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SOCC-91 OP 10: XJ '4i- R CERTIFICATE OF LIABILITY INSURANCE D10/2912018ATE Y) 10/29/2018 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 RPS Bollinger $ orts & Leisure PO Box 390 p Short Hills, NJ 07078 AJ Morgan CONTACT NAME: PHONE F C Nu IAIC, No. Exit EMAIL -- ADDREBE: INSURER $ AFFORDING COVERAGE NAIC N INSURER A: `Minkel insurance Company 38970 INSURED Beginners Edge Sports Training 29634 North 126th Avenue INSURER s: INSURER C : Peoria, AZ 85383 INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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. 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILSR TYPE OF INSURANCE AODL POLICY NUMBER MOLICY EFF MM DAY EXP LIMITS A X COMMERCIAL GENERAL �LIABILITY GLAIMS-MADE �rJ OCCUR X 3602AH025251 11/05/2018 11/05/2019 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence 100,00 X MED EXP(My one person) _$_ $ 5,00 Inel Participenta X SexualAbuse7Mol PERSONAL A ADV INJURY $ 1,000,00 A $1 MILL I $2MILL 11/05/2019 11/05/2019 AGGREGATE LIMIT APPLIES PER: POLICY [,—]PE0 LOC GENERAL AGGREGATE $ 3,000,00 G EN'L PRODUCTS - COMPIOP AGO $ 1,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED A AUTOS UTOS BODILY INJURY (Per accident) $ HIRED AUTOS N--OWNED POaEden DAMAGE $ UMBRELLA LIAB Ll OCCUR EACH OCCURRENCE AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTINEWEXECUTIVE OFFICEMMEMBER EXCLUDE04 ❑NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONSbu. E.L DISEA E 104 ICY LIMIT $ A Accidentinsurance 4102AH025250 11/05/2018 11/05/2019 �$d: 25,00 Full Excess ge e50 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required ,ram,,,.•-- Certificate holder is included as an additional insured. Coverage is provided under these policies only for sponsored/supervised activities of the named insured for which a premium has been paid. G0c�.fa R.SNgeeceatlC)� City of Santa Ana Parks, Recreation and Community Services Agency 1825 W Civic Center Dr Santa Ana, CA 92703 COSANTA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014101) R The ACORD name and logo are registered marks of ACORD riahts reserved