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Angie Digitally signed by <br />Angie Acevedo <br />ACLaMEW <br />DatP.TMPt17.29CERTIFICATEQSU �[��'ff2 <br />2m"�-07'00' 2 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION iS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT Rhonda Crook <br />_ _NAME: <br />fer L. Green & Associates, Inc. ry PHONE FAX <br />3100 Five Forks Trickum Road -"MC No•�c� ____� ____ _ __._. _L�e.NO <br />Suite 101 nii%ss;_ __ __ ... <br />Lisburn, GA 3D04T INSURERS) AFFORDING COVERAGE — - <br />INSURER Vantapro Specialty Insurance Company <br />INSURED INSURER B : U.S. Fire Insurance Co. <br />TumblG-"ids, Inc. <br />16802 Lucia Lane <br />Huntington Beach, CA 92647 <br />...-- <br />rnVI=12Ar.,PA, r'1=DTIFIr A rr- N1IMRFA• or-11 CIf1AI kitI11ARG17- <br />NAIC-_#__ .. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS_ OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR 'TYPE OF INSURANCE ADDL-SUBR-T- POLICY NUMBER - POLICY EFF POLICY EXP LIMITS <br />A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE i $ <br />1,000,000 <br />CLAIMS -MADE X OCCUR '5077-0737.00 412612022 412612023 DAMAGE TO RENTED <br />X PREMISES.IEa i <br />3D0,000 <br />_..._ .. ,....._ I . occurrence)_ : <br />X ABUSEIMOLESTATION i <br />5,000 <br />[ MEN EXP �nanee�son}.�..i_$ _— <br />_— --T -- <br />)( $1 M OCC!$2M AGG <br />1,000,000 <br />PERSONALBAbVINJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: j GENERAL AGGREGATE $ <br />3,DOO,000 <br />X POLICY P O LOC <br />J�GT � '� ! _PRODUC_TS=COMPIOP AGG � $ — <br />1,000 OQO <br />, <br />OTHER: iPARTICIPANTS $ <br />1,000,000 <br />AUTOMOBILE LIABILITY <br />,COMBINED SINGLE LIMIT <br />ANY AUTO <br />BODILY INJUi2Y (Per peraon) j $ <br />- .. .._.. <br />.. _... <br />OWNED `-- SCHEDULED <br />-. ( <br />AUTOS ONLY AUTOS <br />)j _BODILY INJURY_jPer <br />- HIRED NON��yyy�NED <br />AUTOS ONLY —j AU70SONLY <br />PROPERTY DAMAGE I <br />UMBRELLA LIAB ,OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB CLAIMS-MADEAGGREGATE <br />$ <br />1)E1) E.1 RETENTION S <br />WORKERS COMPENSATION <br />AND EMPLOYE LIABILITY <br />PER <br />STATUTE i ERH <br />YIN <br />gR�S'' <br />AFFICERIM IEMTORIEXCLUD I XECUTIVE I <br />NIA <br />E.L. EACH ACCIDENT $ <br />(Mandatary In NM) ---- <br />E.L. DISEASE - EA EMPLOYEE <br />Ifes describe under <br />DESCRIPTION OF OPERATIONS beloww <br />E.L. DISEASE - POLICY LIMIT $ <br />B <br />PARTICIPANT ACCIDENT <br />US1516477-01 4126/2022 4/2612023 (EXCESS COVERAGE <br />25,000 <br />B <br />Deductible $100 <br />US1516477-01 4126/2022 4/26/2023 ',AD&D <br />10,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if morespace is regaired) <br />Coverage Is provided under this policy for sponsored and supervised activities of the named insured for which a premium has been paid. <br />Youth Recreational Gymnastics - Mobile Program <br />The Certificate Holder is an additional insured with respect to the operations of the named insured <br />City of Santa Ana, Risk Management, It's officers, employees, agents, representatives, and volunteers are covered as additional inured. <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation. <br />Coverage is Primary and Non -Contributory. <br />City of Santa Ana <br />Risk Management Divisions <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016103) @ 1988-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />o� M Risk ManagmadDMsian <br />E <br />o N Q` REVIEWED & APPROVED BY: <br />Aeevaa <br />'�--'Risk Management Specialist <br />