CAL JUMP SOUTH ORANGE COUNTY LCC

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A��I P ATE(MMIDDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 0511912025 THIS CERTIFICATE 1S 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 1NSURER(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 CONTANAME:CT Tony Cannizzaro First Commercial Insurance Agency PHONEo. (386)775-1781 FAc No P.O. Box 295 E-MAIL nsurance u com ADDRESS: i g y@cfl.rr. INSURERS AFFORDING COVERAGE NAIC N Cassadaga FL 32706 INSURER A: BEAZLEY 1 CERTAIN UNDERWRITERS AT LLOYC 37540 INSURED INSURER 6; Cal Jump South Orange County LLC INSURER C 2717 S Orange Ave Unit DIE INSURER D INSURER E Santa Ana CA 92707 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. POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVQSUBR POLICY NUMBER MMIDDffYYYY MMIDDNYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X CLAIMS-MADE aceuR PREMISES Ea occurrence $ 300,000 X 3 year extended reporting period MED ExP(Any one parson) $ 25,000 A X Retroactive Date: 05/12/2023 X X ZISMB2420 02 05/12/2025 05/12/2026 PERSONAL&ADV INJURY $ 1,000,000 X GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 POLICY PRO- 7 I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT u OTHER: $ AUTOMOBILE LIABILITY COBINED SINGLE LIMIT Fa M accident $ ANY AUTO "C'DILY INJURY(Per person) $ OWNED SCHEDULED RODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORfPARTNERIEXECUTIVE ❑ F.L.EACH ACCIDENT $ OFFICERIMEMBFR EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-FA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below RL,DISEASE-POLICY LIMIT $ [APPROVED By Tu Tran Nguyen of 2:39 pm,Jun 11,2025 DESCRIPTION OF OPERATIONS lLOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Santa Ana,.its City Council,officers,officials,employees,agents,and volunteers are named as Additional Insured with Waiver of Subrogation as regard the General Liability policy when required by written contract subject to the terms, conditions,and exclusions of the policy, igTitally signed Tu Tran byDu Traa Event Date:07/24125 Nguyen Nguyen Date:2025.06.11U Project Manager Name: Dario Gaitan,Police Department,2627 W McFadden Ave,Santa Ana,CA 92704 N g y 14:45:06-07'00' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, Attn:Dario Gaitan,Police Department AUTHORIZED REPRESENTATIVE 60 Civic Center Plaza,M-23 62 � Santa Ana CA 92701 L c01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD