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ACL CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 12/23/2024 <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 BELOW, <br /> THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE <br /> 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. If <br /> SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT NAME: MM—Zumba Instructor <br /> K&K Insurance Group,Inc. PHONE 1-800-506-4856 FAX 1-260-459-5502 <br /> (A/C,1712 Magnavox Way E-MAILo,Ext): (A/C,No): <br /> Fort Wayne Indiana 46804 ADDRESS: info@fitnessinsurance-kk.com <br /> PRODUCER <br /> CUSTOMER ID: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Markel Insurance Company 38970 <br /> Maria Madrigal INSURER B: <br /> 2613 W Hall Ave <br /> Santa Ana,CA 92704 INSURER C: <br /> A Member of the Sports,Leisure&Entertainment RPG INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: W02889947 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br /> NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br /> ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF <br /> SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADOL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD (MM/DD/YYYY) (MM/DDfYYYY) <br /> A X COMMERCIAL GENERAL LIABILITY X MlRPG0000000500800 01/01/2025 01/01/2026 EACH OCCURRENCE $1,000,000 <br /> CLAIMS- OCCUR 12:01 AM EDT 12:01 AM DAMAGE TO RENTED <br /> MADE PREMISES(Ea Occurrence) $1,000,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $5 000 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG $1,000,000 <br /> R POLICY PRO-JECT LOC PROFESSIONAL LIABILITY <br /> Li El $1,000,000 <br /> BODILY INJUY <br /> OTHER: PARTICIPANTS TO $1,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) <br /> —OWNED AUTOS SCHEDULED <br /> _ONLY _AUTOS BODILY INJURY(Per accident) <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY _AUTOS ONLY (Per accident) <br /> NOT PROVIDED WHILE IN HAWAII <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE <br /> DED n RETENTION <br /> WORKERS COMPENSATION AND N/A PER OTHER <br /> EMPLOYERS'LIABILITY _STATUTEU <br /> ANY PROPRIETORJPARTNERJ Y/N E.L.EACH ACCIDENT <br /> f <br /> EXECUTIVE OFFICER/MEMBER I I <br /> EXCLUDED?(Mandatory in NH) E.L.DISEASE—FA EMPLOYEE <br /> If yes,describe under DESCRIPTION <br /> OF OPERATIONS below E.L.DISEASE—POLICY LIMIT <br /> MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL <br /> EXCESS MEDICAL <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Certified Instructor of:ZUMBA® <br /> Sexual Abuse or Sexual Molestation Liability-$100,000 each occurrence(included above)/$300,000 aggregate(included above) <br /> 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. <br /> CERTIFICATE HOLDER / '.. CANCELLATION <br /> •City of Santa ana '" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attention:Parks,Recreation&Community Services,20 Civic Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Plaza M-23 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Santa Ana,CA 92702 AUTHORIZED REPRESENTATIVE <br /> (Owner/Lessor of Premises) j <br /> Coverage is only extended to U.S.events and activities. <br /> **NOTICE TO TEXAS INSUREDS:The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />