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DATE(MMIDDIYYYY)
<br /> A a� CERTIFICATE OF LIABILITY INSURANCE 511r2026
<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: JUlieth O'Donnell
<br /> Edgewood Partners Ins Center PHONE FAX
<br /> 100 Montgomery St, Suite 2000 WC N Arc No):
<br /> Sall Francisco CA 94104 ADOREss: julieth.odonneli@epicbrokers.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> License#:Lie#0B29730 INSURER A:Philadelphia Indemnity Insurance Co 18058
<br /> INSURED BODYBRA INSURER B:Travelers Casualty Insurance Co of Amer 19046
<br /> Body&Brain Yoga and Health Centers, Inc
<br /> 1234 S, Power Road, Suite#250 INSURER c
<br /> Mesa,AZ 85206 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:2122255141 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 EFF POLICY EXP LIMITS
<br /> LTR POLICYNUMBER MMIDDIYYYY MMIDDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y PHPK2673193013 4/1/2026 4/112027 EACH OCCURRENCE i
<br /> 1 $1,000,000
<br /> CLAIMS-MADE �OCCUR DAMAGE 70 RENTED
<br /> PREMISES Ea occurrence $300,000
<br /> X 2,000 MED EXP(Any one person) $5,040
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
<br /> POLICY O JECOT- LOC PRODUCTS-COMPIOPAGG $3,000,OD0
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y PHPK2673193013 411121 4I112027 COMBINED SINGLE LIMIT $1,000,000
<br /> COMBINED
<br /> 8
<br /> ce4denl
<br /> IANY AUTO BODILY INJURY(Per person) 5
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> A UMBRELLA LIAB X OCCUR PHU8906605013 4/1/2026 4/112027 EACH OCCURRENCE $5,000,000
<br /> X EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED Xt I RETENTION$1 a non $
<br /> B AND EMPS YERS'LI COMPENSATION UB6N6079352543G 711/2025 7/112026 X STATUTE aTH
<br /> AND EMPLOYERS'LIABILITY Y 1 N
<br /> ANYPROPRIETOPJPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESGRI PTION OF C PERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) r—� _r�......m._..... ��._..
<br /> RE:Santa Ana Lawn Bowling Center,2615 N Valencia St,Santa Ana,CA 92706 APPROVED
<br /> Roosevelt Walker Community Center,816 Chestnut Avenue,Santa Ana,CA 92701 By Tu Tran Nguyen at 8:59 am,May 14,2026
<br /> Date of Event: EVERY TUESDAY AND WEDNESDAY starting on 4/7/2026
<br /> Teach Yoga,Tai Chi,Introduce Our Programs,Number of expected participants: 10
<br /> The City of Santa Ana,its officers,officials,employees,agents,and volunteers or any person or organization with whom you have agreed in a written contract
<br /> or agreement are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of
<br /> the Perri including materials,parts,or equipment furnished in connection with such work or operations
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD AMY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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