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TUMBINC-01 RCROOK
<br /> ACORD DATE t�
<br /> CERTIFICATE OF LIABILITY INSURANCE 4/1512025
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder Is an ADDTIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WANED, subject to the terns and conditions of the policy,certain policies may require an endorsement A statement on
<br /> this certificate does not confer ri hts to the Certificate holder in lieu of such endorsement(s).
<br /> PRODUCER c ACT Rhonda Crook
<br /> Terry L Green S Associates,Inc. PHONE FAx
<br /> 3100 Five Forks Trickum Road AIC,No,EXIl: Arc,Na}:
<br /> Suite 101 E-MAIL
<br /> Lllburn,GA 30047
<br /> INSURE S AFFORDING COVERAGE NAIC#
<br /> INSURERA.SiriuS Point 38776
<br /> MUREV INSURER B:
<br /> Tumble-N-Kids,Inc. INSUR r:
<br /> 16802 Lucia Lane INSURER ID:
<br /> Huntington Beach,CA 92647
<br /> INSURER E
<br /> INSURER F-
<br /> COYERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING 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 CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY I"
<br /> A.MueUTS
<br /> A XC CDMMERcmi.GENERAL LU1BAIrY
<br /> EACH OCCURRENCE $ 1,000,000
<br /> CL-JMUTADE ®OCCUR X X PLHOIGL00003941 4126/2025 412W2026 0,CIETORENTED 300,000
<br /> X AbuselMolestation
<br /> x $1M OCC/$2M AGG MED EXP(Any one wwn S 5,000
<br /> PERSONALS ADV INJURY ; 1,000,000
<br /> GEN'LAGGREGATEUMITAPPLiESPER: GENERAL AGGREGATE S 3,0QO,000
<br /> X POLICY L]JECTPRO- D LOC PROQUCTS-COMPIOPAGG 7,000,000
<br /> x I OTHER:PROFESSIONAL$IMI$lM IPARTICIPANT 1,000,000
<br /> AUTOMOBLE LtA]NLmr COMBINED SINGLE LIMIT S
<br /> ANYAUTO BODILY INJURY Per mw
<br /> OWNED AUTOSSNED EQ BODILY INJURY Per accident)AV���rOppS ONLYAUpTµOpSyyN�p
<br /> RUTOS ONLY AU 0s ONLY p e t AMAGE
<br /> UMBRELLA LIAS OCCUR EACH OCCURRENCE
<br /> EXCESS LlAB CLAIMS-MADE AGGREGATE S
<br /> DIED RETENTION 3
<br /> AN!WORKERS
<br /> YIN PER TUTE 071-
<br /> 1
<br /> .
<br /> ANY PROPRIETORIPARTNFRI CUTNE n tL 1=n1GH ACCIDFs1T S
<br /> ((FFIq�C�E,nM%�EXCLUDED? NIA A
<br /> lniy] EL.DISEASE-EA EMPLOY S
<br /> II describe IradP.r
<br /> DESCRIPTION F CPFR4TfOT15 aelaw E.L.DISEASE-POLICY LIMIT S
<br /> A Participant Accident PHSA-BAMH-1024825 412=025 4126MO26 Excess Coverage 25,000
<br /> A Deductible$500 PHSA-BAMH-10248 25 4126/2025 412612026 ADBD 10,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,AddRibrml Remarde Schedule,may ae allaehed if mare Is required)
<br /> Coverage is provided under this policy for sponsored and supervised activities of the named Insured ar whi a premium has been paid.
<br /> Youth Recreational Gymnastics-Mobile Program
<br /> The Certificate Holder is an additional insured with respect to the Operations of the named insured
<br /> Tu Tran Tu Tmn sig dby
<br /> Tu Tra Neu en
<br /> "City of Santa Ana.its City Council,officers,officials,employees,agents,and volunteers." A' Date:2025.0 .16
<br /> Certificate of Insurance shall provide thirty(30)day prior written notice of cancellation. I V g u ye n I2:33:52-01' 0'
<br /> Non-Contributory.
<br /> is Primary and Non-COibutory.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Iu Tran Nguyen at 12:31 pm,Apr f6, 3025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Arta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attention: Parks,Recreation,and Community Services Agenc
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza,CA 92701,M-23
<br /> Santa Ana,CA 92702 AUTHORIZED REPRESENTA1WE
<br /> J j a
<br /> ACORD 25(2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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