE) MASTER POLICY#103 GL 0212472-02-EFFECTIVE DATE 11112025; EXPIRATION 11112026 12:01A.M.Standard Time at your Mailing Address. DESCRIPTION OF OPERATIONS/LOCATIONS The certificate holder is included as Additional Insured as per endorsement T5409-0118. This insurance is Primary and Non-Contributing as per endorsement CG2001-1219. The insurance company waives rights of recovery as per endorsement CG2404-1219. The Insured Member Endorsement cannot be cancelled by the insurance company as per endorsement T1523-0111. Event Type: Arts&Crafts Event date(s): 5/24/2025-5/25/2025 CERTIFICATE HOLDER CANCELLATION City f St A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED y o Santa BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Santa Ana Public Library ACCORDANCE WITH THE POLICY PROVISIONS. 26 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE POLICY#103 GL 0212472-02 COMMERCIAL GENERAL LIABILITY T5409-0118 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Named of Additional Insured Person(s)or Organization(s) City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. Section II - Who Is An Insured is amended to include as additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations;or B. In connection with your premises owned by or rented to you. T5409-0118 ©ISO Properties, Inc.,2004 Page 1 of 1 POLICY#103 GL 0212472-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE (Third-Party) This endorsement modifies insurance under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek (2)You have agreed in writing in a contract or contribution from any other insurance available to agreement that this insurance would be an additional insured under your policy provided primary and would not seek contribution that: from any other insurance available to the (1)The additional insured is a Named Insured additional insured. under such other insurance;and CG 20 01 12 19 Includes Copyrighted material of ISO Properties, Inc.with its permission. Page 1 of 1 POLICY#103 GL 0212472-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name of Person or Organization: As required by written contract with the Named Insured that is executed by the parties to the contract prior to the commencement of work that is called for in the contract. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against the person(s)or organization(s)shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s)or organization(s)prior to loss. This endorsement applies only to the person(s)or organization(s)shown in the Schedule above. CG 24 04 12 19 Contains material copyright,Insurance Services Office,Inc.,with its permission. Page 1 of 1 POLICY#103 GL 0212472-02 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IF CAREFULLY. SEPARATION OF INSUREDS - INSURED MEMBERS AND REPORTING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, and COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, and SECTION I - LIQUOR LIABILITY COVERAGE, 2. Exclusions of the LIQUOR LIABILITY COVERAGE FORM are amended and the following added: This insurance does not apply to: Unreported Events "Bodily injury", "property damage", "personal and advertising injury"or"injury" arising out of any"Insured Member(s)" that you have not reported in the Policyholder's Bordereaux, subject to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS,Reporting Provisions added in item E. below. However, this provision does not apply in the event of an unintentional error or omission in not reporting an "Insured Member" in the Policyholder's Bordereaux if such "Insured Member" received a Certificate of Insurance and paid the premium prior to the"bodily injury","property damage"or"personal and advertising injury' or"injury"that resulted in a claim or"suit". B. SECTION Il - WHO IS AN INSURED, 1. a. of the COMMERCIAL GENERAL LIABIUTY and LIQUOR LIABILITY COVERAGE FORMS,is deleted and replaced with the following: a. An individual, you and your spouse are a named insured, but only with respect to your conduct as an "Insured Member"named on the Certificate of Insurance referenced in item C. below. C. SECTION II - WHO IS AN INSURED of the COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY COVERAGE FORMS is amended and the following added: 4. Any"Insured Member"issued a Certificate of Insurance evidencing coverage under this Master Policy will qualify as a Named Insured. However,for the"Event Information"designated in the Certificate of Insurance: a. COVERAGE A does not apply to"bodily injury"or"property damage"that occurred before the"Event Information"inception date shown in the"Certificate policy period'; and b. COVERAGE B does not apply to"personal and advertising injury"arising out of an offense committed before the"Event Information"inception date shown in the"Certificate policy period"; and c. LIQUOR LIABILITY COVERAGE does not apply to"injury"that occurred before the"Event Information"inception date shown in the"Certificate policy period". D. SECTION IV - COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY CONDITIONS, 7. Separation Of lnsurcds is deleted and replaced with the following: 7. Separation Of Insureds This insurance is provided under a Master Policy and applies: a. as if each"Insured Member"shown on a Certificate of Insurance were the only Named Insured; and T1523-0111 Page I of 3 b. separately to each"Insured Member"against whom claim is made or"suit' is brought. The Limits of Insurance shown in the Certificate of Insurance issued to the"Insured Member"will apply separately to each"Insured Member"to which this insurance applies. All terms and conditions of this Master Policy are the terms and conditions applicable to the"Insured Member"during the"Certificate policy period". If the expiration date of the"Certificate policy period"shown on the Certificate of Insurance issued to the"Insured Member"is after to the expiration date of the Master Policy,coverage will cease upon the expiration date of the "Certificate policy period."In no event will coverage for the"Insured Member"extend beyond twelve (12)months after the expiration of the Master Policy. If the expiration date of the"Certificate policy period"shown on the Certificate of Insurance issued to the"Insured Member"is prior to the expiration,termination or cancellation date of the Master Policy,coverage will cease upon the expiration date of the"Certificate policy period." If this Master Policy is terminated or cancelled prior to the expiration date of the"Certificate policy period"shown on the Certificate of Insurance issued to the"Insured Member",coverage for the"Insured Member"will continue under the terms and conditions of the Master Policy until the expiration of the"Certificate policy period."In no event will coverage for the"Insured Member"extend beyond twelve(12)months after the termination or cancellation of the Master Policy. E. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS and SECTION IV - LIQUOR LIABILITY CONDITIONS are amended and the following added: Reporting Provisions a. The premium charged at the inception of each policy year is an advance premium. Upon our receipt of your complete Policyholder's Bordereaux at the end of each"reporting period", an endorsement will be issued by us for any adjustment in premium because of"Insured Member(s)"you added or deleted in the Policyholder's Bordereaux. b. Premium Reporting: (1)You must file a Policyholder's Bordereaux with us each"reporting period"and at Expiration,in accordance with this Reporting Provision, showing separately each"Insured Member"to be covered. In addition to the information required by the Policyholders Bordereaux,you must include a copy of the Certificate of Insurance issued evidencing the "Insured Members"coverage provided by this Master Policy. (2)You may not correct an inaccurate Policyholder's Bordereaux after a claim or"suit"has occurred. c. Failure to Submit a Policyholder's Bordereaux: Coverage only applies to: (1)"Insured Member(s)"shown in the Policyholder's Bordereaux you filed with us prior to the "bodily injury","property damage","personal and advertising injury"or"injury"that resulted in a claim or "suit",or, (2)"Insured Member(s)"shown on reports or Certificates of Insurance that were on file with HUB International Insurance Services,Inc. prior to the"bodily injury","property damage"or"personal and advertising injury"or"injury"that resulted in a claim or"suit". However,paragraph c. does not apply in the event of an unintentional error or omission in not reporting an"Insured Member"in the Policyholder's Bordereaux except if such"Insured Member"received a Certificate of Insurance and paid the premium prior to the"bodily injury","property damage","personal and advertising injury"or"injury"that resulted in a claim or"suit". T1523-0111 Page 2 of 3 F. SECTION IV - COMMERCIAL GENERAL LIABILITY and SECTION IV - LIQUOR LIABILITY CONDITIONS,5.Premium Audit, are deleted and replaced with the following: 5.Premium Audit a.We will compute all premiums for this Coverage Part in accordance with our rules and rates. b.Premium shown in this Coverage Part as advance premium is a deposit premium only. If the policy is cancelled,to determine any premium refund or additional premium due,we may elect to use an earned premium computed by an audit or pro rata or less than pro rata calculation of the advanced premium or minimum premium. Paragraph 5. of A. Cancellation of the Common Policy Conditions is amended accordingly. c.The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. G. SECTION V-DEFINITIONS is amended and the following added: 1."Insured Member"means: a. a member of the First Named Insured shown in the Declarations and named as the Event Holder on a Certificate of Insurance issued evidencing the"Insured Member's"coverage under this Master Policy; and b.evidenced on the Policyholder's Bordereaux filed with the company. Throughout this policy the words"you"and"your"refer to the"Insured Member"as a Named Insured under this Master Policy. 2."Event Information"means the event and the area or location where the event is being conducted provided the event is designated on the Certificate of Insurance issued to that"Insured Member"and Policyholder's Bordereaux filed with the company. 3."Certificate policy period"means the period of time coverage under this Master Policy will apply for the"Insured Member"indicated on the Certificate of Insurance issued to that"Insured Member". 4."Reporting period"means the period of time shown below that you must record and file with us a Policyholder's Bordereaux on all changes to the issued Certificates of Insurance,including copies of the Certificates of Insurance issued evidencing the"Insured Member's"coverage under this Master Policy. The"reporting period"is: a. each calendar month starting at policy inception, and then each consequential month, and b.ninety(90)days from the date of non-renewal or the date of cancellation if this policy is cancelled prior to policy expiration. Each monthly Policyholder's Bordereaux shall include Certificates of Insurance issued within the previous three(3) calendar months that were not previously reported to us. All references to LIQUOR LIABILITY in this endorsement only apply if a LIQUOR LIABILITY COVERAGE PART is attached to this policy. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. T1523-0111 Page 3 of 3 DATE CERTIFICATE OF LIABILITY INSURANCE 5/14/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE ENDORSEMENT 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 policy(ies)must have ADDITIONAL INSURED provisions or 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: SPECIAL EVENT DEPARTMENT CONTACT INFORMATION HUB International Insurance Services Inc. PHONE 925 609 6547 FAX 925 609 6550 3000 Executive Parkway, Suite 300 EMAIL specialevent cahubinternational.com San Ramon, CA 94583 INSURER(S)AFFORDING COVERAGE NAIC# CA License#0757776 INSURER A: Colony Insurance Company 39993 NAMED INSURED: The Post Gen Inc., 192 Casuda Canyon Dr., Unit G, Monterey Park, CA 91754 COVERAGES This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated below. 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. INSURED MEMBER INSR COVERAGE EFFECTIVE TYPE OF INSURANCE ENDORSEMENT / LIMITS LTR NUMBER EXPIRATION DATE A GENERAL LIABILITY 25014354 5/24/2025-5/25/2025 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $1,000,000 (Ea occurrence) CLAIMS-MADE ❑X OCCURRENCE MED EXP(Any one person) $5,000 PERSONAL&ADV INJU RY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG $2,000,000 LIQUOR LIABILITY PER OCCURRENCE(AGGREGATE INCLUDED IN GENERAL LIABILITY n/a AGGREGATE) MASTER POLICY#103 GL 0212472-02-EFFECTIVE DATE 11112025; EXPIRATION 11112026 12:01A.M.Standard Time at your Mailing Address. DESCRIPTION OF OPERATIONS/LOCATIONS The certificate holder is included as Additional Insured as per endorsement T5409-0118. This insurance is Primary and Non-Contributing as per endorsement CG2001-1219. The insurance company waives rights of recovery as per endorsement CG2404-1219. The Insured Member Endorsement cannot be cancelled by the insurance company as per endorsement T1523-0111. Event Type: Arts&Crafts Event date(s): 5/24/2025-5/25/2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FRIDA CINEMA 305 E 4th St#100,Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE POLICY#103 GL 0212472-02 COMMERCIAL GENERAL LIABILITY T5409-0118 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Named of Additional Insured Person(s)or Organization(s) FRIDA CINEMA 305 E 4th St#100, Santa Ana, CA 92701 Information required to complete this Schedule,if not shown above,will be shown in the Declarations. Section II - Who Is An Insured is amended to include as additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations;or B. In connection with your premises owned by or rented to you. T5409-0118 ©ISO Properties, Inc.,2004 Page 1 of 1 POLICY#103 GL 0212472-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE (Third-Party) This endorsement modifies insurance under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek (2)You have agreed in writing in a contract or contribution from any other insurance available to agreement that this insurance would be an additional insured under your policy provided primary and would not seek contribution that: from any other insurance available to the (1)The additional insured is a Named Insured additional insured. under such other insurance;and CG 20 01 12 19 Includes Copyrighted material of ISO Properties, Inc.with its permission. Page 1 of 1 POLICY#103 GL 0212472-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name of Person or Organization: As required by written contract with the Named Insured that is executed by the parties to the contract prior to the commencement of work that is called for in the contract. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against the person(s)or organization(s)shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s)or organization(s)prior to loss. This endorsement applies only to the person(s)or organization(s)shown in the Schedule above. CG 24 04 12 19 Contains material copyright,Insurance Services Office,Inc.,with its permission. Page 1 of 1 POLICY#103 GL 0212472-02 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IF CAREFULLY. SEPARATION OF INSUREDS - INSURED MEMBERS AND REPORTING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, and COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, and SECTION I - LIQUOR LIABILITY COVERAGE, 2. Exclusions of the LIQUOR LIABILITY COVERAGE FORM are amended and the following added: This insurance does not apply to: Unreported Events "Bodily injury", "property damage", "personal and advertising injury"or"injury" arising out of any"Insured Member(s)" that you have not reported in the Policyholder's Bordereaux, subject to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS,Reporting Provisions added in item E. below. However, this provision does not apply in the event of an unintentional error or omission in not reporting an "Insured Member" in the Policyholder's Bordereaux if such "Insured Member" received a Certificate of Insurance and paid the premium prior to the"bodily injury","property damage"or"personal and advertising injury' or"injury"that resulted in a claim or"suit". B. SECTION Il - WHO IS AN INSURED, 1. a. of the COMMERCIAL GENERAL LIABIUTY and LIQUOR LIABILITY COVERAGE FORMS,is deleted and replaced with the following: a. An individual, you and your spouse are a named insured, but only with respect to your conduct as an "Insured Member"named on the Certificate of Insurance referenced in item C. below. C. SECTION II - WHO IS AN INSURED of the COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY COVERAGE FORMS is amended and the following added: 4. Any"Insured Member"issued a Certificate of Insurance evidencing coverage under this Master Policy will qualify as a Named Insured. However,for the"Event Information"designated in the Certificate of Insurance: a. COVERAGE A does not apply to"bodily injury"or"property damage"that occurred before the"Event Information"inception date shown in the"Certificate policy period'; and b. COVERAGE B does not apply to"personal and advertising injury"arising out of an offense committed before the"Event Information"inception date shown in the"Certificate policy period"; and c. LIQUOR LIABILITY COVERAGE does not apply to"injury"that occurred before the"Event Information"inception date shown in the"Certificate policy period". D. SECTION IV - COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY CONDITIONS, 7. Separation Of lnsurcds is deleted and replaced with the following: 7. Separation Of Insureds This insurance is provided under a Master Policy and applies: a. as if each"Insured Member"shown on a Certificate of Insurance were the only Named Insured; and T1523-0111 Page I of 3 b. separately to each"Insured Member"against whom claim is made or"suit' is brought. The Limits of Insurance shown in the Certificate of Insurance issued to the"Insured Member"will apply separately to each"Insured Member"to which this insurance applies. All terms and conditions of this Master Policy are the terms and conditions applicable to the"Insured Member"during the"Certificate policy period". If the expiration date of the"Certificate policy period"shown on the Certificate of Insurance issued to the"Insured Member"is after to the expiration date of the Master Policy,coverage will cease upon the expiration date of the "Certificate policy period."In no event will coverage for the"Insured Member"extend beyond twelve (12)months after the expiration of the Master Policy. If the expiration date of the"Certificate policy period"shown on the Certificate of Insurance issued to the"Insured Member"is prior to the expiration,termination or cancellation date of the Master Policy,coverage will cease upon the expiration date of the"Certificate policy period." If this Master Policy is terminated or cancelled prior to the expiration date of the"Certificate policy period"shown on the Certificate of Insurance issued to the"Insured Member",coverage for the"Insured Member"will continue under the terms and conditions of the Master Policy until the expiration of the"Certificate policy period."In no event will coverage for the"Insured Member"extend beyond twelve(12)months after the termination or cancellation of the Master Policy. E. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS and SECTION IV - LIQUOR LIABILITY CONDITIONS are amended and the following added: Reporting Provisions a. The premium charged at the inception of each policy year is an advance premium. Upon our receipt of your complete Policyholder's Bordereaux at the end of each"reporting period", an endorsement will be issued by us for any adjustment in premium because of"Insured Member(s)"you added or deleted in the Policyholder's Bordereaux. b. Premium Reporting: (1)You must file a Policyholder's Bordereaux with us each"reporting period"and at Expiration,in accordance with this Reporting Provision, showing separately each"Insured Member"to be covered. In addition to the information required by the Policyholders Bordereaux,you must include a copy of the Certificate of Insurance issued evidencing the "Insured Members"coverage provided by this Master Policy. (2)You may not correct an inaccurate Policyholder's Bordereaux after a claim or"suit"has occurred. c. Failure to Submit a Policyholder's Bordereaux: Coverage only applies to: (1)"Insured Member(s)"shown in the Policyholder's Bordereaux you filed with us prior to the "bodily injury","property damage","personal and advertising injury"or"injury"that resulted in a claim or "suit",or, (2)"Insured Member(s)"shown on reports or Certificates of Insurance that were on file with HUB International Insurance Services,Inc. prior to the"bodily injury","property damage"or"personal and advertising injury"or"injury"that resulted in a claim or"suit". However,paragraph c. does not apply in the event of an unintentional error or omission in not reporting an"Insured Member"in the Policyholder's Bordereaux except if such"Insured Member"received a Certificate of Insurance and paid the premium prior to the"bodily injury","property damage","personal and advertising injury"or"injury"that resulted in a claim or"suit". T1523-0111 Page 2 of 3 F. SECTION IV - COMMERCIAL GENERAL LIABILITY and SECTION IV - LIQUOR LIABILITY CONDITIONS,5.Premium Audit, are deleted and replaced with the following: 5.Premium Audit a.We will compute all premiums for this Coverage Part in accordance with our rules and rates. b.Premium shown in this Coverage Part as advance premium is a deposit premium only. If the policy is cancelled,to determine any premium refund or additional premium due,we may elect to use an earned premium computed by an audit or pro rata or less than pro rata calculation of the advanced premium or minimum premium. Paragraph 5. of A. Cancellation of the Common Policy Conditions is amended accordingly. c.The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. G. SECTION V-DEFINITIONS is amended and the following added: 1."Insured Member"means: a. a member of the First Named Insured shown in the Declarations and named as the Event Holder on a Certificate of Insurance issued evidencing the"Insured Member's"coverage under this Master Policy; and b.evidenced on the Policyholder's Bordereaux filed with the company. Throughout this policy the words"you"and"your"refer to the"Insured Member"as a Named Insured under this Master Policy. 2."Event Information"means the event and the area or location where the event is being conducted provided the event is designated on the Certificate of Insurance issued to that"Insured Member"and Policyholder's Bordereaux filed with the company. 3."Certificate policy period"means the period of time coverage under this Master Policy will apply for the"Insured Member"indicated on the Certificate of Insurance issued to that"Insured Member". 4."Reporting period"means the period of time shown below that you must record and file with us a Policyholder's Bordereaux on all changes to the issued Certificates of Insurance,including copies of the Certificates of Insurance issued evidencing the"Insured Member's"coverage under this Master Policy. The"reporting period"is: a. each calendar month starting at policy inception, and then each consequential month, and b.ninety(90)days from the date of non-renewal or the date of cancellation if this policy is cancelled prior to policy expiration. Each monthly Policyholder's Bordereaux shall include Certificates of Insurance issued within the previous three(3) calendar months that were not previously reported to us. All references to LIQUOR LIABILITY in this endorsement only apply if a LIQUOR LIABILITY COVERAGE PART is attached to this policy. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. T1523-0111 Page 3 of 3