PROOF OF INSURANCE (2026)SPECIALTY CERTIFICATE OF LIABILITY INSURANCE
DATE
(MM/DD/YYYY)
09/25/2025
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION I
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
Specialty Insurance Agency
Contact Name: Heather Weiss Zenzen
Performers of the U.S.
Phone: 715-246-8908 FAX: 715-246-8908
3432 Denmark Ave #231
Email: info@specialtyinsuranceagency.com
Eagan, MN 55123
INSURERS AFFORDING COVERAGE
NAIC #
INSUREO PERFORMERSOFTHE U.S.AND ITS PARTICIPATING MEMBERS:
I INSURER A: Evanston Insurance Company
35378
Lisa A. Stanley
INSURER B:
dba The Voices of Christmas, The Wonderelles, Make Mine
Acoustic, WE-VOC Entertainment
INSURER C:
5033 Denny Avenue
INsuRER o:
North Hollywood, CA 91601
THE POLICIES OF INSURANCE LUSTED 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. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TYPE OF INSURANCE
ADDL
sues
'7. POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
INSD
wv.
DATE (MM/DD/YY)
DATE (MM/DD/YY)
X OMMERCIAL GENERAL
EACH OCCURRENCE
$ 3 000,000
LI-JIL(ABILITY
DAMAGE TO RENTED
CLAIMS MADE�CCUR
PREMISES (Ea occurrence)
$ 300,000
MED EXP (Any one person)
....3
$ 5,000
A
GEN'L AGGREGATE LIMIT
X
X
2CN0184-7294
11/22/2025
11/22/202612:01am
PERSONAL & ADV INJURY
$3,000,000
APPLIES PER:
GENERAL AGGREGATE
$ S,000,OOO
iX POLICY ❑PROJECT
PRODUCTS - COMP/OP
Loc
AGG
$ 5,000,000
PERFORMER ASSISTANT(S)
EACH OCCURRENCE
$
A
AGGREGATE
$
A
BUSINESS PERSONAL
AGGREGATE
$
PROPERTY -INLAND MARINE
SEXUAL ABUSE AND
EACH OCCURRENCE
$
'.. A
MOLESTATION
$
OCCUR
AGGREGATE
A
''.. DATA BREACH AND CYBER
''..
AGGREGATE
$
LIABILITY COVERAGE
A
EQUIPMENT LEASED OR
AGGREGATE
$
RENTED
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
PERFORMER IS A NAMED INSURED AS A MEMBER OF PERFORMERS OF THE U.S.:
Lisa A. Stanley dba The Voices of Christmas, The Wonderelles, Make Mine Acoustic, WE-VOC Entertainment
Insured for: Emcee, Band Leader, Dancer, DJ, Musician, Singer
CERTIFICATE HOLDER 'CANCELLATION
Lisa A. Stanley
dba The Voices of Christmas, The Wonderelles, Make Mine Acoustic,
WE-VOC Entertainment
5033 Denny Avenue
North Hollywood, CA 91601
BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING
COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE A A I . 1
CITY OF EL SEGUNDO
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000),
IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES.
I affirm under penalty of perjury under the laws of California one of the following declarations:
(_) I have and will maintain a certificate of consent of self -insure for workers' compensation, issued by the Director
of Industrial Relations as provided for by Labor Code § 3700 for the performance of the work set forth the agreement
with the City of El Segundo.
Policy No.
(_) I have and will maintain workers' compensation insurance as required by Labor Code § 3700 for the performance
of the work for which the agreement with the City of El Segundo is executed. My workers' compensation insurance
carrier and policy number are:
Carrier
Policy Number Expiration Date
Name of Agent Phone #
(2L) I certify that, in the performance of the work set forth in the agreement with the City of El Segundo, I will not
employ any person in any manner so as to become subject to the workers' compensation laws of California, and
agree that, if I should become subject to the workers' compensation provisions of Labor Code § 3700 1 must
immediately comply with those provisions or the agreement will automatically become void.
11 /17/25
Signature of Applicant
�� � Date
Print Name Lisa Stanley
Agreement for:
Dated:
Reviewed by: