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A Ram CERTIFICATE OF LIABILITY INSURANCE °Aoli1a2025 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(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 rights to the certificate holder In lieu of such ends rsement(s), PRODUCER Bane -Mar: Athletic Insurance Agenny A0E67789 6301 Southwest Boulevard, Suite 101 Fort Worth, Texas 76132 CONTA NAME: PHONE _ 800) 247-1734 FAX �. EEWAIL conlactQbene-marc,com INSURERSAPFOROINGCOVERAGE NAICA INSURERA: HDI Global Specialty BE M-11M022 INSURED Southern California Municipal Athletic Federation (SCMAF) INSURERS: AXIS Global Accident & Health Insurance Cam any 37273 PO Box 3005 INSURERC: INSURERD: South El Monte, CA 91733 INSURERE: SCMAF Member Hortencia Garcia -Latin Zumba and Aerobics -INSURERF: Xtf.ttlif Lont V W JiW:I 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. IL TYPE OF INSURANCE A DDL SUER PDUCYNUMBER POLICY M MNIORY�T r ' LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 18LB7323 01I01f2025 01/0112026 EACH OCCURRENCE $ 1,000,OOD.00 PR I 3 Reaunence $ 100,000.00 MEDEXP Anyone arson) $ 5,000.00 PERSONAL&ADVINJURY $ 1,000,OODAO A X X GENL AGGREGATE LIMIT APPLIES PER: POLICY JEOT LOG GENERALAGGREGATE $ 5,000,000.00 PRODUCTS-COMPIOP AGO $ 1,000,000.00 Participant Liability s 1,000,000.00 OTHER: AUTOMOBXELIAMLITY OaEddaMSl G E MITIE, S ANY AUTO BODILY INJURY (Per parson) $ OVdJED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY U (Par accident) $ PROPE DAMAGE Per acddem $ UMBRELLA LIAB HOCCUR EACHOCCURRENCE S AGGREGATE $ EXCESS LIAB CU\IMS-MADE DED I I RETENTION$ $ WORNERSCOMPENSATION AND EMPLOYERS` LIABILITY YIN ANYPROPRIETOR,PARTNERIEXECUTIVE OFFICERIMEMSEREXClUDEOY El NIA PER 0 —MUTE ER E.L. EACH ACCIDENT $ E.L.OISEASE-EAEMPLOYEE $ (Mandatory M NH) If ESCdeacnbunder D DESCRIPTIONN OF OPERATIONS below E.L. DISEASE -POLICY UNIT $ B Participant Accident Medical SRPO50256.243 O7f07l2025 01101/2026 Deductible: $0.00 Limit: $5,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD I Oi, Additional Remarka Sche W%may be atbvbed If more apace Ie requhed) This policy Includes a blanket additional Insured endorsement that provides additional Insured status to the certificate holder per form CG 20 1101 90. The General UabiMY policy rnnlelns an endorsemenl for Waiver of Transfer or Rights of Recovery Against Others to Us par attached form GO 2404 05 09. Coverage for SCMAF member approved activities for which a premium is paid and reported to the Company. SCMAF Member: Hortencla Garcia - Latin Zumba and Aerobics APPROVED Coverage Is limited to the following activity dates: 01101/25-12/31/25 By To Tran Nguyen at 12.20 pm, Jan 30, 2025 City of Santa Ana Risk Management 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. All SO Lynn HallacN1M1VC `�I'��N V1N�lYIV h1QJlX! 988-2015 ACORD CORPORATION. All Marts reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Tu Tran Digitally Sig ed byTu Tran Nguyen Nguyen .:2025XLin,2-21:15