SECUNDO, MARISCA N. - Laserfiche WebLink

Home Browse Search

�-` %,MKI1t1UAlIII: Ur LIAI9ILITY INSURANCE 13ATE(MWDDNM) 01/09/2020 TM ERTIFIC TE IS ISSUED AS A MATTER Or IN 0 M TION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI 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. 1 PO AN the certificate hol er is an ADDITIONAL INS , t e Pollcy(les) must have AD RED provisions or be an orse IfSUBROGATION IS WAIVED, su"Got to the terms and condhions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer ri hts to the certificate holder in lieu of such andorsement s . PRODUCER - K&K Insurance Group, Inc. 1712 Magnavox Way Fort Wayne IN 46804 ACT NAME: Mass Merchandising Underwriting aD No Ea : 1.800-506-4858 AIc No : 1-260-459-5580 ADDRESS: Info@fitnessinsurance-kk.com Pft CUSTOMER to: INSURER(S)AFFORDING COVERAGE NAICB INSURED Madcsca Secundo 4143 Fulton Way Stanton, CA 90680 INSURER A: Nationwide Mutual Insurance Company 23787 INSURER B: INSURER C: A Member of the Sports, Leisure & Entertainment RPG INSURER D: INSURER E: MSURERF: — r .VIOLVVI numoeK: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ASOVE 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. RISK LTR TYPE OF INSURANCE INSD WVD POLICYNU IBER EFF WDD POLICY EXP MMIDDIYYW LIMITS A X COMMERCIAL GENERAL LIABILITY MASS- OCCUR X 6BRP00000007214200 01/09/2020 4:50 PM EDT 01/09/2021 12:D1 AM EACH OCCURRENCE $1,000,000 PREMISES ISe Occurrence $1,000,000 MEDEXP(Anyoneparson) $5100D PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE $5,000,000 GFN'L AGGREGATE LIMIT APPLIES PER: PRO -POLICY JECT LOG OTHER: PRODUCTS—COMPIOPAGG $1,000,000 PROFESSIONALLIABILnY $1,000,000 LEGAL LIAR TO PARTICIPANTS $1,000,000 MOBILELIMILnY COMB(E SINGLEL IEa accidentAUTOBODILY 5ANY WNEOAUTOS SCHEDULED NLYAUTOS INJU RY(Per perm) BODILY INJURY(Per accident) IREDNON-OWNEDUTOSONLY AUTOS ONLY PROVIDED WHILE IN HAWAII Per eocidentOT UMSRELIAUAB OCCUR EACH OCCURRENCE EXCESS LIMB CLAIMS -MADE AGGREGATE BED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY NIA PER STATUTE OTHER ANY PROPRIETORrPARTNEW YIN EXECUTIVE OFFICEIUMEMBER EL EACHACCIDENT EL, DISEASE —EA EMPLOYEE EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OFOPERATIONS balmE,L, DISEASE —POLICY OMIT MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) Non -certified Instructor of. Ballet, Culturallethnic The certificate holder is added as an additional Insured, but only for liability Paused, in whale or in part, by the acts or omissions of the named Insured. City of Santa Ana Risk Management Division 20 Civic Santa A a, CACenterPlaza 2702 SHOULD ANY OF THE ABOVE DESCRIBED �POLICIES THE EXPIRATION DATE {�BI,EE C$ Nrp�LED BEFORE ACCORDANCE W TH THE POLICY PROVISIC1b5.V l L-'M CU OtEAYt'I uy IN (Owner/Lessor of Premises) AUTHORIZED REPRESENTATIVE By Risk ANACIEMENT (VISION z Coverage Is only extended to U.S. events and activities. "NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the Insurance laws and regulations of the to ACORD 25 (2016103) ©1966-2Di5 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD