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CERTIFICATE OF INSURANCE 10/1//2007 PRODUCER Specialty Insurance &Risk Services, Inc. c American Specialty A-2008-069-68 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND, OR 142 North Main Street ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW. Roanoke, Indiana 46783 LIMITS INSURED INSURERS AFFORDING COVERAGE INS. A: Philadelphia Indemnity Insurance Company United States Amateur Boxing, Inc. d/b/a USA Boxing One Olympic Plaza INS. B: Colorado Springs, CO 80909 INS. C: Each Occurrence 1,000,000 TKO BOXING CLUB Medical Expense Limit (Any One Person xciude 726 S CENTER STREET SANTA ANA, CA 92702 CERT NUMBER: 1000561844 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING 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 CONDITION OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR POLICY TYPE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ,4 GL PHPK264485 10/01/2007 12:01 a.m. 10/01/2008 12:01 a.m. General Aggregate 5,000,000 Products -Com feted Operations Aggregate 1,000,000 Personal and AdvertisingIn u 1,000,000 Each Occurrence 1,000,000 aae to Premises d to YouOne Premie 100,000 Medical Expense Limit (Any One Person xciude DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Coverage is excluded for any martial arts, kick -boxing, or other activities not specifically approved in advance by USA Boxing, regardless of whether or not they are part of a USA Boxing sanctioned activity or club activity. The insurance coverage provided under this policy is primary. ' Coverage is effective October 02, 2007. ' The General Liability policy contains a Self Insured Retention of $100000. ' The Certificateholder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Form PI -AM -002- Additional Insured - Certificateholders, and only with respect to supervised club approved practices and training of USA Boxing member athletes for USA Boxing sanctioned events. CERTIFICATE HOLDER CANCELLATION THE CITY OF SANTA ANA, ITS OFFICERS, 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 Specialty Insurance & Risk Services. Inc REPRESENTATIVES >6��E-a - /',/3 7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER. conducts business as A_S I R I Incurnn An— in rho Onfo mf r-lif—ice