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Administrative Office <br />1400 American Lane <br />Schaumburg, Illinois 60196 <br />STEADFAST INSURANCE COMPANY <br />A ZURICH C0i <br />CERTIFICATE OF LIABILITY INSURANCE <br />Policy Number: EOL5281394-00 <br />Fitness and Wellness Purchasing Group Certificate Number: 0375057 <br />N NAMED <br />0375057 Choc V. Le <br />AGENT <br />Fitness and Wellness Insurance Agency <br />AND <br />rJAME AND <br />380 Stevens Avenue, #206 <br />MAILING <br />4 Fabriano <br />MAILING <br />ADDRESS <br />Solana Beach, CA 92075 <br />ADDRESS <br />Irvine, CA 92620-2576 <br />800-395-8075 - LIC#OD28716 <br />POLICY PERIOD: From: 01/06/04 To: 01/06/05 <br />THIS CERTIFICATE OF LIABILITY INSURANCE FORMS A PART OF THE POLICY REFERENCED ABOVE. <br />INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND <br />PRIVILEGES AFFORDED UNDER THE POLICY. THE INSURANCE COVERAGE PROVIDED UNDER THIS <br />CERTIFICATE IS SUBJECT TO ALL THE TERMS, CONDITIONS, AND EXCLUSIONS OF THE POLICY <br />IDENTIFIED ABOVE, <br />COVERAGES <br />LIMITS OF INSURANCE <br />Bodily Injury, Property Damage or <br />Professional Incident <br />$1 000,000 <br />Each Occurrence Limit <br />Personal and Advertising Injury Limit <br />S1 000,000 <br />Any <br />ore Person or Drgaricaton <br />General Aggregate Limit (Other than <br />$3 000,000 <br />Products/Completed Operations) <br />Products/Completed Operations <br />Aggre2ate <br />Limit <br />Coverage D Medical Expenses <br />S 2,500 <br />Any One aerson <br />Coverage E Sexual and/or Physical Abuse Liability <br />$ 100,000 <br />Ea&,, Claim Limits <br />Coverage F Employer's Liability (Only available in <br />$ 300 000 <br />Only <br />Ann a' Aggregate Laic <br />the following States ND, OH, WVA, N/A and PJY)$ <br />in State(s) <br />100,000 <br />where this Insurance applies: <br />Bodily Injury by Accident — Each Acodert <br />j <br />$ 100,000 <br />Bodily Injury by Disease— Each Employee <br />� l$ <br />500000 <br />Aggrega•eLlmit— EmployersLiability <br />__ <br />Damage tc Premises Rented to You <br />$ 100 000 <br />Any One Premise <br />The most we will pay for any ocecrrerce or related occurrerce that triggers <br />Professional Incident or <br />Bodily Irjury, P•ocerr/ Damage or <br />ary comb nation tl-ereo' is the each occui-rence lrn t. Payments made under Sexual and/or <br />Physical Abuse, Medical Expenses. Employers Liability, (where applicable), and Damages to �rerrises Parted to You <br />ceplete the general aggregate limit of liability. <br />Location of all premises you own, rent or occuoy. <br />1) Various <br />IF YOU HAVE ANY QUESTIONS CONCERNING THIS CERTIFICATE CONTACT. <br />FITNESS AND WELLNESS INSURANCE AGENCY - 800-395-3C75 <br />Jeffrey E. Frick JANUARY 27 2004 <br />Authorized Representative Date <br />Form #: Cert1 <br />'��ol nLkill: Lill :AitUn:r� <br />