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ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE (MMfDOlYYYY) TEIMMiDDNY 2-17-2012 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 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 CONTACT NAME: 99996 / Health & Fitness Direct A Division of Markel Service Incorporated PHONE (A/C No, Ext): FAX (A/C No): 4600 Cox Road E-MAIL Glen Allen, VA 23060 ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # 12-16.2012 INSURED INSURER A: MARKEL INSURANCE COMPANY INSURER B: WEBBY Dance Company #14 INSURER C: P.O. Box 2092 Orange, CA 92859 INSURER D: PRODUCTS - COMN/OP AGO S 1,000,000 INSURER E: 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. INSF LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM D YY POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY F-1 ❑ CLAIMS -MADE ® OCCUR F13602HF320435 ® ❑ 4 12-16.2012 12-163,-2013 EACH OCCURRENCE S 1,000,000 DAMAGE TO PREMISES (Es RENTED encs) $ 100,000 MED EXP (Any one person) ; 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PRO'E T ❑ LOC PRODUCTS - COMN/OP AGO S 1,000,000 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS El 1:1 El COMBINED SINGLE LIMIT $ IEa accident! BODILY INJURY (Per person 9 BODILY INJURY (Per acclident) S S (Per aocidantl PROPERTY DAMAGECl UMBRELLA LIAR ❑ EXCESS UAB ❑ OCCUR CLAIMS -MADE ❑ ❑ EACH OCCURRENCE S AGGREGATE 9 DED RETENTION S g ... WORKERS COMPENSATION AND EMPLOYERS' LIABILITY - — -Y ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NHI If yea, describe under DESCRIPTION OF OPERATIONS befow _..._. N/A ❑ - .. -- ... - .. - .. -.. .... ❑ .. _... _ ... WTORY CSTATSTATU- TS- ER- DTH- E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE g E.L. DISEASE - POLICY LIMIT $ uci,,nn•1�Unl Vr' VYCMAII VIYiILVLAlIVJ9O1Ven1\.LCJ IARaCn AI UXV lUl, Aaaruonai nernar" tticneaual. Ir more space -in required) �S Webby Dance classes conducted at 1825 W. Civic Center Dr., Santa Ana, CA ' p?lkc ;Sk j .92703. A E' ST�RGK �;+.I Attorney - ----CERTIFICATE-HOLDER---- ---- - ---- ----------- .. City Of Santa Ana, Parks, Recreation & Community Svcs Agency 1825 W. Civic Center Drive Santa Ana, Ca 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Bruce A: Kay (c) 1988.201C ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SGA 10 reserved.