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BACKDAN-01 r KMARTIN CERTIFICATE OF LIABILITY INSURANCE OATD0IYYYY) 5/28/28/2024 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on PRODUCER NXME�y�_ Maury, Donnell B Parr, Inc. PHONE FAX 24 Commerce itt. w � A/C, No, �: (¢4Q) 685.463-5 � �� -/�_• A/c Nel:(410( 685-3071 3altimore. MD 21202 /\ _ _ on RIFs 3 i 13 i I I ! • • • \/ l INSURED ✓ INSUREF P. LLy r-1, 1 1 <J I C �A�1✓ V Backhaus Dance INSURF.0 `� PO Box 5690 SU' :R D : • 7 �:7 /� 111 Orange, CA 92863 A —Date: GOZ�1 e arrF. many-�.Tea�� aIIIIIIIIIIIIII 1B.-rraraa Ilic ,e : � w IIIIIII, � IIIIIIF�� THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BF,01' HAVE EiEENISS8EWC'T4ERLIRESZEDMZFOMFVPOLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR C(',ND".ON OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE A, -FORDED 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. II TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE OCCUR x GLP3961460 6/312024 613/2025 EACH OCCURRENCE $ 1,000,000 DAMAGE T ORENTED e PREMISESMED $ 100,000 EXP (My one erson 5,000 PERSONAL dADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PEO LOC OTHER: General Aggregate GENERALAGGREGATE 2,000,000 PRODUCTS -COMPIOPAGG 2,000,000 AUTOMOBILE LIABILITY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT (EaANY BODILY INJURY Per erson BODILY INJURY Per accident dracEd%Zt AMAGE UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DEO I I RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUUVE ❑ pp FICEEMBWEXCLUDED? ( andRIMstory in NH) Nyes, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- ISTATUT ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE EL.DISEASE - POLICY LIMIT A A General Liability General Liability X X GLP3961460 GLP3961460 613/202Z 613/2024 613/2025 6/3/2025 Each Abuse Aggregate Limit 11000,000 2,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is re ulred) The City of Santa Ana, its officers, employees, and volunteers are additional insured. Coverage is primary an r� non-contributory. 30 day prior written notice of cancellation is in favor of The City of Santa Ana. SHOULD ANY OF THE ABOVE DESCF Cityof Santa Ana Risk Management Division THE EXPIRATION DATE THEREI ACCORDANCE WITH THE POLICY PR 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2016103) ©1988-2015 ACORD The ACORD name and logo are registered marks of ACORD REVIEIIPED 6 APPRovED Sr. A- ju AuF44 Risk Management Specielist