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Digitally signed by Ton Pierson Tori Pierson Date: 2022.03.0110s3s8 -0R00' I UM81NC-U1 RCRQOK DATE21312 D/rvrr) /3/2022 ,a►��ro CERTIFICATE OF LIABILITY INSURANCE 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 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 endorsements . PRODUCER coNTtCT Rhonda Crook Terry L. Green & Associates, Inc. 310g Five Forks Trickum Road Suite 101 PHONE FAX (AIC, No, Eat: jAdC, No): E-MAIL oD s Lilburn, GA 30047 INSURERS AFFORDING COVERAGE NAIC a INSURER A: Vanta ro Specialty Insurance Company 44768 INSURED INSURER B : U.S. Fire Insurance Co. INSURERC: Tumble-N-Kids, Inc. INSURER D : 16802 Lucia Lane Huntington Beach, CA 92647 INSURER E INSURER F : COVERAGES CERTIFICATE NUMRFR- REVLCInM 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 CONTRACTOR 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FA]OCCURX X 5075-6329-00 4/26/2021 4/2612022 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 300,000 X MEone person) 5,000 ABUSE/MOLESTATION X$1 OCC/$2M AGG R ONAL& PERM &AOV INJURY 11000,000 GEN-L AGGREGATE LIMIT APPLIES PER: X POLICY PELT LOC GENERAL AGGREGATE 3,000,000 PRODUCTS-COMPIOPAGG 1,000,000 PARTICIPANTS Included OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT BODILY INJURY Per erson ANYAUTO OWNED SCHEDULED AUTOS ONLY AUU�T��OpSSyyyy BODILY INJURY Per accident ROPERTY AMAGE Peraccitlent p AUTOS ONLY AUrO50NtV UMBRELLA LIAR OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YINTUTE Y PROPRIETORIPARTNEWEXECUTIVE ❑ ANR1 an5EMEn EXCLUDED? BER NIA PER OTH- ER E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYE 3,aY i e under Ryes, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMB B PARTICIPANT ACCIDENT US1393094-00 4/2612021 4/2622022 EXCESS COVERAGE 25,000 B Deductible $100 US1393094-00 412612021 4/2612022 AD&D 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more s aco is re dined) Coverage is provided under this policy for sponsored and supervised activities of the named insured or which a premium has been paid. Youth Recreational Gymnastics - Mobile Program The Certificate Holder is an additional insured with respect to the operations of the named Insured City of Santa Ana, Risk Management, It's officers, employees, agents, representatives, and volunteers are covered as additional inured. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation. Coverage Is Primary and Non -Contributory. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVi...... RbkMvagoamaDMdm AUTTTTHORIZED/REPRESENTATIVE 8 4 RLb1eeFD&Appfov®Br _ V Ruk ManagermittlniralNtle '. ACUKU zs (zU1 D/U3) 911988-2015 ACORD C( v `u The ACORD name and logo are registered marks of ACORD