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TUMBINC-01 RCROOK
<br />AcaRO CERTIFICATE OF LIABILITY INSURANCE DAT3/181202E(M 2(12YYYI
<br />4
<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 pollcy(les) 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(a).
<br />PRODUCER cT Rhonda Crook
<br />_PHONE - - ---. ------ -
<br />Tarty L. Green 8 Associates, Inc. wco, Es : . FAX No
<br />3100 Five Forks Trickum Road _ .....
<br />1.11burn, GA 30047
<br />INSUREflSJAFFGROIND9OVSR8AE__ - _„-___
<br />_ NAICA..
<br />ANsuRERA.StatgNatlonallnsufance_Com�Tany____
<br />12831 _,_
<br />INSURED mSURER B: Sirius PDlnt
<br />39776
<br />Tumble-N-Kids, Inc. ,IRSURERC
<br />16802 Lucia Lane';.IR$gR.EB_q.:_-___
<br />Huntington Beach, CA 92647 ----------- --------''------'--"------
<br />i.IN$U,REREJ_.._.
<br />INSURER F:
<br />rnUeoar_ee 1eo1uc.1. re Msuanco.
<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 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 />INSRI----�
<br />TYPE OF INSURANCEAODLI8U9Nh--------POLICY
<br />INSOI
<br />_
<br />POLICY NUMBER EFF: POIJGY EXP ^--OMITS --_—__----
<br />A
<br />X . COMMERCML GENERAL LIABILITY
<br />EACH OCCURRENCE 1,000,000
<br />_
<br />CLAIMSWADE X OCCUR X Ix
<br />LOVE-0000011-02#PH-121116 i412612024 4126)2025 DARMLAGBEES OEREaNcTg 300,000
<br />X 1 Abuse/Molestation
<br />I 5,000
<br />$1M OCC1$2M AGG
<br />. MEGEXPIPnYPr,P Person] _. _._
<br />- - 1;OOU,000
<br />PERGCNAL,,L_AL INJURY S —__
<br />GENL AGGREGATE LIMIT APPLIES PER
<br />C_ENERALAG RELATE g 3,000,000
<br />x POLICY PP& LOC
<br />- 1'000'000
<br />X OTHER. PROFESSIONAL$IMI$iM
<br />PRODUCTS-COMPIOP AGG;$
<br />:PARTICIPANT t,000,000
<br />AUTOMOSILELIABILITY -
<br />SINGLE LIMIT --_--_-
<br />- ANY AUTO _ _
<br />BODILY INJURY (Pe persont_
<br />OWWE) SCHEDULED
<br />Apr�G�O ONLY �AUTOS
<br />- BODILY INJURY(Pe Mxidenlj.$
<br />{nU__
<br />AUTOS ONLY AUTONL�Y
<br />U'a4a1.Eg�)AAIAGE i
<br />UMBRELLA LIr1B .J OCCUR
<br />EACH OCCURRENCE_ _.
<br />E%CESS LNB CLAIMS -MADE:
<br />- .AGGREGATE
<br />_
<br />DED I RETENTIONS
<br />S
<br />WORKERS CUMPENBATION
<br />AANNDCEMPLOeYER�S--LIAea.RY
<br />PER .OR
<br />�-
<br />YIN'.
<br />ANVPROPRE-TORIPARTNERE%ECUTIVE--
<br />EXCLUDED? NIA
<br />! ,EL. EACHACGIOENT
<br />lrnmdatoryffl,
<br />DISEASE -_EA EMPLOYEES
<br />If yyees. deacdeauMer
<br />,E.L _ _ ___..__
<br />:DESCRIPTION OF OPERATIONS hMow
<br />E L DISEASE- POIICV LIMIT
<br />B
<br />'PARTICIPANT ACCIDENT
<br />iPHSA-BAMH-1024E-24 412612024 412612025 ,EXCESS COVERAGE 25,000
<br />B
<br />IDEDUCTIBLE $500
<br />PHSA-SAMH-10248.24 4/2612024 4/2612025 iADBD 10,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schadula, may W eNechad if more s ate is required)
<br />Coverage Is provided under this policy for sponsored and supervised activities of the named Insured �or which a premium has boon 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 />Certlfcate 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 Division
<br />20 Civic Center Plaza, 41h 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 CC
<br />The ACORD name and logo are registered marks of ACORD
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<br />1,11WIMINNIf 1_
<br />®
<br />RiskMMwgorledDMslon
<br />REmEwE06 APPROVED Br.
<br />A*juAav44
<br />Risk Management Specialist
<br />
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