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CERTIFICATE OF LIABILITY INSURANCE <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.I <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is <br />an ADDITIONAL INSURED, the policy(Ias) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />PRDDUDEK NAME'^"' IMass March Underwrlting <br />K&K Insurance Group, Inc. a8"N <br />1712 Magnavox Way e E ,t 868-560-6041 PAO (A1c, N* 60-459.5995 FE.e`ort Wayne Indiana 40804 ADDRESS, info@fltnessinsuranee-kk.com <br />CA 92704 <br />of the Sports, Leisure & Entertainment RPG <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONorrIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />N <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INER <br />3 BR <br />VNO <br />POLICYNUMSER <br />POLICY EFF <br />MMIDD <br />POLIOYaXP <br />MMD <br />LIMITS <br />A <br />GENERAL LIAeacv <br />X <br />6BRPGOOD0005342300 <br />02/1312013 <br />02!13/20M% <br />EAOH OCCURRENCE $1,000,000 <br />X COMMERCIAL bENERAL LIABILITY <br />CLADHUMADEX�oCCUR <br />7:77 PM ED <br />12:01 AM <br />DAMAGEiORENTED $500,00 <br />PREMISES E.e ounBnCe <br />McDeXP(Anyoneponon) $10,000 <br />PERSONAL a ADV INJURY $1,000,000 <br />GENERALAGGREGATE $5.000.000 <br />GEML AGGREGATE LIMIT APPLIES PER: <br />POLICY OPROJECT ❑LOC <br />PRODUCTS-COMPIOPAGO $1000,000 <br />PROFESSIONAL LIASILD7 $1,000,000 <br />LEGAL UAB TOPARTICIPANTS $1,000,000 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />EaAmeenl <br />AVYAUTO <br />II��OHEDULED <br />ALL OWNED AUTOS UTOa <br />BODILY INrp <br />JURY(Peeraon) <br />SODILVINJVRY(Foraccident) <br />HIRcO AVTOS NOKOWNED <br />UTOS <br />PROPERTY DAMAGE <br />Peracoident <br />Not provided while in I Iawaii <br />UMBRELLA LIAROCCUR <br />EACHOCCURRENCE <br />EXCESS LIAe CLAIMS -MAGE <br />AGGREGATE <br />DED RETENTION <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY Y//N <br />ANY PROPRIETORSHIPIPARTNEIUE.L. <br />EXECUTIVE OFFICEWMEMBER <br />E%CLUDEDI <br />(Idandalery In We <br />NIA <br />WC STATV- <br />TORVLIMITB OTHER <br />EACH ACCIDENT <br />E.L.DISEASE -EA EMPLOYEE <br />EL DISEASE-POLICV LIMR <br />If You, daeedbe m:der <br />DESCRIPTION OF OPERATIONS below <br />MEDICAL PAYMENTS FOR PARTICIPA TS <br />PRIMARY MEDICAL <br />EXCESS MEDICAL <br />3ESCRIPTION OF OMRATIONS ILOCATIONS I VEHICLESflet AMD ip1,A ditlpna Rema, s c a ue, 11 mom space mgdretl <br />CenlBed Instmotor of: ZUMBA® <br />Tha eed180ate holder is added as an additional Insured but Only With respect to the liability arising out of the operations of the insured named above. <br />City of Santa Ana, Its officers, agents, and employees <br />1526 W Clvfo Center <br />Santa Ana, CA 92704 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THEE%PIRATJON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE <br />IV41TH THE POLICY PROVISIONS- <br />AUTHORIZED REPRESENTATIVE <br />" to <br />(Owner/Lessor of Premises) <br />Coverage Is only extended to V.S. events and activities. <br />** 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 <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD LD 1988.2010 ACORD CORPORATION. All rights reserved. <br />IPPROVED A9 TO FORI'd <br />LISA E. STORCK <br />Assistant City Attorney �y <br />