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BACKDAN-01 MARTIN AFRO CERTIFICATE OF LIABILITY INSURANCE DATE /2/2/2/2 D/YYYYi 4025 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(ies)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 endorsement(s). PRODUCER CONTACT NAME: Maury,Donnelly&Parr,Inc. PHONE Fax 24 Commerce St. (A/C,No,Ext):(410)685-4625 LAIC,No):(410)685-3071 Baltimore,MD 21202 ADDAIL RESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Great American Assurance Company 26344 INSURED INSURER B: Backhaus Dance INSURER C: PO Box 5890 INSURER D: Orange,CA 92863 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUB R POLICY NUMBER POLICY EFF POLICY EXP INSO DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR X X GLP3961460 6/3/2024 613/2025 DAMAGE PREMISES(Ea ante $ 100,000 MED EXP(Any oneperson) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 X POLICY jECT El LOC PRODUCTS-COMPIOP AGG S 2,000,000 OTHER:General Aggregate S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED _ AUTOS ONLY r AUTOS BODILY INJURY Per accident $ HIRED NON-AWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER O YIN TH- AND EMPLOYERS'LIABILITY STATUTE I ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S A iAbuse&Molestation X X GLP3961460 6/3/2024 6/3/2025 Each Abuse 1,000,000 A Abuse&Molestation X X IGLP3961460 6/312024 613/2025 Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Santa Ana,its officers,employees,and volunteers are additional insured. Coverage is primary and non-contributory. 30 day prior written notice of cancellation is in favor of The City of Santa Ana. olyltallysign d TU Tran by To Tr Nguyen APPROVED Nguyen 1a:22ss?o7 os By Tu Tran Nguyen at 2:20 pm,Apr 08,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Attention:Tram Le,Community Development Agency, Arts&Culture 20 Civic Center Plaza,M-25 AUTHORIZED REPRESENTATIVE Santa Ana,CA 92701 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD