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BACKDAN-01KMARTIN DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/28/2024 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 endorsement(s). CONTACT PRODUCER NAME: PHONEFAX Maury, Donnelly & Parr, Inc. (410) 685-4625(410) 685-3071 (A/C, No, Ext):(A/C, No): 24 Commerce St. E-MAIL Baltimore, MD 21202 ADDRESS: Ejhjubmmz!tjhofe! INSURER(S) AFFORDING COVERAGENAIC # Great American Assurance Company26344 INSURER A : Bohjf! INSURED INSURER B : cz!Bohjf!Bdfwfep! INSURER C : Backhaus Dance PO Box 5890 INSURER D : Orange, CA 92863 Ebuf;!3135/17/24! INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: Bdfwfep 27;24;21!.18(11( 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR X GLP39614606/3/20246/3/2025 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 X POLICYLOC PRODUCTS - COMP/OP AGG$ JECT General Aggregate OTHER:$ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ UMBRELLA LIABOCCUR EACH OCCURRENCE$ EXCESS LIABCLAIMS-MADE AGGREGATE$ DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ General LiabilityGLP39614606/3/20246/3/2025 Each Abuse1,000,000 A X General LiabilityGLP39614606/3/20246/3/2025 Aggregate Limit2,000,000 A X DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, employees, and volunteers are additional insured. Coverage is primary and non-contributory. 30 day prior written notice of cancellation is in favor of The City of Santa Ana. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD