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ACO,RO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIY Ofi122I202613 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 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: Sportslnsurarlce.com PHONE 1-866-889-4763 FAX C No Ext: A/C No: E-MAIL info@sportsinsurance.com P,O.Sox 1155, ADDRESS: PRODUCER Lake Placid,NY,12946 CUSTOMERID INSURERS AFFORDING COVERAGE NAIL# INSURED Spurts Marketing Program Management Inc, INSURER A: NIS Tmnsvene Specialty Insurance Company 41807 FUN Skateboarding Camp LLC INSURER R: INSURER C: 39004 Alpine Street Newark,CA,94560 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: A-SP-SI-26-06-03-377289 E2 508323 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. VSR t TIP TYPE OF INSURANCE ADDL SUER �-�� LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000.00 q Y Y M0465GL000001-04 06f2212026 08107(2026 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE TO PREMISES S 300,00fl.0a RENTED An one remises CLAIMS-MADE F-9 OCCUR MED EXP(any one person) $5 0Q0.00 X INCLUDES ATHLETIC PARTICIPANTS PERSONAL&ADV INJURY S 000,000.00 GENERAL AGGREGATE s 3,000,000.00 GENERAL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO s 2.000.000.00 POLICY PROJECT D LOC $ AUTOMOBILE LIALiJrI' COMBINED SINGLE LIMIT ANY AUTO HIRED AUTOS (Ea accident) S ALLOVNJED NON-OWNED AUTO BODILY INJURY(Per person) 8 AUTOS BODILY INJURY(Per accident) 5 SCHEDULED PROPERTY DAMAGE AUTOS Per accident S UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE S AGGREGATE $ DEDUCTIBLE S RETENTION S S VAX4 RSCOMPENSATION WCSTATU- OTH- AND EMPLOYERS LIABILITY ANY PRCPRIETCILPARTNEREXECUUVE OFFICERMIEMBER EXCUUDED? watx"01NA) N!A E.L.EACH ACCIDENT S If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-EA EMPLOYEE S E.L.DISEASE-POLICY LIMIT I$ OTHER A AbuselMolestation Y Y MD405GL000001-00 06122/2026 0810712026 Each Occurrence:S 1.000.000.00 Aggregate:5 1,000,000.00 Ap Iroved by Tu Tian Nguyen 6/17/26 9:48 AM DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 101.Additionai Remarks Schedule,4 more space is required) Endorsed Date:Jun 22 2023 12,4OAM EST Liability Policy Deductible:50.00 Deductible for Bodily Injury and 5 1000.00 per Property Damage Claim.ISO Occurrence farm CIS 00 01 04 13 and company's specifrc forms. Coverage for Participant Legal Liability requires that every participant signs a waiverlrelease. City of Santa Ana,its City Council,officers,officials,employees,(continued on next page) CERTIFICATE HOLDER CANCELLATION City of Santa Ana Attention:Parks,Recreation and Community Services Agency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 20 Civic Center Plaza M-23 DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana,CA,92701 AUTHORIZED REPRESENTATIVE Mark Di Perno ACORD 26(2D16103) The AGORD name and logo are registered marks of ACORD 01988.2009 ACORD CORPORATION.All rights reserved.