ST. ROSE PHILIPPINE DUCHESNE CATHOLIC PARISH REDACTED.PDF

MERCHANT1
BONDING COMPANY
2100 FLEUR DRIVE • DES MOINES, IOWA 50321-1158
(515) 243-8171 • (515) 243-3854 FAX
FIREWORKS DISPLAY BOND
Bond No, AZ 411797
KNOW ALL PERSONS BY THESE PRESENTS, that we
EPA, LTD. dba FIREWORKS PRODUCTIONS OF ARIZONA
as Principal, and MERCHANTS BONDING COMPANY (MUTUAL) , a corporation
organized under the laws of the State of Iowa, with its home office in the
City of Des Moines, Iowa, and duly authorized and licensed to do business in
the State of Arizona, as Surety, are firmly bound unto MARICOPA COUNTY
State of Arizona
in the sum of One Thousand Dollars DOLLARS ($$1,000.00
lawful money of the United States, to the payment of which sum, well and
truly to be made, the Principal and Surety bind themselves, their and each
of their heirs, executors, administrators, successors and assigns, jointly
and severally, firmly by these presents.
WA, LTD, Llba FIREWORKS PRODUCTIONS
WHEREAS the above bounden Principal OF ARIZONA
desires to have a permit for Fireworks Display and in order to have such
display it is necessary for said EPA, LTD. dba FIREWORKS PRODUCTIONS OF
ARIZONA
to execute a surety bond in the amount of One Thousand Dollars
Dollars ($ SI,000.00 conditioned for the payment of all damages which may
be caused to persons or property by reason of the permitted display as
provided in Chapter 46, Arizona Legislative Session Laws of 1941.
FPA, LTD. dba FIREWORKS PRODUCTIONS OF
NOW, THEREFORE, if the said ARIZONA
well and truly observe, carry out, perform and comply with all requirements,
terms and provisions of the Ordinances of the Board of Supervisors of
MARICOPA County, State of Arizona,
conditioned for the payment of all damages which may be caused to persons or
property by reason of the permitted display as provided in Chapter 4 6 ,
Arizona Legislative Session Laws of 1941, for a period from 12:01 A.M.
August 23, 2015 to 12:01 A.M. August 23, 2016 then this
obligation to be void, and of no effect.
SIGNED, sealed and dated this 151 day of J u ne 2015
FPA, LTD. dba FIREWORKS PRODUCTIONS OF
ARIZONA
Principal
By
LP 0265 AZ (12/99)

FIREWORKS DISPLAY SITE MAP
Indicate the following:
1. North direction 5. Fire department access
2. Distance from firing area to impact/fallout area 6. Hydrants
3. Spectator location 7. Distance to structures
4. Storage area 8. Overhead lines
(North)

ACC0R0 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY)
8/31/2015
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 policy(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 NAME:
Britton Gallagher INC PHONE No Ex0:216-658-7100 FAX (A/C. No216-658-7101
One Cleveland Center, Floor 30 E-MAIL
1375 East 9th Street ADDRESS:
Cleveland OH 44114 INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A :Everest National Insurance Company le 20
INSURED INSURER B :Maxum Indemnity Company A' • •
FPA, Ltd. INSURER c :Everest Indemnity Insurance Co. 10851
17034 S 54th St INSURER D :Travelers Property Casualty Co. of
Chandler AZ 85226
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1756652543 REVISION 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. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH 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 TYPE OF INSURANCE ADDL INSR SUER INVD POLICY NUMBER (MMIDD/YYYY) POLICY EFF (MM/DD/YYYY) POLICY EXP LIMITS
C GENERAL LIABILITY Y Y SI8ML00014-151 10/9/2015 10/9/2016 EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $500,000
CLAIMS-MADE X OCCUR MED EXP (Any one person)
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
POLICY X 78 LOC $
A AU OMOBILE LIABILITY Y Y SI8CA00008-151 10/9/2015 10/9/2016 COMBINED (Ea accident) SINGLE LIMIT $1,000,000
X ANY AUTO BODILY INJURY (Per person) $
AUTOS ALL OWNED AUTOS SCHEDULED BODILY INJURY (Per accident) $
X HIRED AUTOS AUTOS NON-OWNED PROPERTY (Per accident) DAMAGE $
$
B UMBRELLA LIAB X OCCUR Y Y EXC6017189-04 10/9/2015 10/9/2016 EACH OCCURRENCE $9,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE $9,000,000
DED RETENTION $ $
D WORKERS COMPENSATION y 6JUB-2E48371 -0-14 (AZ) 10/9/2015 10/9/2016 X TORY WC STATU- LIMITS OTH- ER
AND EMPLOYERS' LIABILITY Y / N
ANY OFFICER/MEMBER PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? N IA E.L. EACH ACCIDENT $500,000
(Mandatory in NH) EL. DISEASE - EA EMPLOYEE $500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT $500,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Date of Display: October 17, 2015
Location of Display: St. Rose Parish
Additional Insured(s): State of Arizona; Maricopa County; Daisy Mountain Fire District; St. Rose Philippine Duchesne.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
St. Rose Philippine Duchesne ACCORDANCE WITH THE POLICY PROVISIONS.
2825 W. Rose Canyon Circle
Anthem AZ 85086 AUTHORIZED REPRESENTATIVE
4,112,47
© 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD

Parish
Rose Anthem
St. info@fireworksaz.corn
Pressurized Aerial
2-A 2.5" 480-948-0090
Class Size:
2
Shell
Maximum
Arizona
of
rroductions
Map
rireworics
Site

EXHIBIT A
St. Rose Philippine Duchesne Catholic Parish
Saturday, October 17, 2015
10 minute display
Total Aerial Effects 650
Total Shells 250 Total Effects in Basins 400
Opening:
The celebration of this special evening begins with a beautiful burst of fiery color.
10 — 2.5" Chinese Fancy Color Shells
Aerial Display:
A gorgeous assortment of brilliantly-colored shells, including Chrysanthemums,
Waves, Crowns, Peonies, Strobes, Diadems, and Crossettes in gorgeous Reds,
Yellows, Blues, Greens, Silvers, and Golds.
Your Aerial Display will contain a total of 200 aerial shells and 400 basin effects.
1 1/2" - 4 FPA Premier Specialty Basin
2.5" - 200 Chinese Fancy's & Specials
GRANDE FINALE:
Your celebration will close in spectacular excitement as multiple styles of brilliantly-
colored shells, rocket skyward growing and glowing in breath-taking Blues, Golds,
Greens, Silvers, Yellows, Purples and Red.
Your Grande Finale consists of 40 aerial shells:
Your Grande Finale: 40 — 2.5" shells
f:)esned for5t. Kose finlippine DucAesne CatJ4 olIc fan:517
by: rircworks froductions of Arizona


Daisy Mountain Fire Prevention
Mrs. Harris,
Thank you for the notification that Fireworks Productions of Arizona will be
conducting the firework display for the St. Rose Philippine Duchesne Parish
event in Anthem on October 17th, 2015. As in the past, once you have the
required County permits, you can apply to the Daisy Mountain Fire District
for a site permit, inspection and stand-by units. This site has been approved
in the previous years and we look forward to working with you again.
Please let us know if you need any further information or if there will be a
major change to the site from last year.
Dave Nielsen
Fire Prevention Division Chief
Fire.Marshal@dmfd.org

rireworks rroductions of Arizona
September 1, 2015
Clerk of the Board of Supervisors
Maricopa County
301 W. Jefferson
Phoenix, AZ. 85003
To Whom It May Concern:
Attached is the permit application for St. Rose Philippine Duchesne Catholic
Parish Fireworks scheduled for October 17, 2015. I have also included a copy
of the letter from Dave Nielsen of Daisy Mountain Fire Department since they
will be the responding Fire Department.
Once the permit has been approved with Maricopa County Board of
Supervisors please send me a copy either by mail or email to the following
address:
Fireworks Productions of Arizona
Attn: Sarah Harris
17034 S. 54th Street
Chandler, AZ. 85226
sarah@fireworksaz.com
If you have any questions or need any additional information please do not
hesitate to contact my office. Thank you very much!
Pyrotechnically Yours,
Sarah Harris
Pyro Office Manager
Pyrotechnician
SEP 4)4;5.
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
(A-LVA/e-x voittO
17034 S. 54th Street • Chandler, Arizona 85226 • office (480) 948-0090 • fax (480) 423-5430 • toll free 1-877-948-0090
e-mail: info@fireworksaz.com • web: www.fireworksaz.com