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A� �P CERTIFICATE OF LIABILITY INSURANCE DIG DA6/29/201.7 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(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 lieu of such endomement(s). PRODUCER Anthony Insurance Services, Inc. P.O. Box 927 Edwards, CO 81632 www.AnthonylnsuranceServices.com CONTACT NAME: PHOAICNNo EXt: NC, No: ADDRESS: lCaitlyn@anthonyinsuranceservices.com INSURER(S) AFFORDING COVERAGE NAICN INSURERA: U.S. Fire Insurance Company 21113 INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION(PURCHASING GROUP) AND ITS PARTICIPATING MEMBERS: INSURER B: INSURERC: HISTORY THROUGH THE EYES OF WOMEN INSURERD: DEBORAH MCINTOSH 23454 DARCY LANE INSURERE: INSURERF: NEWHALL, CA 91321 COVERAGES CERTIFICATE NUMBER: USS350089 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. INSR LTR rypEOFINSURANCE ADDL INSR SUER WVD pOLICYNUMeER POLICY EFF MMIDDIYYYY POUCYEXP MMIDDIYYYY LIMITS GENERALLIABILITY GENERALAGGREGATE $ 1.000,000 PRODUCTS-COMPIOP AGO $ 1,000,000 X COMMERCIALGENERA.UAyUTY PERSONAL &ADV INJURY $ 1,000,000 A Cl-NMS-MADE rX1 OCCUR SRPG-101-0717 12:01 01 A AM 12:01:0117 AM EACH OCCURRENCE 3 1,000,000 FIRE DAMAGE (Any one fire) S 300,000 MED EXP(Any One person) $ 5,000 GENL AGGREGATE LIMITAPPLIEe PER: -XI POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acddem IS BODILY INJURY (Per person) $ ANY AUTO H\e ALL OWNED SCHEDULED AUTOS AUTOS 1(� BODILY INJURY (Per accident) $ HIREDAUTO NON-GMED AUTOS YJ� PROPERTY DAMAGE Peraccitlent $ S UMBRELLA LIAB OCCUR EACH OCCURRENCE IS EXCESS LIAB CUk MS -MADE S AGGREGATE $ BED RETENTION $ `ate r `yeA V •0 $ WORKERS COMPENSATION AND EMPLOYERS' UASIDTY YIN ANY PROPRIETORIPARTNER,EXEC1frIVE OFFICER/MEMBER EXCLUDED? ❑N/A \CA_ �j� �/ 1 GW J WCSTATU- To UMITS OTH Eft $ E.L. EACH $ (Mandatory in NH) E. L. DISEEASEASE-EA EMPLOYEE g DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT AD&D MAXIMUM MEDICAL DEDUCTIBLE TERMS OF PAYMENT DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (Attach ACORD 101, AEEItIonal Remarks Schedule, it more space Is required) Covered Performer Type: Historical Portrayal. Certificate Holder is named as additional insured with respect to the operations of the Named Insured. CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE API.��LPPI.rJ rPl�.l%'1-A-�L.C�,sF.l-V� @ 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD