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Ane Digitally signed by J Anaie Acevedo "`� u CERTIFICATE OF LIA ILITY IN l;RMQU22.m.29 DATE(MMDOYYYY) 06/30/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL O F Rc No R O 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(les) 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 rigsto the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: MM - Fitness Instructor/Personal Trainer K&K Insurance Group, Inc. 1712 Magnavox Way Fort Wayne IN 46804 aIc No Ezl : 1-800-506-4856 ac NJ: 1-260-459-5502 ADDRESS: info@fitnessinsurance-kk.com PRODUCER CUSTOMER to, INSURERS) AFFORDING COVERAGE NAIC® INSURED INSURER A: Markel Insurance Company 38970 Brittany Perez 13641 Fairview St., Unit 11 Garden Grove, CA 92843 INSURER B: INSURERQ INSURER D: A Member of the Sports, Leisure & Entertainment RPG INSURER E: NSURER F: COVERAGES CERTIFICATE NUMBER: W02237386 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMB)DNYYY) (MMODNYYYI OMITS A X COMMERCIAL GENERAL LIABILITY MADES OCCUR X Ml RPGOOOOOOD016600 07/01/2022 12:01 AM EDT 07/0112023 12:01 AM EACH OCCURRENCE $1,000,000 PREMISES Ea Occurrence $1,000,000 MED EXP(Any one person) $5,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $5,000,000 GENT AGGREGATE UMITAPPLIES PER: POLICY PRO- LOC JECT OTHER: PRODUCTS—COMP/OP AGG $1.000,000 PROFESSIONAL LIABILITY $1,000,000 PARTICIPANTS $1,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS SCHEDULED ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY NOT PROVIDED WHILE IN HAWAII Ea accident BODILY INJURY (Par person) BODILY INJURY (Par acadent) Per accident UMBRELLA LMB OCCUR EXCESS UABL_J CLAIMS -MADE DEO RETENTION EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' WIBILITY ANY PROPRIETORIPARTNERI YIN EXECUTIVE (Mandatory In ER EXCLUDED?(MandaRM In NH) N) ❑ If yes, descnbe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE OTHER E.LESCHACCIOENT EL DISEASE —EA EMPLOYEE EL DISEASE —PODGY LIMB MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached R more space Is required) Certified Instructor of. Aerobics, ZUMBA The certificate holder is added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 90022 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (Owner/Lessor of Premises) Coverage is only extended to U.S. events and activities. RhIeMmPgaltodDMdon M NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations i °`-"'°• RENEWED& APPROVED BY: a A Auvutd ACORD 26 (2076/03) 01966.2016, The ACORD name and logo are registered marks of ACORD - Risk Management Specialist