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BACKDAN-01 KMARTIN CERTIFICATE OF LIABILITY INSURANCE DAT6412 DIYYYY) r4rzoz 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ' CONTACT NAME: Maury,Donnelly&Parr,Inc. PHONE FAX 24 Commerce St. (Arc,No,Ext):(410)685-4625 LAIC,No):(410)685-3071 Baltimore,MD 21202 A©o.�L INSURERS AFFORDING COVERAGE NAIC 9 _ INSURER A:Great American Assurance C©m an 26344 INSURED INSURER B: Backhaus Dance rINSURERC: PO Box 5890 I INSURERD:. Orange,CA 92863 INSURER E: _ i INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP L IN SD MM16DfYYYY. MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CLAIMS-MADE ' OCCUR GLP3961460 61312025 61312026 DAMMAGE TISES ENTED 100,000 ;� X X PREMISES Ea occurcenca $ MED EXP(Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LI MIT APPLIES PER, GENERAL AGGREGATE $ 2,000,000 POLICY PRO- LOC PRODUCTS-COMPIOP AGO $ OTHER:General Aggregate i $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Per person) 5 OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY Per accident $ HIRED NOW PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE I $ EXCESS LIAB CLAIMS-MADE L AGGREGATE $ __ DE❑ 1 RETENTION$ S. WORKERS COMPENSATION PER YIN OTH- AND EMPLOYERS'LIABILITY j STATUTE ER_ E.L.EACH ACCIDENT 5 OFF EWMEMB RIPARLUDEDXEGUTIVE �FFICER;MEMBER EXCLUDED � N f A — (Mandatory in NH) E.L.DISEASE-EA.EMPLOYEE S if yes,describe under DESCRIPTION OF OPERATIONS balaw E.L.DISEASE-POLICY LIMIT S A Abuse&Molestation X X GLP3961460 61312025 613/2026 Each Abuse 1,000,000 A Abuse&Molestation X X GLP3961460 6/312025 6/3/2026 :Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) The City of Santa Ana,its City Council,officers,employees,and volunteers are additional insured. Coverage is primary and non-contributory. 30 day prior written notice of cancellation is in favor of The City of Santa Ana. Tu Tran 1Ii1311y,,gnedby Tu Tran Nguyen Nguyen°o ds�4°ems APPROVED By Tu Tran Nguyen at 7:09 am,Jun 05,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Parks,Recreation,and Community Services Agenc 20 Civic Center Plaza,M-23 Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE ' 1 ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD