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AC -R-D-t CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/1 YYY) 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 eertiflcate holder Is an ADDITIONAL INSURED, the policy(les) must 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 F.-RODUCER AME: MASS March UnderwNtin K&K Insurance Group, Inc. , No. E tic 888-580-804'! FAX: (NC, No} 260-459-5995 1712 Magnavox Way RES3: info fitnessinsurance-kiccom Fort Wayne Indiana 46804 CUSTOMER ID is INSURED INSURER 3 AFF RDING COVERAGEMaria M Vigil Nationwide Mutual Insurance Com an 23787 DBA: Ria Vigil Group Fit 308 Columbia Newport Beach, CA 92663 A Member of tha Sports, Leisure & Entertainment RPG INSURER D: 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 MAYBE 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. INS LTR TYPEOFINSURANCEIHSR fNSR 'VO WVD POLICYNUMBER POLICY EFF MM/DD POLICYEXP MMID LIMITS A GENERAL IJABTLITY X COMMERCIAL GENERAL LIABILITY CLAIM4-MADE X�OCCl1R 6BRPG0000004934600 01/11/2011 5:13 PM EDT 01/11/2012 12:01 AM EACH OCCURRENCE $1,000100 DAMAGE TO RENTED $500,00 PREMISES Ea occurrence MED EXP (Ary ons bonen) $10000 PERSONAL 8 AOV INJURY $1,000,00 GENERALAGGREGATE $3.000.00( GF 'L AGGREGATE LIMIT APPLIES PER: POLICY =PROJECT OLOC PRODUCTS-COMP/OP AGG $1,000.00C PROFESSIONAL LIABILITY $1,000,00 LEGAL LIAB TO PARTICIPANTS $1,000,00 AUTOMOBILE LIABILITY AANYAUTO ALL OWNED AUTDS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Not IXoAded whre In Bowan COMBINED SINGLE LIMIT Ea Accident BODILY INJURY (Per person) BODILY INJURY (Per aecitlent) PROPERTY DAMAGE Paractltlent UMBRELLA LIABOCCUR EXCESS LIAB CLAIMS -MADE DEDUCTIBLE RETENTION EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND BMPLOYEUK LIABLITY V / N ANY UTNE FFICE IP/EMBER iL Q EXECUTIVE OFFICERIMEMBER EXCLUDED? IMandatoryb NH) If ES IPTION lower DESCRIPTION OF OPERATIONS below N / A ORYTLIMTo OTHER E.L. EACHACCIDENT EL OISFJi3E — EA E MPLOYEE E.L. DISEASE—POLICY LIMIT MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL CNN t a emarks c a a, mora sAaea • raga ra Certified Instructor of Aerobics, Children's fllness programs, Dance, Exercise, Strength, ZUMBA0 The Certificate holder is added as an additional Insured, but only with respect to the liability arising out of the operations of the insured named above. Ria Vigil SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 622 Strawberry Lana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92706 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHDR... RR---/ENTAT/IVE (Owner/Lessor of Premises) Coverage is only extended to U.S. events and activities. " NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD C 1988-2009 ACORD CORPORATION. All rights reserved.