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<br />.. <br /> <br />. <br /> <br />.----) CEK rJFICAlE OF INSURANCE I 02/2012007 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />American Specialty Insurance & Risk Services. Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND. OR <br />142 North Main Street ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW <br />Roanoke. Indiana 46783 <br />INSURED INSURERS AFFORDING COVERAGE <br />Uniled States Amateur Boxing, Inc d/b/a USA Boxing INS. A: Philadelphia Indemnity Insurance Company <br />One Olympic Plaza INS.B: <br />Colorado Springs. CO B0909 INS.C: <br />A-2007 -105-042 <br />TKO BOXING CLUB <br />726 S CENTER STREET <br />SANTA ANA. CA 92702 <br /> CERT NUMBER: 1000495359 <br />i. <br /> <br />COVERAGES <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY PERIOD <br />INDICATED, NOT WITHSTANDING 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 CONDITION OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INS POLICY POLICY POLICY <br /> LTR TYPE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS <br /> General Aooreoate 5.000,000 <br /> GL PHPK193755 10/01/2006 10101/2007 Producls-ComDleted Ollerallons Aooreoale 1.000.000 <br /> A Personal and AdvArtb'll'1l'I IniuN 1,000.000 <br /> 12:01 a m 12:01 am Damene to PrAmlses Renled 10 You IAnv One Premisesl 100.000 <br /> 1.000.000 <br /> Medical EXDense LlmillAnv One Person I Excluded <br /> _...1 <br /> - 'l-'V'" .---",. <br /> ..a ,,"" ~ ~. <br /> ._n r.. L.-"I/f Y"'-' ___ <br /> ~,?'fJ 0"- L~___ "- <br /> './ ~ ~Il , /7 \ <br /> L..J ~ "c:.."'{\,.; _....tIt. v..-/ J <br /> ~ tio._,..., f).'\"\....1' /7 / <br /> ......1\'1. v -, I <br /> ",'- , <br /> "- <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDDRSEMENTlSPECIAL PROVISIONS <br />- Coverage Is excluded for any martial arts. kick-boxing. or olher activities not specifically approved in advance by USA Boxing, regardless of whether or nOlthey are part of a USA Bolllng <br /> sanclloned aclivily or club activlly <br />- The CerUficaleholder Is only an Addillonallnsured with resped 10 lIabUily caused by the negligent BCts or omissions o! the Named Insured, and only wllh respecllo supervised club <br /> approved praclk:es end training o! USA Boxing member athletes for USA Boxing sanctioned events <br />- The Insurance coverage provlded under this polley Is primary <br />- Coverage i$ elfeclive October 03. 2006 through Seplemb81 30 2007 <br /> <br />CERllFICA TE HOLDER <br /> <br />CANCELLA liON <br /> <br />THE CITY OF SANTA ANA. ITS OFFICERS. EMPLOYEES. AGENTS AND REPRESENTATIVES SHOULD ANY OF THE ABOVE DESCRIBED <br />20 CIVIC CENTER PLAZA POLICIES BE CANCELED BEFORE THE <br />SANTA ANA, CA 92701 EXPIRATION DATE THEREOF, THE ISSUING <br /> COMPANY WILL MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTtFICATE HOLDER <br /> AU~ZED REPRESENTATIVE <br /> '~Q.~ <br /> <br />American Specially Insurance & Risk Services. Inc also conducts business as A SIR S I Insurance Agency In the stale of California <br /> <br />