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Policy Number: CPS20552174 Date Enieredi""TT7 'y sa Ln acQRo CERTIFICATE OF LIABILITY INSURANCE MMi DATE24/2015 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 pollcy(ies) 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 (feu of such endorsement(s). PRODUCER Cheryl Hart -Munoz Insurance 41667 I St. Ste. H8 Murrieta, CA. 92562 CONTACT NAME,"' PHONE (951)600-0500 F^X 951)332-8000 Arc No: E-MAIL ADORE INSURER(S) AFFORDING COVERAGE NAICM INSURER A; Scottsdale Insurance Co. INSURED Active Learning INSURER B INSURER0: HIBA SHUBLAR 14 Surfside Court INSURER O: Newport Beach, CA 92663 INSURER E: INSURER F: ■tl�11R:C1C1a.�10a9 I I NVII 1=11111110i IN= slATJ LY hid0 MIIT, 1t1yv� 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. LTR TYPE OF INSURANCE NOD -AUI SUER POLIDYNUMBER MMI�ICIYVYY MMUOOIYYVY LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ICPS2052179 1/26/2015 1/26/2016 EACH OCCURRENCE $ 1, 000, 000 DAMAGE TO RENTED PREMISE Eac Curren $ MEDEXP(Anyoneperson) $5,000 PERSONAL& AOV INJURY $1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER; PR - POLICY ❑ JJECT ❑ LOC GENERAL AGGREGATE I$2,000,000 PRCOUCTS-COMPIOP AGG $ 1, DDD, DDD $ OTHER: AUTOMOBILE _ .'.._�ALLOWNED LIABILITY ANYAUTO __ SCHEDULED AUTOS AUTOSNON-OWNED y� `I "' �Q,V` COMBINEDSINGLE LIMIT . accident $ BODILY INJURY (Per parson) $ BODILY INJURY (per accitlenp $ I HIRED AUTOS (AUTOS PROPERTY DAMAGE Paraccident $ 8 UMBRELLA UAS (OCCUR EACH OCCURRENCE S AGGREGATE b EXCESS LIAR CLAIMS MADE { Sta OED RETENTION$ I$ WORKERS COMPENSATION YIN ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA n y� Yr ((````T]C1lr� �" 4J ( P e } olit r�'�li 1 STATUT ER STATUTE EL. EACH ACCIDENT Is EL DISEASE-Gq EMPLOYEE $ (MentlelpYy In NH) y�(a c1� It yes, describe under T' + DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLIGY LIM IT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, me beallaohetlitmmesp... N inquired) After school dance instruction class in the Santa Ana S%ool District for elementary and middle schools CITY OF SANTA ANA, its officers, officials, agents, employees, and volunteers as additional insureds. Primary and non contributory endorsement included CERTIFICATE HOLDER'IS ALSO ADDITIONAL INSURED CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 CIVIC CENTER PLAZA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, SANTA ANA , CA 92701 AUTHORIZED REPRESENTATIVE DHERYL HART—MUNOZ © 1988-2014 ACORD`CORPORATION. All rights lkservec ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Produced using Forms Ross Plus simmerswww.Fnrnnii com: Impressive Publishing 8011977