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Saco o® CERTIFICATE OF LIABILITY INSURANCE DAo210sr2026' 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: Bene-Marc Athletic Insurance Agency#OE67789 PHONE o t,(800)247-1734 AAX c No 6301 Southwest Boulevard,Suite 101 E-MAIL contact@bene-marc.com ADDRESS: Fort worth,.Texas 76132 INSURERS AFFORDING COVERAGE NAIL# INSURERA: HDI Global Specialty SE AA-1120822 INSURED INSURERS: AXIS Global Accident&Health Insurance Company 37273 Southern California Municipal Athletic Federation(SCMAF) PO BOX 3605 INSURER.C: South El Monte,CA 91733 INSURER D: SCMAF Member: Hortencia Garcia-Latin Zumba and Aerobics INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 9066-57159 REVISION NUMBER: 02/24/2026 REVISED 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 SUBR POLICY EFF POLICY EXP LTR _ POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 18LB8383 0110112026 0110112027 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occumence $ 100.000.00 MED EXP(Any one person) $ 5.000.00 A X X Abuse&Molestation PERSONAL&ADVINJURY $ 1,000,000.00 GEN'LAGGREGATELIMITAPPLIESPER.- GENERAL AGGREGATE $ 5,000,000.00 X POUCY JE® LOG 1,000,000 OCC.12,000,000 Agg. PRODUCTS-COMP/OP AGG $ 1,000,000.00 OTHER Participant Liability $ 1,000,000.00 AUTOMOBILE LIABILITY COM BINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED S UTOS CHEDULED A AUTOS ONLY BODILY INJURY(Per accident} $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADF AGGREGATE $ OEO RETENTION$ $ WORKERS COMPENSATION PER CTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ANYPROFFICEIM MBE EXCL DED9 CUTIVE OFFICERIMEM BER EXCLU[lE0? � NIA E.L.EACH ACCIDENT $ (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S B Participant Accident Medical SRPO-50256-243 01/01120213 01,01/2027 Deductible: $0.00 Limit: $5,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) This policy includes a blanket additional insured endorsement that provides additional insured status to the certificate holder per form CG 20 26 07 04. The General Liability policy contains Primary and Nan Contributory wording per endorsement E1602AJ-1112,.The General Liability policy contains an endorsement for Waiver of Transfer of Rights of Recovery Against Others to Us per attached form CG 24 04 05 09.City of Santa Ana entity,it's officers,officials,agents and it's volunteers are additional insured. Coverage for SCMAF member approved activities for which a premium is paid and reported to the Company. SCMAF Member: Hortencia Garcia-Latin Zumba and Aerobics Coverage is limited to the following activity dates: 02 O1126-12/31/26 APPROVED CERTIFICATE HOLDER CANCELLATION I By Ty Tran Nguyen at 1:04P.,Mar If, City of Santa Ana Risk Management SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana,CA 92701 Alisa Lynn Hall "I �""�"� I�111 l`-uuJ ©1988-2015ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD