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ACORD_.M CERTIFICATE OF LIABILITY <br />DATE(MM'DD,YYYY) <br />INSURANCE 10/21/2008 <br />CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />vnooucER (818)229-6100 FAX: (818)224-6099 <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />C. M. Meiers Company, Inc. <br />R HE COVERAGEIAFFORDED BY TTHE POLCIES BELOW.CATE DOES NOT AMEND, EXTEND OR <br />21045 Califa St. #100Woodland <br />FHHOLDER. <br />Hills CA 91367 <br />RS AFFORDING COVERAGE NAICM <br />INSURED Sports, Leisure, and EnteItalnment RPGA: <br />Nationwide Mutual Ins. <br />dba: Jurgens, Jennifer <br />INsuaeRB. <br />Certified or Member of AFAR <br />INSURER C: <br />450 W Ist St. #5 <br />INSURER D'. <br />Tustin CA 92780 <br />INSURER E: <br />THE <br />POLICIES <br />OF INSURANCE LISTED BELOW <br />HAVE BEEN ISSUED TO THE INSURED <br />NAMED ABOVE <br />WITH RESPECT <br />FOR THE POLICY <br />TO WHICH THIS CERTIFICATE <br />PERIOD INDICATED. NOTWITHSTANDING ANY <br />MAY BE ISSUED OR MAY PERTAIN, <br />REQUIREMENT, <br />TERM OR CONDITION OF ANY <br />CONTRACT OR OTHER DOCUMENT <br />HEREIN IS SUBJECT <br />TO ALL THE <br />TERMS, EXCLUSIONS <br />AND CONDITIONS OF SUCH POLICIES. <br />THE <br />INSURANCE <br />AFFORDED BY THE POLICIES <br />DESCRIBED <br />A <br />R <br />MIT H N M H <br />I <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />INSR <br />ADD'L <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MMIODIYV <br />DATE MMIDDIYY <br />2,000,000 <br />GENERAL LIABILITY <br />EA HO RREN E $ <br />DAMAGE TO RENTED $ 300,000 <br />PR r <br />X COMMERCIAL GENERAL LIABILITY <br />� <br />RPG41925 <br />10/21/2008 <br />10/21/2009 <br />MED EXP An one arson S 5,000 <br />P NA ADV IN RY $ 2,000,000 <br />A <br />X <br />CLAIMS MADE OCCUR <br />X Professional Liab. <br />2,000,000 <br />GENERALA GREGATE $ <br />P D T -COMP/ PA $ 2,000,000 <br />GFN'I ,'RELATE LIMIT APPLIES PER: <br />X POLICY PRO LOU <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $ <br />Ftiaccident) <br />ANY AUTO <br />ALL OWNED AUTOS <br />BODILY INJURY $ <br />(Par Person) <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />BODILY INJURY S <br />(Per accident) <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHERTHAN AA <br />AUTO ONLY'. AGG $ <br />EXCESS/UMBRELLA LIABILITY <br />' <br />_T �,'�Tl <br />S <br />OCCUR CLAIMS MADE <br />L M <br />AGGREGATE S <br />S <br />8 <br />DEDUCTIBLE <br />T ENTION 8WC <br />D4i@dE,�lf��A`MrMI(� <br />� CIO <br />nay <br />STATU- OTH- <br />E.L. EACH ACCIDENT $ <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNEPoEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYEE $ <br />E.L. DISEASE -POLICY LIMIT Is <br />It yes, describe under <br />A <br />SPECIAL PROVISIONS below <br />OTHER Legal liability <br />RPG41925 <br />10/21/2008 <br />10/21/2009 <br />$2,000,000 per Occurrence <br />to participants <br />DESCRIPTION OF OPERATIONS/LOCATIONSA'EHICLE&EXCLUSIONS ADDED BY ENDORSEMENRSPECIAL PROVISIONS <br />Premium and fees are fully earned at inception. Group Trainer.The City of Santa Ana, its of£iciers, employees, agents, <br />volunteers are named as additional insureds with regard to liability and defense of suits arising from the <br />and <br />operations and uses performed by or on behalf of the named insured. <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />ACORD 25 (2001108) <br />INS025 (0+05).08 - <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL Yl%6KXAXXX MAAI�Le <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, WIVE <br />THORIZED REPRESENTATIVE <br />Rothman/KIHJON _A":z" <br />CORPORATION 1988 <br />Page 1 of 2 <br />