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KIDZL-2 nP In. nc '`'i "�'?" CERTIFICATE OF LIABILITY INSURANCE DATE(YY) 02!/14!11411YY2 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 I AL INVRFR, tM Joy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an en d'rsement. A statement on this certificate doe not confer rights to the certificate holder in lieu of such endorsement PRODUCER -�• 650-469-040_ SBC Insurance Services, Inc. 5150 EI Camino Real Bldg B #31 Los Altos, CA 94022 Mike Courtney NE: .650169-042 PHONE FAX c No Ext): AIC No -MA ADDRESS: INSURERS AFFORDING COVERAGE ! NAIC aF A INSURERA: Markel Insurance Company X INSURED North American Youth Activities, LLC dba Kidz Love INSURER B: - INSURER C : Soccer / INSURER D: Malcolm Guthrie �( 1 (,, P.O. Box 337(1 1 1" Corte Madera, CA 94976 INSURER E : %1 y. 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. I R AUDL TYPE OF INSURANCE OLICY UM R I Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR X 8502AH0210452 12/01/11 12/01/12 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00cl MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 X Incl Participants GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY 7-1 PRD LOC PRODUCTS - COMP/OP AGG $ 1,000,00 $ AUTOMOBILE LIABILITY L; Ea accident $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOSNON-OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per acc,dent) $ PROPERTY DAMAGE Per accident $ UMBRELLALIAS EXCESS OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ -[ D RET NTI N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y! N ANY PROPRIETORIPARTNERfEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WC STATU- OTH- T V If IT R E.L. EACH ACCIDENT $ L. DISEASE - EA EMPLOYE $ FE L. DISEASE- POLICY LIMIT $ A Group Accident 4102AH0210441 12/01/11 12/01/12 Med Max. 1,000,00 Ded. 5,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Santa Ana, its officers, agents and employees are added as dditional Insured per attached CG20260704. 30 days written notice ofcancellation. �7' CISANAA City Of Santa Ana Parks, Recreation and Communitity SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE MILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Services Agency 1825 W. Civic Center Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE W 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD