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TE A CERTIFICATE OF LIABILITY INSURANCE DA08/01/2024YY) 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 CONTAC FL Dean Bjorn Rosinus NAME: _ • • • 12800 UNIVERSITY DR ST 5 (A//C,NNo, :xt is $ N FORT MYERS,FL 33907- E-MAIL ADDRES', bjefdZJ.coI7 INSURER(S)AFFORDING COVI�RAGE NAIC# le ng INSURER A a I ra p.n, RS INSURED SPORTS AND RECREATION PROVIDE AS (PURCHASING GROUP)AND INSURE 8: ITS PARTICIPATING MEMBERS: - Smashvent, LLC dba OC Laser Tag&OC Fun Evnets INSUF AC 17522 WOODFERN LN INS .ERD: ate• HUNTINGTON BEACH,C 49-483 IN • =P*6LICF144 It RERCOVERAGES F U R: 13 '' ISiON BER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAV' BEEN ISSUED TO H SCRE N ML• FOR INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COP )ITI' J OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURAN= 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE SE TO RENTED ence $300,000 CLAIMS-MADE �OCCUR PREMMED EXP(Any one person) $0 PAC 4725036 07/27/2024 07/27/2025 A X HOST LIQUOR LIABILITY INCLUDED X X 12:00AM 12:01 AM PERSONAL&ADVINJURY $1,000,000 X INCLUDES ATHLETIC PARTICIPANTS GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 RO- ( POLICY JPECT LOC A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident ANYAUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILYINJURY(Per AUTOS AUTOS accident) HIREDAUTO NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION $ A Professional Liability X X PAC 4725036 07/27/2024 07/27/2025 EACH OCCURRENCE $1,000,000 12:00 AM 12:01 AM AGGREGATE LIMIT $1,000,000 07/27/2024 07/27/2025 AD&D $5,000 A Accident/Medical Coverage BSR-E762813-02 12:00 AM 12:01 AM MAXIMUM MEDICAL $25,000 DEDUCTIBLE $100 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Covered Activities: Mobile Laser Tag, Nerf Tag,Lawn Games,Carnival Games,Water Tag,Arts/Crafts, Face Painting, Balloon Art, Photo Booth The Certificate Holder is added as an additional insured but only with respect to liability arising out of the named insured during the policy period.Waiver of Subrogation applies. Scheduled Activities Exclusion Applies-Please Refer to Named Insured Member Certificate of Coverage CERTIFICATE HOLDER CANCELLATION City of Santa Ana-Risk Management Division SHOULD ANY OF THE ABOVE DI 20 Civic Center Plaza BEFORE THE EXPIRATION DATE THE RiekManag rnentDivisinrt Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PIR a" "�F REVIEWED&APPROVED BY. AUTHORIZED REPRESENTATIVE n. ,•, Itecv4 1 Risk Management Specialist ACORD 25(2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD