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Af D� CERTIFICATE OF LIABILITY INSURANCE DATE <br /> 512 02 5YY7 <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 be endorsed. If SUBROGATION IS WAIVED, subject <br /> to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights <br /> to the certificate holder in lieu of such endorsernent(s). <br /> PRODUCER CONTACT <br /> FL Dean Bjorn Rosinus NAME: <br /> 12800 UNIVERSITY DR STE 125 HONNo,E.t: (239)990-8161 AAC,Na <br /> FORT MYERS,FL 33907-5335 E-MAIL <br /> ADDRESS: bj@fdean.com <br /> INSURER(S)AFFORDING COVERAGE NAIC q <br /> INSURER A: Great American Insurance Company 16691 <br /> INSURED SPORTS AND RECREATION PROVMERS ASSOCIATION(PURCHASING GROUP)AND INSURER B: <br /> ITS PARTICIPATING MEMBERS. <br /> Smashvent,LLC dba OC Laser Tag&OC Fun Events INSURERC: <br /> 17522 WOODFERN LN INSURER D: <br /> HUNTINGTON BEACH,CA 92649-4839 INSURERE: <br /> INSURER.F: <br /> COVERAGES CERTIFICATE NUMBER: GAP146525 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 <br /> THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSP <br /> TYPE OF INSURANCE ADOL SUBR POLICY NUMBER POLICY EFF POLICY EXP <br /> LTR INSR WVD MMIDDIYYYY MMIDDIYYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE S 1,000 coo <br /> DAMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABILITYPREMISES IEa accnrrenc.I 5300,000 <br /> CLAIM.-MADE F OCCUR MED EXP(Any one person) so <br /> 02 <br /> 12:000 A AM 12:01 Nl <br /> A X HOST LIQUOR LIABILITY INCLUDED X X PAC 4725038 0712 071271 AM PERSONAL&ADV INJURY 31.coo,0co <br /> M <br /> X INCLUDES ATHLETIC PARTICIPANTS GENERALAGGREGATE S2,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMPIOP AGG 32 000 aaD <br /> PRO- <br /> X POLICY JECT LOC <br /> MBINE <br /> AUTOMOBILE LIA 91 L1TY fCO D Ea accidennSINGLE LIMIT <br /> ANY AUTO BODILY INJURY(Per person) <br /> ALL OWNED SCHEDULED BODILY INJURY(Per <br /> AUTOS AUTOS aCLidenC <br /> HIREOAUTO NON-0WNED PROPERTY DAMAGE <br /> AUTOS fPer accident) <br /> UMBRELLA LIAR H OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE <br /> OEO RETENTION 5 <br /> PAC 4725Q3$ 07/2712025 07/27/2026 EACH OCCURRENCE $1 000,000 <br /> A Professional LiabilityX X <br /> 12:00 AM 12:01 AM AGGREGATE uMlr 51,000.000 <br /> A Inland Marine Coverage GIM102256 07/27/2025 07/27/2026 LIMITS See supplement <br /> 12:00 AM 12:01 AM <br /> 07/27/2025 07/2612026 AD&D s5,000 <br /> A Accident/Medical Coverage BSR-E762813-03 MAXIMUM MEDICAL s25.o00 <br /> 12:00 AM 11:59 PM DEDUCTIBLE $too <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Covered Activities:Mobile Laser Tag,Nerf Tag, Lawn Games.Carnival Games,Water Tag,Arts/Crafts, Face Painting, Balloon Art, Photo Booth <br /> Inland Marine Equipment Floater:(1)$250.00 Deductible(2)$25.000.00 Sports Unscheduled <br /> City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers is added as an additional insured but only with respect to liability <br /> arising out of the named insured during the policy period.Waiver of Subrogation applies. <br /> Scheduled Activities Exclusion Applies-Please Refer to Named Insured Member Certificate of Coverage <br /> Digitally signed <br /> Tu Trait N9'y"n rAPPROVEDNguyenCERTIFICATE HOLDER CANCELLATION— Tu Tran Nguyen at 4:47 cm.Jul25,2625 <br /> City of Santa Ana, Attention: Parks, Recreation, and Community SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> Services Agency BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> 20 Civic Center Plaza, CA 92701, M-23 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br /> Frra-r�.Gli�y L. Deaw <br /> ACORD 25(2016/03) O 1988-2016 ACORD CORPORATION. Ad rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />