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SKYHSPO-02 BH'ATCH <br />DATE (MMPDDIYYYY) <br />CERTIFICATE CIF' LIABILITY INSURANCE 312412017 <br />................. .-._-..... .. <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />NAME: <br />Alliant Insurance Services Inc. PHONE FAX <br />Moloneyy O°Neill (Arc, No, Exti:(50925-3024 ) (AIc, No): <br />818 W Riverside Ave, Ste 800 EMAIL <br />ADDRESS: <br />Spokane, WA 99201 _ <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A: Philadelphia Indemnity Insurance Company 18058 _. <br />INSURED INSURER B : -.. -_. <br />Skyhawks Sports Academy Inc INSURERC: <br />9425 N Nevada St, #210 INSURER D <br />Spokane, WA 99218 INSURERE: <br />INSURER. F : <br />COVERAGES CERTIFICATE NUMBER: CA <br />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 <br />PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br />THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR TYPE OF INSURANCE <br />ADDL SUBR. POLICY EFF POLICY EXP <br />INSD WVD POLICY NUMBER (MMIDOYYYYY) (MMIDOfYYYY <br />LIMITS <br />A X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />1,000,000 <br />CLAIMS -MADE X. OCCUR <br />... .. .... <br />X X PHPK161017'9 02108/2017' 0210812018 <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) $ <br />300,000. <br />MED EXP (Any one person).. $ <br />Excluded <br />PERSONAL & ADV INJURY $ <br />1,000,000 <br />GEN"L AGGREGATE.. LIMIT APPLIES PER: <br />GENERAL. AGGREGATE S <br />3,000,000 <br />O. <br />X POLICY EC LOC <br />PRODUCTS - COMPiCP AGO $ <br />3,000,000 <br />OTHER <br />Abuse/Molest $ <br />1,000,000 <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $ <br />(Pa accident) <br />1,000,000 <br />X ANY AUTO <br />PHPK1610179 02108/2017 0210812018 <br />PODIu Y INLflJRY (Per person) $ <br />-.. ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) S _... <br />-._ <br />__.. NON-OVVNED <br />PROPERTY DAMAGE _ S <br />HVRED AUTOS AUTOS <br />(Per accident) <br />5 <br />._ .._,,., _ .....�. <br />UMBRELLA <br />X UMBRELLA LIAR X OCCUR <br />_.,...._.. ........ . ............ _. . ..__.__ <br />''�j 62/08/2017 <br />._. _ <br />EACH OCCURRENCE $ <br />5,®00,000 <br />A LAB CLAIMS -MADE <br />PHUB572546 0 812018 <br />of,_ <br />AGGREGATE $ <br />.._ <br />5,0001000 <br />DIED x. RETENTION$ 10,000 <br />'GJ <br />S <br />WORKERS COMPENSATION <br />A EMPLOYERS'LIABILITY <br />_ <br />— .. Qj "r <br />Y�'+ <br />`�° "r*"� <br />" <br />PER OTH- . <br />STATUTE ER <br />--- <br />YIN <br />"� <br />AND <br />ANY PROPRIETOWPARTNERIEXE`C'UiTIVc <br />+ ryr +tY^ <br />NIA <br />EL EACH ACCIDENT S <br />OFFICER/MFtu1BER EXCLUDED? <br />(Mandatory in NH) <br />a c r <br />E L. DISEASE - EA EMPLOYEE S <br />PT under <br />DES dOF OPERATIONS below <br />DESCRIPTION <br />t <br />E L DISEASE.; POLICY LIMIT 8 <br />410 <br />DESCRIPTION OF OPERATIONS I LOCATION'S f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />City of Santa Ana its officers, agents, and employees are additional insured as respects general liability for the ongoing operations of the named insured. <br />Coverage is primary non contributory and waiver of subrogation applies. Per forms CG2010 0704, PI-GL-005 (07 12) and CG2404 0509 attached. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />y ACCORDANCE WITH THE POLICY PROVISIONS. <br />Finance & Management Services Agency <br />PO Box 1988 M-16 <br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE <br />1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />