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MATCPOI-01 ESARAIVA
<br /> ,dâ–ºcoRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 9/17/2025
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. 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 an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> MPX Insurance Services PHONE FAX
<br /> 200 Congress Park Drive,Suite 100 (A/C,No,Ext):(866)553-2900 (A/C,No):(949)281-2877
<br /> Delray Beach, FL 33445 E-MAIL service@mpxinsurance.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURERA:Scottsdale Insurance Company 41297
<br /> INSURED INSURER B:Ohio Security Insurance Company 24082
<br /> Match Point Tennis Academy LLC INSURER 7
<br /> 800 Cabrillo Park Dr INSURER 7
<br /> Santa Ana,CA 92701
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR CPS8284857 9/12/2025 9/12/2026 rl DAMAGE TO RENTED 100 000
<br /> X X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> Ea accident $
<br /> ANY AUTO BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident)
<br /> ccident $
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> Y/N XWS59985843 6/23/2025 6/23/2026 1,000,000
<br /> ANY PROPRIETOR/EXCLUDED?
<br /> R/EXECUTIVE N/A E.L.EACH ACCIDENT $
<br /> OF EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,ODU
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A General Liability CPS8284857 9/12/2025 9/12/2026 Sexual$100k/Abuse 300,000
<br /> A General Liability CPS8284857 9/12/2025 9/12/2026 Participant Inj $25k 50,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are to be covered as additional insureds on the CGL policy with respect to liability
<br /> arising out of work or operations performed by or on behalf of the Permittee including materials,parts,or equipment furnished in connection with such work
<br /> or operations.Waiver of subrogation applies to the General Liability policy per the attached endorsement.Cancellation provisions apply to the General
<br /> Liability policy per the attached endorsement. Tu Tran Digitally signed by
<br /> Tu Tran Nguyen
<br /> Workers Comp:Owner-Elson De Cantuaria Date:2025.09.22
<br /> Nguyen 13:56:48-07'00' APPROVED
<br /> By Tu Tran Nguyen at 1:56 pm,Sep 22,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention:Parks, Recreation and Community Services
<br /> 20 Civic Center Plaza, M-23
<br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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